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Published on: December 8, 2023

Autologous stem cell transplantation for pediatric solid tumors in a resource-limited setting: a single-center

Debabrata Mohapatra1, Deepam Pushpam1, Sameer Bakhshi1

  • 1Department of Medical Oncology, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital (IRCH), All India Institute of Medical Sciences (AIIMS), New Delhi, India.

Frontiers in Oncology
|July 1, 2026
PubMed

Insights

Autologous hematopoietic stem-cell transplant (ASCT) in children with solid tumors in low- and middle-income countries shows promising survival rates. This study highlights ASCT as a viable treatment option, even with resource limitations.

Area of Science:

  • Pediatric Oncology
  • Hematology
  • Transplant Immunology

Background:

  • Autologous hematopoietic stem-cell transplant (ASCT) is a key treatment for pediatric solid tumors.
  • Data from low- and middle-income countries (LMICs) are limited, especially for tumors other than neuroblastoma.
  • Outcomes in LMICs may be affected by infrastructure and infection risks.

Purpose of the Study:

  • To evaluate survival outcomes, engraftment kinetics, and toxicities of ASCT in children, adolescents, and young adults (CAYA) with solid tumors in India.
  • To assess the feasibility and effectiveness of ASCT in a resource-limited setting.
  • To provide evidence for ASCT in diverse pediatric solid tumors beyond neuroblastoma.

Main Methods:

  • Retrospective analysis of 92 CAYA (0-25 years) with solid tumors undergoing ASCT between 2008 and 2025.
  • Data collected from patient files and electronic databases.
  • Assessment of diagnoses including high-risk neuroblastoma, Ewing sarcoma, germ-cell tumors, retinoblastoma, and soft-tissue sarcoma.

Main Results:

  • The 3-year overall survival (OS) for the cohort was 50.6%, and event-free survival (EFS) was 35.9%.
  • Specific 3-year OS rates were: HRNB 48.5%, EWS 43.8%, GCT 56.3%, STS 66.7%, and RB 50.0%.
  • BuMel-140 regimen showed improved OS compared to CEM-200 for HRNB and EWS (HR=0.15, p=0.005).

Conclusions:

  • ASCT can achieve acceptable outcomes for selected high-risk or relapsed/refractory pediatric solid tumors in LMICs.
  • Outcomes for germ-cell tumors were comparable to global standards.
  • Experience from a high-volume center demonstrates the potential of ASCT in resource-limited settings.
Abstract

Keywords:
Ewing sarcomaautologous stem cell transplantgerm cell tumorslow- and middle-income countriesneuroblastomapediatric solid tumors

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