Abstract

Hematopoietic stem cell transplantation (HSCT) has revolutionized the treatment of high-risk and relapsed pediatric malignancies, offering a potential cure for conditions such as leukemia, lymphoma, and certain solid tumors. Over the years, advancements in donor selection, conditioning regimens, and graft-versus-host disease (GVHD) management have improved survival outcomes and reduced complications. However, challenges remain, including transplant-related toxicities, immune reconstitution delays, and the risk of GVHD. Innovations in haploidentical transplantation, reducedintensity conditioning, and post-transplant immune modulation are shaping the future of HSCT in pediatric oncology. This review discusses the successes, ongoing challenges, and emerging strategies in optimizing HSCT outcomes for children with cancer.