Transplantation and Cellular Therapy最新文献

{"title":"Mortality is increased in those with a ≥10% reduction in spirometry following allogeneic hematopoietic stem cell transplant: a retrospective 5-year follow-up study from a single transplant service.","authors":"Cassandra S Thompson, Megan Hogg, Jonathon Lennon, Yang Song, Catherine Farrow, David Gottlieb, Peter G Middleton","doi":"10.1016/j.jtct.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.jtct.2025.03.019","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary graft versus host disease is a common and serious complication of haematopoietic stem cell transplant (HSCT). Early diagnosis is essential for rapid treatment before irreversible changes in lung function occur. The NIH support that a decline in forced expiratory volume in 1 second (FEV<sub>1</sub>) of ≥10% from baseline values require further investigation and close monitoring post HSCT-transplant. Previous research demonstrates that a 10-19% and ≥20% reduction in FEV<sub>1</sub>, within 6 months of transplant, is associated with higher odds of 1-mortality; however, to the authors' knowledge, there is no long-term follow-up data of FEV<sub>1</sub> decline with an onset after the first 6-month period.</p><p><strong>Objectives: </strong>We aimed to investigate the clinical significance of a ≥10% decrement in FEV<sub>1</sub> measured by spirometry for predicting all-cause mortality in HSCT recipients, over a period of 5-years. A comparison was made to patients who met the NIH diagnostic criteria for lung GvHD.</p><p><strong>Study design: </strong>Long-term follow-up data of patients who received an allogeneic HSCT at Westmead was retrospectively audited, using a censoring period of 5-years. A decrease in lung function was defined as a change in FEV<sub>1</sub> by ≥10% from their best value, usually at the beginning of the transplant process. Recovery was defined as a ≥10% increase in FEV<sub>1</sub>, from the patient's maximum decline in lung function. A diagnosis of lung GvHD was made when the following criteria were met: FEV1/FVC ratio of < 0.7, and an FEV1 <75% of predicted normal with ≥10% reduction over less than two years and evidence of gas trapping.</p><p><strong>Results: </strong>Data from 364 patients who underwent an allogeneic HSCT between 2013 and 2019 were analysed; 173 patients (47.7%) experienced a ≥10% reduction in FEV<sub>1</sub> after transplant. Ninety-five patients experienced an FEV<sub>1</sub> decline lasting <6 months and were likely to recover over half their lost lung function (median % FEV recovered = 68.7%). Seventy-eight patients experienced an FEV<sub>1</sub> decline lasting >6 months and were unlikely to recover any lost lung function (median % FEV recovered = 0%). There was a significant relationship between ≥10% FEV<sub>1</sub> decline and death, X<sup>2</sup>(1, 364) = 15.67, p <0.001. All-cause mortality was doubled in those who experienced ≥10% FEV<sub>1</sub> decline (34%), compared with those without any decline (16%). Mortality was highest in those who experienced decline without any recovery (OR = 2.98 [1.64-5.41]). However, in the group who had a decline and then later recovered mortality was still elevated (OR = 2.08 [1.17-3.69]) compared with those who did not experience any FEV<sub>1</sub> decline ≥10%.</p><p><strong>Conclusion: </strong>Mortality risk is elevated from the first ≥10% reduction in FEV<sub>1</sub> and remains elevated even if FEV<sub>1</sub> recovery","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Structured Peer Support Intervention for Patients with Hematologic Malignancies Undergoing Hematopoietic Stem Cell Transplantation: Peer Support Interventionists' Perspectives.","authors":"Michelle Guo, Emma P Keane, Michael Baliousis, Lisa M Gudenkauf, Manfred N Mate-Kole, Annabella C Boardman, Isabella S Larizza, M Tim Song, Emma D Wolfe, Daniel A Schaefer, Corey Cutler, Heather S Jim, Stephanie J Lee, Areej El-Jawahri, Hermioni L Amonoo","doi":"10.1016/j.jtct.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.jtct.2025.03.017","url":null,"abstract":"<p><strong>Background: </strong>Peer support is emerging as an important component of supportive care for patients with hematologic malignancies, but it has not been robustly implemented in patients undergoing hematopoietic stem cell transplantation (HSCT).</p><p><strong>Objectives: </strong>This qualitative study aimed to explore the experiences of peer support interventionists (participants) delivering a structured, five-session, phone-delivered peer support intervention, the Supporting Transplant Experiences with Peer Program (STEPP) for patients undergoing HSCT.</p><p><strong>Methods: </strong>Adult patients who underwent allogeneic or autologous HSCT for the treatment of a hematologic malignancy within the past three years were eligible to volunteer in this study as trained STEPP participants. Semi-structured qualitative interviews were conducted to explore participants' experiences, including their motivations for volunteering, reflections on intervention delivery and on the impact of peer support, and challenges faced while serving in this role. Interviews were deductively analyzed by two coders using framework-guided rapid analysis.</p><p><strong>Results: </strong>Twenty STEPP interventionists participated in this study. Participants were 65% men, with a median age of 63.5 years. 75% had undergone allogeneic HSCT. Emerging themes from the qualitative interviews highlighted that participants were motivated to serve as interventionists by a sense of gratitude for their transplant care and a desire to share their transplant experiences with others. The impact of the STEPP intervention on interventionists included opportunities to process their transplant journey while also providing support to their peers. Interventionists reported a preference for free-flowing conversations, which were still guided by the structured manual. Challenges included terminating the interventionist-patient relationship at the conclusion of STEPP.</p><p><strong>Conclusion: </strong>Peer support interventions for patients undergoing HSCT have the potential to enhance well-being and provide meaning for both patients preparing to undergo HSCT and HSCT survivors who serve as interventionists. Large-scale randomized clinical trials are needed to test the efficacy of peer support interventions for improving health-related outcomes among patients undergoing HSCT and HSCT survivors serving as interventionists for these interventions.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to Quality of Life and Prognostic Awareness in Caregivers of Patients Receiving Chimeric Antigen Receptor T-Cell Therapy Transplantation and Cellular Therapy, 30 (2024) 452 - 453.","authors":"Anna Barata, Tejaswini Dhawale, Richard A Newcomb, Hermioni L Amonoo, Ashley M Nelson, Daniel Yang, Kyle Karpinski, Katherine Holmbeck, Emelia Farnam, Matt Frigault, P Connor Johnson, Areej El-Jawahri","doi":"10.1016/j.jtct.2025.03.002","DOIUrl":"10.1016/j.jtct.2025.03.002","url":null,"abstract":"","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Melphalan Exposure Increases the Risk of Graft-versus-Host Disease in Pediatric Patients Undergoing Alpha-Beta T-Cell Depleted Haploidentical Transplantation.","authors":"Christopher C Dvorak, Soohee Cho, Gabriel Salinas Cisneros, Christine S Higham, Julia Chu, Lena E Winestone, William C Temple, Sandhya Kharbanda, Kristin A Shimano, Serine Avagyan, Philip T Pauerstein, James N Huang, Geoffrey Cheng, Nahal Lalefar, Paibel Aguayo-Hiraldo, Ron J Keizer, Michael A Pulsipher, Janel R Long-Boyle","doi":"10.1016/j.jtct.2025.03.020","DOIUrl":"https://doi.org/10.1016/j.jtct.2025.03.020","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Melphalan is often used as the backbone agent for conditioning prior to A/B-T-cell depleted (A/B-TCD) hematopoietic cell transplant (HCT) due to lower rates of organ toxicity compared to busulfan or total-body irradiation, albeit with significant mucosal injury. Traditional dosing based on body-surface-area (BSA) may result in non-optimal melphalan exposure among certain patient subsets.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;As mucosal injury is linked to initiation of alloreactivity, we hypothesized that high exposure of melphalan predicted via a pharmacokinetic (PK) model would be associated with an increased risk of acute graft-versus-host disease (aGVHD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;We performed an analysis of 85 patients who underwent A/B-TCD haploidentical HCT on two prospective trials using melphalan-based conditioning for treatment of malignancy at three centers from 2015-2024. Most patients (61.2%) received a total dose of melphalan at 140 mg/m&lt;sup&gt;2&lt;/sup&gt; using actual body weight; others received a dose adjusted for obesity or age &lt;2 years. We analyzed outcomes based on whether melphalan exposure was above or below the median exposure for the group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The 100-day cumulative incidences of engraftment syndrome (ES), grade II-IV aGVHD, and grade III-IV aGVHD were 34.2%, 24.8%, and 17.1%, respectively. The 3-year cumulative incidence of chronic GVHD (cGVHD), non-relapse mortality (NRM), and relapse were 17.5%, 8.7%, 21.8%, respectively. The 3-year cumulative incidence of disease-free survival (DFS) and severe GVHD-relapse-free survival (GRFS) were 71.4% and 55.6%, respectively. ES was significantly associated with the subsequent development of aGVHD, both grade II-IV (41.4% vs. 17.3% in those with and without ES, p=0.01) and grade III-IV (34.5% vs. 8.5% in those with and without ES; p=0.003). Chronic GVHD occurred at significantly higher rates in patients with prior Grade II-IV (66.7% vs. 0% for Grade 0-I; p&lt;0.001) and Grade III-IV aGVHD (75% vs. 4.3% for Grade 0-II; p&lt;0.001). Compared to non-obese patients, the PK model predicted lower melphalan exposure (p=0.02) in obese patients where adjusted ideal body weight was utilized, suggesting overcorrection of the dose. There was no impact of melphalan exposure on immunologic rejection. The median melphalan exposure was 6.81 mg*hr/L (range, 4.4-8.8). Compared to a melphalan exposure ≤6.8 mg*hr/L, a melphalan exposure &gt;6.8 mg*hr/L was associated with a higher incidence of ES (48.8% vs. 19.1%; p=0.005), grade II-IV aGVHD (39.3% vs. 10.1%; p=0.002), and grade III-IV aGVHD (31.5% vs. 2.5%; p&lt;0.001). The 3-year incidence of cGVHD was 27.2% in those with high predicted melphalan exposure compared to 7.4% for low exposure (p=0.03); with no difference in 3-year NRM incidence (9.2% vs. 7.7%; p=0.82) or 3-year relapse incidence (16.8% vs. 27.6%; p=0.31) for high compared to low exposure. However, GRFS was significantly worse in patients ","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simple, rapid, reproducible and biomarker-validated clinical grading system for murine models of xenogeneic graft-versus-host disease.","authors":"Allan Thiolat, Cécile Pivert, Romane Bariseel, Frédéric Charlotte, Christine Sedlik, Eliane Piaggio, Sébastien Maury, Mathieu Leclerc, Jimena Tosello, José L Cohen, Caroline Pilon","doi":"10.1016/j.jtct.2025.03.015","DOIUrl":"https://doi.org/10.1016/j.jtct.2025.03.015","url":null,"abstract":"<p><p>Experiment models of xenogeneic graft-versus-host disease (xeno-GVHD), in which human immune cells are injected into immunodeficient mice, are increasingly used to study human immune cell behavior in vivo and to test therapeutic approaches. Today, the main, and more commonly accepted clinical parameters used to characterize xeno-GVHD are weight loss and mortality. These criteria do not provide an accurate and subtle assessment of the disease intensity, nor do they reflect the great variability of xeno-GVHD, which depends on the donor. Relying on previous work in which we described an original clinical grading system for assessing GVHD in mice, we propose an adaptation of this system for xeno-GVHD models. This simple, solid, and reproducible scoring system of xeno-GVHD is constituted of the binary (yes or no) evaluation of four easy-to-evaluate parameters that reflect the complexity of the disease without the need to sacrifice the mice. This scoring system is consistent with the gold standard histological grading of human GVHD and with numerous biomarkers characteristic of the disease. We propose this new clinical grading system to evaluate and compare the results obtained with a common tool, regardless of the experimenters and laboratories where the experiments would have been carried out and whatever the therapeutic strategy evaluated.</p><p><strong>Background: </strong>Experiment models of xenogeneic graft-versus-host disease (xeno-GVHD), in which human immune cells are injected into immunodeficient mice, are increasingly used to study human immune cell behavior in vivo and to test therapeutic approaches. Today, the main, and more commonly accepted clinical parameters used to characterize xeno-GVHD are weight loss and mortality. These criteria do not provide an accurate and subtle assessment of the disease intensity, nor do they reflect the great variability of xeno-GVHD, which depends on the donor.</p><p><strong>Objective: </strong>Relying on previous work in which we described an original clinical grading system for assessing GVHD in mice, we propose an adaptation of this system for xeno-GVHD models.</p><p><strong>Study design: </strong>This simple, solid, and reproducible scoring system of xeno-GVHD is constituted of the binary (yes or no) evaluation of four easy-to-evaluate parameters that reflect the complexity of the disease without the need to sacrifice the mice.</p><p><strong>Results: </strong>This scoring system is consistent with the gold standard histological grading of human GVHD and with numerous biomarkers characteristic of the disease.</p><p><strong>Conclusion: </strong>We propose this new clinical grading system to evaluate and compare the results obtained with a common tool, regardless of the experimenters and laboratories where the experiments would have been carried out and whatever the therapeutic strategy evaluated.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academic Writing: Who is the Audience and What is the Message?","authors":"Daniel Weisdorf","doi":"10.1016/j.jtct.2025.03.003","DOIUrl":"10.1016/j.jtct.2025.03.003","url":null,"abstract":"","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 4","pages":"Pages 187-189"},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged Neurologic Symptoms After CAR T Cell Therapy – What Is It?","authors":"Michael D. Jain","doi":"10.1016/j.jtct.2025.03.004","DOIUrl":"10.1016/j.jtct.2025.03.004","url":null,"abstract":"","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 4","pages":"Pages 190-191"},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Officers and Directors of ASTCT","authors":"","doi":"10.1016/S2666-6367(25)01072-3","DOIUrl":"10.1016/S2666-6367(25)01072-3","url":null,"abstract":"","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 4","pages":"Page A3"},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Masthead (Purpose and Scope)","authors":"","doi":"10.1016/S2666-6367(25)01070-X","DOIUrl":"10.1016/S2666-6367(25)01070-X","url":null,"abstract":"","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 4","pages":"Page A1"},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Melt the IKAROS Wings?","authors":"Sebastian Giebel","doi":"10.1016/j.jtct.2025.03.005","DOIUrl":"10.1016/j.jtct.2025.03.005","url":null,"abstract":"","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 4","pages":"Pages 192-193"},"PeriodicalIF":3.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}