Non-Infection Complications Post-HSCT

HSCT may be the only therapeutic option for several malignant and non-malignant disorders in children. Significant morbidity and mortality are associated with HSCT. These may be a result of pre-existing illness, the toxicity of the conditioning regimen, or post-transplantation complications. Early complications include engraftment syndrome, VOD, capillary leak syndrome, pulmonary complications, and thrombotic microangiopathies (TMA), and are associated with activation and dysfunction of endothelial cells (endothelial syndromes). Graft-versus-host disease (GVHD) remains a major complication of HSCT with high incidence and is the leading cause of morbidity and mortality. The prognosis of patients with high-grade GVHD is dismal and the survival rate varies between 25% in the adult populations to 55% in pediatric patients. HSCTs survivors need prolonged follow-up due to a high incidence of late effect complications; pulmonary, endocrine, eye, oral, skin, cardiac, fertility as well as secondary cancer and psychological problems.

The main goal of this Research Topic is to evaluate the incidence, risk factors, and impact on the survival of different early and late complications post-HSCT in pediatric patients with malignant and non-malignant diseases. This Research Topic aims to define and create the prophylactic strategy and treatment guidelines to decrease the incidence of post-transplant complications and improve the outcome and the quality of life of pediatric HSCTs.

This Research Topic welcomes articles covering all aspects of non-infection complications during and post-pediatric hematopoietic transplantations, including:

• Early endothelial complications

• Acute and chronic graft versus host disease

• Neurological complications

• Late complications (endocrinology, fertility, ophthalmology, stomatology, cardiac, renal, hepatic, etc.)

• Psychological and neurodevelopment issues