{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T19:58:48Z","timestamp":1788551928952,"version":"build-2803163510"},"reference-count":51,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Haploidentical hematopoietic cell transplantations (haplo-HCTs) with post-transplant cyclophosphamide (PT-Cy) are standard practice, but complications causing morbidity and mortality are not well described. Methods: The aim of this prospective non-interventional multicenter study was to document frequency of potential non-infectious and infection-related complications and main transplant outcomes after the first unmanipulated haplo-HCT with PT-Cy between 2017 and 2019 in 129 adult patients with hematological malignancies. The median follow-up was 37.3 months [95% CI: 34.3\u201339.7]. Results: The cumulative incidence (CI) of acute graft versus host disease (aGvHD) at day +100 was 22.4% grade II-IV [95% CI: 15.5\u201330.1] and 8.8% grade III-IV [95% CI: 4.6\u201314.6], respectively. The cumulative incidence of chronic GvHD (cGvHD) at 24 months was 25.8% [95% CI: 18.5\u201333.6]; extensive cGvHD was 10.9% [95% CI: 6.3\u201317.1], respectively. The most frequent non-infectious complications for the whole study population were mucositis\u201437.5% (n = 48); renal insufficiency\u201418% (n = 23); and cardiovascular complications\u201410.9% (n = 14). The following infection-related complications were diagnosed: bacterial in 84 (65.1%), viral in 66 (51.6%), and fungal in 24 (18.6%) recipients. Two-year OS was 58.1% [95% CI: 50.2\u201367.3]; NRM\u201427.1% [95% CI: 19.7\u201335]; PFS\u201450.4% [95% CI: 42.5\u201359.8]; and GRFS\u201438.8% [95% CI: 31.2\u201348.1]. About 50% of all deaths were directly caused by infection or infection-related conditions. Conclusions: Disease remission status at transplant significantly affected PFS, chronic GvHD, and GRFS. Although clinical applications of haplo-HCT with PTCy are widespread, the study confirms the need to reduce infection-related mortality after this type of GvHD prophylaxis.<\/jats:p>","DOI":"10.3390\/cancers17244029","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T09:15:21Z","timestamp":1766049321000},"page":"4029","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Complications of Haploidentical Hematopoietic Cell Transplantation with Post-Transplant Cyclophosphamide\u2014A Prospective Study on Behalf of the EBMT Transplant Complications Working Party"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5485-3680","authenticated-orcid":false,"given":"Agnieszka","family":"Tomaszewska","sequence":"first","affiliation":[{"name":"Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3858-8180","authenticated-orcid":false,"given":"Grzegorz W.","family":"Basak","sequence":"additional","affiliation":[{"name":"Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Peczynski","sequence":"additional","affiliation":[{"name":"EBMT Paris Study Unit, Department of Haematology, Saint Antoine Hospital, INSERM UMR-S 938, Sorbonne University, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle","family":"Polge","sequence":"additional","affiliation":[{"name":"EBMT Paris Study Unit, Department of Haematology, Saint Antoine Hospital, INSERM UMR-S 938, Sorbonne University, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3919-517X","authenticated-orcid":false,"given":"Pascale","family":"Ambron","sequence":"additional","affiliation":[{"name":"EBMT Paris Study Unit, Department of Haematology, Saint Antoine Hospital, INSERM UMR-S 938, Sorbonne University, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9739-0816","authenticated-orcid":false,"given":"William","family":"Boreland","sequence":"additional","affiliation":[{"name":"EBMT Paris Study Unit, Department of Haematology, Saint Antoine Hospital, INSERM UMR-S 938, Sorbonne University, 75012 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2426-3465","authenticated-orcid":false,"given":"Simona","family":"Sica","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Radiologiche ed Ematologiche, Universita Cattolica S. Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2039-8557","authenticated-orcid":false,"given":"Mutlu","family":"Arat","sequence":"additional","affiliation":[{"name":"Department of Hematology and Transplantation, \u015ei\u015fli Memorial Hospital, 34384 Istanbul, T\u00fcrkiye"},{"name":"Faculty of Medicine, Bah\u00e7e\u015fehir University, 34734 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Passweg","sequence":"additional","affiliation":[{"name":"University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Luis Lopez","family":"Lorenzo","sequence":"additional","affiliation":[{"name":"Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2053-3384","authenticated-orcid":false,"given":"Urpu","family":"Salmenniemi","sequence":"additional","affiliation":[{"name":"HUS Comprehensive Cancer Center, 00029 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8415-7069","authenticated-orcid":false,"given":"Pavel","family":"Jindra","sequence":"additional","affiliation":[{"name":"Charles University Hospital, 32300 Pilsen, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9589-4136","authenticated-orcid":false,"given":"Alexander","family":"Kulagin","sequence":"additional","affiliation":[{"name":"RM Gorbacheva Research Institute, Pavlov University, 197022 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5143-4042","authenticated-orcid":false,"given":"Rodrigo Martino","family":"Bufarull","sequence":"additional","affiliation":[{"name":"Hospital Santa Creu i Sant Pau, 08025 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Eder","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hemostasis, Oncology, and Stem Cell Transplantation, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed-Amine","family":"Bekadja","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Ahmed Benbella-1 University, 31000 Oran, Algeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4088-036X","authenticated-orcid":false,"given":"Alberto","family":"Mussetti","sequence":"additional","affiliation":[{"name":"Institut Catal\u00e1 d\u2019Oncologia, Hospital Duran i Reynals, 199203 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte E.","family":"Graham","sequence":"additional","affiliation":[{"name":"Comprehensive Cancer Centre, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7568-8239","authenticated-orcid":false,"given":"H\u00e9l\u00e8ne","family":"Schoemans","sequence":"additional","affiliation":[{"name":"University Hospital Gasthuisberg, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf","family":"Penack","sequence":"additional","affiliation":[{"name":"Charit\u00e9-CVK, University Medicine Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Moiseev","sequence":"additional","affiliation":[{"name":"RM Gorbacheva Research Institute, Pavlov University, 197022 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zinaida","family":"Peri\u0107","sequence":"additional","affiliation":[{"name":"University Hospital Centre Rijeka and School of Medicine, University of Rijeka, 51000 Rijeka, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1200\/JCO.2012.44.3523","article-title":"T-Cell\u2013Replete HLA-Haploidentical Hematopoietic Transplantation for Hematologic Malignancies Using Post-Transplantation Cyclophosphamide Results in Outcomes Equivalent to Those of Contemporaneous HLA-Matched Related and Unrelated Donor Transplantation","volume":"31","author":"Bashey","year":"2013","journal-title":"J. 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