Transplantation and Cellular Therapy最新文献

{"title":"Adjusting Disease Risk Index for Regional Variations and Donor Selection","authors":"Makoto Iwasaki,&nbsp;Yachiyo Kuwatsuka,&nbsp;Hiromi Hayashi,&nbsp;Shinichi Kobayashi,&nbsp;Marie Ohbiki,&nbsp;Naoyuki Uchida,&nbsp;Noriko Doki,&nbsp;Takahiro Fukuda,&nbsp;Masatsugu Tanaka,&nbsp;Tetsuya Nishida,&nbsp;Yuta Hasegawa,&nbsp;Toshiro Kawakita,&nbsp;Yuta Katayama,&nbsp;Tetsuya Eto,&nbsp;Yoshinobu Kanda,&nbsp;Fumihiko Ishimaru,&nbsp;Tatsuo Ichinohe,&nbsp;Yoshiko Atsuta,&nbsp;Junya Kanda","doi":"10.1016/j.jtct.2026.06.005","DOIUrl":"10.1016/j.jtct.2026.06.005","url":null,"abstract":"<div><div>The Disease Risk Index (DRI) is a widely used prognostic tool following hematopoietic stem cell transplantation (HSCT), based on disease classification and status. However, the refined DRI (rDRI) does not fully account for regional variations in disease distribution and treatment practices. To refine the rDRI by accounting for underrepresented disease entities in the rDRI and by considering regional differences in HSCT treatment strategies, and to identify the most suitable donor selection strategy based on the newly developed disease risk criteria. We analyzed 7720 patients with hematologic malignancies who underwent their first allogeneic HSCT between 2014 and 2016 and developed a region-adjusted DRI (raDRI) using the Japanese registry database. We then validated predictive performance in 5108 patients transplanted between 2017 and 2018. The raDRI demonstrated superior accuracy compared with the rDRI (time-dependent AUC: .705 versus .670; integrated calibration index: .016 versus .017). In patients with low to intermediate raDRI, matched related donors (MRD) were associated with improved overall survival compared with matched unrelated bone marrow donors (bone marrow (BM): hazard ratio (HR) .50, 95% CI: .26 to .96; peripheral blood (PB): HR .54, 95% CI: .36 to .83), whereas no differences were seen in patients with high to very high raDRI (MRD-BM: HR: 1.03, 95% CI: .69 to 1.54, MRD-PB: 1.15, 95% CI: .89 to 1.49). Our findings underscore that prognostic indices such as the DRI are inherently shaped by the populations and clinical practices from which they are derived. Regional differences in disease prevalence, treatment strategies, and donor-source utilization can substantially influence risk stratification and transplant outcomes.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1293.e1-1293.e12"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148195190","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":"Lung Complications After Allogeneic Hematopoietic Cell Transplant and Outcomes: Implications Beyond Bronchiolitis Obliterans Syndrome","authors":"Yu Kuang Lai,&nbsp;Husham Sharifi,&nbsp;Sally Arai,&nbsp;Amelia Scheck,&nbsp;Theresa Brondstetter,&nbsp;David J. Epstein,&nbsp;Joe L. Hsu","doi":"10.1016/j.jtct.2026.06.010","DOIUrl":"10.1016/j.jtct.2026.06.010","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Lung chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic cell transplantation (HCT) comprises heterogeneous pulmonary phenotypes known as lung complications after transplantation (LCAT). While bronchiolitis obliterans syndrome (BOS) is well recognized and is associated with poor survival, restrictive phenotypes—including HCT-associated organizing pneumonia (HCT-OP) and truncal sclerosis (TS)-remain poorly defined. Prior studies often grouped restrictive phenotypes, potentially obscuring phenotype-specific risk profiles and introducing survival bias by not taking into account the variable timing of LCAT onset. Direct comparison between specific LCAT phenotypes and patients with cGVHD without lung involvement is limited, leaving uncertainty regarding the relative prognostic impact of individual LCAT phenotypes. Using dynamic time-dependent Cox regression, we hypothesized that LCAT phenotypes represent clinically and prognostically distinct entities. We conducted a longitudinal retrospective cohort study of adults with cGVHD. LCAT phenotypes were adjudicated as BOS, HCT-OP, or TS based on clinical, physiologic, and radiographic criteria. Patients with cGVHD without lung involvement served as the control group. Baseline for all survival analyses was defined as the date of cGVHD diagnosis. Multivariable Cox proportional hazards models were fit with LCAT phenotype as a time-varying exposure to account for variable onset timing and mitigate immortal-time bias; adjusted survival curves were derived using dynamic standardization. Non-relapse mortality (NRM) was analyzed using cause-specific Cox models with relapse occurring after cGVHD onset as a competing event. Of 895 patients who met inclusion criteria, LCAT was identified in 183 patients: BOS (n = 85), HCT-OP (n = 42), TS (n = 32), and mixed phenotypes (n = 24). Median time from cGVHD diagnosis to LCAT onset differed significantly: 3.3 months for HCT-OP, 9.4 months for BOS and 20.5 months for TS (&lt;em&gt;P&lt;/em&gt; &lt; .001). Pulmonary function tests showed distinct patterns, with severe airflow obstruction in BOS, predominant diffusion impairment in HCT-OP; and restriction in TS. In multivariable time-dependent Cox models, BOS was independently associated with inferior OS (hazard ratio [HR] 2.14; 95% confidence interval [CI] 1.51 to 3.02; &lt;em&gt;P&lt;/em&gt; &lt; .001) and elevated NRM (HR 3.04; 95% CI 2.08 to 4.43; &lt;em&gt;P&lt;/em&gt; &lt; .001) relative to controls. TS was independently associated with increased NRM (HR 2.33; 95% CI 1.12 to 4.86; &lt;em&gt;P&lt;/em&gt; = .024) but not OS (HR 1.53; 95% CI 0.78 to 3.05; &lt;em&gt;P&lt;/em&gt; = .217). HCT-OP was not significantly associated with increased OS or NRM risk relative to controls, a finding confirmed by sensitivity landmark analyses. In the LCAT burden model, mixed LCAT (≥2 phenotypes) conferred the greatest risk for both OS (HR 3.22; 95% CI 1.78 to 5.83; &lt;em&gt;P&lt;/em&gt; &lt; .001) and NRM (HR 4.95; 95% CI 2.55 to 9.62; &lt;em&gt;P&lt;/em&gt; &lt; .001) compared with contro","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1295.e1-1295.e16"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Bridging Response on Outcomes after CD19 CAR T-Cell Therapy in Large B-Cell Lymphoma","authors":"Beatriz Wills,&nbsp;Sarah Samorodnitsky,&nbsp;Samantha Brown,&nbsp;Jessica R. Flynn,&nbsp;Sean Devlin,&nbsp;Michael Scordo,&nbsp;Sandeep Raj,&nbsp;Karthik Nath,&nbsp;Gunjan L. Shah,&nbsp;Juliana Castro,&nbsp;Jennifer E. Liu,&nbsp;Heiko Schoder,&nbsp;Burcin Agridag Ucpinar,&nbsp;Akshay Bedmutha,&nbsp;Ofrat Beyar-Katz,&nbsp;Iris Halamish,&nbsp;Andrew Ip,&nbsp;Brandon Imber,&nbsp;Sergio Giralt,&nbsp;Miguel-Angel Perales,&nbsp;Maria Lia Palomba","doi":"10.1016/j.jtct.2026.06.017","DOIUrl":"10.1016/j.jtct.2026.06.017","url":null,"abstract":"<div><div>Bridging therapy (BT) is frequently administered during CD19 CAR T-cell manufacturing for relapsed or refractory large B-cell lymphoma (LBCL), and although disease status at infusion has been associated with outcomes, the prognostic relevance of response to BT, independent of BT modality, has been variably defined in real-world cohorts. To assess the impact of bridging response on clinical outcomes after CD19 CAR T-cell therapy in patients with LBCL, and to determine whether response to BT or BT regimen type are associated with progression-free survival (PFS), overall survival (OS), and treatment-related toxicities. We conducted a retrospective multicenter study of 377 adults with relapsed/refractory LBCL treated with commercial CD19 CAR T-cell products (axicabtagene ciloleucel, tisagenlecleucel, and lisocabtagene maraleucel) between 2020 and 2024. BT was administered in 248 patients (66%) during the manufacturing period and categorized by regimen type. Response to BT and CAR T therapy were assessed using Lugano criteria. The primary endpoints were PFS and OS after CAR T infusion. Secondary endpoints included rates of cytokine release syndrome (CRS), immune effector cell–associated neurotoxicity syndrome (ICANS), and hematologic toxicity. Multivariable Cox regression models adjusted for performance status, lactate dehydrogenase (LDH), CAR T product, and BT category were applied to evaluate associations. Among patients receiving BT, the overall response rate prior to CAR T infusion was 49%, including complete response (CR) in 12%. Patients achieving CR or partial response (PR) to BT had significantly longer PFS and OS compared with those with stable or progressive disease (SD/PD) (median PFS and OS not reached vs shorter durations; <em>P</em> &lt; .01). In multivariable analysis, response to BT remained an independent predictor of both PFS (hazard ratio [HR] for SD/PD versus CR: 2.59, 95% confidence interval [CI] 1.28 to 5.22) and OS (HR: 4.53, 95% CI 1.64 to 12.5), while BT modality itself was not independently associated with survival outcomes. Patients with favorable BT responses demonstrated lower pre-infusion tumor burden and reduced systemic inflammatory markers. Rates of CRS and ICANS did not differ significantly by BT response category. Severe hematologic toxicity was more frequent following intensive chemotherapy-based BT regimens but was not independently associated with long-term outcomes. In this large observational real-world multicenter cohort, response to BT, rather than the specific BT modality, was strongly associated with improved survival outcomes after CD19 CAR T-cell therapy in LBCL. These findings emphasize the prognostic significance of pre-infusion disease control and support treatment strategies focused on achieving effective BT responses while balancing regimen toxicity.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1270-1282"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid Overload Syndrome is Associated With Increased Non-Relapse Mortality After Allogeneic Hematopoietic Stem Cell Transplantation: A Systematic Review and Narrative Synthesis","authors":"Bastian Wobbe,&nbsp;Matthias Bröer","doi":"10.1016/j.jtct.2026.05.025","DOIUrl":"10.1016/j.jtct.2026.05.025","url":null,"abstract":"<div><div>Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains associated with substantial non-relapse mortality (NRM) despite advances in supportive care. Fluid overload syndrome is a frequent but underrecognized complication during conditioning and the early post-transplant period. Although fluid overload is known to worsen outcomes in critical illness and heart failure, its prognostic impact in allo-HSCT has not been systematically evaluated. The aim of this analysis was to systematically assess the association between fluid overload syndrome and survival outcomes following allogeneic hematopoietic stem cell transplantation. We conducted a systematic review in accordance with PRISMA guidelines and registered the protocol in PROSPERO (CRD42025634151). PubMed, Cochrane Register, ClinicalTrials.gov, and additional sources were searched for studies reporting fluid overload syndrome and survival outcomes after allo-HSCT. Study quality was assessed using the Newcastle-Ottawa Scale. Due to heterogeneity in definitions of fluid overload syndrome and in outcome reporting, a narrative synthesis was performed. We performed exploratory quantitative aggregation using Fisher’s combined <em>P</em>-value method. Nine retrospective single-center studies comprising 2410 patients met inclusion criteria. Definitions and grading systems for fluid overload syndrome varied substantially, with reported incidences ranging from 4% to 37%. Eight of nine studies demonstrated significantly reduced overall survival (OS) in patients who developed fluid overload syndrome. Five of six studies reported significantly increased NRM, with the remaining study showing a non-significant adverse trend. Fisher’s method demonstrated highly significant aggregated effects for OS (χ² = 96.9, <em>P</em> &lt; .0001) and NRM (χ² = 66.43, <em>P</em> &lt; .0001). Fluid overload syndrome is consistently associated with inferior overall survival and increased non-relapse mortality after allo-HSCT. Despite heterogeneity in definitions, the direction of effect is remarkably uniform across studies. Given that fluid administration is a modifiable component of supportive care, these findings support the integration of fluid stewardship strategies into transplant management. Standardized definitions, prospective multicenter studies, and mechanistic investigations are urgently needed to refine risk stratification and improve outcomes in allo-HSCT recipients.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1317.e1-1317.e5"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975783","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":"Risk Factors and Predictive Model of Poor Graft Function After Allogeneic Hematopoietic Stem Cell Transplantation","authors":"Ming Gao,&nbsp;Yaqiong Tang,&nbsp;Jiaqian Qi,&nbsp;Xiaofei Song,&nbsp;Peng Wang,&nbsp;Depei Wu,&nbsp;Yue Han","doi":"10.1016/j.jtct.2026.05.043","DOIUrl":"10.1016/j.jtct.2026.05.043","url":null,"abstract":"<div><div>Poor graft function (PGF) is a serious and life-threatening complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Current therapeutic approaches show suboptimal clinical outcomes, with substantial variability in treatment efficacy across studies, which highlights the critical need for timely identification of PGF and appropriate preventive strategies to improve prognosis. To identify PGF risk factors and establish a nomogram-based predictive model of PGF, this real-world study analyzed 795 hematological malignancies patients underwent allo-HSCT. We identified lower CD34⁺ cell dose in the graft, infection, cytomegalovirus activation, splenomegaly and anti-HLA antibody as independent risk factors for PGF. Severe graft-versus-host disease exhibited significant association with secondary PGF in subgroup analysis. Recipients with good graft function demonstrated higher 3-year overall survival (OS) rate compared to PGF cohorts (78.1% versus 50.6%). Notably, secondary PGF cases exhibited superior 3-year OS relative to primary PGF cases (52.0% versus 46.2%), and the primary PGF group showed a higher cumulative incidence of NRM than secondary PGF group. Restricted cubic spline analysis demonstrated a dose-dependent relationship between infused stem cell doses and the risk of PGF. Both CD34⁺ cell dose and MNC dose showed inverse associations with the predicted probability of PGF. To assess the relative contribution of each covariate to PGF risk stratification, we constructed a predictive model based on the nomogram framework. Ten clinically relevant predictors were incorporated into the model, which demonstrated strong predictive performance and excellent calibration. The model also exhibited robust discriminative capacity (C-statistics = .782) and provided meaningful clinical utility. Importantly, this predictive tool facilitates identification of patients at high risk of PGF who could benefit from preventive measures</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1289.e1-1289.e13"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176825","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":"Outcomes of Tocilizumab for Cytokine Release Syndrome after Post-Transplant Cyclophosphamide","authors":"Tuan L. Phan,&nbsp;Roberta Azbell,&nbsp;Hannah Choe,&nbsp;Nathan Denlinger,&nbsp;Marcos de Lima,&nbsp;Misty Lamprecht,&nbsp;Karilyn Larkin,&nbsp;Sam Penza,&nbsp;Polina Shindiapina,&nbsp;Jeremy Sen,&nbsp;Justin C. Tossey,&nbsp;Kennedi Vandergriff,&nbsp;Sumithira Vasu,&nbsp;Sarah Wall,&nbsp;Jiasheng Wang","doi":"10.1016/j.jtct.2026.06.036","DOIUrl":"10.1016/j.jtct.2026.06.036","url":null,"abstract":"<div><div>Cytokine release syndrome (CRS) is common after allogeneic hematopoietic cell transplantation (alloHCT) using post-transplant cyclophosphamide (PTCy)–based graft-versus-host disease (GVHD) prophylaxis. Although tocilizumab effectively manages CRS, its impact on transplant outcomes in the PTCy setting remains unclear. We performed a single-center retrospective study of adult patients undergoing PTCy-based alloHCT from 2014 to 2024. Patients who received tocilizumab for CRS were matched 1:1 with patients with CRS who did not receive tocilizumab using propensity score matching. Of 346 patients, 190 (55%) developed CRS. Greater HLA mismatch and peripheral blood graft source (versus bone marrow) were the only independent risk factors for CRS. Among those with CRS, 46 (24%) received tocilizumab; after propensity score matching, 40 patients were included per group. Tocilizumab was associated with shorter CRS duration (median 2 versus 3 d), but also with delayed neutrophil engraftment (median 19 versus 17 d) and higher 100-d bacterial infection rates (65% versus 28%). Tocilizumab use was linked to lower grade II to IV acute GVHD (HR 0.52, 95% CI 0.30 to 0.92; <em>P</em> = .02) and all-grade chronic GVHD (HR 0.35, 95% CI 0.15 to 0.81; <em>P</em> = .02), with nonsignificant trends toward reduced grade III to IV acute GVHD (HR 0.40, 95% CI 0.13 to 1.24; <em>P</em> = .11) and moderate-to-severe chronic GVHD (HR 0.41, 95% CI 0.14 to 1.14; <em>P</em> = .09). No significant differences were seen in relapse, non-relapse mortality, GVHD-free/relapse-free survival, or overall survival. In PTCy-based alloHCT, tocilizumab for CRS was associated with reduced grade II to IV acute GVHD and all-grade chronic GVHD, at the expense of delayed neutrophil engraftment and increased early bacterial infections.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1285.e1-1285.e9"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148319281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcomes of Adult B-Cell Acute Lymphoblastic Leukemia with Post-Transplant Relapse in the Era of Immunotherapeutic Agents","authors":"Hiroaki Shimizu,&nbsp;Yuho Najima,&nbsp;Shinichi Kako,&nbsp;Takayoshi Tachibana,&nbsp;Akihiko Izumi,&nbsp;Susumu Tanoue,&nbsp;Emiko Sakaida,&nbsp;Takuya Miyazaki,&nbsp;Katsuhiro Shono,&nbsp;Kota Yoshifuji,&nbsp;Makoto Onizuka,&nbsp;Atsushi Jinguji,&nbsp;Takashi Toya,&nbsp;Noriko Doki,&nbsp;Masatsugu Tanaka,&nbsp;Shun-ichi Kimura,&nbsp;Satoru Takada,&nbsp;Shin-ichiro Fujiwara,&nbsp;Masatoshi Sakurai,&nbsp;Satoshi Takahashi,&nbsp;Yoshinobu Kanda","doi":"10.1016/j.jtct.2026.05.033","DOIUrl":"10.1016/j.jtct.2026.05.033","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Post-transplant relapse remains a major cause of treatment failure in adult B-cell acute lymphoblastic leukemia (ALL). The introduction of inotuzumab ozogamicin (InO) and blinatumomab (Blina) has expanded salvage options; however, their impact on outcomes and safety in patients relapsing after allogeneic stem cell transplantation has not been fully defined. To evaluate the impact of the availability of InO and Blina on clinical outcomes in adult B-cell ALL patients with post-transplant relapse, and to assess the safety of these agents in the post-transplant setting. We retrospectively analyzed 150 adult patients with B-cell ALL who relapsed after the first allogeneic stem cell transplantation. Patients were divided according to the time of their post-transplant relapse based on the approvals of InO and Blina in Japan: the pre-InO/Blina group (&lt;em&gt;n&lt;/em&gt; = 95) and the post-InO/Blina group (&lt;em&gt;n&lt;/em&gt; = 55). Outcomes were analyzed separately for Philadelphia chromosome (Ph)-negative and Ph-positive ALL. Overall survival (OS) after post-transplant relapse, complete remission (CR) rates as the best response before a second transplantation or last follow-up, and outcomes after a second transplantation were compared between groups. Adverse events associated with post-transplant use of InO and Blina were also evaluated. Among 95 patients with Ph-negative ALL, outcomes were significantly better in the post-InO/Blina group than in the pre-InO/Blina group, with the 2-year OS after post-transplant relapse improving from 19% to 51% (&lt;em&gt;P&lt;/em&gt; = .003) and, among 88 treated patients, the CR rate increasing from 36% to 77% (&lt;em&gt;P&lt;/em&gt; &lt; .001). Multivariable analyses identified the time of post-transplant relapse and disease status at the first transplantation as independent prognostic factors for OS. Among 43 patients who underwent a second transplantation, the 2-year OS after second transplantation improved from 27% in the pre-InO/Blina group to 55% in the post-InO/Blina group (&lt;em&gt;P&lt;/em&gt; = .029). In contrast, among 55 patients with Ph-positive ALL, OS after post-transplant relapse did not differ between groups. Among 32 patients treated with InO after post-transplant relapse, no patient developed veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) during InO therapy; however, 5 of 17 patients (29%) who subsequently underwent the second transplantation developed VOD/SOS. An interval of &lt;2.5 months between InO and the second transplantation was associated with a higher VOD/SOS risk (56% versus 0%, &lt;em&gt;P&lt;/em&gt; = .029). Among 30 patients treated with Blina, cytokine release syndrome occurred in 53% (grade 3 to 4, 7%) and immune effector cell-associated neurotoxicity syndrome in 13% (grade 3, 3%), with no fatal events. The prognosis of adult Ph-negative B-cell ALL after post-transplant relapse improved substantially in the post-InO/Blina era, including improved survival after a second transplantation. Overall, the safety profiles of In","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1352.e1-1352.e12"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989306","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 Critical Review of Clinical Factors and Tools for Predicting Chimeric Antigen Receptor T-Cell Toxicities","authors":"Jian Li,&nbsp;Mark R Dowling,&nbsp;Miriam Wronski,&nbsp;Christina Kazzi,&nbsp;Salvatore Fiorenza,&nbsp;Martin Cherk,&nbsp;Shu-Min Wong,&nbsp;Shafqat Inam,&nbsp;Thomas W Barber,&nbsp;Mastura Monif,&nbsp;Shaun A Fleming,&nbsp;Andrew Spencer,&nbsp;Constantine S Tam","doi":"10.1016/j.jtct.2026.05.027","DOIUrl":"10.1016/j.jtct.2026.05.027","url":null,"abstract":"<div><div>Chimeric antigen receptor T (CAR T) cell therapy has improved outcomes in several hematological malignancies but is associated with immune and hematologic toxicities, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), immune effector cell-associated hematotoxicity (ICAHT), and immune effector cell-associated hemophagocytosis-like syndrome (IEC-HS). Although diagnostic and grading criteria have been established, there is no consensus on the optimal use of prediction tools. This review describes the incidence of these toxicities and highlights the utility of available tools for predicting and risk-stratifying patients. These studies focus on clinical scores, immunoassays by analyzing CAR T-cell expansion and imaging biomarkers of tumor burden. Among the former, the EASIX score and its derivatives have been validated for predicting severe CRS and ICANS, whereas the CAR-HEMATOTOX score has been validated for predicting prolonged cytopenia. Emerging prediction models aim to integrate these domains to allow early intervention or de-escalation of immunosuppression therapy.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1254-1267"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148102022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Concurrent Graft-versus-Host Disease on Long-Term Survival in Critically Ill Patients Following Allogeneic Hematopoietic Stem Cell Transplantation for Hematological Malignancies","authors":"Zhixue Li,&nbsp;Peng Zhao,&nbsp;Gang Zhou,&nbsp;Jie Lv,&nbsp;Liping Yang,&nbsp;Jin Wu,&nbsp;Qiusha Huang,&nbsp;Haixia Fu,&nbsp;Yuanyuan Zhang,&nbsp;Fengrong Wang,&nbsp;Chenhua Yan,&nbsp;Zhidong Wang,&nbsp;Jun Kong,&nbsp;Tingting Han,&nbsp;Jingzhi Wang,&nbsp;Yao Chen,&nbsp;Meng Lv,&nbsp;Yuqian Sun,&nbsp;Yuhong Chen,&nbsp;Xiaodong Mo,&nbsp;Xiaohui Zhang","doi":"10.1016/j.jtct.2026.05.031","DOIUrl":"10.1016/j.jtct.2026.05.031","url":null,"abstract":"<div><div>Graft-versus-host disease (GVHD) is a common and potentially fatal complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The impact of GVHD on the long-term survival of critically ill patients after allo-HSCT for hematological malignancies is underestimated. In this study, we aimed to elucidate the impact of concurrent GVHD on the long-term survival of critically ill patients after transplantation for hematological malignancies. Between January 2010 and June 2025, all critically ill patients after transplantation for hematological malignancies were retrospectively identified and included in this cohort. A total of 726 critically ill patients were finally analyzed. In total, 198 (27.3%) patients with concurrent GVHD and 528 (72.7%) patients without concurrent GVHD were included in the cohort. The 12-month overall survival rate of the cohort was 27.7%, which was significantly lower in patients with concurrent GVHD than in those without concurrent GVHD (16.2% versus 32.8%, log rank <em>P</em> &lt; .001). Multivariate analyses revealed that concurrent GVHD (<em>P</em> = .002, hazard ratio [HR] 1.342, 95% confidence interval [CI] 1.117 to 1.613), relapse of hematological malignancies (<em>P</em> = .015, HR 1.510, 95% CI 1.083 to 2.105), sinusoidal obstruction syndrome (<em>P</em> = .048, HR 1.632, 95% CI 1.004 to 2.651), and ≥2 organ failures in the intensive care unit (<em>P</em> &lt; .001, HR 1.864, 95% CI 1.559 to 2.228) were independent risk factors for overall survival. In conclusion, for critically ill patients who underwent allo-HSCT for hematologic malignancies, concurrent GVHD significantly reduced long-term survival.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1348.e1-1348.e12"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006882","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":"Tuberculosis After Allogeneic Hematopoietic Cell Transplant: A 15-Year Case Series Highlighting Diagnostic Challenges","authors":"Cesar Figueroa-Ortiz,&nbsp;Scott Schoninger,&nbsp;June L. Chan,&nbsp;Tomas A. Bermudez,&nbsp;Yuxuan Li,&nbsp;Sasha Cander,&nbsp;Bridget Mcgonagle,&nbsp;Curtis W. Bacon,&nbsp;Or Kalchiem-Dekel,&nbsp;Mohit Chawla,&nbsp;Richard Lin,&nbsp;Roni Tamari,&nbsp;Brian C Shaffer,&nbsp;Miguel-Angel Perales,&nbsp;Gil Redelman-Sidi,&nbsp;Zainab Shahid,&nbsp;Raghu Loganathan,&nbsp;Mini Kamboj,&nbsp;Genovefa A. Papanicolaou,&nbsp;Yeon Joo Lee","doi":"10.1016/j.jtct.2026.06.007","DOIUrl":"10.1016/j.jtct.2026.06.007","url":null,"abstract":"<div><div>Tuberculosis (TB) is an uncommon but potentially fatal complication after allogeneic hematopoietic cell transplant (HCT). Diagnosis is often delayed due to nonspecific clinical presentations, limited sensitivity of screening tests for latent TB infection, and slow turnaround of conventional TB diagnostic methods. The study aim is to describe the clinical and diagnostic characteristics of allogeneic HCT recipients with TB in the era of molecular and sequence based diagnostic methods. We conducted a retrospective review of microbiologically confirmed TB cases among HCT recipients at a tertiary cancer center from 2010 to 2025. We detail clinical, demographic, and diagnostic characteristics including metagenomic next-generation sequencing (mNGS) testing of bronchoalveolar lavage (BAL) and blood (Eurofins Viracor, Lenexa, KS) for 2 individuals. Ten patients were diagnosed with active TB at a median of 122 days post-HCT (range: 36 to 2557). The median age was 53 yr, and 6 were male. Except for 1 patient, all patients were foreign-born. Pre-HCT TB screening was performed in 7 patients; however, only 3 had positive (tuberculin skin test, n = 1; interferon-gamma release assay [IGRA], n = 2), and 1 had indeterminate IGRA results. All patients had abnormal CT chest findings compatible with latent TB. Nine of 10 patients presented with either fever or cough, while 1 patient was asymptomatic with incidental radiographic abnormalities. TB was diagnosed by <em>Mycobacterium tuberculosis</em> (MTB) complex PCR in 8 cases, 4 patients had disseminated TB, and 3 died. mNGS results were available in 2 patients. In both cases MTB was detected in BAL, and in 1, MTB was detected in the blood. Among 9 patients with available susceptibility testing data, moxifloxacin resistance was identified in 1 case.</div><div>In our cohort, post-HCT TB occurred mainly in foreign-born patients. Infection was diagnosed early after transplant and was frequently disseminated, with high mortality. These results underscore the limitations of current screening methods, and the diagnostic challenges of post-HCT TB.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1313.e1-1313.e12"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211032","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}