HCMCA 32-month-old girl, in Dak Lak, weighing 11 kg, has neuroblastoma. If the marrow is not transplanted, the ability to live a year is about 12%.
Doctor Phan Thi Thu Trang, Deputy Head of Hematology Oncology, Children’s Hospital 2, on January 28, said that in mid-December 2020, the baby had hematopoietic stem cells collected at the City Hospital of Hematology Transfusion HCM City. Chemotherapy doctors kill high doses of marrow for a week in order to destroy the maximum remaining cancer cells, before conducting the stem cell transplant on December 30, 2020.
The baby has a number of complications due to chemotherapy to destroy the marrow and reduce the protective function of the body when the new source of marrow has not yet grown, such as liver damage, damage to the gastrointestinal mucosa, inflammation of the intestines. Doctors actively treat, support, increase immune function, feed through the stomach and veins, help early control of complications.
“The baby recovered very quickly, 10 days after the transplant had grown graft, no organ infection, discharged earlier than expected”, Dr. Trang said. Initially, doctors were concerned about infection, so they carefully prepared plans for positive resuscitation, blood transfusion, and platelets.
On January 28, the child was active, healthy, and had fun with his parents when he was re-examined at the hospital to monitor the recovery of the hematopoietic system and late complications. Currently, the blood cell lines are recovering favorably, the liver and kidney function is within normal limits. Your baby does not need a blood transfusion or medication for transplant-related complications.
Pediatric patients will receive radiation therapy after a few weeks and maintenance therapy after a stem cell infusion for three months to limit the likelihood of tumor recurrence.
According to Dr. Trang, autologous blood stem cell transplantation is part of the treatment of some groups of pediatric cancer, especially solid tumors. The doctor takes blood stem cells from the patient’s autologous blood to store the clot and then transmit it back into the patient’s body to help restore the ability to make blood from the damaged bone marrow.
Among the solid tumor pathology groups in Vietnam, neuroblastoma is the most common non-brain tumor in children. In the absence of multiple modalities of combined treatment of chemotherapy, surgery, stem cell transplantation, radiation therapy, and maintenance therapy, the child’s 5-year survival rate was quite low. The introduction of hematopoietic stem cell transplantation, targeted treatment, helps the 5-year survival rate to 30-60%.
Doctor Trinh Huu Tung, Director of Children’s Hospital 2, said this is the first autologous hematopoietic stem cell transplant performed at the hospital. Since 2015, this place has coordinated with the Ho Chi Minh City Hematology Blood Transfusion Hospital with strong chemotherapy with autologous marrow transplantation for some solid tumors. Seven children were successfully transplanted, with a disease-free life time after 15-18 months, of which five were still alive and three children had not had cancer after transplantation.
According to Dr. Tung, the construction of stem cell transplant centers at the hospital helps pediatric patients more opportunities to access marrow transplant treatment, ensuring criteria for pediatric care and resuscitation. Previously, the children had to be transferred to the hospital for transplant, waited for marrow recovery before returning to radiation therapy, taking maintenance chemicals. This makes the post-transplant treatment process more fragmented, easy to slow pace for multi-modal treatment connection.
The cost of a transplant is about 200-400 million VND.