Optimizing Haploidentical Donor Selection for Pediatric Hematopoietic Cell Transplant

作者：Nicole Liberio, Mariam Allbee-Johnson, Kwang Woo Ahn, Amy M. Moskop, Rachel Phelan, Bronwen E. Shaw, Kristin Page, Kirk R. Schultz, Christine L. Phillips, Parinda A. Mehta, Muna Qayed, Akshay Sharma, Amanda E. Lipsitt, Heather Jill Symons, Javier Bolaños-Meade, Sandhya Kharbanda, Christopher C. Dvorak, Neena Kapoor, Erin Doherty, Rishikesh S. Chavan, Larisa A. Broglie · 发表于：Journal of Clinical Oncology · 年份：2026 · DOI：10.1200/jco-25-01591 · 被引用次数：2 · 研究领域：Hematopoietic Stem Cell Transplantation、Acute Lymphoblastic Leukemia research、Immunodeficiency and Autoimmune Disorders

PURPOSE: Critical guidance on selecting haploidentical donors for pediatric patients is lacking. It is unclear whether parents, siblings, and extended family affect acute and chronic graft-versus-host disease (aGVHD and cGVHD) differently. METHODS: We analyzed 1,069 pediatric (<19 years) recipients of hematopoietic cell transplant during 2013-2019. Primary end points were aGVHD frequency at 100 days and cumulative incidence of cGVHD at 2 years, assessed by donor age (<18 years, 18-35, >35 years) and donor relationship, with multivariable analysis. RESULTS: < .0001). Age-relationship interaction: Maternal donors were associated with more GVHD than siblings, regardless of age (aGVHD II-IV, mothers >35 years, HR, 2.53 [95% CI, 1.46 to 4.41]; mothers 18-35 years, HR, 2.05 [95% CI, 1.14 to 3.69]) (cGVHD: mothers >35 years, HR, 3.10 [95% CI, 1.72 to 5.60]; mothers 18-35 years, HR, 3.35 [95% CI, 1.8 to 6.25]). CONCLUSION: Donors <18 years are associated with reduced aGVHD and cGVHD, whereas maternal donors are associated with increased cGVHD risk. For pediatric patients, sibling donors should be considered to reduce GVHD.