Transplantation and Cellular Therapy最新文献

{"title":"US Geriatric Assessment Practices for Older Adults Undergoing Hematopoietic Cell Transplantation or Chimeric Antigen Receptor T Cell Therapy: An American Society for Transplantation and Cellular Therapy Physician Survey from the Aging Special Interest Group and Committee on Practice Guidelines","authors":"Pashna N. Munshi ,&nbsp;Rebecca L. Olin ,&nbsp;Sarah Wall ,&nbsp;Shannon R. McCurdy ,&nbsp;Taha Al-Juhaishi ,&nbsp;Julie Baker ,&nbsp;Vijaya Raj Bhatt ,&nbsp;Nora Chokr ,&nbsp;Parastoo Dahi ,&nbsp;Zachariah DeFilipp ,&nbsp;Manuel Espinoza-Gutarra ,&nbsp;Shatha Farhan ,&nbsp;Lohith Gowda ,&nbsp;Betty K. Hamilton ,&nbsp;Yoshihiro Inamoto ,&nbsp;Rena Jayani ,&nbsp;Mohamed A. Kharfan-Dabaja ,&nbsp;Richard Lin ,&nbsp;Gabrielle Meyers ,&nbsp;Asmita Mishra ,&nbsp;Andrew S. Artz","doi":"10.1016/j.jtct.2025.02.014","DOIUrl":"10.1016/j.jtct.2025.02.014","url":null,"abstract":"<div><div>Geriatric assessment (GA) may identify vulnerabilities and promote risk-stratification in older adults predisposed to toxicities after autologous (auto), allogeneic (allo) hematopoietic cell transplantation (HCT) and chimeric antigen T-cell therapies (CAR T). With increased utilization cellular therapies for older adults the American Society for Transplantation and Cellular Therapy (ASTCT) Committee on Practice Guidelines and its Special Interest Group for Aging (SIG) conducted an online cross-sectional survey between April 2023 and August 2023 to determine transplantation and cellular therapy physicians' practice patterns regarding GA in older patients receiving HCT and CAR T-cell therapies. E-mail surveys were sent to 1168 ASTCT physician members and only 96 (8.2%) respondents completed the survey. Most (86%) were affiliated with university/teaching centers and 70% had a combined HCT and cellular therapy practice. More than 50% of respondents were interested in pursuing GA but 68% described barriers. The top two recognized barriers to GA were lack of time (96%) and clinical support staff (90%). Despite interest, only 15% respondents reported to know the domains of GA ‘well’. Among those using GA, the minimum age used for routine GA was 65 years for allo-HCT and CAR T in over 91% respondents. Taken together, we recommend the HCT community leadership and GA experts combine efforts to address the gap in GA uptake and implementation.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 5","pages":"Pages 285-296"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442143","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 Amphiregulin Expression in Intestinal Biopsies of Pediatric Patients with Severe Acute Graft-Versus-Host Disease","authors":"Fjolla Zeka ,&nbsp;Silvia Angori ,&nbsp;Dorothea Rutishauser ,&nbsp;Holger Moch ,&nbsp;Carsten Posovszky ,&nbsp;Khalid Amin ,&nbsp;Shernan Holtan ,&nbsp;Tayfun Güngör ,&nbsp;Daniel Drozdov","doi":"10.1016/j.jtct.2025.02.020","DOIUrl":"10.1016/j.jtct.2025.02.020","url":null,"abstract":"<div><div>Acute graft-versus-host disease (GvHD) is a major complication of hematopoietic cell transplantation (HCT). Despite of recent advances in prophylaxis, diagnosis and treatment it is still a serious cause of morbidity and mortality after HCT. Amphiregulin (AREG) is an epidermal growth factor receptor ligand known for restoring damaged intestinal tissue. AREG has been studied as a blood biomarker in acute GvHD and was found predictive of steroid response and mortality. However, the expression of AREG in intestinal tissue in pediatric patients with acute GvHD is unknown. The aim of this study is to analyze and evaluate AREG expression in intestinal tissue biopsies of pediatric patients with GvHD, in comparison to patients with inflammatory bowel disease (IBD) and a control group with no pathological findings to provide insights in the biological tissue expression of this potential diagnostic and prognostic biomarker. We performed a retrospective study with pediatric patients who had an intestinal biopsy performed after HCT between 2010 and 2021, patients who had a diagnosis of IBD and patients with normal findings at the University Children's Hospital Zurich. Intestinal biopsies were stained for AREG. We used a semi-quantitative score ranging from 0 (not present) to 3 (intense) to grade the AREG expression. The grading was performed by a pathologist blinded to the group allocation. Lerner scores were also performed. The median AREG scores between the groups were compared using multivariable linear regression with age and sex as confounders. The study protocol was approved by the Ethical committee of Canton Zürich, Switzerland, number 2022-01037. Overall, 59 biopsies were stained for AREG, 20 after HCT (6 patients with severe GvHD, 5 with mild GvHD and 9 without GvHD), 19 with IBD and 20 controls. The median for the AREG overall grade for control group was 2, for the HCT with severe GvHD group 2.5 (<em>P</em> = .060) and for the IBD group 2.5 (<em>P</em> = .007). The results for the AREG epithelium and lamina propria grades were similar. There were no differences in survival between patients with GvHD with overall AREG scores below and greater or equal to the median of 2.5. This study showed that AREG scores were higher in intestinal biopsies from patients with severe GvHD and IBD compared to controls and patients with mild or no GvHD. Consequently, AREG staining could potentially be used as an additional marker for severe inflammation as seen in GvHD and IBD.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 5","pages":"Pages 323.e1-323.e9"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524529","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":"Granulocyte Colony-Stimulating Factor–Primed Bone Marrow Transplantation Experience in 350 Matched Sibling Donor Grafts for Severe Thalassemia","authors":"Rajat Kumar Agarwal ,&nbsp;Rakesh Dhanya ,&nbsp;Deepa Trivedi ,&nbsp;Vaibhav Shah ,&nbsp;Mohan Reddy ,&nbsp;Priya Marwah ,&nbsp;Amit Sedai ,&nbsp;Kumari Ankita ,&nbsp;Lalith Parmar ,&nbsp;Lawrence Faulkner","doi":"10.1016/j.jtct.2025.01.890","DOIUrl":"10.1016/j.jtct.2025.01.890","url":null,"abstract":"<div><h3>Background</h3><div>For matched related hematopoietic cell transplantation (HCT) for non-malignant diseases, most centers prefer bone marrow (BM) over peripheral blood stem cell (PBSC) grafts owing to increased risk of chronic graft-versus-host disease (GVHD–associated with the latter. BM generally entails delayed neutrophil and platelet recovery compared with PBSC transplants. Granulocyte colony-stimulating factor–primed bone marrow (G-BM) has been associated with faster hematologic recovery while retaining a decreased risk of GVHD. Moreover, it may allow for reduced marrow collection volumes.</div></div><div><h3>Objectives</h3><div>We retrospectively analyzed our experience with G-BM as graft source from July 2015 to February 2023 across 350 consecutive first matched sibling transplants in children with severe thalassemia in four centers in India.</div></div><div><h3>Findings</h3><div>We observed that G-BM is associated with rapid hematologic recovery with relatively low rates of cytomegalovirus reactivation (16%), low rates of moderate to severe GVHD (grade 3-4 acute GVHD was 5% and moderate to severe chronic GVHD was 3%), and reduced marrow collection volumes (12.5 ml/kg of donor's weight), and thus is potentially safer for both donors and recipients compared with standard bone marrow. This observation was made in a relatively homogenous cohort of multiply transfused patients with thalassemia who are at high risk of rejection. None of the donors required third-party blood transfusion irrespective of donor–recipient weight discrepancy.</div></div><div><h3>Conclusion</h3><div>Our experience suggests that G-BM is associated with prompt engraftment and very low rates of moderate or severe GVHD. It also appears to be safe for donors and decreases the risk for third-party red blood cell transfusions. Finally, it is relatively easy and inexpensive to collect. G-BM should be strongly considered as a preferable graft source in matched-related donor transplantations for thalassemia and potentially other transplant indications.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 5","pages":"Pages 319.e1-319.e8"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075529","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 Real-World Clinical Factors on an Analysis of the Cost-Effectiveness of “Immediate CAR-T” Versus “Late CAR-T” as Second-Line Treatment for DLBCL Patients","authors":"Chihiro Yamamoto ,&nbsp;Seina Honda ,&nbsp;Ryutaro Tominaga ,&nbsp;Daizo Yokoyama ,&nbsp;Shuka Furuki ,&nbsp;Atsuto Noguchi ,&nbsp;Shunsuke Koyama ,&nbsp;Rui Murahashi ,&nbsp;Hirotomo Nakashima ,&nbsp;Shin-ichiro Kawaguchi ,&nbsp;Kazuki Hyodo ,&nbsp;Yumiko Toda ,&nbsp;Kento Umino ,&nbsp;Daisuke Minakata ,&nbsp;Masahiro Ashizawa ,&nbsp;Masuzu Ueda ,&nbsp;Kaoru Hatano ,&nbsp;Kazuya Sato ,&nbsp;Ken Ohmine ,&nbsp;Shin-ichiro Fujiwara ,&nbsp;Yoshinobu Kanda","doi":"10.1016/j.jtct.2025.02.013","DOIUrl":"10.1016/j.jtct.2025.02.013","url":null,"abstract":"<div><div>While chimeric antigen receptor (CAR-T) targeting CD19 as second-line therapy for diffuse large B cell lymphoma (DLBCL) is a promising strategy, the high costs and limited access to CAR-T pose significant challenges. When assessing the cost-effectiveness of CAR-T, we need to consider not only individual outcomes but also how to effectively integrate CAR-T into the overall treatment approach for relapsed DLBCL. We conducted a cost-effective analysis for patients with DLBCL in early relapse or primary refractory, to compare “immediate CAR-T,” which proceeds directly to CAR-T, and “late CAR-T,” which initially aims at ASCT and quickly switches to third-line CAR-T if non-responsive. The primary analysis used a patient age of 60 years, and it also examined variations from 40 to 70 years. The analysis was performed for both Japanese and US settings using a Markov model incorporating life expectancy in both countries, with extensive sensitivity analysis including factors such as age, the choice of CAR-T (lisocabtagene maraleucel or axicabtagene ciloleucel), and the opportunity to receive third-line CAR-T, to reflect real-world situations. The length of a Markov cycle was defined to be 1 month, and patients in the model were assumed to age 1 year every 12 Markov cycles. The analysis was made over a lifetime horizon, and the outcome was measured based on incremental cost-effectiveness ratio (ICER), with willingness-to-pay (WTP) thresholds of ¥7,500,000 and $150,000 per quality-adjusted life years (QALY) in Japan and the US, respectively, with an annual discount rate of 3%. Compared with “late CAR-T,” the “immediate CAR-T” strategy gained QALYs of 0.97 and 0.89 with an incremental cost of ¥5,998,354 and $88,440 in Japan and the US, respectively. The ICERs were ¥6,170,058/QALY in Japan and $99,596/QALY in the US. In the probabilistic sensitivity analysis for patients aged 60, “immediate CAR-T” was cost-effective in 54.8% and 61.7% of the 10,000 Monte Carlo iterations in Japan and the US, respectively. Sensitivity analyses showed that “immediate CAR-T” was not cost-effective when patients were over 68.4 in Japan, when the standardized mortality ratio of CAR-T and ASCT survivors was close, and when utility during treatment-free remission was low. Incorporating various clinical factors, the analysis showed that “immediate CAR-T” is more cost-effective than “late CAR-T.” However, this conclusion should be interpreted with caution, as the ICERs were very close to the WTP thresholds, and the results were highly sensitive to parameter changes.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 5","pages":"Pages 339.e1-339.e15"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426375","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":"Assessment of the Immunodeficiency Scoring Index for Predicting Outcomes After Respiratory Syncytial Virus Infection in Allogeneic Stem Cell Transplant Recipients","authors":"Mireia Micó-Cerdà ,&nbsp;Ariadna Pérez ,&nbsp;Juan Montoro ,&nbsp;Pedro Chorão ,&nbsp;Dolores Gómez ,&nbsp;Rafael Hernani ,&nbsp;Manuel Guerreiro ,&nbsp;Juan Carlos Hernández-Boluda ,&nbsp;David Navarro ,&nbsp;Carlos Solano ,&nbsp;José Luis Piñana","doi":"10.1016/j.jtct.2025.02.012","DOIUrl":"10.1016/j.jtct.2025.02.012","url":null,"abstract":"<div><div>Respiratory syncytial virus (RSV) is a common cause of respiratory infections in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients. The immunodeficiency scoring index (ISI) has shown predictive value in assessing the risk of progression to lower respiratory tract disease (LRTD) and mortality in allo-HCT recipients developing RSV infection but requires further validation in external cohorts. This retrospective study examined RSV episodes in adult allo-HCT recipients from December 2013 to June 2023 at 2 Spanish hospitals. The aim was to validate the predictive value of ISI for LRTD progression and infectious mortality at day +100 after RSV detection and to identify other conditions associated with disease severity. A total of 207 allo-HCT recipients developed 262 episodes of RSV infection, of which 102 (39%) progressed to LRTD. Independent variables significantly associated with LRTD risk were umbilical cord blood transplant [odds ratio (OR) 2.72, <em>P =</em> .016], high-risk ISI (OR 4.4, <em>P =</em> .008), the transplant periods between 2014 and 2016 (OR 0.31, <em>P =</em> .007) and after 2020 (OR 0.13, <em>P =</em> .026), and ribavirin use (OR 0.49, <em>P =</em> .047). The 100-day infectious mortality rate after RSV detection was 8.7%, increasing to 18% in those with LRTD. Variables significantly associated with the risk of mortality were donor/recipient HLA mismatch [hazard ratio (HR) 5.09, <em>P =</em> .011] and absolute lymphocyte count (ALC) [&lt;0.2 × 10^9/L (HR 11.27, <em>P =</em> .003) and 0.2 to 1 × 10^9/L (HR 8.21, <em>P =</em> .008)]. ISI was associated with mortality (HR 6.8, <em>P =</em> .006) only when ALC categories were excluded from the multivariable model. In transplant recipients with RSV infection, a high-risk ISI category is associated with an increased risk of progression to LRTD, whereas ribavirin appears to have a protective role. Mortality in LRTD cases was influenced by HLA mismatch and different levels of lymphopenia, factors which if incorporated may enhance the ISI's ability to predict mortality.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 5","pages":"Pages 325.e1-325.e17"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415353","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":"Two Nonmyeloablative HLA-Matched Related Donor Allogeneic Hematopoietic Cell Transplantation Regimens in Patients with Severe Sickle Cell Disease","authors":"Zaina Inam ,&nbsp;Neal Jeffries ,&nbsp;Mary Link ,&nbsp;Wynona Coles ,&nbsp;Priscilla Pollack ,&nbsp;Christina Luckett ,&nbsp;Oswald Phang ,&nbsp;Elizabeth Harvey ,&nbsp;Triscia Martin ,&nbsp;Tiffani Farrey ,&nbsp;John F. Tisdale ,&nbsp;Matthew M. Hsieh","doi":"10.1016/j.jtct.2025.02.021","DOIUrl":"10.1016/j.jtct.2025.02.021","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Nonmyeloablative (NMA) conditioning is being used increasingly with success in matched related donor (MRD) and alternative donor allogeneic hematopoietic cell transplantation (allo-HCT) in individuals with sickle cell disease (SCD). Advantages include decrease toxicity and applicability in patients otherwise unable to tolerate conditioning regimens due to end-organ damage or age. We aimed to add to published data outcomes of two similar NMA conditioning protocols, termed Protocol 1 (ClinicalTrials.gov ID &lt;span&gt;&lt;span&gt;NCT00061568&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;) and Protocol 2 (ClinicalTrials.gov ID: &lt;span&gt;&lt;span&gt;NCT02105766&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;)) in mainly adult patients with SCD to evaluate the safety, toxicity, and success of these regimens in individuals at high-risk for poor transplantation-related outcomes. We also evaluated the tolerability and outcomes of Protocol 2, which included preconditioning immunodepletion, in patients at even higher risk of T cell-mediated rejection or plasma/B cell-mediated anti-donor erythrocyte antibody production—the latter due to ABO incompatibility or recipient RBC alloimmunization to a donor antigen. Finally, we evaluated the incidence and trajectory of mixed donor myeloid chimerism over time following allo-HCT. In this retrospective analysis of the 2 prospective phase 2 NMA transplant protocols, 91 individuals with SCD or transfusion-dependent β-thalassemia underwent MRD allo-HCT at the National Heart, Lung, and Blood Institute; regimens contained alemtuzumab, low-dose radiation, and sirolimus for graft-versus-host disease (GVHD) prophylaxis with or without preconditioning immunodepletion with pentostatin and oral cyclophosphamide (Protocol 2). In the total cohort of 91 transplantation recipients, outcomes were favorable with timely neutrophil and platelet engraftment (median, 21 days [range, 7 to 67 days] and 21 days [range, 10 to 112 days], respectively), minimal high-grade acute GVHD and no chronic GVHD, overall survival of 90%, sickle-free survival of 85%, and mixed donor myeloid chimerism in 43% at a median follow up of 7.3 years (range, 0.8 to 20 years). Most patients with mixed myeloid chimerism at 2-years post-HCT remained stable in their values. In analyzing each protocol separately, outcomes were comparable except for higher cytomegalovirus reactivation necessitating treatment in Protocol 2 without an associated increase in graft failure. In the combined cohort, graft failure occurred in 11 patients, and hematologic malignancy or abnormal cytogenetics on bone marrow evaluation developed in 7 patients. In a subanalysis of factors that may implicate transplantation outcomes, the number of RBC units transfused post-HCT was significantly higher in recipients with pre-HCT history of alloimmunization to donor RBC antigens. There was no difference in the number of RBC units transfused, duration of transfusion, or red cell engraftment in those with major ABO incompatibility;","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 5","pages":"Pages 305-318"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516916","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":"T Cell Immune Response to Influenza Vaccination When Administered Prior to and Following Autologous Chimeric Antigen Receptor-Modified T Cell Therapy","authors":"Hannah Kinoshita ,&nbsp;Carla S. Walti ,&nbsp;Kathleen Webber ,&nbsp;Gloria Pezzella ,&nbsp;Mariah Jensen-Wachspress ,&nbsp;Haili Lang ,&nbsp;Kiel Shuey ,&nbsp;Jim Boonyaratanakornkit ,&nbsp;Steven A. Pergam ,&nbsp;Helen Y. Chu ,&nbsp;Catherine M. Bollard ,&nbsp;Michael D. Keller ,&nbsp;Joshua A. Hill","doi":"10.1016/j.jtct.2025.02.019","DOIUrl":"10.1016/j.jtct.2025.02.019","url":null,"abstract":"<div><div>Chimeric antigen receptor-modified T (CAR-T) cell therapies are gaining wider use in relapsed and refractory malignancies. However, data on vaccination in this population is lacking. We evaluated T cell responses in an established cohort of CAR-T recipients and healthy controls before and after 2019 to 2020 influenza vaccination. Peripheral blood mononuclear cells were isolated from healthy controls and patients who received the 2019 to 2020 influenza vaccine pre- or post-CD19, CD20, or B cell maturation antigen CAR-T. T cells were expanded in vitro for 10 days with peptide libraries for hemagglutinin (HA) and nucleoprotein from the 2019 to 2020 vaccine influenza A strains and analyzed by flow cytometry following interferon-γ/tumor necrosis factor-α (IFNγ/TNFα) intracellular staining. Antibody response was evaluated by a hemagglutination inhibition assay. Twenty-nine participants, including eight immunocompetent adults, seven pre-CAR-T, and 14 post-CAR-T patients, were evaluated. IFNγ⁺/TNFα⁺ T cell responses after influenza vaccination in healthy controls varied with an increased response to HA-Kansas after vaccination in 7/8 individuals. In the pre-CAR-T cohort, there was a rise in CD4+ T cell response to HA-Brisbane in 6/7 patients after vaccination that remained detectable in 3/4 evaluable patients 90 days post-CAR-T. Five of six patients who lacked an antibody response nonetheless demonstrated a T cell response to HA-Brisbane. There was no association between time since CAR-T administration, baseline immunoglobulin G, or absolute lymphocyte count and change in CD4+ T cell IFNγ⁺/TNFα⁺ response pre- to postvaccine for the post-CART cohort. These data demonstrate that cell-mediated immunity to the influenza vaccine can be elicited in patients vaccinated pre-CAR-T and sustained post-CAR-T, filling an important gap from lack of humoral responses.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"31 5","pages":"Pages 327-338"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543350","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":"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":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;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&lt;sub&gt;1&lt;/sub&gt;) 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&lt;sub&gt;1&lt;/sub&gt;, 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&lt;sub&gt;1&lt;/sub&gt; decline with an onset after the first 6-month period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;We aimed to investigate the clinical significance of a ≥10% decrement in FEV&lt;sub&gt;1&lt;/sub&gt; 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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;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&lt;sub&gt;1&lt;/sub&gt; by ≥10% from their best value, usually at the beginning of the transplant process. Recovery was defined as a ≥10% increase in FEV&lt;sub&gt;1&lt;/sub&gt;, 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 &lt; 0.7, and an FEV1 &lt;75% of predicted normal with ≥10% reduction over less than two years and evidence of gas trapping.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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&lt;sub&gt;1&lt;/sub&gt; after transplant. Ninety-five patients experienced an FEV&lt;sub&gt;1&lt;/sub&gt; decline lasting &lt;6 months and were likely to recover over half their lost lung function (median % FEV recovered = 68.7%). Seventy-eight patients experienced an FEV&lt;sub&gt;1&lt;/sub&gt; decline lasting &gt;6 months and were unlikely to recover any lost lung function (median % FEV recovered = 0%). There was a significant relationship between ≥10% FEV&lt;sub&gt;1&lt;/sub&gt; decline and death, X&lt;sup&gt;2&lt;/sup&gt;(1, 364) = 15.67, p &lt;0.001. All-cause mortality was doubled in those who experienced ≥10% FEV&lt;sub&gt;1&lt;/sub&gt; 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&lt;sub&gt;1&lt;/sub&gt; decline ≥10%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Mortality risk is elevated from the first ≥10% reduction in FEV&lt;sub&gt;1&lt;/sub&gt; and remains elevated even if FEV&lt;sub&gt;1&lt;/sub&gt; 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}