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Second allogeneic transplants in children: twelve years of experience.

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Title: Second allogeneic transplants in children: twelve years of experience.
Alternate Title: Segundos trasplantes alogénicos en niños: experiencia de doce años.
Authors: Franco, Alexis Antonio1,2, Manzi, Eliana2,3, Cabrera-Salcedo, Sergio3, Muñoz-Caluce, Diana3, Medina, Diego1,2 trasplantemedulaoseapediatrico@fvl.org.co
Source: Biomédica: Revista del Instituto Nacional de Salud. mar2026, Vol. 46 Issue 1, p121-127. 7p.
Subjects: HEMATOPOIETIC stem cell transplantation, GRAFT rejection, DISEASE relapse, HOMOGRAFTS, TREATMENT effectiveness, GRAFT versus host disease, SCHOOL children
Abstract (English): Introduction. A second hematopoietic stem cell transplant is required when the first transplant fails, usually due to relapse or graft failure, and is associated with increased morbidity and mortality. Survival rates range from 74 to 82% in non-neoplastic diseases and from 39 to 58% in neoplastic conditions. Evidence on second hematopoietic stem cell transplant in children is limited, particularly in low- and middle-income countries. Objective. To describe the clinical characteristics, complications, and outcomes of children who underwent a second transplant at a high-complexity center between 2012 and 2024. Materials and methods. Case series study with descriptive and survival analysis using the Kaplan-Meier method in Stata 14™. Results. A total of 346 allogeneic transplants were performed, of which 20 patients underwent a second transplant. Of these, 17 received a haploidentical donor for their second transplant, and the primary indication was a neoplastic disease in 13 cases. The second transplant was performed due to graft failure in 11 of the 20 patients, and due to relapse in the remaining 9. The mean age was 10.7 ± 5 years, with a male predominance (14 out of 20). Haploidentical transplants accounted for 16 of the 20 cases, and 11 used the same donor. The most common complications were acute graft-versus-host disease in 7 cases, 2 of grade III, cytomegalovirus infection in 10 cases, and graft failure after the second transplant in 4 cases: 3 primary, 1 secondary. Transplant-related mortality was 31%. The 2-year overall survival was 54%, with a median follow-up of 11 months. Conclusions. Second hematopoietic stem cell transplant is a viable therapeutic option when no other alternatives are available, particularly in resource-limited settings. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción. El segundo trasplante de progenitores hematopoyéticos es un procedimiento de alto riesgo, indicado principalmente por falla del injerto o recaída de la enfermedad. La supervivencia global varía entre el 40 y el 82 % en las enfermedades no neoplásicas y entre el 39 y el 58 % en las neoplásicas. La evidencia en la población pediátrica es limitada, especialmente en los países de ingresos bajos y medianos. Objetivo. Describir las características clínicas, complicaciones y desenlaces en niños que recibieron un segundo trasplante en un centro de alta complejidad entre el 2012 y el 2024. Materiales y métodos. Se llevó a cabo un estudio de serie de casos con análisis descriptivo y de supervivencia mediante el método de Kaplan-Meier, utilizando el software Stata 14™. Resultados. De 410 trasplantes practicados, 346 fueron alogénicos; 20 pacientes recibieron un segundo trasplante alogénico. La mayoría (13/20) presentaba enfermedad neoplásica. Diecisiete de estos trasplantes fueron haploidénticos. Las indicaciones del segundo trasplante fueron por falla del injerto (11/20) y recaída (9/20). La edad media fue de 10 ± 5 años; 14 eran varones. Dieciséis segundos trasplantes fueron haploidénticos, y en 11 se utilizó el mismo donante. Las complicaciones frecuentes incluyeron la enfermedad aguda de injerto contra huésped (7 pacientes, 2 con grado III), la infección por citomegalovirus (10 pacientes) y la falla de injerto posterior al trasplante (4 casos). La mortalidad relacionada fue del 31 %. La supervivencia global a 2 años fue del 54 %, con una mediana de seguimiento de 11 meses. Conclusiones. El segundo trasplante de progenitores hematopoyéticos puede ser una alternativa viable en niños cuando no existen otras opciones terapéuticas, especialmente en contextos con recursos limitados. [ABSTRACT FROM AUTHOR]
Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Second allogeneic transplants in children: twelve years of experience.
– Name: TitleAlt
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  Data: Segundos trasplantes alogénicos en niños: experiencia de doce años.
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  Data: <searchLink fieldCode="AR" term="%22Franco%2C+Alexis+Antonio%22">Franco, Alexis Antonio</searchLink><relatesTo>1,2</relatesTo><br /><searchLink fieldCode="AR" term="%22Manzi%2C+Eliana%22">Manzi, Eliana</searchLink><relatesTo>2,3</relatesTo><br /><searchLink fieldCode="AR" term="%22Cabrera-Salcedo%2C+Sergio%22">Cabrera-Salcedo, Sergio</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Muñoz-Caluce%2C+Diana%22">Muñoz-Caluce, Diana</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Medina%2C+Diego%22">Medina, Diego</searchLink><relatesTo>1,2</relatesTo><i> trasplantemedulaoseapediatrico@fvl.org.co</i>
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  Data: <searchLink fieldCode="JN" term="%22Biomédica%3A+Revista+del+Instituto+Nacional+de+Salud%22">Biomédica: Revista del Instituto Nacional de Salud</searchLink>. mar2026, Vol. 46 Issue 1, p121-127. 7p.
– Name: Subject
  Label: Subjects
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  Data: <searchLink fieldCode="DE" term="%22HEMATOPOIETIC+stem+cell+transplantation%22">HEMATOPOIETIC stem cell transplantation</searchLink><br /><searchLink fieldCode="DE" term="%22GRAFT+rejection%22">GRAFT rejection</searchLink><br /><searchLink fieldCode="DE" term="%22DISEASE+relapse%22">DISEASE relapse</searchLink><br /><searchLink fieldCode="DE" term="%22HOMOGRAFTS%22">HOMOGRAFTS</searchLink><br /><searchLink fieldCode="DE" term="%22TREATMENT+effectiveness%22">TREATMENT effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22GRAFT+versus+host+disease%22">GRAFT versus host disease</searchLink><br /><searchLink fieldCode="DE" term="%22SCHOOL+children%22">SCHOOL children</searchLink>
– Name: Abstract
  Label: Abstract (English)
  Group: Ab
  Data: Introduction. A second hematopoietic stem cell transplant is required when the first transplant fails, usually due to relapse or graft failure, and is associated with increased morbidity and mortality. Survival rates range from 74 to 82% in non-neoplastic diseases and from 39 to 58% in neoplastic conditions. Evidence on second hematopoietic stem cell transplant in children is limited, particularly in low- and middle-income countries. Objective. To describe the clinical characteristics, complications, and outcomes of children who underwent a second transplant at a high-complexity center between 2012 and 2024. Materials and methods. Case series study with descriptive and survival analysis using the Kaplan-Meier method in Stata 14™. Results. A total of 346 allogeneic transplants were performed, of which 20 patients underwent a second transplant. Of these, 17 received a haploidentical donor for their second transplant, and the primary indication was a neoplastic disease in 13 cases. The second transplant was performed due to graft failure in 11 of the 20 patients, and due to relapse in the remaining 9. The mean age was 10.7 ± 5 years, with a male predominance (14 out of 20). Haploidentical transplants accounted for 16 of the 20 cases, and 11 used the same donor. The most common complications were acute graft-versus-host disease in 7 cases, 2 of grade III, cytomegalovirus infection in 10 cases, and graft failure after the second transplant in 4 cases: 3 primary, 1 secondary. Transplant-related mortality was 31%. The 2-year overall survival was 54%, with a median follow-up of 11 months. Conclusions. Second hematopoietic stem cell transplant is a viable therapeutic option when no other alternatives are available, particularly in resource-limited settings. [ABSTRACT FROM AUTHOR]
– Name: Abstract
  Label: Abstract (Spanish)
  Group: Ab
  Data: Introducción. El segundo trasplante de progenitores hematopoyéticos es un procedimiento de alto riesgo, indicado principalmente por falla del injerto o recaída de la enfermedad. La supervivencia global varía entre el 40 y el 82 % en las enfermedades no neoplásicas y entre el 39 y el 58 % en las neoplásicas. La evidencia en la población pediátrica es limitada, especialmente en los países de ingresos bajos y medianos. Objetivo. Describir las características clínicas, complicaciones y desenlaces en niños que recibieron un segundo trasplante en un centro de alta complejidad entre el 2012 y el 2024. Materiales y métodos. Se llevó a cabo un estudio de serie de casos con análisis descriptivo y de supervivencia mediante el método de Kaplan-Meier, utilizando el software Stata 14™. Resultados. De 410 trasplantes practicados, 346 fueron alogénicos; 20 pacientes recibieron un segundo trasplante alogénico. La mayoría (13/20) presentaba enfermedad neoplásica. Diecisiete de estos trasplantes fueron haploidénticos. Las indicaciones del segundo trasplante fueron por falla del injerto (11/20) y recaída (9/20). La edad media fue de 10 ± 5 años; 14 eran varones. Dieciséis segundos trasplantes fueron haploidénticos, y en 11 se utilizó el mismo donante. Las complicaciones frecuentes incluyeron la enfermedad aguda de injerto contra huésped (7 pacientes, 2 con grado III), la infección por citomegalovirus (10 pacientes) y la falla de injerto posterior al trasplante (4 casos). La mortalidad relacionada fue del 31 %. La supervivencia global a 2 años fue del 54 %, con una mediana de seguimiento de 11 meses. Conclusiones. El segundo trasplante de progenitores hematopoyéticos puede ser una alternativa viable en niños cuando no existen otras opciones terapéuticas, especialmente en contextos con recursos limitados. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.7705/biomedica.7946
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        Text: English
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      – SubjectFull: GRAFT rejection
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      – SubjectFull: TREATMENT effectiveness
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      – SubjectFull: GRAFT versus host disease
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      – SubjectFull: SCHOOL children
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      – TitleFull: Second allogeneic transplants in children: twelve years of experience.
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