Paediatria Croatica - Indications for hematopoietic stem cell transplantation in children with solid tumors

Indications for hematopoietic stem cell transplantation in children with solid tumors

Autologous haematopoietic stem cell transplantation (auto-HSCT) has been widely used in the treatment of childhood malignancies, primarily as a treatment option for solid tumors. Auto-HSCT incorporates high-dose chemotherapy (HDC) followed by infusion of previously frozen autologous bone marrow (BM) or peripheral blood (PB) haematopoietic stem cells and administration of haematopoietic growth factors. This procedure is also known as autologous haematopoietic rescue. The major indications for auto-HSCT in children are poor risk solid tumors of childhood such as recurrent or resistant cancers, metastatic presentation at diagnosis, incomplete surgical resection, unfavourable histological and biological features. Whereas the role of auto-HSCT is well established in metastatic (disseminated) neuroblastoma in patients over 1 year of age, the benefit of auto-HSCT in other solid tumors is still to be defined in controlled clinical trials.