{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T16:04:47Z","timestamp":1767110687771,"version":"3.48.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>Hematopoietic stem cell transplant (HSCT) remains the cornerstone of treatment in patients with high-risk and relapsed acute myeloid leukemia (AML). In the absence of a fully matched donor, haploidentical HSCT is a feasible option. The aim of this study is to analyze the outcomes of pediatric AML patients, who underwent HSCT at our center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a retrospective analysis of 48 pediatric patients who underwent 50 transplants at our center from January 2014 to December 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Median age at transplant was 8.5 years, and the male-to-female ratio was 1.9:1. Of 48 children, 46 patients had de novo AML, and 2 had secondary AML. Twenty-nine patients underwent matched sibling donor (MSD), 3 underwent matched related donor (MRD) and the remaining 18 received haploidentical HSCT. All patients received Fludarabine-based conditioning regimens and engrafted. Incidence of acute graft versus host disease (GVHD) in matched donor and haploidentical HSCT was 21.8% and 44.4%, respectively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.09). Incidence of chronic GVHD was 3.1% in matched donor and 5.5% in haploidentical HSCT (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.72). Cumulative incidence of relapse was 16%. Viral reactivations were seen in 17 patients, cytomegalovirus (CMV) being the commonest. At a median follow-up of 40.9 months, EFS and OS of the overall cohort were 78% and 86%, respectively. Nonrelapse mortality (NRM) was 6%. EFS in matched donor and haploidentical HSCT was 78.1% versus 77.8% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.78). OS in matched donor and haploidentical HSCT was 84.4% versus 88.9% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.83). GVHD-free relapse-free survival (GRFS) was 58%. Among the factors analyzed, only pretransplant minimal residual disease (MRD) positivity was found to be associated with significantly poor outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>HSCT for children with AML from the developing world shows promising outcomes with high survival rates even in the absence of matched donors. Having expertise in multiple specialties, such as a molecular hematologist, infectious disease (ID), and intensive care specialist, can significantly enhance the outcomes for transplant patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/mph.0000000000003151","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T21:00:33Z","timestamp":1765227633000},"page":"18-23","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Excellent Outcomes of Hematopoietic Stem Cell Transplant for Pediatric High Risk and Relapsed Acute Myeloid Leukemia\u2013A Decade Long Experience From Developing Nation"],"prefix":"10.1097","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4531-6546","authenticated-orcid":false,"given":"Sunisha","family":"Arora","sequence":"first","affiliation":[{"name":"Departments of Pediatric Haematology-Oncology and BMT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun S.","family":"Danewa","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Haematology-Oncology and BMT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sohini","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Haematology-Oncology and BMT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swati","family":"Bhayana","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Haematology-Oncology and BMT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha R.","family":"Panda","sequence":"additional","affiliation":[{"name":"Fortis Memorial and Research Institute, Gurugram, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shrinidhi","family":"Nathany","sequence":"additional","affiliation":[{"name":"Fortis Memorial and Research Institute, Gurugram, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhur","family":"Arora","sequence":"additional","affiliation":[{"name":"Critical Care Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Kumar","sequence":"additional","affiliation":[{"name":"Hematology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anusha","family":"Swaminathan","sequence":"additional","affiliation":[{"name":"Hematology"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parminder P.","family":"Singh","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Haematology-Oncology and BMT"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Surbhi","family":"Pokhriyal","sequence":"additional","affiliation":[{"name":"Departments of Pediatric Haematology-Oncology and 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