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국내 조혈모세포이식 현황 - 소아 환아를 대상으로 -

Other Titles
 Current Status of Hematopoietic Stem Cell Transplantation in Korean Children 
Authors
 정대철  ;  강형진  ;  구홍회  ;  국훈  ;  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 
Citation
 Korean Journal of Hematology, Vol.41(4) : 235-242, 2006 
Journal Title
 Korean Journal of Hematology 
ISSN
 1738-7949 
Issue Date
2006
Keywords
Hematopoietic stem cell transplantation ; Children ; Allogeneic ; Autologous
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.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Lyu, Chuhl Joo(유철주) ORCID logo https://orcid.org/0000-0001-7124-7818
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/109510
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