{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T15:50:45Z","timestamp":1784389845558,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"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":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cytokine release syndrome (CRS) is a frequent early complication of T cell\u2013replete peripheral blood haploidentical hematopoietic stem cell transplantation (PB\u2010haploHSCT), particularly in pediatric recipients. Post\u2010transplant cyclophosphamide (PTCy) is the standard for graft\u2010versus\u2010host disease (GVHD) prophylaxis, but the role of early cyclosporine initiation in this setting remains underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 50 pediatric patients with hematolymphoid malignancies who underwent PB\u2010haploHSCT with uniform myeloablative conditioning between 2017 and 2024. GVHD prophylaxis included PTCy and cyclosporine initiated on Day \u22122. CRS was graded according to ASTCT criteria. Survival and relapse outcomes were estimated using Kaplan\u2013Meier and competing risk analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At a median follow\u2010up of 28\u2009months, 68% of patients developed only Grade I CRS, with no cases of Grade\u2009\u2265\u2009II. The 2\u2010year overall survival (OS), relapse\u2010free survival (RFS), and GVHD\u2010free, relapse\u2010free survival (GRFS) were 72.1%, 65.5%, and 55.4%, respectively. The 2\u2010year transplant\u2010related mortality (TRM) was 6.0%. The cumulative incidence of grade III\u2013IV acute GVHD was 14.1%, while moderate\u2010to\u2010severe chronic GVHD occurred in 6.8%. Although CRS was not associated with inferior survival, it was linked to a lower relapse incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Early cyclosporine initiation before PTCy in pediatric PB\u2010haploHSCT appears feasible and may attenuate CRS without increasing GVHD or relapse risk. These findings support further prospective studies to validate early calcineurin inhibitor strategies in pediatric transplant protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/petr.70220","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T04:09:36Z","timestamp":1762229376000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Early Cyclosporine on Cytokine Release Syndrome and Outcomes in Pediatric Haploidentical Hematopoietic Stem Cell Transplantation"],"prefix":"10.1111","volume":"29","author":[{"given":"Veerendra C.","family":"Patil","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Pediatric Haematology Oncology Basavatarakam Indo\u2010American Cancer hospital and Research Institute  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddhartha Reddy","family":"Dodda","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Pediatric Haematology Oncology Basavatarakam Indo\u2010American Cancer hospital and Research Institute  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavan Kumar","family":"Boyella","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Basavatarakam Indo\u2010American Cancer hospital and Research Institute  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan Kamlesh","family":"Tewani","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Basavatarakam Indo\u2010American Cancer hospital and Research Institute  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pallavi J.","family":"Ladda","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Basavatarakam Indo\u2010American Cancer hospital and Research Institute  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjana Alekhya","family":"Somayajula","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Pediatric Haematology Oncology Basavatarakam Indo\u2010American Cancer hospital and Research Institute  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. V. T.","family":"Krishnamohan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Basavatarakam Indo\u2010American Cancer hospital and Research Institute  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreeramakrishnaiah","family":"Sompalli","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Basavatarakam Indo\u2010American Cancer hospital and Research Institute  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shree Hasitha","family":"Koneru","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Pediatric Haematology Oncology Basavatarakam Indo\u2010American Cancer hospital and Research Institute  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senthil J.","family":"Rajappa","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Basavatarakam Indo\u2010American Cancer hospital and 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