Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Pediatric Oncology

Background/Objectives; A balanced risk-benefit approach to hematopoietic cell transplantation (HCT), with accurate assessment of underlying risk factors related to the outcome is the key for maximized chances of cure with acceptable quality of life in pediatric patients with advanced hematologic malignancies. This study aimed to assess different risk factors that affect the outcome of allogeneic HSCT in pediatric cancer patients and Formulate comorbidity index that predict the transplant related morbidity and mortality. Patients and Methods; A retrospective study included pediatric cancer patients who underwent allogeneic HSCT at the HSCT unit, Cancer Hospital Egypt (CCHE), from January 2011 and January 2019. Impact of different pre and post transplant risk factors on the outcome of these patients was analyzed. Results: A total of 159 patients were included with median age of 8.8 years and male to female ratio 1.4:1. Based on our Disease Risk Stratification19% of the patients were classified as LR group (CML), 51.6% as IR (AML CR1, ALL, MDS) and 28.3% of them were HR group (AML CR2 and JMML). From the whole study patients, (86.8%) received Allograft from matched related donors (MRD), 16 (10.1%) from Haploidentical donors and 5 (3.1%) from Mismatched related donors (MMRD). Bone marrow was used as stem cell source for 92.5 % of the patients While Mobilized Peripheral blood was used in 7.5%. With median duration of follow up of 64 months, the 3-year overall survival of the Whole patients was 64% and non-relapse mortality was 7.5%. Age of the patient, Disease risk and HLA matching were the 3 factors statistically significant in Cox regression with worst survival outcome was associated with younger age < 6 years, HR disease group and haploidentical transplant

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