Hematopoietic Stem Cell Transplantation for Pediatric Chronic Myeloid Leukemia

Chronic myeloid leukemia (CML) accounts for approximately 2 to 3% of all pediatric leukemias. Compared to adults, children tend to present with more aggressive features, such as higher leukocyte counts and massive splenomegaly, and are more likely to be diagnosed with advanced stage disease. Before the advent of tyrosine kinase inhibitors, a couple of decades ago, allogeneic hematopoietic stem cell transplantation (allo-HSCT) was the mainstay of treatment for this disease. This, however, was associated with considerable treatment-related morbidity and mortality. Even so, despite its secondary and somewhat limited indication today, allo-HSCT remains an important alternative and the only curative treatment for CML. In 2020, the Brazilian Group for Pediatric Bone Marrow Transplantation of the Brazilian Society for Blood and Marrow Transplantation and Cellular Therapy (SBTMO) convened a task force to provide evidence-based guidance on the use of allo-HSCT for the appropriate management of childhood CML, the results of which are presented here.