The Tale of Pediatric Hematopoietic Stem Cell Transplantation in Iran: An Uphill Battle

Hematopoietic stem cell transplantation (HSCT) has revolutionized the treatment of hematologic malignancies, immunodeficiencies, and storage disorders. While this transformative therapy is widely adopted globally, its introduction in Iran faced significant challenges due to geopolitical and economic hardships. In 2007, the first pediatric HSCT department in Iran was established at Tehran University of Medical Sciences. Over the past 18 years, this department has made substantial contributions to the field, including pioneering various HSCT modalities and establishing the first HLA registry in the region, facilitating access to matched unrelated donors. Despite significant challenges, including economic constraints and limited access to advanced therapies, the department and its affiliated research center have persevered in their mission to provide care to pediatric patients and advance in cutting-edge research, including immune cell therapies and gene therapies. With constantly aggravating economic hurdles and geopolitical issues, these milestones could not be achieved without the financial support of health care philanthropies and the sacrifices of dedicated physicians, researchers, and nurses. However, no health system, no matter how resilient, is immune to debacle under perpetuated hurdles, underscoring the need for global collaborations. This letter highlights the journey of pediatric HSCT in Iran and the importance of public advocacy in overcoming obstacles.