Malignant hemopathies and immune deficiencies are the main indications for allogeneic
bone marrow transplantation in children. Among the former, the most common condition is
acute lymphoblastic leukemia, in which a bone marrow transplant can be performed during the second or first complete remission (CR). Thirty to 50% and 60 to 75% of these grafts, respectively, are successful. The success rate is 50 to 70% among patients with
acute myeloblastic leukemia grafted during the first complete remission, and among patients with
chronic myeloid leukemia grafted during the chronic phase. Severe medullary aplasia and Fanconi disease are undoubtedly good indications for
bone marrow transplantation, which has a 60 to 70% success rate. Severe combined immune deficiencies (SCID) and Wiskott-Aldrich disease are also good indications for HLA-identical
bone marrow transplantation, which is successful in 60% of cases. Among the
metabolic diseases, good results have been obtained only in
Hurler disease and
Gaucher disease. Questionable indications include
thalassemia,
Blackfan-Diamond disease, and
chronic granulomatous disease. Results are disappointing in most
metabolic diseases, as well as in non-HLA-identical
transplantations in diseases other than SCID.