{
  "abstract": "Introduction: Donor age and relationship has emerged as a key modifiable variable in haploidentical hematopoietic cell transplantation, with younger and sibling donors associated with reduced non-relapse mortality and graft-versus-host disease in adult cohorts. Evidence specific to pediatric patients using a uniform post-transplant cyclophosphamide platform, particularly from middle-income countries, remains scarce. Objectives: Evaluate the impact of donor age and donor relationship on acute and chronic graft-versus-host disease, graft failure, relapse, event-free survival, and overall survival in a post-transplant cyclophosphamide pediatric haploidentical transplant cohort. COHORT: 142 consecutive pediatric recipients of haploidentical hematopoietic cell transplantation, all receiving post-transplant cyclophosphamide-based graft-versus-host disease (GVHD) prophylaxis at a single pediatric center in a high-middle-income country. Methods: Retrospective cohort study. Kaplan-Meier survival plots with log-rank test for group comparisons; cumulative incidence (CI) function for GVHD and graft failure. Multivariable Cox proportional hazards regression adjusted for donor relationship, donor age, cell source, patient sex, disease type (malignant vs. non-malignant), and donor lymphocyte infusion (DLI) for moderate-to-severe chronic GVHD. Primary cutoff: donor age ≤ 18 years (n = 31), 19-30 years (n = 70) and ≥ 31 years (n = 31); secondary cutoff: 1-10 years (n = 11), 11–18 years (n = 20), and > 18 gt; 18 years (n = 111). Results: No significant differences were found in overall survival (OS) (p = 0.86), event-free survival (EFS) (p = 0.47), relapse (p = 0.7), death (p = 0.9), or graft failure CI (p = 0.31) between donors in primary or secondary cutoff. MAGIC II-IV acute GVHD was significantly lower with sibling donors versus fathers, mothers, and Others (cousins and aunts) donors (23% vs. 43% vs. 45% vs. 62% at 1 year, p = 0,032). Moderate-to-severe chronic GVHD was significantly lower with Others vs. siblings, father and mother donors (0% vs. 19% vs. 22% vs. 51% at 1 year, p = 0,0059). Multivariate Cox Regression analysis revealed mother donors (HR 3.61, 95% CI 1.68–7.76, p = 0.001) and non-malignant disease (HR 0,24, 95% CI 0.08–0.75, p = 0.014) as significant predictors for moderate-to-severe chronic GVHD. Although not significant, we observed that donors 1-10 years had zero graft failures in 11 transplants vs. 3 failures in 20 transplants of the 11-18 years donor group (p = 0.054). Conclusions: In a pediatric haploidentical transplant cohort with uniform post-transplant cyclophosphamide, donor relationship was determinant for acute GVHD and chronic GVHD CI; mother donors were independently associated with augmented chronic GVHD, and non-malignant disease was independently associated with reduced chronic GVHD. There was no improvement nor decline in OS or EFS. Our results provide platform-specific pediatric evidence to guide donor selection where PTCY is standard of care.",
  "abstract_shown": true,
  "affiliations": [
    "Hospital do GRAACC, São Paulo, SP, Brazil",
    "Hospital do GRAACC, Vitória, ES, Brazil"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 24,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Luiza Dornelles Penteado PACHECO E SILVA"
    },
    {
      "affs": [
        1
      ],
      "name": "Ana Carolina Ribeiro CORREA"
    },
    {
      "affs": [
        0
      ],
      "name": "Aline Ferrari MARTINS"
    },
    {
      "affs": [
        0
      ],
      "name": "Ana Cláudia Ramos Donatelli BRONZONI"
    },
    {
      "affs": [
        0
      ],
      "name": "Laís Lima QUINTINO"
    },
    {
      "affs": [
        0
      ],
      "name": "Maria Gabriela Alves Dias MATOS"
    },
    {
      "affs": [
        0
      ],
      "name": "Luciana Dos Santos DOMINGUES"
    },
    {
      "affs": [
        0
      ],
      "name": "Valéria Cortez GINANI"
    },
    {
      "affs": [
        0
      ],
      "name": "Roseane Vasconcelos GOUVEIA"
    },
    {
      "affs": [
        0
      ],
      "name": "Raisa Machado AMARAL"
    },
    {
      "affs": [
        0
      ],
      "name": "Fernanda De Oliveira MOTA"
    },
    {
      "affs": [
        0
      ],
      "name": "Lahis Cardoso de CASTRO"
    },
    {
      "affs": [
        0
      ],
      "name": "Maria De Los Angeles Duran SALAS"
    },
    {
      "affs": [
        0
      ],
      "name": "Lucas Augusto Monetta da SILVA"
    },
    {
      "affs": [
        0
      ],
      "name": "Beatriz Vale FARKAS"
    },
    {
      "affs": [
        0
      ],
      "name": "Yohanna Bastani de MATTOS"
    },
    {
      "affs": [
        0
      ],
      "name": "Mayara Satsuki KUNII"
    },
    {
      "affs": [
        0
      ],
      "name": "Adriane Da Silva Santos IBANEZ"
    },
    {
      "affs": [
        0
      ],
      "name": "Cintia Monteiro LUSTOSA"
    },
    {
      "affs": [
        0
      ],
      "name": "Camilla Margarida Maria Soares de Sousa PARRODE"
    },
    {
      "affs": [
        0
      ],
      "name": "Vanessa Aparecida do Nascimento VARJAO"
    },
    {
      "affs": [
        0
      ],
      "name": "Olga Margareth Wanderley de Oliveira FéLIX"
    },
    {
      "affs": [
        0
      ],
      "name": "Cristiane Menezes Vitoria ALFERI"
    },
    {
      "affs": [
        0
      ],
      "name": "Adriana SEBER"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6w79ahegqr9vs.bib",
  "cited_by": 0,
  "doi": "10.1016/j.htct.2026.106853",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2531137926006000",
  "id": "6w79ahegqr9vs",
  "issns": [
    "2531-1379",
    "2531-1387"
  ],
  "landing_url": "https://doi.org/10.1016/j.htct.2026.106853",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC633-647.5"
    ],
    [
      "openalex",
      "2720|Hematopoietic Stem Cell Transplantation"
    ]
  ],
  "openalex": "W7223087714",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/6w79ahegqr9vs.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:43:35Z",
      "native_id": "a1adae23176a461b91014d32f085b420",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.htct.2026.106853"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC633-647.5",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "DETERMINANTS OF PEDIATRIC HAPLOIDENTICAL HEMATOPOIETIC CELL TRANSPLANTATION (HCT) WITH POST-TRANSPLANT CYCLOPHOSPHAMIDE (PT-CY): THE INFLUENCE OF DONOR CHARACTERISTICS",
  "title_text": "DETERMINANTS OF PEDIATRIC HAPLOIDENTICAL HEMATOPOIETIC CELL TRANSPLANTATION (HCT) WITH POST-TRANSPLANT CYCLOPHOSPHAMIDE (PT-CY): THE INFLUENCE OF DONOR CHARACTERISTICS",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:35Z",
  "url": "https://research.draconitic.com/paper/6w79ahegqr9vs",
  "venue": "Hematology, Transfusion and Cell Therapy",
  "versions": []
}