title: Unrelated hematopoietic stem cell transplantation in the pediatric population: single institution experience.
abstract: OBJECTIVE
  Hematopoietic stem cell transplantation has been successfully used to treat the pediatric population with malignant and non-malignant hematological diseases. This paper reports the results up to 180 days after the procedure of all unrelated hematopoietic stem cell transplantations in pediatric patients that were performed in one institution.
  
  
  METHODS
  A retrospective review was performed of all under 18-year-old patients who received unrelated transplantations between 1995 and 2009. Data were analyzed using the log-rank test, Cox stepwise model, Kaplan-Meier method, Fine and Gray model and Fisher's exact test.
  
  
  RESULTS
  This study included 118 patients (46.8%) who received bone marrow and 134 (53.2%) who received umbilical cord blood transplants. Engraftment occurred in 89.47% of the patients that received bone marrow and 65.83% of those that received umbilical cord blood (p-value<0.001). Both neutrophil and platelet engraftments were faster in the bone marrow group. Acute graft-versus-host disease occurred in 48.6% of the patients without statistically significant differences between the two groups (p-value=0.653). Chronic graft-versus-host disease occurred in 9.2% of the patients with a higher incidence in the bone marrow group (p-value=0.007). Relapse occurred in 24% of the 96 patients with malignant disease with 2-year cumulative incidences of 45% in the bone marrow group and 25% in the umbilical cord blood group (p-value=0.117). Five-year overall survival was 47%, with an average survival time of 1207 days, and no significant differences between the groups (p-value=0.4666).
  
  
  CONCLUSIONS
  Despite delayed engraftment in the umbilical cord blood group, graft-versus-host disease, relapse and survival were similar in both groups.
authors.affiliation: Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil. Electronic address: dhmarinho@hotmail.com.
authors.forename: Daniela Hespanha
authors.initials: DH
authors.lastname: Marinho
authors.affiliation: Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
authors.forename: José Zanis
authors.initials: JZ
authors.lastname: Neto
authors.affiliation: Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
authors.forename: Carmem Maria Sales
authors.initials: CM
authors.lastname: Bonfim
authors.affiliation: Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
authors.forename: Vaneuza Araujo Moreira
authors.initials: VA
authors.lastname: Funke
authors.affiliation: Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil.
authors.forename: Lisandro Lima
authors.initials: LL
authors.lastname: Ribeiro
keywords: Bone marrow transplantation; Child; Cord blood stem cell transplantation; Hematopoietic stem cell transplantation; Unrelated donors