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Peripheral-blood stem cell transplantation in pediatric recipients in Peru: Experience of a reference center.

e21530 Background: Stem cell transplantation (SCT) is a curative treatment for children with refractory/relapsed malignancies. However, data on pediatric transplantation in developing countries like Peru is still needed. The aim of this study was to describe and assess the survival and complications of children with neoplastic disease who have received peripheral-blood stem cell transplantation (PBSCT) at a reference center in Peru. Methods: A retrospective longitudinal study was performed by reviewing medical histories of 20 children (≤14 years) with neoplastic disease who underwent related allo- or auto-PBSCT from October 2014 to December 2017 of INEN (Instituto Nacional de Enfermedades Neoplásicas). In the cases of ALL > 3 years, radiotherapy was not part of the conditioning regimen. The Kaplan-Meier method was used to determine the overall survival (OS) and event-free survival (EFS). Data were analyzed using Stata/MP 14.0. Results: We found 13 males and 7 females with a median age of 9.5 years (1-14), of whom 18 received allo-SCT and 2 auto-SCT. Diagnosis: 14 ALL(66.6%), 1 AML(4.7%), 1 NHL(4.7%), 2 biphenotypic leukemia(9.5%), 1 juvenile chronic myelomonocytic leukemia(4.7%) and 1 germ cell tumor(4.7%) who performed two auto-transplants. Complete remission (CR) was achieved before transplantation in 19 cases: 8(38%) 1CR; 8(38%) 2CR and 3(14.2%) 3CR. A median of 7.14x106CD34+/kg (3.97-13.05) (auto- vs allo-; 6.35 vs 7.27) were collected and median time to myeloid engrafment: 11 days. At a median follow-up of 12 months (1-39) the 2-year OS and EFS were 75.7% (95% confidence interval [CI], 38-92%) and 51.6% (95% CI, 22-74%) respectively. Considering only ALL > 3 years, OS and EFS were 51.9% and 45.1%, respectively. Acute graft-versus-host disease (GVHD), chronic GVHD, transplantation-related mortality (TRM) and relapse were 27.7%, 11.1%, 4.7%, and 33.3%, respectively. Conclusions: We are encouraged by this first experience in our country. OS and EFS are comparable with results at the international level. However, survival of children with ALL > 3 years who did not receive radiotherapy is less than international standards. Studies with a higher number of cases and longer follow-up time are needed to reach definitive conclusions.