• Biol. Blood Marrow Transplant. · Dec 2019

    Review

    Hematopoietic Stem Cell Transplantation to Treat Leukodystrophies: Clinical Practice Guidelines from the Hunter's Hope Leukodystrophy Care Network.

    • Kristin M Page, Elizabeth O Stenger, James A Connelly, David Shyr, Tara West, Susan Wood, Laura Case, Maureen Kester, Soo Shim, Lauren Hammond, Matthew Hammond, Christin Webb, Alessandra Biffi, Barbara Bambach, Ali Fatemi, and Joanne Kurtzberg.
    • Pediatric Transplant and Cellular Therapy, Duke University, Durham, North Carolina. Electronic address: kristin.page@duke.edu.
    • Biol. Blood Marrow Transplant. 2019 Dec 1; 25 (12): e363-e374.

    AbstractThe leukodystrophies are a heterogeneous group of inherited diseases characterized by progressive demyelination of the central nervous system leading to devastating neurologic symptoms and premature death. Hematopoietic stem cell transplantation (HSCT) has been successfully used to treat certain leukodystrophies, including adrenoleukodystrophy, globoid leukodystrophy (Krabbe disease), and metachromatic leukodystrophy, over the past 30 years. To date, these complex patients have primarily been transplanted at a limited number of pediatric centers. As the number of cases identified through pregnancy and newborn screening is increasing, additional centers will be required to treat these children. Hunter's Hope created the Leukodystrophy Care Network in part to create and standardize high-quality clinical practice guidelines to guide the care of affected patients. In this report the clinical guidelines for the care of pediatric patients with leukodystrophies undergoing treatment with HSCT are presented. The initial transplant evaluation, determination of patient eligibility, donor selection, conditioning, supportive care, and post-transplant follow-up are discussed. Throughout these guidelines the need for early detection and treatment and the role of the partnership between families and multidisciplinary providers are emphasized.Copyright © 2019 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.

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