{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:32:45Z","timestamp":1790195565430,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T00:00:00Z","timestamp":1650240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Post\u2010transplant graft\u2010versus\u2010leukemia (GVL) effect\u00a0has been shown to be an important\u00a0determinant of a successful outcome following hematopoietic stem cell transplantation (HSCT) in children with acute leukemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and\u00a0Methods<\/jats:title><jats:p>We performed a retrospective analysis of the children\u00a0up to 18\u00a0years of age\u00a0with acute leukemia who underwent HSCT between November 2002 and November 2018.\u00a0GVL induction strategies included whole blood donor lymphocyte infusions (DLI) and\/or lenalidomide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 134 children\u00a0were included with engraftment in\u00a0125 children (93%). Acute\u00a0graft\u2010versus\u2010host disease (GVHD)\u00a0was documented in 85 (63%) children without any induction strategies. GVL induction strategies were employed in 19 children (14%); DLI (<jats:italic>n<\/jats:italic>\u00a0=\u00a012), Lenalidomide (<jats:italic>n<\/jats:italic>\u00a0=\u00a02), DLI\u00a0+\u00a0lenalidomide (<jats:italic>n<\/jats:italic>\u00a0=\u00a05). Among the 19, 12 children (63%) are alive without relapse;\u00a06 children died of relapse (31%). Among the 6 who died of relapse despite induction strategies, 5\/6\u00a0had ALL and one child had AML. GVL induction was effective in preventing relapse in 7\/12 (58%) children with ALL and 5\/6 (83%) children with AML. Relapse\u2010free survival in the cohort is 73\/134 (55%) with a median follow\u2010up of 32\u00a0months.\u00a0GVHD of any grade was significantly associated with a lower risk of relapse (<jats:italic>p\u00a0<\/jats:italic>=\u00a0.008). Median survival time was 160.3\u00a0days (range 132\u2013187) in those with chronic GVHD versus 88.3\u00a0days (range 68\u2013107) in those without\u00a0(<jats:italic>p<\/jats:italic> value\u00a0=\u00a0.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pre\u2010emptive whole\u00a0blood DLIs\u00a0in graded aliquots, and\u00a0lenalidomide\u00a0are important tools for post HSCT GVL induction, which significantly impacts relapse\u2010free survival in childhood leukemia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14293","type":"journal-article","created":{"date-parts":[[2022,4,19]],"date-time":"2022-04-19T05:49:06Z","timestamp":1650347346000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Post\u2010transplant strategies to improve relapse\u2010free survival in childhood leukemia: Whole blood donor lymphocyte infusions and lenalidomide for inducing graft\u2010versus\u2010leukemia effect"],"prefix":"10.1111","volume":"26","author":[{"given":"Rumesh","family":"Chandar","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation Apollo Hospitals  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satishkumar","family":"Meena","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation Apollo Hospitals  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0991-3493","authenticated-orcid":false,"given":"Harika","family":"Varla","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation Apollo Hospitals  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balasubramaniam","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Apollo Hospitals  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkateswaran","family":"Vellaichamy Swaminathan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation Apollo Hospitals  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5771-8214","authenticated-orcid":false,"given":"Ramya","family":"Uppuluri","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation Apollo Hospitals  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Revathi","family":"Raj","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology, Blood and Marrow Transplantation Apollo Hospitals  Chennai India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/OTT.S78567"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.v98.6.1982"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cac2.12014"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41423\u2010021\u201000640\u20109"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.28.8852"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.666091"},{"issue":"6","key":"e_1_2_12_8_1","first-page":"825","article-title":"1994 Consensus conference on acute GVHD grading","volume":"15","author":"Przepiorka D","year":"1995","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2014.12.001"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2018027003"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.01217"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.05.007"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2010.08.023"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102017\u201005\u2010780668"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409\u2010019\u20100580\u20107"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102005\u201010\u20104184"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/265840"}],"container-title":["Pediatric Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.14293","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/petr.14293","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/petr.14293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,6]],"date-time":"2024-09-06T12:59:02Z","timestamp":1725627542000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/petr.14293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,18]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1111\/petr.14293"],"URL":"https:\/\/doi.org\/10.1111\/petr.14293","archive":["Portico"],"relation":{},"ISSN":["1397-3142","1399-3046"],"issn-type":[{"value":"1397-3142","type":"print"},{"value":"1399-3046","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,18]]},"assertion":[{"value":"2021-09-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14293"}}