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Evaluation of Children with Malignancies for Blood and Marrow Transplantation: A Report from the ASTCT Committee on
Ellen Fraint1, Hisham Abdel-Azim2, Neel S Bhatt3
1Division of Pediatric Hematology, Oncology, and Cellular Therapy, Children's Hospital at Montefiore, Bronx, New York.
Insights
Pediatric hematopoietic cell transplantation (HCT) evaluation lacks clear guidelines. This report provides a practical framework for evaluating pediatric HCT candidates with malignancies, addressing gaps in current adult-focused recommendations.
Area of Science:
- Pediatric Hematology/Oncology
- Transplantation Science
Background:
- Hematopoietic cell transplantation (HCT) candidate evaluation exhibits significant intercenter variability.
- Established adult HCT evaluation guidelines do not adequately address the unique needs of pediatric patients.
- A lack of specific guidance for pediatric HCT eligibility contributes to inconsistent patient management.
Framework:
- Developed by a panel of pediatric HCT experts from the American Society of Transplantation and Cellular Therapy (ASTCT).
- Presents a practical framework tailored for evaluating pediatric patients with malignancies undergoing HCT.
- Highlights critical differences between pediatric and adult HCT evaluation criteria.
Implementation:
- Convened a geographically diverse panel of pediatric HCT specialists.
- Focused on addressing the specific needs and vulnerabilities of children undergoing HCT.
- Leveraged expertise from the ASTCT Committee on Practice Guidelines.
Implications:
- Aims to reduce intercenter variability in pediatric HCT candidate evaluation.
- Provides a foundation for standardized, child-specific pre-HCT assessment.
- Identifies key areas requiring further research to optimize pediatric HCT best practices.
Abstract:
Evaluation of a candidate for hematopoietic cell transplantation (HCT) is a complex process with substantial intercenter variability. Although literature providing guidance for evaluating the eligibility of adults is well established, similar guidance for children is lacking. To address gaps between adult recommendations and the specific needs of children, we convened a panel of pediatric HCT experts from a wide geographic range of American Society of Transplantation and Cellular Therapy (ASTCT) member institutions to offer recommendations for pediatric-focused pre-HCT evaluation. In this report from the ASTCT Committee on Practice Guidelines, we present a practical framework for evaluating children with malignancies who are candidates for HCT. We also highlight key differences from adults and emphasize areas of unmet need that require additional research to delineate best practices.
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