Indications for pediatric hematopoietic stem cell transplantation: consensus presented at the First Meeting on Brazilian Hematopoietic Stem Cell Transplantation Guidelines - Brazilian Society of Bone Marrow Transplantation, Rio de Janeiro, 2009

摘要

The Brazilian Bone Marrow Transplant Society (SBTMO) held its First Meeting on Bone Marrow Transplant Guidelines in 2009. A working group of hematologists and oncologists with experience in pediatrics was formed to review evidence-based indications for pediatric transplants. Scientific publications were carefully assessed and, for each disease, the evidence for recommendation (from A to C) and the quality of the evidence (from 1 to 3) were defined. The recommendations include malignant and non-malignant hematological diseases, solid tumors, immunodeficiency, and storage diseases treated with hematopoietic stem cell transplants: either autologous or allogeneic from matched sibling donors or unrelated donors (adults or umbilical cord blood). Guidelines for reduced-intensity transplants, manipulated grafts or partially compatible donors were not included as there are no uniformly accepted recommendations. All indications are based on the best current knowledge which may change over time. Thus, this review should not be directly applied to patient care without taking into account the disease, donor and patient characteristics. Additionally, this paper should not be used as a document to limit patient access to transplant if correctly indicated. In this review we also point out differences between transplantation in adults and children and make some specific recommendations for pediatric transplants.