Isa HM, Bucheeri ST, Aldoseri JY, Redha AA, Mubarak AF, Altamimi SA, AlOraibi AA, Alshaikh MI. Characteristics and outcomes of Bahraini pediatric patients sent abroad for bone marrow transplantation: A ten-year retrospective cohort study. World J Transplant 2025; 15(2): 100065 [PMID: 40535487 DOI: 10.5500/wjt.v15.i2.100065]
Corresponding Author of This Article
Hasan M Isa, MBChB, Associate Professor, Consultant Physician-Scientist, Department of Pediatrics, Salmaniya Medical Complex, No. 2904, Al Salmaniya Area, Manama 26671, Bahrain. halfaraj@hotmail.com
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Transplantation
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Retrospective Cohort Study
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Jun 18, 2025 (publication date) through Feb 28, 2026
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World Journal of Transplantation
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2220-3230
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Isa HM, Bucheeri ST, Aldoseri JY, Redha AA, Mubarak AF, Altamimi SA, AlOraibi AA, Alshaikh MI. Characteristics and outcomes of Bahraini pediatric patients sent abroad for bone marrow transplantation: A ten-year retrospective cohort study. World J Transplant 2025; 15(2): 100065 [PMID: 40535487 DOI: 10.5500/wjt.v15.i2.100065]
World J Transplant. Jun 18, 2025; 15(2): 100065 Published online Jun 18, 2025. doi: 10.5500/wjt.v15.i2.100065
Characteristics and outcomes of Bahraini pediatric patients sent abroad for bone marrow transplantation: A ten-year retrospective cohort study
Hasan M Isa, Shahd T Bucheeri, Jarrah Y Aldoseri, Ayah A Redha, Abdulla F Mubarak, Shaikha A Altamimi, Ameera A AlOraibi, Mohamed I Alshaikh
Hasan M Isa, Department of Pediatrics, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 26671, Bahrain
Hasan M Isa, Ameera A AlOraibi, Mohamed I Alshaikh, Department of Pediatrics, Salmaniya Medical Complex, Manama 26671, Bahrain
Shahd T Bucheeri, Jarrah Y Aldoseri, Ayah A Redha, Abdulla F Mubarak, School of Medicine, Royal College of Surgeons in Ireland-Medical University of Bahrain, Busaiteen 15503, Bahrain
Shaikha A Altamimi, The Overseas Office, Supreme Committee for Treatment Abroad, Ministry of Health, Manama 26671, Bahrain
Author contributions: All authors made substantial contributions to this paper. Isa HM was the main contributor in study design, data analysis, and overseeing all phases of the project; Bucheeri ST and Aldoseri JY were responsible for literature review, data collection, data analysis, drafting, and manuscript revision; Redha AA and Mubarak AF were responsible for literature review, data collection, and manuscript revision; Altamimi SA, AlOraibi AA, and Alshaikh MI were responsible for project supervision. All the authors have read and approved the final manuscript.
Institutional review board statement: The study was conducted per the principles of the Helsinki Declaration of 1975 (revised 2013), and it was ethically approved by the Research and Research Ethics Committee, Salmaniya Medical Complex, Government hospitals, Kingdom of Bahrain (IRB number: 110311023, November 6, 2023).
Informed consent statement: Consent was not needed as the study was retrospective without exposure to the patients’ data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement:
Data are available upon reasonable request.
Corresponding author: Hasan M Isa, MBChB, Associate Professor, Consultant Physician-Scientist, Department of Pediatrics, Salmaniya Medical Complex, No. 2904, Al Salmaniya Area, Manama 26671, Bahrain. halfaraj@hotmail.com
Received: August 11, 2024 Revised: December 20, 2024 Accepted: January 7, 2025 Published online: June 18, 2025 Processing time: 193 Days and 16.7 Hours
Abstract
BACKGROUND
Bone marrow transplantation (BMT) is a breakthrough procedure for patients with hematological and oncological conditions, particularly when all other treatments fail. Its indications vary between patients and settings, and its outcomes depend on the donor type, transplantation facility, and center expertise. In countries where transplantation facilities are lacking, sending patients abroad for transplantation might be a safe and effective alternative to leaving the patient to face eventual disease morbidity or even mortality if the procedure is not performed locally. However, studies evaluating BMT abroad are scarce.
AIM
To assess the clinical characteristics of patients who underwent BMT overseas and analyze the factors affecting their survival outcomes.
METHODS
We conducted a retrospective cohort study of all Bahraini pediatric patients who underwent BMT between 2013 and 2024. Medical records from Salmaniya Medical Complex and Overseas Treatment Office were reviewed. Patient demographics, transplant indications, donor type, transplantation type, overseas centers, complications, and outcomes (overall and 5-year survival rates) were analyzed. Clinical characteristics and outcomes were compared using χ2 test, Student’s t-test, Mann–Whitney U test, and Kaplan–Meier method. Univariate and multivariate analyses were used to estimate survival predictors.
RESULTS
Of the 75 listed patients, 62 (82.7%) underwent BMT and were included, 10 (13.3%) did not, and 3 (4.0%) were awaiting transplantation. Most patients were male (n = 33, 53.2%). The mean age at transplantation was 7.8 ± 4.9 years. The main indication for treatment was acute myeloid leukemia (AML) (n = 15, 36.6%). Six patients (9.7%) required re-transplantation. Of the 68 transplants, 60 (88.2%) involved conditioning, mostly a combination of fludarabine and total body irradiation (n = 7, 11.7%). Most patients underwent allogeneic transplantation (n = 48, 77.4%), primarily from related donors (n = 47/48, 97.9%). The most common complication was infection (n = 51, 79.7%). Follow-up averaged 3.3 ± 2.5 years. The overall survival rate was 77.4%. Survival odds were better for non-AML patients and Middle Eastern centers (P = 0.015 and P = 0.032, respectively).
CONCLUSION
Bahraini males with AML primarily underwent allogeneic BMT. Non-AML patients and those transplanted in the Middle East had better survival rates, despite high complication rates.
Core Tip: The clinical characteristics and outcomes of Bahraini children who underwent overseas bone marrow transplantation (BMT) have not been previously studied. Here, we found a male predominance among BMT recipients. The most common indications were acute myeloid leukemia (AML) and lymphoblastic leukemia. Most patients received allogeneic grafts. Although the overall survival rate was 77.4%, the incidence of infectious complications was high. Survival rates varied according to BMT indications and centers. Non-AML patients and those who underwent BMT in Middle Eastern countries had better survival outcomes. BMT remains a life-saving procedure for patients with oncological and hematological conditions.
