Allogeneic Stem Cell Transplantation for Children and Adolescents With Acute Lymphoblastic Leukaemia
- Conditions
- Acute Lymphoblastic Leukaemia
- Interventions
- Registration Number
- NCT01949129
- Lead Sponsor
- St. Anna Kinderkrebsforschung
- Brief Summary
The ALL SCTped 2012 FORUM is a multinational, multi-centre, controlled, prospective phase III study for the therapy and therapy optimisation for children and adolescents with ALL in complete morphological remission (CR, less than 5% bone marrow blasts, no blasts in cerebrospinal fluid, no other extramedullary leukemia), who have an indication for HSCT with a myeloablative conditioning regimen.
The stratification of patients in first and following remissions according to the individual transplantation modalities rests upon an indication for allogeneic HSCT and the availability of a suitable donor within the individual transplantation groups.
- Detailed Description
Acute and late side effects of TBI in combination with other chemotherapeutic are manifold to the growing organism and include severe organ dysfunction/failure due to toxicity. Although transplant associated mortality was reduced after HSCT in the last decade due to better HLA matching, infection prevention and control, the burden of late complications is still a matter of concern. Growth retardation, hormonal dysfunction, sterility and the risk of secondary cancer are the late consequences of TBI in children. However, so far no prospective study has demonstrated similar outcomes in paediatric ALL using chemo-conditioning regimen before HSCT. The reason for that is manifold: only a minority of children with ALL qualifies for allogeneic HSCT as most patients are cured with sole modern chemotherapy approaches. Those with dismal prognosis are treated in HSCT centres offering a care to patients with different diseases. Therefore it is nearly impossible to answer the complex outcome questions in single centres or even in single countries. International cooperation is essential to allow prospective investigation within comparable patient cohorts.
The trial was initiated to investigate whether chemotherapy based conditioning could replace TBI in pediatric patients with acute lymphoblastic leukemia (ALL) undergoing allogeneic hematopoietic stem cell transplantation (HSCT). It was registered and approved as a prospective, randomized, controlled, open-label, international, multicenter, phase III, non-inferiority trial. Pediatric patients with acute lymphoblastic leukemia (ALL) aged ≤18 years at diagnosis and 4-21 years at HSCT in complete remission pre-HSCT, and with an HLA-compatible related (MSD) or unrelated donor (MD) were randomly assigned to myeloablative conditioning with fractionated 12 Gy TBI and etoposide versus fludarabine (Flu), thiotepa (Thio), and either busulfan (Bu) or treosulfan (Treo). The decision to use the irradiation-free conditioning or Flu/Thio/Treo or Flu/Thio/ivBu was country specific. Patients aged \< 4 years received irradiation-free conditioning. Patients with a mismatched donor (MMD) were stratified according to the donor's stem cell source (cordblood, haploidentical tx or bone marrow/peripheral blood stem cells).
The stopping rule was applied on March 31, 2019 following a suspension of random assignment in December 2018 after the chemoconditioning was proven to be significantly inferior to TBI. As a result, TBI/VP16 conditioning remains the standard for patients older than 4 years with MSD/MD, but the age limit for TBI/VP16-based conditioning may be optionally lowered to 2 years.The use of Flu/Thio/Treo or Flu/Thio/ivBu conditioning in this age group is made at centre level based on individual patient assessment. Alternatively, patients aged 0-2 years may receive Bu/VP16/Cy at the discretion of the treating physician.
The MSD/MD randomised patients remain in a follow-up to explore the impact of risk factors on the incidence of Adverse Events of Special Interest (AESIs) and on overall survival and event free survival in the entire MSD/MD cohort.
In MMD patients, event free survival (EFS) after HSCT from HLA mismatched donors using mismatched unrelated donors (MMD), mismatched cord blood or HLA haplo-identical family members is observed
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 1800
Patients with ALL (except for patients with B-ALL) who fulfil the following criteria:
- age at diagnosis ≤ 18 years. Age at HSCT ≤ 21 years
- indication for allogeneic HSCT
- complete remission (CR) before HSCT
- written consent of the parents (legal guardian) and, if necessary, the minor patient via "Informed Consent Form"
- no pregnancy
- no secondary malignancy
- no previous HSCT
- HSCT is performed in a study participating centre
- patients who do not fulfil the inclusion criteria
- Non Hodgkin-Lymphoma
- the whole protocol or essential parts are declined either by patient himself/herself or the respective legal guardian
- no consent is given for saving and propagation of anonymous medical data for study reasons
- severe concomitant disease that does not allow treatment according to the protocol at the investigator's discretion (e.g. malformation syndromes, cardiac malformations, metabolic disorders)
- Karnofsky / Lansky score < 50%
- subjects unwilling or unable to comply with the study procedures
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Flu/Thio/Treo ATG Thymoglobulin Fludarabine/Thiotepa/Treosulfan is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide TBI/VP16 VP16 TBI (Total Body Irradiation) / VP16 is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients older than 48 months with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide. Patients aged 24-48 months may optionally receive Total Body Irradiation (TBI). Bu/VP16/Cy VP16 Busulfan/VP16/Cyclophosphamide is an alternative conditioning arm that may optionally be used for HSCT with MSD/MD and MMD graft in patients aged 0-24 months. Patients undergoing MD HSCT will also receive ATG Thymo- or Grafalon. TBI/VP16 TBI TBI (Total Body Irradiation) / VP16 is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients older than 48 months with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide. Patients aged 24-48 months may optionally receive Total Body Irradiation (TBI). Flu/Thio/ivBu ATG Thymoglobulin Fludarabine/Thiotepa/iV Busulfan is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide TBI/VP16 ATG Thymoglobulin TBI (Total Body Irradiation) / VP16 is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients older than 48 months with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide. Patients aged 24-48 months may optionally receive Total Body Irradiation (TBI). Flu/Thio/Treo Grafalon Fludarabine/Thiotepa/Treosulfan is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide TBI/VP16 Grafalon TBI (Total Body Irradiation) / VP16 is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients older than 48 months with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide. Patients aged 24-48 months may optionally receive Total Body Irradiation (TBI). Flu/Thio/ivBu Grafalon Fludarabine/Thiotepa/iV Busulfan is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide Flu/Thio/Treo Treosulfan Fludarabine/Thiotepa/Treosulfan is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide Flu/Thio/Treo Thiotepa Fludarabine/Thiotepa/Treosulfan is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide Flu/Thio/Treo Fludarabine Fludarabine/Thiotepa/Treosulfan is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide Flu/Thio/ivBu Cyclophosphamide Fludarabine/Thiotepa/iV Busulfan is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide Flu/Thio/ivBu Thiotepa Fludarabine/Thiotepa/iV Busulfan is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide Flu/Thio/ivBu Fludarabine Fludarabine/Thiotepa/iV Busulfan is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide Flu/Thio/ivBu Busulfan Fludarabine/Thiotepa/iV Busulfan is used as conditioning regimen for haematopoietic stem cell transplantation (HSCT) in patients with: * MSD (matched sibling donors) or MD (matched related or unrelated donors). In addition, patients undergoing MD HSCT will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) with CB (Cord blood) or TCD (T-Cell depletion) or CD34+ selection. In addition, these patients will receive ATG Thymo- or Grafalon. * MMD (mismatched donors) patients receiving Post TX-Cyclophosphamide Bu/VP16/Cy Busulfan Busulfan/VP16/Cyclophosphamide is an alternative conditioning arm that may optionally be used for HSCT with MSD/MD and MMD graft in patients aged 0-24 months. Patients undergoing MD HSCT will also receive ATG Thymo- or Grafalon. Bu/VP16/Cy Cyclophosphamide Busulfan/VP16/Cyclophosphamide is an alternative conditioning arm that may optionally be used for HSCT with MSD/MD and MMD graft in patients aged 0-24 months. Patients undergoing MD HSCT will also receive ATG Thymo- or Grafalon.
- Primary Outcome Measures
Name Time Method Event free survival (EFS) Stratum 2 (mismatched donor transplantation) first: 18 months after inclusion of first patient, afterwards annually up to 10 years EFS after allogeneic HSCT. EFS calculated from date of recruitment to disease progression or relapse, secondary neoplasm and death from any cause.
Overall Survival (OS) Stratum 1a (randomisation TBI+ chemo-conditioning vs. chemo-conditioning only) first: 18 months after inclusion of first patient, afterwards annually up to 10 years Stratum 1 - randomisation related question was closed in December 2018; patients are in active follow-up: To show that a non total body irradiation (TBI) containing conditioning (Flu/Thio/ivBu or Flu/Thio/Treo) results in a non-inferior survival as compared to conditioning with TBI/Etoposide in children older than 4 years after HSCT from a Human leucocyte antigen (HLA) identical sibling donor (MSD) or a HLA matched donor (MD). The primary endpoint is the OS calculated from the date of the randomisation. Death from any cause will be considered an event.
Overall Survival (OS), Stratum 1b: MSD/MD without randomisation first: 18 months after inclusion of first patient, afterwards annually up to 10 years To explore the impact of risk factors on the incidence of adverse events of special interest (AESIs) and on overall survival and event free survival in the entire MSD/MD cohort
- Secondary Outcome Measures
Name Time Method TRM first: 18 months after inclusion of first patient, afterwards annually up to 10 years Cumulative Incidence of Treatment-related mortality (TRM) for Stratum 1 and 2.
EFS (Stratum 1a and 1b) first: 18 months after inclusion of first patient, afterwards annually up to 10 years EFS calculated from date of randomization (1a) or recruitment (1b) to disease progression or relapse, secondary neoplasm and death from any cause. Patients lost to follow-up without event will be censored at the date of their last follow-up evaluation.
Relapse/progression first: 18 months after inclusion of first patient, afterwards annually up to 10 years Cumulative Incidence of Relapse for Stratum 1a, 1b and 2.
Acute and late toxicity for Stratum 1a, 1b and 2 first: 18 months after inclusion of first patient, afterwards annually up to 10 years according a preselection out of CTC3
OS (Stratum 2) first: 18 months after inclusion of first patient, afterwards annually up to 10 years The primary endpoint is the OS calculated from the date of the recruitment . Death from any cause will be considered an event.
Trial Locations
- Locations (118)
Hospital Sor Maria Ludovica, Department Hematology Stem Cell Transplant Unit
🇦🇷La Plata, Argentina
University Hospitals Leuven Kinderhemato-oncologie
🇧🇪Leuven, Belgium
Dana Children's Hospital
🇮🇱Tel Aviv, Israel
University childrens' hospital, UMCL
🇸🇮Ljubljana, Slovenia
Hospital de Pediatria "Juan P. Garrahan" Combate de Los Pozos N°1800 CABA
🇦🇷Buenos Aires, Argentina
Universitätsklinik für Kinder- und Jugendheilkunde, Abt. f. Hämato-Onkologie
🇦🇹Graz, Austria
Belarusian Research Center for Pediatric Oncology, Hematology and Immunology
🇧🇾Minsk, Belarus
Saint Sophia Children's Hospital BMT Unit
🇬🇷Athens, Greece
Leiden University Medical Center Department of Pediatrics/BMT unit
🇳🇱Leiden, Netherlands
King Abdullah specialists children hospital
🇸🇦Riyadh, Saudi Arabia
University Children's Hospital
🇸🇰Bratislava, Slovakia
Universitätsklinik für Kinder- und Jugendheilkunde
🇦🇹Innsbruck, Austria
Centre Hospitalier Universitaire de Liège Domaine Universitaire du Sart Tilman
🇧🇪Liège, Belgium
University of Medicine and Pharmacy V. BABES, Emergency Children's Hospital LOUIS TURCANU, III. Clinic of Pediatrics , Department of Onco-hematology and Bone Marrow Transplantation
🇷🇴Timişoara, Romania
University Hospital Gent Pediatrische hemato-oncologie
🇧🇪Gent, Belgium
University of Malaya, Department of Paediatrics
🇲🇾Kuala Lumpur, Malaysia
University Hospital No.1, Collegium Medicum UMK, department of Paediatrics, Oncology, Hematology and Paediatric Transplantology
🇵🇱Bydgoszcz, Poland
Division of Hematology-Oncology and Stem Cell Transplantation, Hospital for Children and Adolescents, Univ. of Helsinki
🇫🇮Helsinki, Finland
Children's University Hospital, Dept. Pediatric Hematology, Oncology, and Transplantology
🇵🇱Lublin, Poland
HUG Hôpitaux Universitaire de Genève
🇨🇭Geneva, Switzerland
National Institute of Haematology and Infectious Disease, Hospital of Southern Pest, Paediatric Bone Marrow Transplantation Unit
🇭🇺Budapest, Hungary
Hôpital Universitaire des Enfants Reine Fabiola (HUDERF)
🇧🇪Brussels, Belgium
Lady Cilento Children's Hospital
🇦🇺South Brisbane, Australia
St. Anna Children's Hospital, Vienna, Austria
🇦🇹Vienna, Austria
Cliniques Universitaires Saint-Luc (UCL) Hématologie et oncologie pédiatrique
🇧🇪Brussels, Belgium
Hospital Dr Luis Calvo Mackenna
🇨🇱Santiago, Chile
CHU Sainte-Justine Hematology-Oncology Division
🇨🇦Montreal, Canada
Department of Pediatrics, UHC Zagreb
🇭🇷Zagreb, Croatia
Alberta Children's Hospital Division of Pediatric Oncology
🇨🇦Calgary, Canada
BC Children's Hospital
🇨🇦Vancouver, Canada
Department of Pediatric Hematology and Oncology Teaching Hospital Motol, 2nd Medical School, Charles University
🇨🇿Prague, Czechia
IHOP / Lyon, Service Hématologie et d'Oncologie pédiatrique
🇫🇷Lyon, France
CHRU Lille, Service d'Hématologie Pédiatrique
🇫🇷Lille, France
Hopital Arnaud de Villeneuve
🇫🇷Montpellier, France
CHU Nancy - Hopital d'Enfants
🇫🇷Nancy, France
Universitätsklinikum Essen, Klinik für Kinderheilkunde III
🇩🇪Essen, Germany
Universitätsklinikum Erlangen, Kinder- und Jugendklinik
🇩🇪Erlangen, Germany
Universitätsklinikum Bonn, Abteilung für Pädiatrische Hämatologie und Onkologie
🇩🇪Bonn, Germany
Klinikum der Johann Wolfgang Goethe-Universität, Klinik für Kinder- und Jugendmedizin (KKJM)
🇩🇪Frankfurt am Main, Germany
Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Kinder- und Jugendmedizin
🇩🇪Halle, Germany
Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Pädiatrische Hämatologie und Onkologie
🇩🇪Hamburg, Germany
Medizinische Hochschule Hannover, Zentrum Kinderheilkunde und Jugendmedizin
🇩🇪Hannover, Germany
Universitätsklinikum Heidelberg, Zentrum für Kinder- und Jugendmedizin
🇩🇪Heidelberg, Germany
Universitätsklinikum Münster, Klinik für Kinder- und Jugendmedizin
🇩🇪Münster, Germany
Universitätsklinikum Regensburg, Klinik und Poliklinik für Kinder- und Jugendmedizin
🇩🇪Regensburg, Germany
Universitätsklinikum Ulm, Klinik für Kinder- und Jugendmedizin
🇩🇪Ulm, Germany
Azienda Ospedaliero-Universitaria Policlinico S. Orsola-Malpighi di Bologna
🇮🇹Bologna, Italy
Ospedale Mayer di Firenze SODc Tumori Pediatrici e TMO
🇮🇹Florence, Italy
Istituto Gaslini Genova Oncoematologia Pediatrica-
🇮🇹Genoa, Italy
Universitäts-Kinderklinik Würzburg
🇩🇪Würzburg, Germany
Rambam Medical Center
🇮🇱Haifa, Israel
Schneider Children's Medical Center of Israel
🇮🇱Petach-Tikva, Israel
A.O. San Gerardo di Monza Clinica Pediatrica
🇮🇹Monza, Italy
Instituto Nacional de Peditria
🇲🇽Ciudad de México, Mexico
Princess Máxima Center for Pediatric Oncology
🇳🇱Utrecht, Netherlands
Oslo University Hospital Rikshospitalet
🇳🇴Oslo, Norway
University Children's Hospital in Krakow, Department of Transplantation
🇵🇱Kraków, Poland
Starship Children's Hospital
🇳🇿Auckland, New Zealand
Poznan University of Medical Sciences, Department of Pediatric Onology, Hematology & HSCT
🇵🇱Poznań, Poland
Cape of Hope, Wroclaw Medical University
🇵🇱Wrocław, Poland
Hospital Virgen de la Arrixaca
🇪🇸Murcia, Spain
Queen Silvia Children's Hospital, Department of Pediatric Oncology (Avdelnig 321-322)
🇸🇪Göteborg, Sweden
Hospital Santa Creu i Sant Pau
🇪🇸Barcelona, Spain
Acibadem University Atakent Hospital Pediatric Stem Cell Transplantation Unit
🇹🇷Istanbul, Turkey
Universitäts-Kinderspital Zurich
🇨🇭Zurich, Switzerland
Ankara University School of Medicine Pediatric Stem Cell Transplantation Unit
🇹🇷Ankara, Turkey
Hospital Universitario Central de Asturias
🇪🇸Oviedo, Spain
Karolinska University Hospital, Department of Pediatrics
🇸🇪Stockholm, Sweden
University Children's Hospital, Dept. of Women's & Children's Health Section for Pediatrics
🇸🇪Uppsala, Sweden
Dokuzeylul University School of Medicine Pediatric Stem Cell Transplantation Unit
🇹🇷Izmir, Turkey
Gülhane Training and Research Hospital
🇹🇷Ankara, Turkey
Erciyes University School of Medicine Pediatric Stem Cell Transplantation Unit
🇹🇷Kayseri, Turkey
Bahcesehir University School of Medicine Pediatric Stem Cell Transplantation Unit
🇹🇷Istanbul, Turkey
Bahcelievler Medicalpark Hospital Pediatric Stem Cell Transplantation Unit
🇹🇷Istanbul, Turkey
Hopital la Timone Adulte
🇫🇷Marseille, France
CHU Nantes, Service d'onco hémato pédiatrie
🇫🇷Nantes, France
Hôpital Robert Debré
🇫🇷Paris, France
CHU de Rennes, Serive d'Onco-Pédiatrie
🇫🇷Rennes, France
CHU de Rouen, Hopital des Enfants, Service d' Immuno-Hématologie Oncologie Pédiatrique
🇫🇷Rouen, France
CHU Strasbourg, Service d'hématologie et d'oncologie pédiatrique
🇫🇷Strasbourg, France
Gazi University School of Medicine Pediatric Stem Cell Transplantation Unit
🇹🇷Ankara, Turkey
A.O.R.N. Santobono Pausilipon, Dipartimento di Oncoematologia
🇮🇹Napoli, Italy
Azienda Ospedaliera di Padova Oncoematologia Pediatrica
🇮🇹Padova, Italy
Fondazione IRCCS Policlinico San Matteo
🇮🇹Pavia, Italy
Azienda Ospedaliero Universitaria Pisana U.O. di Oncoematologia Pediatrica A.O.
🇮🇹Pisa, Italy
Montreal Children's Hospital
🇨🇦Montral, Canada
Hospital for Sick Children University of Toronto Division of Haematology/Oncology
🇨🇦Toronto, Canada
CancerCare Manitoba/University of Manitoba
🇨🇦Winnipeg, Canada
Hospital Materno Infantil de Málaga
🇪🇸Málaga, Spain
Hospital Vall d'Hebron
🇪🇸Barcelona, Spain
Universitätsklinikum Jena, Sektion für Stammzelltransplantation
🇩🇪Jena, Germany
Universitätsklinikum Freiburg, Zentrum für Kinder- und Jugendmedizin
🇩🇪Freiburg, Germany
Universitätsmedizin Leipzig, Abteilung für Pädiatrische Onkologie, Hämatologie und Hämostaseologie
🇩🇪Leipzig, Germany
Universitätsklinik für Kinder- und Jugendmedizin Tübingen
🇩🇪Tübingen, Germany
UKSH - Universitätsklinikum Schleswig-Holstein, Klinik für Allgemeine Pädiatrie
🇩🇪Kiel, Germany
Paediatric Stem Cell Transplant and Immune Deficiency, Dept. for children and adolescents 4072, Rigshospitalet
🇩🇰Copenhagen, Denmark
Sydney Children's Hospital
🇦🇺Randwick, Australia
Children's Cancer Centre The Royal Children's Hospital
🇦🇺Melbourne, Australia
Princess Margaret Hospital for Children
🇦🇺Perth, Australia
The Children's Hospital at Westmead Oncology Unit
🇦🇺Sydney, Australia
CHU Clermont-Ferrand
🇫🇷Clermont-Ferrand, France
CHU Bordeaux
🇫🇷Bordeaux, France
CHU Grenoble - Clinique Universitaire de Pédiatrie, Hôpital Couple Enfant
🇫🇷Grenoble, France
Uniklinik RWTH Aachen, Kinder- und Jugendmedizin
🇩🇪Aachen, Germany
Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum
🇩🇪Berlin, Germany
Universitätsklinikum Gießen, Zentrum für Kinder- und Jugendmedizin
🇩🇪Gießen, Germany
Universitätsmedizin Greifswald, Klinik und Poliklinik für Kinder- und Jugendmedizin
🇩🇪Greifswald, Germany
Universitätsklinikum Düsseldorf, Klinik für Kinder-Onkologie, -Hämatologie und Klinische Immunologie
🇩🇪Düsseldorf, Germany
Klinikum der Universität München, Dr. von Haunersches Kinderspital
🇩🇪München, Germany
Städt. Krankenhaus München Schwabing, Universitätskinderklinik der TU München
🇩🇪München, Germany
Ospedale Pediatrico Bambino Gesù, Sapienza, University of Rome
🇮🇹Rome, Italy
Ospedale Infantile Regina Margherita SC Oncoematologia e Centro Trapianti
🇮🇹Torino, Italy
IInsitutul Clinic Fundeni, Sectia de Transplant Medular
🇷🇴Bukarest, Romania
Skane University Hospital, Dept. of Pediatrics, Section for Hematology and Oncology
🇸🇪Lund, Sweden
Universitäts-Kinderspital beider Basel (UKBB)
🇨🇭Basel, Switzerland
Akdeniz University School of Medicine Pediatric Stem Cell Transplantation Unit
🇹🇷Antalya, Turkey
Medipol Mega Üniversite Hastanesi
🇹🇷Istanbul, Turkey
Ege University School of Medicine Pediatric Stem Cell Transplantation Unit
🇹🇷Izmir, Turkey