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Abstract

Bone marrow transplantation (BMT) remains a critical therapeutic option for pediatric patients with acute lymphoblastic leukemia (ALL), particularly for those with high-risk or relapsed disease. This study aimed to evaluate long-term graft survival, immune reconstitution, and overall outcomes in pediatric patients undergoing allogeneic BMT. A retrospective analysis of 150 pediatric patients who underwent BMT between 2010 and 2020 was conducted. The median follow-up was 7.5 years. The primary endpoints included overall survival (OS), event-free survival (EFS), graftversus- host disease (GVHD) incidence, and immune reconstitution dynamics. Our results demonstrated an overall survival rate of 72% at 5 years, with significant improvement in immune reconstitution observed within the first 12 months post-transplant. Chronic GVHD was observed in 30% of patients, with most cases being mild to moderate in severity. The study concludes that BMT remains an effective treatment for pediatric ALL, with promising long-term survival rates and manageable complications.