Hematopoietic stem cell transplantation for pediatric acute lymphoblastic leukemia

Liane Esteves Daudt; Ana Carolina Ribeiro Correa; Antonella  Zanette; Antonio Vaz de  Macedo; Carla Nolasco Monteiro Breviglieri; Cilmara Kuwahara; Cláudio Galvão de Castro Junior; Luciana dos Santos Domingues; Paulo Klinger; Maura Ikoma; Mecneide Mendes Lins; Renata Guimarães; Virginio Fernandes Junior; Luis Fernando Bouzas; Adriana Seber

doi:10.46765/2675-374X.2025v6n1e308

Hematopoietic stem cell transplantation for pediatric acute lymphoblastic leukemia

Authors

Liane Esteves Daudt Universidade Federal do Rio Grande do Sul – Porto Alegre (RS), Brazil|Hospital de Clínicas de Porto Alegre – Porto Alegre (RS), Brazil|Hospital Moinhos de Vento – Porto Alegre (RS), Brazil. https://orcid.org/0000-0001-9495-6932
Ana Carolina Ribeiro Correa Universidade Federal de São Paulo – São Paulo (SP), Brazil|Grupo de Apoio ao Adolescente e à Criança com Câncer – São Paulo (SP), Brazil. https://orcid.org/0000-0003-2573-4070
Antonella Zanette Hospital Erastinho – Curitiba (PR), Brazil. https://orcid.org/0009-0002-2511-7208
Antonio Vaz de Macedo Hospital da Polícia Militar – Clínica de Hematologia – Belo Horizonte (MG), Brazil|Instituto Mário Penna – Hospital Luxemburgo – Serviço de Transplante de Medula Óssea – Belo Horizonte (MG), Brazil. https://orcid.org/0000-0002-7633-8839
Carla Nolasco Monteiro Breviglieri Hospital Samaritano de São Paulo – São Paulo (SP), Brazil. https://orcid.org/0000-0002-6089-5526
Cilmara Kuwahara Hospital Pequeno Príncipe – Curitiba (PR), Brazil. https://orcid.org/0000-0001-9812-7437
Cláudio Galvão de Castro Junior Hemacore São José dos Campos – Guaratinguetá (SP), Brazil|Certho – Guaratinguetá (SP), Brazil. https://orcid.org/0000-0002-4610-8282
Luciana dos Santos Domingues Universidade Federal de São Paulo – São Paulo (SP), Brazil|Grupo de Apoio ao Adolescente e à Criança com Câncer – São Paulo (SP), Brazil. https://orcid.org/0009-0004-4764-1881
Paulo Klinger Associação para Criança e Adolescente com Câncer – São Paulo (SP), Brazil|Hospital Santa Marcelina – São Paulo (SP), Brazil. https://orcid.org/0000-0001-6739-062X
Maura Ikoma Hospital Amaral Carvalho – São Paulo (SP), Brazil. https://orcid.org/0000-0002-1473-9696
Mecneide Mendes Lins Instituto de Medicina Integral Professor Fernando Figueira – Recife (PE), Brazil. https://orcid.org/0000-0002-9155-5030
Renata Guimarães Universidade de São Paulo – Faculdade de Medicina, Hospital das Clínicas – Ribeirão Preto (SP), Brazil. https://orcid.org/0009-0002-8488-8766
Virginio Fernandes Junior Hospital Grupo de Pesquisa e Assistência ao Câncer Infantil – Sorocaba (SP), Brazil.
Luis Fernando Bouzas Hospital Unimed – Volta Redonda (RJ), Brazil|Medcel Medicina Celular – Hospital Vitória Rede Américas – Rio de Janeiro (RJ), Brazil. https://orcid.org/0000-0002-6267-9448
Adriana Seber Hospital Samaritano de São Paulo – São Paulo (SP), Brazil. https://orcid.org/0000-0003-4578-9423

DOI:

https://doi.org/10.46765/2675-374X.2025v6n1e308

Keywords:

Precursor Cell Lymphoblastic Leukemia-Lymphoma, Hematopoietic Stem Cell Transplantation, Consensus, Pediatrics

Abstract

This article details the 2025 consensus update from the Brazilian Group for Pediatric Bone Marrow Transplantation and the Brazilian Society for Pediatric Oncology regarding hematopoietic stem cell transplantation (HSCT) for pediatric acute lymphoblastic leukemia (ALL). Allogeneic HSCT is the standard treatment for high-risk or relapsed ALL. Key indications include, in first remission, very high risk patients defined by primary induction failure or positive minimal residual disease (MRD) after consolidation. In second remission, it is indicated for early bone marrow relapse, early isolated extramedullary B-cell relapse, and all T-cell ALL relapses. The consensus recommends myeloablative conditioning as standard, preferring total body irradiation based regimens for children over 2–3 years old. The preferred donor hierarchy is a matched sibling, followed by a matched unrelated donor, with bone marrow being the preferred cell source. Post-HSCT monitoring of MRD is critical for guiding interventions and identifying relapse. This document serves as an essential, updated guide for clinical decision-making in this field.

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Daudt, L. E., Correa, A. C. R., Zanette, A., Macedo, A. V. de, Breviglieri, C. N. M., Kuwahara, C., … Seber, A. (2026). Hematopoietic stem cell transplantation for pediatric acute lymphoblastic leukemia. JOURNAL OF BONE MARROW TRANSPLANTATION AND CELLULAR THERAPY, 6(1). https://doi.org/10.46765/2675-374X.2025v6n1e308

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Copyright (c) 2026 Liane Esteves Daudt, Ana Carolina Ribeiro Correa, Antonella Zanette, Antonio Vaz de Macedo, Carla Nolasco Monteiro Breviglieri, Cilmara Kuwahara, Cláudio Galvão de Castro Junior, Luciana dos Santos Domingues, Paulo Klinger, Maura Ikoma, Mecneide Mendes Lins, Renata Guimarães, Virginio Fernandes Junior, Luis Fernando Bouzas, Adriana Seber

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Hematopoietic stem cell transplantation for pediatric acute lymphoblastic leukemia

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