Hematopoietic stem cell transplantation in children: current practice

Over the years, indications to hematopoietic stem cell transplantation (HSCT) have increased thanks to the progress in techniques and to the results that have been obtained. Several malignant and non-malignant diseases of childhood represent a model of how progress in HSCT has modified the natural course and the poor prognosis of many of these diseases. In addition, increased knowledge of the biological mechanisms involved in engraftment, in graft-versus-tumor effect and in graft-versus-host disease, and the new techniques that have been developed to control them have improved the efficacy and safety of HSCT. By reviewing currently available data and published experience, this paper describes the current practice in the application of HSCT in children and defines the indications to autologous and allogeneic HSCT, donor selection criteria and various potential sources of stem cells.