Current Status of Hematopoietic Stem Cell Transplantation in Korean Children.
10.5045/kjh.2006.41.4.235
- Author:
Dae Chul JEONG
1
;
Hyung Jin KANG
;
Hong Hoe KOO
;
Hoon KOOK
;
Sun Young KIM
;
Soon Ki KIM
;
Thad GHIM
;
Hack Ki KIM
;
Hwang Min KIM
;
Hyung Nam MOON
;
Kyung Duk PARK
;
Byung Kiu PARK
;
Sang Gyu PARK
;
Young Sil PARK
;
Hyeon Jin PARK
;
Jong Jin SEO
;
Ki Woong SUNG
;
Hee Young SHIN
;
Hyo Sup AHN
;
Kun Hee RYU
;
Kyung Ha RYU
;
Eun Sun YOO
;
Chuhl Joo LYU
;
Kwang Chul LEE
;
Soon Yong LEE
;
Young Ho LEE
;
Young Tak LIM
;
Jae Young LIM
;
Pil Sang JANG
;
In Sang JEON
;
Nak Gyun CHUNG
;
Bin CHO
;
Jeong Ok HAH
;
Pyung Han HWANG
;
Tai Ju HWANG
Author Information
1. Department of Pediatrics, College of Medicine, The Catholic University of Korea, Korea.
- Publication Type:Original Article
- Keywords:
Hematopoietic stem cell transplantation;
Children;
Allogeneic;
Autologous
- MeSH:
Autografts;
Bone Marrow;
Child*;
Disulfiram;
Female;
Fetal Blood;
Hematologic Diseases;
Hematologic Neoplasms;
Hematopoietic Stem Cell Transplantation*;
Hematopoietic Stem Cells*;
Humans;
Insurance;
Insurance Coverage;
Parents;
Rare Diseases;
Siblings;
Social Control, Formal;
Stem Cells;
Tissue Donors;
Unrelated Donors;
Surveys and Questionnaires
- From:Korean Journal of Hematology
2006;41(4):235-242
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is one of the most important armamentarium against various hematologic malignancies or some solid tumors. We investigated the number of patients who might need transplants and compared with that of actual transplants to conceptualize current status and circumstances of HSCTs in Korean children. METHODS: Questionnaires were sent to Korean Society of Hematopoietic Stem Cell Transplantation (KSHSCT) members who were taking care of children with malignancies or hematologic diseases. Almost all of the newly diagnosed patients between Jan, 1st and Dec, 31st, 2003 were enrolled in the study. RESULTS: Seven hundred forty eight children (male to female ratio = 1.4:1) were enrolled. The median age was 6.1 years old (8 days~28.8 years old). Malignant diseases consisted of 695 cases (92.9%), and among them almost half were hematologic malignancies. The participating members speculated that HSCTs should be indicated in 285 children (38.1%) which included 209 allogeneic, and 76 autologous transplants. In reality, however, allogeneic HSCTs were performed only in 140 children (67.0%) with the median interval of 5.9 month, and autologous transplants in 44 children (57.9%) with 8.3 month. In autologous setting, all the patients received peripheral blood stem cells (PBSCs), whereas bone marrow (61%), cord blood (34%), and PBSC (5%) were used in allogeneic HSCTs. Donor types were as follows: unrelated donor (37%), cord blood (34%), sibling donor (25%), and family (4%). The reasons for not performing HSCTs were unfavorable disease status or death, no availability of suitable donor, economical situation, and refusal by parental preferences. Under the strict insurance regulations, many transplants were not covered by insurance. More autologous transplants were performed without insurance coverage than allogeneic HSCTs (P=0.013). Those cases were advanced cases and HLA mismatch transplants for allogeneic setting, and relatively rare diseases still awaiting favorable results of transplants for autologous setting. CONCLUSION: HSCTs are essential part of treatment strategies for children with various diseases. Unfortunately, however, a third of patients who were in need of transplants did not receive HSCTs due to various reasons. It is necessary to expand unrelated donor pool or cord blood banks for the cases lacking HLA-identical sibling donors. Also medical insurances should cover HSCTs for rare diseases as well as for less favorable but novel situations where there are no suitable alternatives.
