Transplantation and Cellular Therapy最新文献

{"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}

{"title":"PTCy-Based versus ATG-Based GVHD Prophylaxis in Mismatched Unrelated Donor HCT: A Secondary Analysis of CIBMTR Data","authors":"Sergio Rodriguez-Rodriguez,&nbsp;Gonzalo Bentolila,&nbsp;Archit Pandharipande,&nbsp;Nico Gagelmann,&nbsp;Nihar Desai","doi":"10.1016/j.jtct.2026.05.026","DOIUrl":"10.1016/j.jtct.2026.05.026","url":null,"abstract":"<div><div>The optimal graft-versus-host disease (GVHD) prophylaxis strategy for 7/8 human leukocyte antigen (HLA)-mismatched unrelated donor (MMUD) hematopoietic cell transplantation (HCT) has not been established. We performed a secondary analysis of a publicly available Center for International Blood and Marrow Transplant Research (CIBMTR) dataset (P-5891) including adults undergoing first 7/8 MMUD HCT between 2017 and 2021. Patients were stratified by GVHD prophylaxis: anti-thymocyte globulin (ATG) with calcineurin inhibitor (CNI) and methotrexate (n = 221), or post-transplant cyclophosphamide (PTCy) with CNI and mycophenolate mofetil (n = 613). PTCy was associated with lower grade II-IV acute GVHD (30.7% versus 50.3%; <em>P</em> &lt; .001) and grade III-IV acute GVHD (7.7% versus 23.8%; <em>P</em> &lt; .001). Nonrelapse mortality (NRM) at 24 months was 17.2% versus 35.1% (<em>P</em> &lt; .001). Rates of moderate-severe chronic GVHD and relapse were comparable. GVHD-free/relapse-free survival (GRFS) at 24 months was 44.9% versus 26.7% (<em>P</em> &lt; .001), and overall survival (OS) at 24 months was 63.9% versus 46.6% (<em>P</em> &lt; .001). On multivariable analysis, PTCy was independently associated with improved GRFS (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.48-0.72; <em>P</em> &lt; .001), lower NRM (HR 0.44, 95% CI 0.32-0.60; <em>P</em> &lt; .001), and improved OS (HR 0.60, 95% CI 0.44-0.72; <em>P</em> &lt; .001), without an increase in relapse risk (HR 1.07, 95% CI 0.77-1.48; <em>P</em> = .68).</div><div>In this registry-based analysis, PTCy-based prophylaxis was associated with improved OS, NRM, and GRFS compared with ATG-based prophylaxis in 7/8 MMUD HCT. Prospective studies comparing these strategies specifically in MMUD recipients are needed to confirm these findings.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1335-1345"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975763","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":"Poor Graft Function (PGF) Following In Vivo T Cell–Depleted Allogeneic Stem Cell Transplantation: The Role of Delayed Immune Reconstitution","authors":"Davide Murgia,&nbsp;Alessandra Algarotti,&nbsp;Chiara Pavoni,&nbsp;Benedetta Rambaldi,&nbsp;Giuliana Rizzuto,&nbsp;Maria Chiara Finazzi,&nbsp;Elena Oldani,&nbsp;Orietta Spinelli,&nbsp;Cristian Meli,&nbsp;Alessandro Rambaldi,&nbsp;Federico Lussana,&nbsp;Anna Grassi","doi":"10.1016/j.jtct.2026.06.003","DOIUrl":"10.1016/j.jtct.2026.06.003","url":null,"abstract":"<div><div>Poor graft function (PGF) is a severe early complication of allogeneic hematopoietic stem cell transplantation (HSCT), defined by persistent cytopenias despite full donor chimerism. Its characterization has been limited by heterogeneous diagnostic criteria, impairing reliable estimates of incidence, risk factors, and biological correlates. An internationally harmonized definition was introduced in 2024 which provided a standardized framework for clinical and biological investigations, facilitating comparisons across studies. To assess the incidence, risk factors, clinical outcomes, and immune reconstitution associated with PGF using the 2024 harmonized definition in a large adult HSCT cohort. We conducted a retrospective single-center study including 655 consecutive adult HSCT recipients between 2015 and 2025. PGF was defined according to 2024 harmonized criteria. The primary endpoint was cumulative incidence of PGF; secondary endpoints included overall survival (OS), nonrelapse mortality (NRM), cumulative incidence of relapse (CIR), and immune reconstitution. Risk factors were assessed using univariate and multivariate logistic regression. Time-to-event outcomes were analyzed using competing-risk models and Simon–Makuch methodology. Immune reconstitution (CD3⁺, CD4⁺, CD8⁺, CD16⁺, CD19⁺ subsets) was evaluated longitudinally using linear mixed-effects and time-point analyses. PGF occurred in 46 patients (12-month cumulative incidence 7%), with a median onset of 86 days post-HSCT. In multivariate analysis, myelofibrosis (OR: 7.25, <em>P</em> &lt; .001), myelodysplastic syndromes (OR: 4.91, <em>P</em> = .002), major ABO incompatibility (OR: 2.32, <em>P</em> = .019), CD34⁺ cell dose &lt;5 × 10⁶/kg (OR: 2.34, <em>P</em> = .022), and post-transplant cyclophosphamide (PTCy) (OR: 2.39, <em>P</em> = .022) were independently associated with PGF. Five-year NRM was higher in PGF (25% versus 15%, <em>P</em> = .04), predominantly due to infections, prompting evaluation of post-transplant immune reconstitution as a potential underlying mechanism. Indeed, PGF was associated with delayed immune reconstitution, with impaired recovery of CD3⁺, CD4⁺, CD8⁺, and CD16⁺ cells throughout the first year after transplant, independent of PTCy or antithymocyte globulin exposure. B-cell recovery was also impaired, with lower CD19⁺ counts and increased hypogammaglobulinemia rates at 1 year after transplant. PGF is an early, severe post-HSCT complication associated with increased infectious NRM. This study represents the largest analysis of immune reconstitution in PGF, demonstrating delayed recovery across lymphocyte subsets, which may contribute to the observed excess infectious NRM. Distinct disease- and transplant-related factors identify higher-risk patients, supporting improved pretransplant risk stratification, graft optimization, and tailored post-transplant monitoring strategies.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1291.e1-1291.e10"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176705","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":"The Influence of Race/Ethnicity and Social Vulnerability on Non-Relapse Mortality after Allogeneic Hematopoietic Cell Transplant in Older (≥60 Years) Adults","authors":"Rusha Bhandari,&nbsp;Haoyue Shan,&nbsp;Jorge Ramos-Perez,&nbsp;Sitong Chen,&nbsp;Alysia Bosworth,&nbsp;Dongyun Yang,&nbsp;Monzr Al Malki,&nbsp;William Dale,&nbsp;Stephen J. Forman,&nbsp;Ryotaro Nakamura,&nbsp;F. Lennie Wong,&nbsp;Saro H. Armenian,&nbsp;Andrew Artz","doi":"10.1016/j.jtct.2026.05.040","DOIUrl":"10.1016/j.jtct.2026.05.040","url":null,"abstract":"","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1243.e1-1243.e3"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056920","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 Impact of Female-To-Male Allogeneic Hematopoietic Cell Transplantation on Survival Outcomes Varies by Recipient Age","authors":"Kosuke Takano,&nbsp;Masaharu Tamaki,&nbsp;Yoshitaka Inoue,&nbsp;Shunto Kawamura,&nbsp;Seitaro Terakura,&nbsp;Dai Keino,&nbsp;Shinichi Kako,&nbsp;Shin-ichiro Fujiwara,&nbsp;Noriko Doki,&nbsp;Tetsuya Nishida,&nbsp;Yuta Hasegawa,&nbsp;Noboru Asada,&nbsp;Masashi Sawa,&nbsp;Masatsugu Tanaka,&nbsp;Naoyuki Uchida,&nbsp;Nobuhiro Hiramoto,&nbsp;Hirohisa Nakamae,&nbsp;Koji Kawamura,&nbsp;Takahiro Fukuda,&nbsp;Marie Ohbiki,&nbsp;Hideki Nakasone","doi":"10.1016/j.jtct.2026.05.036","DOIUrl":"10.1016/j.jtct.2026.05.036","url":null,"abstract":"<div><div>Sex-mismatched allogeneic hematopoietic cell transplantation (allo-HCT), particularly with female donors and male recipients (FtoM), is known to be associated with an increased risk of chronic graft-versus-host disease (GVHD) and nonrelapse mortality (NRM). This adverse effect of FtoM allo-HCT is considered to result from allo-immunity against Y-chromosome antigens. However, it has not been elucidated whether the adverse impact of FtoM allo-HCT varies by recipient age. This study aims to examine the effect of sex-mismatch on clinical outcomes in allo-HCT from human leukocyte antigen (HLA)-matched donors, stratified by recipient age group. Using a Japanese transplantation registry database, we analyzed 10392 patients (n = 2169, 2573, and 5650 in FtoM, MtoF, and sex-matched allo-HCT, respectively) with standard-risk hematological malignancies who had undergone their first allo-HCT from HLA-matched related or unrelated donors without in vivo T-cell depletion between 2008 and 2022. The impact of sex-mismatch on clinical outcomes was separately assessed by recipient age groups: ≤15, 16-39, and ≥40 years. The primary endpoint was overall survival (OS). Secondary endpoints included disease-free survival, NRM, and the cumulative incidences of acute and chronic GVHD. In recipients aged ≥40 years, OS and NRM at 5 years post-HCT were significantly worse in the FtoM group compared with the MtoF and sex-matched groups (5-year OS 49.5% versus 59.6% versus 57.1%, <em>P</em> &lt; .001; 5-year NRM 27.9% versus 21.9% versus 23.0%, <em>P</em> &lt; .001), while no differences were observed among the FtoM, MtoF, and sex-matched groups in recipients aged ≤ 15 years or 16-39 years. Multivariate analyses confirmed that FtoM allo-HCT was significantly associated with increased mortality only in recipients aged ≥ 40 years (hazard ratio [HR] for OS 1.31, <em>P</em> &lt; .001; HR for NRM 1.44, <em>P</em> &lt; .001). The FtoM group in recipients aged ≥ 40 years frequently experienced fatal infection and fatal noninfectious pulmonary complications. In addition, we confirmed that the adverse effect of FtoM allo-HCT on OS similarly appeared only in recipients aged ≥ 40 years in both sub-cohorts divided by a median of donor age (40 years). The adverse impact of FtoM allo-HCT on survival outcomes differed according to recipient age. Our findings suggest that female donors should be avoided, especially in older male recipients undergoing allo-HCT.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1287.e1-1287.e11"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148056924","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":"Desmosine as a Novel Biomarker Candidate for Pulmonary and Cutaneous Chronic Graft-Versus-Host Disease","authors":"Aaron T. Zhao,&nbsp;Filip Pirsl,&nbsp;Jackie Parkin,&nbsp;Alain Mina,&nbsp;Rania Hishmeh,&nbsp;Noa G. Holtzman,&nbsp;Eduard Schulz,&nbsp;Steven Z. Pavletic,&nbsp;Najla El Jurdi","doi":"10.1016/j.jtct.2026.05.034","DOIUrl":"10.1016/j.jtct.2026.05.034","url":null,"abstract":"<div><div>Pulmonary and cutaneous fibrotic manifestations are common in chronic graft-versus-host disease (cGVHD) and can significantly reduce patients’ quality of life and functional status. Plasma desmosine (pDES), a byproduct of elastin breakdown, may serve as a biomarker for fibrotic tissue involvement in cGVHD. The primmary objective was to evaluate the association between plasma desmosine levels and pulmonary and cutaneous manifestations in patients with cGVHD. We measured pDES levels in 81 cGVHD patients enrolled in the NIH cGVHD Natural History Study using liquid chromatography-tandem mass spectrometry. Patients were evaluated for bronchiolitis obliterans syndrome (BOS) according to NIH consensus criteria, lung involvement using FEV1-based NIH lung cGVHD scores, and skin sclerosis as defined by NIH skin feature scores. Statistical analyses included logistic and linear regression, adjusted for relevant covariates. The median pDES level was 0.39 ng/mL, with 77% of patients exceeding the upper limit of normal (0.280 ng/mL). No significant association was observed between pDES levels and BOS diagnosis (odds ratio [OR]: 1.15, 95% confidence interval [CI]: 0.89-1.52, <em>P</em> = .31). Among patients with skin sclerosis, 84% had elevated pDES levels compared with 67% of those without sclerosis. Similarly, 82% of patients with impaired lung function had elevated pDES levels versus 56% of those with normal lung function. On multivariate analysis, each 0.1 ng/mL increase in pDES was associated with a twofold increase in the odds of impaired lung function (OR: 1.96, 95% CI: 1.13-3.91; <em>P</em> = .032) and higher odds of skin sclerosis (OR: 1.36, 95% CI 1.02-1.92; <em>P</em> = .048). Elevated pDES levels were significantly associated with pulmonary function impairment and skin sclerosis in cGVHD, supporting the potential role of desmosine as a biomarker of organ involvement. Although these findings should be interpreted cautiously, they provide a strong rationale for evaluation in larger, prospective cohorts. Future studies are warranted to validate these observations and to clarify the potential utility of pDES as a prognostic biomarker, as well as its role in monitoring disease progression and treatment response.</div></div>","PeriodicalId":23283,"journal":{"name":"Transplantation and Cellular Therapy","volume":"32 10","pages":"Pages 1246.e1-1246.e10"},"PeriodicalIF":4.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057183","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}