Transplantation and Cellular Therapy最新文献

{"title":"Corrigendum to 'Clinical Practice Recommendations for Hematopoietic Cell Transplantation.' Transplant Cell Ther. 2024 Sep;30(9):832-843.","authors":"Madiha Iqbal, Ambuj Kumar, Peter Dreger, Julio Chavez, Craig S Sauter, Anna M Sureda, Veronika Bachanova, Richard T Maziarz, Martin Dreyling, Sonali M Smith, Caron Jacobson, Bertram Glass, Carla Casulo, Olalekan O Oluwole, Silvia Montoto, Ranjana Advani, Jonathon Cohen, Gilles Salles, Nada Hamad, John Kuruvilla, Brad S Kahl, Mazyar Shadman, Abraham S Kanate, Lihua Elizabeth Budde, Manali Kamdar, Christopher Flowers, Mehdi Hamadani, Mohamed A Kharfan-Dabaja","doi":"10.1016/j.jtct.2025.05.022","DOIUrl":"https://doi.org/10.1016/j.jtct.2025.05.022","url":null,"abstract":"","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486002","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":"The Caregiver Paradigm in Hematopoietic Cell Transplant: Current and Future Directions.","authors":"Ben Tweeten, Jill Randall, Anna Barata, Nandita Khera, Melody A Griffith, Anna M DeSalvo, Katie Schoeppner, Jaime M Preussler","doi":"10.1016/j.jtct.2025.06.022","DOIUrl":"10.1016/j.jtct.2025.06.022","url":null,"abstract":"<p><p>Many transplant centers (TCs) require a patient to have a caregiver 24 hours a day, 7 days a week for a minimum timeframe to proceed with an allogeneic hematopoietic cell transplant (alloHCT). However, this requirement varies across TCs, with timing of requirements varying from no requirements up to 180 days, and there is inconclusive evidence to support the need for this requirement. The current caregiver requirement paradigm can limit access for many patients, besides causing significant physical, emotional, and financial burden on caregivers. This article reviews literature on the current alloHCT caregiver paradigm and identifies barriers to change. Lastly, it highlights alternative caregiving models that are currently being implemented, as well as opportunities for future directions to improve access, including the need for research on interventions such as remote monitoring, community partnerships, policy changes, and enhanced screening. There is a need for evidence-based patient-centered care models to transform the caregiver paradigm to ensure that all patients can receive the treatment they need, irrespective of whether they have a caregiver. The future of post-alloHCT care demands a shift towards patient-centered, flexible caregiving models that accommodate the diverse needs and circumstances of patients. Such evidence-based changes in the paradigm can help improve access to, and outcomes of, alloHCT.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369251","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":"Assessing Physical Function in Transplantation and CAR-T Recipients: Expert Recommendations from the Survivorship, Aging and Biobehavioral Special Interest Groups of ASTCT.","authors":"Shatha Farhan, Vanessa E Kennedy, Manuel R Espinoza-Gutarra, Hannah Lust, Maria Silvina Odstrcil Bobillo, Adam Yuh Lin, Rebecca L Olin, Richard J Lin, Kelly E Rentscher, Mallory R Taylor, Lathika Mohanraj, William A Wood, Hemant S Murthy, Nuasheen Ahmed, Amylou C Dueck, Rachel Phelan, Debra Lynch Kelly, Carrie Yuen, Pashna N Munshi, Hélène Schoemans, Betty K Hamilton, Catherine Lee, Anthony D Sung","doi":"10.1016/j.jtct.2025.06.017","DOIUrl":"10.1016/j.jtct.2025.06.017","url":null,"abstract":"<p><p>The past few decades have witnessed significant advancements in stem cell transplant and cell therapy (TCT). This allowed their expanded use in older patients and those with comorbidities with favorable outcomes. However, these procedures carry significant risks, such as graft-versus-host disease, infection, cytokine release syndrome, and immune effector cell-associated neurotoxicity. Therefore, physical function assessment is crucial to assess patient fitness and potential optimization before and after TCT. The existence of diverse assessment tools makes implementation, comparison, and sharing knowledge among centers difficult. This paper proposes a tiered approach aiming to harmonize physical assessment in TCT. This allows healthcare facilities to prioritize recommended assessments based on their current capabilities and resources. TCT patients should receive comprehensive physical assessment pre- and post-TCT using a combination of both patient-reported and objective measures. For patient-reported measures, the Patient-Reported Outcomes Measurement Information System can be considered. For objective measures, we recommend considering a physical performance assessment (e.g., gait speed) or muscle strength assessment (e.g., hand grip), if feasible. Albumin and C reactive protein are also informative in predicting the risk of non-relapse mortality. Other composite tools, questionnaire libraries, biomarkers, imaging, and wearables can be added according to research and clinic needs. A care workflow needs to be in place in case any impairment is found during the evaluation with goals of increasing physiology reserve and mitigating stressors. This tiered approach will increase awareness and adoption of these tools and hence improve patient care, facilitate data sharing, and enhance collaboration in this field.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369250","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":"Inflammatory markers and microbiome dysbiosis in hematopoietic cell transplant recipients with lung graft-versus-host disease.","authors":"Victoria Brehm, Ziyi Wang, Luis Rocha, Breanna Jones, Robert R Jenq, Chia-Chi Chang, Guang-Shing Cheng, Joe Hsu, Husham Sharifi, Gregory Yanik, Luis Luna, Anum Waqar, Jhankruti Zaveri, Burton F Dickey, Lara Bashoura, Elizabeth J Shpall, Matt Zinter, David O'Dwyer, Richard E Champlin, George Chen, Amin Alousi, Sophie Paczesny, Christine B Peterson, Ajay Sheshadri","doi":"10.1016/j.jtct.2025.06.020","DOIUrl":"10.1016/j.jtct.2025.06.020","url":null,"abstract":"<p><p>Bronchiolitis obliterans (BOS) is a manifestation of pulmonary chronic graft versus host disease (cGVHD) and is a devastating complication of allogenic hematopoietic stem cell transplantation (HCT). Early detection and treatment of BOS may improve outcomes, but biomarkers which accurately identify BOS early are lacking. We aimed to determine whether certain validated cGVHD markers could also accurately diagnose BOS as compared to patients without BOS and with or without extrapulmonary cGVHD. In addition, we sought to determine whether dysbiosis of gut or oral microbiomes was associated with BOS or with inflammatory biomarkers. We enrolled 43 allogenic HCT recipients, of whom 16 had BOS. For each patient, we obtained pulmonary function tests, measured the levels of nine serum biomarkers utilizing enzyme linked immunosorbent assays, and analyzed both the oral and gut microbiome using microbial DNA amplification and sequencing. We compared biomarker levels to lung function, both at baseline and over time, as well as to microbiome diversity. Higher IL1RL1 (p = 0.002) and IL-17 (p = 0.041) at enrollment were negatively correlated with FEV1% lung function over time. Increases in IL1RL1 (p = 0.035), IL-17 (p = 0.009), and WFDC2 (p = 0.045) levels over time were associated with worsened lung function/FEV1% over time. There were minimal correlations between gut microbiome diversity and lung function or serum biomarkers. Oral microbiome alpha diversity was lower in subjects with BOS than without (p = 0.00057), and oral beta diversity was associated with FEV1% and with levels of several biomarkers. Our pilot study suggests that certain serum cGVHD markers may identify allogeneic HCT recipients at higher risk for pulmonary impairment over time, and should be followed with robust, controlled studies.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340431","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":"Impact of Abatacept Inclusive Graft Versus Host Disease Prophylaxis in Pediatric Stem Cell Transplantation for Hemoglobinopathy.","authors":"Niketa C Shah, Alexander Ngwube, Tara Suresh, Anna Sowa, Allistair Abraham, Eric Anderson, Martin Andreansky, Monica Bhatia, Sonali Chaudhury, Geoffrey D E Cuvelier, Jignesh Dalal, Michael Grimley, David Jacobsohn, Naynesh Kamani, Jennifer Krajewski, Lakshmanan Krishnamurti, Shermini Saini, Jodi Skiles, Shalini Shenoy","doi":"10.1016/j.jtct.2025.06.015","DOIUrl":"10.1016/j.jtct.2025.06.015","url":null,"abstract":"<p><strong>Background: </strong>Allogeneic hematopoietic cell transplantation (HCT) provides a curative option for patients with hemoglobinopathies by establishing donor-derived hematopoiesis. However, outcomes can be compromised by toxicities and graft-versus-host disease (GVHD), particularly in patients older than 13 years.</p><p><strong>Objectives: </strong>To evaluate the safety and benefit of extended duration (until day +365) abatacept incorporated into GVHD prophylaxis compared to the inclusion of prednisone in children and adolescents with hemoglobinopathy undergoing HCT from related and unrelated donors.</p><p><strong>Study design: </strong>Forty patients with hemoglobinopathy received reduced intensity conditioning and prednisone-inclusive GVHD prophylaxis. Outcomes were compared with 20 subsequent patients who received extended duration abatacept instead of prednisone.</p><p><strong>Results: </strong>The incidence of posterior reversible encephalopathy syndrome was 17% with prednisone and 0% with abatacept. Acute grade 3-4 GVHD occurred in 28% of patients who received prednisone and in 0% that received abatacept (p=0.011). Among patients who received prednisone, chronic GVHD was observed in 2.5% (mild), 5% (moderate), and 30% (severe) of cases. In contrast, abatacept recipients experienced chronic GVHD at rates of 25% (mild), 5% (moderate), and 5% (severe). Oral involvement was most common in patients with chronic GVHD who received abatacept. Post-transplant immune reconstitution patterns were similar in both groups. Infection in the presence of GVHD and systemic immune suppression was the primary cause of mortality in patients who received prednisone. Two patients in the abatacept group developed EBV-associated lymphadenopathy that responded to rituximab. The only death following abatacept-inclusive prophylaxis was in a patient that died after primary graft rejection and a subsequent transplant. Overall survival and event-free survival were 87% and 80% (OS) with prednisone. The corresponding numbers were 95% and 90%, respectively, with abatacept despite a higher proportion of recipients at risk for poor outcomes (older age, mismatched grafts) in the abatacept group.</p><p><strong>Conclusion: </strong>Including extended duration abatacept to GVHD prophylaxis is effective in reducing the incidence and severity of GVHD and allows expansion of donor and transplant options in children and adolescents with hemoglobinopathy, with unrelated donor HCT outcomes matching those after matched sibling donor HCT.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340430","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":"Long-Term Outcomes After Allogeneic Hematopoietic Stem Cell Transplantation in Relapsed/Refractory B-Cell Non-Hodgkin Lymphoma: An Italian Multicenter Collaborative Study.","authors":"Corrado Tarella, Simona Sammassimo, Samuele Frassoni, Alida Dominietto, Raffaella Cerretti, Maria Caterina Micò, Rocco Pastano, Martina Pennisi, Maria Chiara Di Chio, Chiara Ghiggi, Gottardo De Angelis, Alessandra Algarotti, Patrizia Chiusolo, Enrico Derenzini, Simona Sica, Paolo Corradini, Vincenzo Bagnardi, Emanuele Angelucci, Alessandro Rambaldi, William G Arcese, Anna Dodero, Andrea Bacigalupo","doi":"10.1016/j.jtct.2025.06.004","DOIUrl":"10.1016/j.jtct.2025.06.004","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Allogeneic hematopoietic stem cell transplantation (allo-HSCT) use in refractory/relapsed B-cell non-Hodgkin lymphoma (R/R B-NHL) has been reduced due to the efficacy of CAR-T-cell therapy as salvage treatment. However, there remains a need for data regarding the long-term outcomes following allo-HSCT, to fully characterize this procedure as benchmark to design further studies on the role of allogeneic stem cell transplantation OBJECTIVE: To assess long-term outcomes of R/R B-NHL patients after allo-HSCT, in a multicenter study among six Italian hematology centers STUDY DESIGN: Data were collected from 285 allo-HSCT procedures performed among 281 R/R B-NHL patients, in 2000-2020. All patients signed informed consent for sharing data with the GITMO/EBMT Registry, the study was approved by the Institutional Review Board of the coordinating center. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), cumulative incidence function (CIF) of disease-related death and non-relapse mortality (NRM). The median age at transplant was 50 years (19-70), with 94 (33%) female patients. Histological subsets included indolent lymphoma (123 patients; 43.3%), aggressive lymphoma (124; 43.7%), and mantle-cell lymphoma (MCL; 37; 13%). At allo-HSCT, 135 patients (47.7%) exhibited complete remission (CR), 63 (22.3%) partial response, 30 (10.6%) stable disease, and 55 (19.4%) progressing disease. Myeloablative regimens were employed in 86 procedures (30.2%). The median follow-up for surviving patients was 8.7 years (0.3-22).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Three-year PFS was 43.7% (95% CI 37.9-49.4), 9-year PFS 39.3% (33.4- 45.1), 3-year OS 50.4% (44.5-56.1), and 9-year OS 46.6% (40.5-52.5). Positive predictors of 3-year PFS included indolent lymphoma (55.3%) vs. aggressive (37.9 %) and MCL (27.0%); and CR at allo-HSCT (51.9%) vs non-CR (30.9-38.9%). Similar associations were observed for OS. Among patients in CR, outcomes did not significantly differ among histological subtypes. Among patients not in CR, outcomes were significantly better for indolent lymphoma (3-year PFS: 56.6%), compared to aggressive (26.4%), and MCL (0%). Regarding transplant-procedures, the subgroup receiving post-transplant cyclophosphamide-based program for GVHD prophylaxis had a significantly improved outcome. Overall, 56 patients (19.6%) died from lymphoma progression, with 1-year and 3-year CIF of disease-related death of 15.9% (95% CI 11.9-20.5) and 18.5 (14.2-23.2), respectively. The latest disease recurrence occurred at 5.4 years post-allo-HSCT. Early NRM occurred in 75 patients (12-month CIF 26.1%), and late NRM in 25 patients (5-year CIF 31.2%; 25.9-36.7). At present, 95 patients (33.3%) are long survivors in continuous CR at 5-22 years since transplant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Despite pronounced toxicity, allo-HSCT is effective in high-risk, R/R B-NHL, with 5-year PFS expectancy of ∼40%, ","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337045","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":"Genital graft-versus-host-disease predicts decreased sexual function in female survivors of Allogeneic Hematopoietic Stem Cell Transplant.","authors":"Dana Shanis, Li Yang, Margaret Bevans, Claire Scrivani, Melissa A Merideth, Richard W Childs, Minoo Battiwalla, Pamela Stratton","doi":"10.1016/j.jtct.2025.06.021","DOIUrl":"10.1016/j.jtct.2025.06.021","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Impaired sexual health is a common long-term issue for female allogeneic hematopoietic stem cell transplant survivors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective(s): &lt;/strong&gt;To compare sexual function among clinically stable female transplant survivors to age-matched healthy female volunteers and to explore the contribution of key post-transplant factors over time on sexual function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;Secondary analysis of sexual function of female transplant survivors and healthy female volunteers aged 18 to 50 years enrolled in a year-long prospective clinical trial of HPV vaccination. Clinically stable transplant survivors were at least 90 days post-transplant. The general assessment of post-transplant health included assessment for genital and systemic chronic GvHD. Gynecologists assessed for and treated genital chronic GvHD including topical, targeted therapies, assessed ovarian function, performed cervical cancer screening, provided recommendations about contraception and ovarian hormone treatments, and discussed sexual function. Participants completed the Sexual Functioning Questionnaire (SFQ) at enrollment, 7 and 12 months. Genital and systemic chronic graft-versus-host-disease (GvHD), sexual activity, ovarian hormonal status, systemic immunosuppression use, and antidepressant use were prospectively evaluated over time post-transplant and compared to sexual function and health characteristics of healthy females. Comparisons between groups were made using independent t-tests. Transplant complications of systemic or genital chronic graft-versus-host-disease (GvHD), sexual activity, ovarian hormonal status, immunosuppression, and antidepressant use were evaluated over time using linear mixed models for their association with SFQ scores.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sixty-four females included 20 healthy volunteers and 44 transplant survivors, of whom 23 (52%) were receiving systemic immunosuppressive therapy. At baseline, whether participants were not currently sexually active, had low sexual function or had high sexual function significantly differed between transplant survivors (45% versus 30% versus 20% of 44 women, respectively) and volunteers (20% versus 15% versus 65% of 20 women, respectively, p=0.003). SFQ overall and subscale scores were lower in transplant survivors compared to healthy females at baseline and the difference persisted over time (all p&lt;0.05). Baseline SFQ overall scores were similar between transplant survivors on and off immunosuppression (p=0.09). At one year, survivors had significantly higher SFQ overall and health impact scores (p=0.05 and p&lt;0.001, respectively) and a lower problems score (p=0.04) compared to baseline, but the other subscale scores did not change. At each timepoint, females with genital chronic GvHD had lower SFQ overall scores compared to those without (p=0.04).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion(s): &lt;/strong&gt;Female transplant survivors participating in an HPV vaccine ","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337044","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 Diagnosis of post-hematopoietic stem cell transplant bronchiolitis obliterans syndrome in children: time for a rethink? Transplantation and Cellular Therapy. 2024 Aug;30(8):760-769.","authors":"Shivanthan Shanthikumar, William A Gower, Kenneth R Cooke, Anne Bergeron, Kirk R Schultz, Amisha Barochia, Maximiliano Tamae-Kakazu, Edward Charbek, Erin E Reardon, Charlotte Calvo, Alicia Casey, Pi Chun Cheng, Theresa S Cole, Stella M Davies, Shailendra Das, Aliva De, Robin R Deterding, Deborah R Liptzin, Francoise Mechinaud, Jonathan H Rayment, Paul D Robinson, Roopa Siddiah, Anne Stone, Saumini Srinivasin, Christopher T Towe, Gregory A Yanik, Narayan P Iyer, Samuel B Goldfarb","doi":"10.1016/j.jtct.2025.05.009","DOIUrl":"10.1016/j.jtct.2025.05.009","url":null,"abstract":"","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302913","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":"Comparative study of Bu/Cy/ATG and Flu/Cy/ATG conditioning regimens for unrelated donor hematopoietic stem cell transplantation in severe aplastic anemia.","authors":"Liangliang Wu, Xiaowei Chen, Ming Zhou, Wenjian Mo, Ruiqing Zhou, Yumiao Li, Shilin Xu, Caixia Wang, Shiyi Pan, Wei Zhou, Tingfen Deng, Yuling Zhang, Yuping Zhang, Shunqing Wang","doi":"10.1016/j.jtct.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.jtct.2025.06.014","url":null,"abstract":"<p><p>Unrelated donor hematopoietic stem cell transplantation (URD-HSCT) is a curative option for severe aplastic anemia (SAA), but the optimal conditioning regimen remains unclear. This retrospective study compares Busulfan/Cyclophosphamide/Anti-thymocyte globulin (Bu/Cy/ATG) and Fludarabine/Cyclophosphamide/Anti-thymocyte globulin (Flu/Cy/ATG) protocols to identify the best regimen for SAA patients. We retrospectively analyzed the clinical outcomes of 107 SAA patients who underwent URD-HSCT with Flu/Cy/ATG (n=63) or Bu/Cy/ATG (n=44) between November 2012 and December 2022. No significant differences were observed in the cumulative incidence of neutrophil/platelet engraftment, graft failure, graft-versus-host disease (GVHD), or CMV viremia. Overall survival (OS) at 7 years was 95.5% (95% CI: 89.5-100) with Bu/Cy/ATG vs. 85.5% (95% CI: 77.1-94.7) with Flu/Cy/ATG, and failure-free survival (FFS) at 7 years was 95.5% (95% CI: 89.5-100) versus 83.9% (95% CI: 75.2-93.6). Multivariate analysis identified Bu/Cy/ATG protocol as favorable for OS (Hazard ratio, HR 0.122, 95% CI: 0.021-0.715, P = 0.020) and FFS (HR 0.090, 95% CI: 0.015-0.538, P = 0.008). Moreover, multivariate analysis confirmed that the Bu/Cy/ATG regimen significantly reduced the risk of EBV viremia (Relative risk, RR 0.175, 95% CI: 0.026-0.717, P = 0.032) and post-transplant lymphoproliferative disorder (RR 0.031, 95% CI: 0-0.536, P = 0.012). Subgroup analysis through multivariate modeling further demonstrated that the Bu/Cy/ATG regimen demonstrated superior OS, FFS and EBV infection outcomes in patients older than 30 years. The Bu/Cy/ATG regimen, compared to Flu/Cy/ATG protocol, offers superior outcomes, including improved OS/FFS and reduced EBV infection, suggesting it may be the preferred choice for SAA patients undergoing URD-HSCT, especially for patients older than 30 years. Larger cohorts and prospective trials are needed to validate these findings.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295007","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":"American Society for Transplantation and Cellular Therapy Series #10: Management of Parainfluenza and Human Metapneumovirus Infections in Hematopoietic Cell Transplantation and Cellular Therapy Recipients.","authors":"Marjorie Vieira Batista, Firas El Chaer, Janet A Englund, Michael Boeckh, Paul A Carpenter, Sanjeet S Dadwal, Alpana Waghmare, David Navarro, Hans H Hirsch, Jose Luis Piñana, Genovefa A Papanicolaou, Roy F Chemaly","doi":"10.1016/j.jtct.2025.06.016","DOIUrl":"https://doi.org/10.1016/j.jtct.2025.06.016","url":null,"abstract":"<p><p>In 2019, The Practice Guidelines Committee of the American Society for Transplantation and Cellular Therapy partnered with its Transplant Infectious Diseases Special Interest Group to update the 2009 compendium-style infectious disease guidelines for hematopoietic cell transplantation (HCT). The new format is now structured around frequently asked questions (FAQs), concise tables, and figures to better support clinical providers. Here, a panel of experts in HCT and infectious diseases identified relevant FAQs, which they graded based on the strength of clinical practice recommendations and the level of supporting evidence, as described herein. In the ninth set of guidelines in the series, the focus is on parainfluenza virus and human metapneumovirus, with FAQs addressing epidemiology, incidence, clinical manifestations, risk factors, diagnosis, prevention (including vaccines), and therapeutic management in recipients of HCT and chimeric antigen receptor T cells (cellular therapy). Special considerations for pediatric patients, unmet needs, and future research directions are conveyed in the guidelines.</p>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295003","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}