Supportive care
Before and after transplantation, all children receivedPneumocystis pneumonia and antifungal prophylaxis according to institutional guidelines. Irradiated blood products were used for transfusion support. Together with the CloEC, all patients received dexamethasone, both as antiemetic prophylaxis and as prophylaxis for cytokine release syndrome. No antibacterial prophylaxis was given, although an aggressive empirical treatment of febrile neutropenia episodes was mandatory. After transplantation, the patients were screened at least weekly for CMV, AdV, and EBV. If viral DNA was detected, the number virus copies was monitored, and appropriate antiviral treatment was started when indicated. All patients with IgG specific for varicella-zoster or herpes simplex viruses received prophylactic acyclovir according to institutional guidelines. Defibrotide was not used as VOD prophylaxis. Human granulocyte colony-stimulating factor was not used to enhance neutrophil recovery after transplantation.