{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:26:36Z","timestamp":1786739196607,"version":"build-2736575974"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2020,10,1]],"date-time":"2020-10-01T00:00:00Z","timestamp":1601510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,3,17]],"date-time":"2020-03-17T00:00:00Z","timestamp":1584403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Haploidentical stem cell transplantation (haplo-SCT) is an option for patients without human leukocyte antigen-matched related or unrelated donor. Post-transplantation cyclophosphamide (PTCy) is an effective method of graft versus host disease (GVHD) prophylaxis and permits the use of T-cell replete grafts in settings were ex vivo manipulation is not feasible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective study among patients younger than 18 years, with a history of hematologic malignancies who underwent haplo-SCT between 2012 and 2016. All patients received a preparative regimen of fludarabine, busulfan, and 400 cGy total body irradiation or melphalan. Post-transplant GvHD prophylaxis consisted either of PTCy (50 mg\/kg on Days + 3 and + 4) and cyclosporine (CSA) plus mycophenolate (MMF) (15 mg\/kg\/dose, thrice daily, per os), or minidose methotrexate (MTX; 5 mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      dose) on Days + 5, +7, +10, and + 15.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A +total of 52 children were included, whose median age was 9 years (interquartile range, 4.9\u201314; range, 1.2\u201317 years), and 63% were males. The most common complications were cytomegalovirus reactivation (57%) and hemorrhagic cystitis (36%). The acute GVHD prophylaxis was PTCy, CSA, and mini-dose MTX in 42 (81%) patients, and 10 (19%) patients received PTCy, CSA, and MMF. The cumulative incidence of acute GvHD II\u2013IV, acute GvHD III\u2013IV, and chronic GvHD were 42%, 8.5%, and 19%, respectively. Grades I\u2013IV acute GvHD occurred in 100% of the patients who received prophylaxis with CSA and MMF, and 62% who received CSA and mini-dose MTX (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .055). The transplant-related mortality at 100 days was 18%. The 5-year overall and event-free survival were 59% and 57%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Haplo-SCT with PT\/Cy can be an available, safe, and feasible option for children with hematologic malignancies; meanwhile, the use of mini-dose of MTX was associated with lower rates of acute GVHD. However, our results require further support from prospective randomized studies to improve the efficacy of this prophylactic strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.hemonc.2020.01.003","type":"journal-article","created":{"date-parts":[[2020,3,20]],"date-time":"2020-03-20T12:37:00Z","timestamp":1584707820000},"page":"208-213","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["Haploidentical stem cell transplant with post-transplantation cyclophosphamide and mini-dose methotrexate in children"],"prefix":"10.4103","volume":"13","author":[{"given":"Diego","family":"Medina","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayra","family":"Estacio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Rosales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliana","family":"Manzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-4-20241211","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1532\/IJH97.06185","article-title":"Outcome of non-T-cell-depleted HLA-haploidentical hematopoietic stem cell transplantation from family donors in children and adolescents","volume":"85","author":"Yoshihara","year":"2007","journal-title":"Int J Hematol"},{"key":"R2-4-20241211","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1038\/pr.2011.60","article-title":"New strategies for haploidentical transplantation","volume":"71","author":"Oevermann","year":"2012","journal-title":"Pediatr Res"},{"key":"R3-4-20241211","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/j.bbmt.2008.03.005","article-title":"HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide","volume":"14","author":"Luznik","year":"2008","journal-title":"Biol Blood Marrow Transplant"},{"key":"R4-4-20241211","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1053\/j.seminhematol.2016.01.005","article-title":"Haploidentical bone marrow and stem cell transplantation: experience with post-transplantation cyclophosphamide","volume":"53","author":"Robinson","year":"2016","journal-title":"Semin Hematol"},{"key":"R5-4-20241211","doi-asserted-by":"crossref","first-page":"1459","DOI":"10.1038\/bmt.2012.45","article-title":"Prophylaxis and treatment of GVHD after allogeneic haematopoietic SCT: a survey of centre strategies by the European Group for blood and marrow transplantation","volume":"47","author":"Ruutu","year":"2012","journal-title":"Bone Marrow Transplant"},{"key":"R6-4-20241211","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.clim.2004.09.001","article-title":"The anti-inflammatory action of methotrexate is not mediated by lymphocyte apoptosis, but by the suppression of activation and adhesion molecules","volume":"114","author":"Johnston","year":"2005","journal-title":"Clin Immunol"},{"key":"R7-4-20241211","doi-asserted-by":"crossref","first-page":"2919","DOI":"10.1182\/blood-2007-09-112789","article-title":"Prevention of acute graft-versus-host disease by blocking T-cell entry to secondary lymphoid organs","volume":"111","author":"Beilhack","year":"2008","journal-title":"Blood"},{"key":"R8-4-20241211","doi-asserted-by":"crossref","first-page":"980301","DOI":"10.1155\/2014\/980301","article-title":"Methotrexate for the treatment of graft-versus-host disease after allogeneic hematopoietic stem cell transplantation","volume":"2014","author":"Nassar","year":"2014","journal-title":"J Transplant"},{"key":"R9-4-20241211","doi-asserted-by":"crossref","first-page":"113","DOI":"10.5045\/kjh.2012.47.2.113","article-title":"The effectiveness of tacrolimus and minidose methotrexate in the prevention of acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation in children: a single-center study in Korea","volume":"47","author":"Park","year":"2012","journal-title":"Korean J Hematol"},{"key":"R10-4-20241211","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1111\/ctr.12561","article-title":"Low-dose methotrexate may preserve a stronger antileukemic effect than that of cyclosporine after modified donor lymphocyte infusion in unmanipulated haploidentical HSCT","volume":"29","author":"Yan","year":"2015","journal-title":"Clin Transplant"},{"key":"R11-4-20241211","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1080\/08880010902772208","article-title":"Haploidentical hematopoietic stem cell transplantation in child hematologic malignancies with G-CSF-mobilized marrow grafts without T-cell depletion: a single-center report of 45 cases","volume":"26","author":"Wang","year":"2009","journal-title":"Pediatr Hematol Oncol"},{"key":"R13-4-20241211","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.bbmt.2009.11.010","article-title":"Mycophenolate pharmacokinetics and association with response to acute graft-versus-host disease treatment from the blood and marrow transplant clinical trials network","volume":"16","author":"Jacobson","year":"2010","journal-title":"Biol Blood Marrow Transplant"},{"key":"R14-4-20241211","doi-asserted-by":"crossref","first-page":"978","DOI":"10.1002\/cncr.27761","article-title":"Longterm follow-up of haploidentical hematopoietic stem cell transplantation without in vitro T cell depletion for the treatment of leukemia","volume":"119","author":"Wang","year":"2013","journal-title":"Cancer"},{"key":"R15-4-20241211","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1038\/sj.bmt.1705445","article-title":"Haploidentical hematopoietic stem cell transplantation without in vitro T-cell depletion for the treatment of hematological malignancies","volume":"38","author":"Huang","year":"2006","journal-title":"Bone Marrow Transplant"},{"key":"R16-4-20241211","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.bbmt.2008.02.007","article-title":"Haploidentical hematopoietic stem cell transplantation without in vitro T cell depletion for treatment of hematological malignancies in children","volume":"14","author":"Liu","year":"2008","journal-title":"Biol Blood Marrow Transplant"},{"key":"R17-4-20241211","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1016\/j.bbmt.2006.06.007","article-title":"Unmanipulated HLA 2\u20133 antigen-mismatched (haploidentical) stem cell transplantation using nonmyeloab-lative conditioning","volume":"12","author":"Ogawa","year":"2006","journal-title":"Biol Blood Marrow Transplant"},{"key":"R18-4-20241211","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.bbmt.2012.08.007","article-title":"Donor selection in T cell\u2013replete haploidentical hematopoietic stem cell transplantation: knowns, unknowns, and controversies","volume":"19","author":"Ciurea","year":"2013","journal-title":"Biol Blood Marrow Transplant"},{"key":"R19-4-20241211","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1097\/MPH.0b013e3182431e1b","article-title":"Once-daily intravenous busulfan for 47 pediatric patients undergoing autologous hematopoietic stem cell transplantation","volume":"34","author":"Gonz\u00e1lez-Vicent","year":"2012","journal-title":"J Pediatr Hematol Oncol"},{"key":"R20-4-20241211","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s00280-007-0455-2","article-title":"Prospective validation of a novel IV busulfan fixed dosing for paediatric patients to improve therapeutic AUC targeting without drug monitoring","volume":"61","author":"Vassal","year":"2007","journal-title":"Cancer Chemother Pharmacol"},{"key":"R21-4-20241211","first-page":"825","article-title":"1994 consensus conference on acute GVHD grading","volume":"15","author":"Przepiorka","year":"1995","journal-title":"Bone Marrow Transplant"},{"key":"R22-4-20241211","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1038\/sj.bmt.1705963","article-title":"Searching for alternative hematopoietic stem cell donors for pediatric patients","volume":"41","author":"Rocha","year":"2008","journal-title":"Bone Marrow Transplant"},{"key":"R23-4-20241211","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.bbmt.2007.10.007","article-title":"Alternative allogeneic donor sources for transplantation for childhood diseases: unrelated cord blood and haploidentical family donors","volume":"14","author":"Cairo","year":"2008","journal-title":"Biol Blood Marrow Transplant"},{"key":"R24-4-20241211","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1080\/14653240802251507","article-title":"The history and future prospective of haplo-identical stem cell transplantation","volume":"10","author":"Handgretinger","year":"2008","journal-title":"Cytotherapy"},{"key":"R25-4-20241211","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1111\/petr.12724","article-title":"Haploidentical transplantation in children with unmanipulated peripheral blood stem cell graft: the need to look beyond posttransplantation cyclophosphamide in younger children","volume":"20","author":"Jaiswal","year":"2016","journal-title":"Pediatr Transplant"},{"key":"R26-4-20241211","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.bbmt.2015.11.010","article-title":"Haploidentical peripheral blood stem cell transplantation with post-transplantation cyclophosphamide in children with advanced acute leukemia with fludarabine-, busulfan-, and melphalan-based conditioning","volume":"22","author":"Jaiswal","year":"2016","journal-title":"Biol Blood Marrow Transplant"},{"key":"R27-4-20241211","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1111\/petr.12658","article-title":"Haploidentical hematopoietic stem cell transplantation with post-transplant high-dose cyclophosphamide in high-risk children: a single-center study","volume":"20","author":"Yesilipek","year":"2016","journal-title":"Pediatr Transplant"},{"key":"R28-4-20241211","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.leukres.2013.12.012","article-title":"Mycophenolate mofetil vs. methotrexate for the prevention of graft-versus-host-disease \u2013 systematic review and meta-analysis","volume":"38","author":"Ram","year":"2014","journal-title":"Leuk Res"},{"key":"R29-4-20241211","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.bbmt.2009.10.007","article-title":"An age-dependent pharmacokinetic study of intravenous and oral mycophenolate mofetil in combination with tacrolimus for GVHD prophylaxis in pediatric allogeneic stem cell transplantation recipients","volume":"16","author":"Bhatia","year":"2010","journal-title":"Biol Blood Marrow Transplant"},{"key":"R30-4-20241211","doi-asserted-by":"crossref","first-page":"S374","DOI":"10.1016\/j.bbmt.2015.11.885","article-title":"GVHD prophylaxis with short course MTX and tacrolimus in HLA-haploidentical hematopoietic stem cell transplantation using post-transplant high dose cyclophosphamide","volume":"22","author":"Ohata","year":"2016","journal-title":"Biol Blood Marrow Transplant"},{"key":"R32-4-20241211","doi-asserted-by":"crossref","first-page":"490","DOI":"10.3345\/kjp.2013.56.11.490","article-title":"Evaluation of risk for graft-versus-host disease in children who receive less than the full doses of mini-dose methotrexate for graft-versus-host disease prophylaxis in allogeneic hematopoietic stem cell transplantation","volume":"56","author":"Yum","year":"2013","journal-title":"Korean J Pediatr"},{"key":"R33-4-20241211","first-page":"349","article-title":"Influence of post-methotrexate folinic acid rescue on regimen-related toxicity and graft-versus-host disease after allogeneic bone marrow transplantation","volume":"9","author":"Nevill","year":"1992","journal-title":"Bone Marrow Transplant"},{"key":"R34-4-20241211","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1002\/ajh.21630","article-title":"Reduced intensity conditioning regimen with fludarabine, busulfan, and low-dose TBI (Flu-BU2-TBI): clinical efficacy in high-risk patients","volume":"85","author":"Takahata","year":"2010","journal-title":"Am J Hematol"},{"key":"R35-4-20241211","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.bbmt.2009.11.017","article-title":"The addition of 400 cGY total body irradiation to a regimen incorporating once-daily intravenous busulfan, fludarabine, and antithymocyte globulin reduces relapse without affecting nonrelapse mortality in acute myelogenous leukemia","volume":"16","author":"Russell","year":"2010","journal-title":"Biol Blood Marrow Transplant"},{"key":"R36-4-20241211","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1002\/hon.985","article-title":"Higher busulfan dose intensity does not improve outcomes of patients undergoing allogeneic haematopoietic cell transplantation following fludarabine, busulfan-based reduced toxicity conditioning","volume":"29","author":"Hamadani","year":"2011","journal-title":"Hematol Oncol"},{"key":"R37-4-20241211","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1016\/j.bbmt.2007.03.003","article-title":"Allogeneic transplantation for adult acute leukemia in first and second remission with a novel regimen incorporating daily intravenous busulfan, fludarabine, 400 CGY total-body irradiation, and thymoglobulin","volume":"13","author":"Russell","year":"2007","journal-title":"Biol Blood Marrow Transplant"},{"key":"R38-4-20241211","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.bbmt.2016.11.016","article-title":"Nonmyeloablative haploidentical bone marrow transplantation with post-transplantation cyclophosphamide for pediatric and young adult patients with high-risk hematologic malignancies","volume":"23","author":"Klein","year":"2017","journal-title":"Biol Blood Marrow Transplant"}],"container-title":["Hematology\/Oncology and Stem Cell Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387620300418?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1658387620300418?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ovid.com\/10.1016\/j.hemonc.2020.01.003","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:26:33Z","timestamp":1786735593000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1016\/j.hemonc.2020.01.003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1016\/j.hemonc.2020.01.003","relation":{},"ISSN":["1658-3876"],"issn-type":[{"value":"1658-3876","type":"print"}],"subject":[],"published":{"date-parts":[[2020,10]]}}}