Pediatric oncologist Dr. Rishikesh Chavan recently authored a study in the Journal of Clinical Oncology that details critical guidance on selecting donors for stem cell transplants in pediatric patients.
Dr. Chavan and his research colleagues found that having a donor 18 years old or younger was associated with lower levels of acute or chronic graft-versus-host disease (GVHD), and maternal donors were associated with higher levels of chronic GVHD.
Blood and marrow transplant (BMT) can cure leukemia, sickle cell disease, and other blood diseases. However, BMT can cause serious effects, such as GVHD.
Many children who need BMT don’t have a fully matched donor. A half-matched (haploidentical or haplo) donor can be a parent or sibling.
Study findings
Doctors wanted to know which haplo donors are least likely to cause GVHD. Dr. Chavan and his colleagues studied more than 1,000 children and teens, younger than 19, who received a haplo transplant. Everyone had a transplant in the U.S. during 2013-2019.
Some patients got acute GVHD, which typically occurs early, in the first three months after transplant. Others had chronic GVHD, which may happen later after transplant. GVHD sometimes affects the eyes, digestive system, genitals, lungs, mouth, and skin.
The donors’ age and relationship affected patients’ chances of getting GVHD. Younger donors were safer for patients.
Serious acute GVHD happened in:
- 10% of all patients
- 7% of patients with donors younger than 18
Chronic GVHD happened in:
- 23% of all patients
- 16% of patients with donors younger than 18
- 36% of patients whose mothers were their donors
When available, a sibling donor is associated with less GVHD than a parental donor.
Keep in mind
It’s important to protect children who are asked to donate cells.
Experts recommend:
- An independent doctor, not the patient’s doctor, should examine the child donor.
- This doctor should explain the how donation works and side effects.
Donating is usually safe, but children should understand the process and should feel comfortable.
This story was adapted from a summary of Dr. Chavan’s paper that was written by the Center for International Blood & Marrow Transplant Research (CIBMTR), a research collaboration between the Medical College of Wisconsin and the National Marrow Donor Program (NMDP).
CHOC Hospital was named one of the nation’s best children’s hospitals by U.S. News & World Report in its 2024-25 Best Children’s Hospitals rankings and ranked in the cancer specialty.
