title: Haploidentical hematopoietic stem cell transplantation with post-transplant high-dose cyclophosphamide in high-risk children: A single-center study.
abstract: Recently, haploidentical transplantations have been performed with unmanipulated BM or PBSC. This approach is becoming more widely adopted with the use of PTCY. However, there is limited evidence about this approach in children. We present 15 children who received 16 haploidentical HSCT with unmanipulated BM or PBSC using PTCY for GVHD prophylaxis. Post-transplant CY(50 mg/kg IV) was given on the third and fifth day, and CsA or tacrolimus with MMF or MP was also used for GVHD prophylaxis. All patients engrafted at a median of 16 and 18 days for neutrophil and thrombocyte recovery, respectively. Grades II-III acute GVHD developed in seven patients, and mild chronic GVHD was found in two patients. Two patients died within the first 100 days due to sepsis (TRM 12.5%). Eleven patients are currently alive, with a median follow-up of 12 months (range 6-22 months). The 12-month OS and DFS were 75 ± 10.8% and 68.8 ± 11.6%, respectively. Our results with these high-risk patients are encouraging for haploidentical HSCT in pediatric patients. Future studies should continue to assess haploidentical HSCT, including comparison of other modalities, in a primary pediatric population.
authors.affiliation: Pediatric Stem Cell Transplantation Unit, Department of Pediatric Hematology, Bahcesehir University School of Medicine, Istanbul, Turkey.
authors.forename: M Akif
authors.initials: MA
authors.lastname: Yesilipek
authors.affiliation: Pediatric Stem Cell Transplantation Unit, Department of Pediatric Hematology, Bahcesehir University School of Medicine, Istanbul, Turkey.
authors.forename: Vedat
authors.initials: V
authors.lastname: Uygun
authors.affiliation: Pediatric Stem Cell Transplantation Unit, Department of Pediatric Hematology, Bahcesehir University School of Medicine, Istanbul, Turkey.
authors.forename: Gulsun
authors.initials: G
authors.lastname: Karasu
authors.affiliation: Pediatric Stem Cell Transplantation Unit, Medicalpark Antalya Hospital, Antalya, Turkey.
authors.forename: Hayriye
authors.initials: H
authors.lastname: Daloglu
authors.affiliation: Pediatric Stem Cell Transplantation Unit, Medicalpark Antalya Hospital, Antalya, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Dincer
mesh_terms: D000293:Adolescent; D001792:Blood Platelets / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000009:adverse effects*; D016572:Cyclosporine / Q000008:administration & dosage; D005260:Female; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007938:Leukemia / Q000628:therapy; D008223:Lymphoma / Q000628:therapy; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects; D009173:Mycophenolic Acid / Q000009:adverse effects; D009504:Neutrophils / Q000187:drug effects; D012189:Retrospective Studies; D012306:Risk; D018805:Sepsis / Q000150:complications; D016559:Tacrolimus / Q000008:administration & dosage; D014019:Tissue Donors; D019172:Transplantation Conditioning
chemical_list: D016572:Cyclosporine; D003520:Cyclophosphamide; D009173:Mycophenolic Acid; D016559:Tacrolimus; D008775:Methylprednisolone
keywords: children; haploidentical; hematopoietic stem cell transplantation; post-transplant cyclophosphamide