Hematopoietic Cell Transplantation and Cellular Therapeutics in the Treatment of Childhood Malignancies Kanwaldeep Mallhi, MD a , Lawrence G. Lum, MD, DSc b , Kirk R. Schultz, MD a, *, Maxim Yankelevich, MD c INTRODUCTION Hematopoietic cell transplantation (HCT) represents the most common and effective form of immunotherapy for childhood malignancies. The role of the graft-versus- leukemia (GVL) effect in allogeneic HCT has been well established in childhood malig- nancies, but is also associated with short-term and long-term morbidity. HCT may be ineffective in some settings at obtaining control of the malignancy, and as such cannot a Department of Pediatrics, BC Children’s Hospital, 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada; b Department of Oncology, Barbara Ann Karmanos Cancer Insti- tute, Wayne State University, 3901 Beaubien, Detroit, MI 48201, USA; c Division of Hematolo- gy/Oncology, Children’s Hospital of Michigan, Wayne State University, 3901 Beaubien, Detroit, MI 48201, USA * Corresponding author. Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Pediatrics, BC Children’s Hospital, University of British Columbia, 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada. E-mail address: kschultz@mail.ubc.ca KEYWORDS  Hematopoietic cell transplantation  Cellular therapy  Children  Adolescents  Cancer KEY POINTS  Hematopoietic cell transplantation continues to be the only established immune therapy for childhood cancer.  Cellular therapy shows great promise to either replace HCT and act as an adjuvant to stan- dard chemotherapy for childhood cancer.  Survival after HCT has improved primarily due to new approaches to decrease it’s toxicity.  Better understanding of the immune mechanisms of the graft-versus-leukemia/tumor ef- fect are needed to improve the efficacy of HCT. Pediatr Clin N Am 62 (2015) 257–273 http://dx.doi.org/10.1016/j.pcl.2014.10.001 pediatric.theclinics.com 0031-3955/15/$ – see front matter Ó 2015 Elsevier Inc. All rights reserved.