Pediatric hematopoietic stem cell transplantation: fifteen year experience in Puerto Rico

This study summarizes the development and progress of the pediatric Hematopoietic Stem Cell Transplantation (HSCT) program in Puerto Rico. Data from the two pediatric transplant centers was collected from July 1994 through December 2009. Overall, in the last 15 years 97 transplants have been performed to 87 children and young adults. These included 55 males and 32 females, aged between 1 and 38 years of age. The diagnosis included: acute leukemia, chronic leukemia, myelodysplasia, aplastic anemia, histiocytosis, neuroblastoma, lymphomas, PNET, Wilms tumor, and desmoplastic round cell tumor. Sources of hematopoietic stem cells for transplantation included: 5 autologous bone marrow, 23 allogeneic bone marrow using HLA matched sibling; 18 allogeneic peripheral blood stem cell (PBSC) using HLA-matched sibling and one syngeneic PBSC; 4 haploidentical T-cell depleted bone marrow transplant and 47 autologous PBSC. The results in the past 15 years are encouraging and conform that HSCT is a valuable treatment option in our pediatric population to no other alternative therapy. Our experience compares to those published by others with a 15-year overall survival of 48%. In this same group, the transplant related mortality was 14.9% comparable to published experience in Europe and USA.