Original Article

Korean J Hematol 2006; 41(4):

Published online December 30, 2006

https://doi.org/10.5045/kjh.2006.41.4.235

© The Korean Society of Hematology

국내 조혈모세포이식 현황 - 소아 환아를 대상으로 -

정대철, 강형진, 구홍회, 국 훈, 김선영, 김순기, 김태형, 김학기, 김황민, 문형남, 박경덕, 박병규, 박상규, 박영실, 박현진, 서종진, 성기웅, 신희영, 안효섭, 유건희, 유경하, 유은선, 유철주, 이광철, 이순용, 이영호, 임영탁, 임재영, 장필상, 전인상, 정낙균, 조빈, 하정옥, 황평한, 황태주, 대한조혈모세포이식학회 학술위원회

가톨릭대학교 의과대학,
서울대학교 의과대학,
성균관대학교 의과대학,
전남대학교 의과대학,
충남대학교 의과대학,
인하대학교 의과대학,
국립암센터,
연세대학교 원주의과대학,
울산대학교 의과대학,
이화여자대학교 의과대학,
연세대학교 의과대학,
고려대학교 의과대학,
인제대학교 의과대학,
동아대학교 의과대학,
부산대학교 의과대학,
경상대학교 의과대학,
가천의과학대학교,
영남대학교 의과대학,
전북대학교 의과대학 소아과학교실

Current Status of Hematopoietic Stem Cell
Transplantation in Korean Children

Dae Chul Jeong, 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, Scientific Committee of Korean Society of Hematopoietic Stem Cell Transplantation , KSHSCT

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul National University, Sungkyunkwan University, Chonnam National University, Chungnam National University, Inha University, National Cancer Center, Yonsei University Wonju College of Medicine, Ulsan University, Ewha Women's University, Yonsei University, Korea University, Inje University, Dong, A University, Pusan National University, Gyeongsang National University, Gachon University of Medicine and Science, Yeungnam University, Chonbuk National University

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.

Keywords Hematopoietic stem cell transplantation, Children, Allogeneic, Autologous

Article

Original Article

Korean J Hematol 2006; 41(4): 235-242

Published online December 30, 2006 https://doi.org/10.5045/kjh.2006.41.4.235

Copyright © The Korean Society of Hematology.

국내 조혈모세포이식 현황 - 소아 환아를 대상으로 -

정대철, 강형진, 구홍회, 국 훈, 김선영, 김순기, 김태형, 김학기, 김황민, 문형남, 박경덕, 박병규, 박상규, 박영실, 박현진, 서종진, 성기웅, 신희영, 안효섭, 유건희, 유경하, 유은선, 유철주, 이광철, 이순용, 이영호, 임영탁, 임재영, 장필상, 전인상, 정낙균, 조빈, 하정옥, 황평한, 황태주, 대한조혈모세포이식학회 학술위원회

가톨릭대학교 의과대학,
서울대학교 의과대학,
성균관대학교 의과대학,
전남대학교 의과대학,
충남대학교 의과대학,
인하대학교 의과대학,
국립암센터,
연세대학교 원주의과대학,
울산대학교 의과대학,
이화여자대학교 의과대학,
연세대학교 의과대학,
고려대학교 의과대학,
인제대학교 의과대학,
동아대학교 의과대학,
부산대학교 의과대학,
경상대학교 의과대학,
가천의과학대학교,
영남대학교 의과대학,
전북대학교 의과대학 소아과학교실

Current Status of Hematopoietic Stem Cell
Transplantation in Korean Children

Dae Chul Jeong, 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, Scientific Committee of Korean Society of Hematopoietic Stem Cell Transplantation , KSHSCT

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul National University, Sungkyunkwan University, Chonnam National University, Chungnam National University, Inha University, National Cancer Center, Yonsei University Wonju College of Medicine, Ulsan University, Ewha Women's University, Yonsei University, Korea University, Inje University, Dong, A University, Pusan National University, Gyeongsang National University, Gachon University of Medicine and Science, Yeungnam University, Chonbuk National University

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.

Keywords: Hematopoietic stem cell transplantation, Children, Allogeneic, Autologous

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