Establishment of a pediatric HSCT program in a public hospital in Chile.
BACKGROUND
In Chile, survival estimates for pediatric patients with cancer are comparable to those in the United States and Western Europe. Approximately 80% of these patients are treated at government-supported centers, and an estimated 65% are cured. We reasoned that cure rates could be further improved if transplantation with hematopoietic stem cells were available for patients with chemotherapy-resistant malignancy.


METHODS
Physicians and nurses were selected to be trained in international centers, and a transplantation unit was developed at Luis Calvo Mackenna Hospital in Santiago. Between October 1999 and December 2003, 59 patients received transplants. Of these, 42 were from HLA-matched family members and 11 were autologous.


RESULTS
The 3-year event-free survival estimate was 72 +/- 10% overall, and it was 81 +/- 10% for the subgroup treated with matched related transplants. Peritransplant mortality was 6.6%. The average cost for an allogeneic transplant in our unit was 50,000 US dollars.


CONCLUSIONS
We are encouraged by this experience as well as by the overall survival rates and hope to expand the program. Our goal is to extend treatment to all children in the country for whom HSCT is indicated, including those who do not have HLA-identical family donors.
Palma
Julia
J
Bone Marrow Transplant Unit, Luis Calvo Mackenna Hospital, Santiago, Chile.
Mosso
Claudio
C
Paris
Claudia
C
Campbell
Myriam
M
Tong
Xin
X
King
Alejandra
A
Carrion
Flavio
F
Rivera
Gaston K
GK
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002677:Chile / Q000453:epidemiology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D006757:Hospital Units / Q000458:organization & administration*; D006779:Hospitals, Public; D006801:Humans; D007223:Infant; D008297:Male; D009313:National Health Programs / Q000458:organization & administration*; D016730:Program Development; D015996:Survival Rate; D016896:Treatment Outcome