Transplant immunology最新文献

{"title":"JC polyomavirus-associated nephropathy in a kidney allograft: A case report and literature review","authors":"Xue Li ,&nbsp;Wei Wang ,&nbsp;Jing Jiang ,&nbsp;Dongrui Cheng ,&nbsp;Jinsong Chen","doi":"10.1016/j.trim.2025.102212","DOIUrl":"10.1016/j.trim.2025.102212","url":null,"abstract":"<div><div>JC virus-associated nephropathy (JCV PyVAN) is a late infectious complication after kidney transplantation and represents a rare cause of allograft dysfunction. Herein, we report a case of JCV PyVAN in a 34-year-old woman presenting with elevated serum creatinine 13 years after kidney transplantation. Diagnosis was rendered with a positive JC viremia and viruria, in combination with histological findings consistent with PyVAN and immunohistochemical staining for large T antigen SV-40. A total of 17 cases of JCV PyVAN were retrieved from the reported literature, and patient characteristics, treatments and prognosis were summarized. This study highlights that although the prognosis for JCV PyVAN is generally favorable with reduction of immunosuppression, future research should further investigate the optimal therapeutic management of this rare condition.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102212"},"PeriodicalIF":1.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activation of anti-donor CD8 alloimmune response in clinically diagnosed acute rejection early after living-donor lobar lung transplantation and its impact on outcome","authors":"Satona Tanaka ,&nbsp;Naoki Tanimine ,&nbsp;Akiyoshi Nakakura ,&nbsp;Koichiro Uchida ,&nbsp;Ichiro Sakanoue ,&nbsp;Hidenao Kayawake ,&nbsp;Mamoru Takahashi ,&nbsp;Shigeto Nishikawa ,&nbsp;Yojiro Yutaka ,&nbsp;Yoshito Yamada ,&nbsp;Akihiro Ohsumi ,&nbsp;Masatsugu Hamaji ,&nbsp;Daisuke Nakajima ,&nbsp;Toyofumi F. Chen-Yoshikawa ,&nbsp;Yuka Tanaka ,&nbsp;Hideki Ohdan ,&nbsp;Hiroshi Date","doi":"10.1016/j.trim.2025.102201","DOIUrl":"10.1016/j.trim.2025.102201","url":null,"abstract":"<div><h3>Background</h3><div>The characteristics and prognostic impacts of early graft infiltration after lung transplantation and clinically diagnosed acute rejection remain unclear. Furthermore, the alloimmune response status in lung transplantation remains uninvestigated.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, we evaluated 92 living-donor lobar lung transplantations (LDLLT) to establish the effect of graft infiltration—diagnosed as acute rejection—within one-month post-transplantation (cAR), on chronic lung allograft dysfunction (CLAD)-free LDLLT survival. The alloimmune response was evaluated using the carboxyfluorescein diacetate succinimidyl ester (CFSE)-mixed lymphocyte reaction (MLR) in lymphocytes isolated from donor and recipient blood one week after LDLLT. The anti-donor proliferation of CD4+ and CD8+ T cells was determined using flow cytometry.</div></div><div><h3>Results</h3><div>cAR was observed in 54 (58.7 %) patients who underwent LDLLT. The median postoperative day of cAR occurrence was 7 days (ranging between 5 and 28 days). Only one episode of cAR occurred in 51 patients (94.4 %). CLAD-free survival was significantly lower in patients who underwent cAR, especially within 2 years after LDLLT (<em>p</em> = 0.016). Thirteen CFSE-MLR assays were performed in seven consecutive LDLLT cases (six bilateral and one unilateral LDLLT). Increased anti-donor proliferation of CD8+ T cells, but not CD4+ T cells, was associated with cAR, irrespective of human leukocyte antigen (HLA) class I mismatch.</div></div><div><h3>Conclusion</h3><div>Early lung graft infiltration after LDLLT increases the risk of the early development of CALD. Augmented anti-donor CD8 + response was also associated with graft infiltration, which could not be predicted from HLA mismatches but could be monitored using MLR in LDLLT.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102201"},"PeriodicalIF":1.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Despite routing to GI and pulmonary tissues, donor cells fail to engraft after intra-amniotic or intravascular cell delivery in a healthy allogeneic mouse model","authors":"Kerry A. Swanson,&nbsp;Hannah M. Phelps,&nbsp;Matthew T. Grant,&nbsp;Eliza P. Lang,&nbsp;Brad W. Warner,&nbsp;Jesse D. Vrecenak","doi":"10.1016/j.trim.2025.102200","DOIUrl":"10.1016/j.trim.2025.102200","url":null,"abstract":"<div><div>In utero hematopoietic cell transplantation (IUHCT) exploits tolerogenic fetal immunologic development to facilitate engraftment of donor. Non-hematopoietic donor-derived cells have been described in both in-utero and post-natal models of hematopoietic cell transplantation. However, while epithelial routing has been reported, long-term engraftment following IUHCT has not been well studied. We utilized intra-amniotic (IA) or intravascular (IV) IUHCT to evaluate routing and engraftment within the pulmonary and gastrointestinal (GI) tract. High donor-cell viability is observed in the amniotic fluid 24 h after IA injection (mean 89.1 %). At 24 and 72 h, donor cells were present within the lumens of GI and pulmonary tissues and in the parenchyma of the liver, suggesting that donor cells route effectively to epithelial surfaces and hematogenous targets following IA injection. However, following IA delivery, long-term engraftment was not observed in peripheral blood, and there was no evidence of donor-derived cells in any target tissue including lung, bowel, or liver. Following IV injection, mean peripheral blood chimerism at terminal harvest was 23.86 % (SEM 12.44; Range 0.00–98.90). Following IV delivery, donor-derived cells were noted in the bowel, liver, and lung but not in the epithelium, suggesting these cells are circulating or tissue-resident leukocytes. Despite the routing of donor cells to multiple fetal sites, the IA injection was an extremely inefficient method for long-term engraftment in the hematopoietic niche, in organ parenchyma, or on epithelial surfaces. In contrast, despite IV IUHCT being able to consistently produce hematopoietic engraftment, epithelial engraftment was not observed, suggesting a limited role for IV IHUCT in epithelial disorders.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"89 ","pages":"Article 102200"},"PeriodicalIF":1.6,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-HLA antibodies may be a subset of polyreactive immunoglobulins generated after viral superinfection","authors":"Steven D. Heron ,&nbsp;Jim Shaw ,&nbsp;Johannes Dapprich","doi":"10.1016/j.trim.2025.102197","DOIUrl":"10.1016/j.trim.2025.102197","url":null,"abstract":"<div><div>Chronic rejection remains an obstacle to long-term allograft survival. Donor-specific anti-HLA antibodies (DSA) play a significant role in causing chronic antibody-mediated allograft rejection. Exposure to mismatched HLA antigens via transfusion, pregnancy, or transplanted tissue has been described in the literature as an immunogenic stimulus of anti-HLA antibodies. Yet anti-HLA antibodies also develop in the absence of traditional sensitization events and molecular mimicry has been postulated as a stimulus for these naturally occurring alloantibodies. While heterologous reactivity has been documented between virus components and allogeneic T cells, there is insufficient evidence to support the development of anti-HLA antibodies from viral components. We hypothesized that anti-HLA antibodies may develop following viral coinfection or superinfection. The objectives of this investigation included: 1) developing an in-silico algorithm to identify viral peptide components that exhibit HLA-specific homology, and 2) identifying cellular changes that take place during ischemia/reperfusion injury which could facilitate the generation of novel anti-HLA antibodies from viral sources. We developed the neoepitope transplant rejection and autoimmune disease (NETRAD) algorithm to identify amino acid sequence homology between viral envelope proteins and HLA. The algorithm integrates post-translational protein modifications that are consistent with ischemia/reperfusion injury. Seventy-two HLA-specific epitopes were demarcated as examples using this approach. In conclusion, we present in-silico evidence which supports the identification of anti-HLA antibodies as a subset of polyreactive antibodies generated from stress-modified viral envelope proteins. Remarkably, each targeted HLA epitope associated with a distinct anti-HLA antibody could be consistently attributed to a major envelope glycoprotein component of Epstein Barr virus.</div><div><strong>Transplant Immunology manuscript</strong> # TRIM-D-24-00351.</div><div><strong>Dryad data repository:</strong> <span><span>https://doi.org/10.5061/dryad.qjq2bvqpq</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"90 ","pages":"Article 102197"},"PeriodicalIF":1.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut microbiota variation and diversity and gut graft-versus-host disease (GVHD) in pediatrics: A systematic review","authors":"Mohammad Hassan Sohouli ,&nbsp;Arefeh Zahmatkesh ,&nbsp;Zahid Khan ,&nbsp;Maryam Behfar ,&nbsp;Amir Ali Hamidieh ,&nbsp;Pejman Rohani","doi":"10.1016/j.trim.2025.102199","DOIUrl":"10.1016/j.trim.2025.102199","url":null,"abstract":"<div><h3>Background</h3><div>Allogeneic hematopoietic stem cell transplantation (HSCT) provides children with life-threatening conditions an opportunity for survival. Complications from graft-versus-host disease (GVHD) are a major source of morbidity and death, recently linked to gut dysbiosis in the hematopoietic stem cell transplantation (HSCT) population. But so far, no comprehensive study has been conducted to investigate this relationship in the children population. In this systematic study, we investigated the Gut microbiota variation and diversity and gut GVHD in pediatrics.</div></div><div><h3>Methods</h3><div>A systematic review according to PRISMA standards was performed from inception till August 2024. Out of 568 originally chosen publications, 10 studies involving 490 pediatric subjects satisfied the eligibility criteria and were included.</div></div><div><h3>Results</h3><div>The findings obtained from the study included in the present systematic study mostly indicated the use of combined treatments including Busulfan, Cyclophosphamide, and total body irradiation and in some studies the use of anti-thymocyte globulin and Melphalan as conditioning regimens. In addition, out of 10 reviewed studies, 9 reported a significant decrease in gut microbiota diversity following GVHD. However, in all studies, an increased variation was reported. So that most of the studies showed a decrease in the levels of beneficial bacteria and producers of short-chain fatty acid products in the intestine such as <em>Ruminococcaceae</em> and <em>Enterococcus</em>, which is also observed in the intestinal microbiota population of healthy people.</div></div><div><h3>Conclusion</h3><div>As a result, our findings indicated a decrease in diversity as well as a change in intestinal microbiota in children with GVHD under HSCT in most of the studies.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"89 ","pages":"Article 102199"},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induction outcomes in adult kidney transplantation: Two decades of UNOS data analysis","authors":"Emmanuel Aydin-Ghormoz ,&nbsp;Jorge Ortiz ,&nbsp;Kathryn Schubauer ,&nbsp;Naoru Koizumi ,&nbsp;Meng-Hao Li ,&nbsp;Geovani Faddoul","doi":"10.1016/j.trim.2025.102198","DOIUrl":"10.1016/j.trim.2025.102198","url":null,"abstract":"<div><h3>Objectives</h3><div>In the US, 92 % of kidney transplant recipients are treated with induction therapy. This analysis assesses the impact of induction immunosuppression on outcomes such as graft failure, patient mortality, and length of hospitalization.</div></div><div><h3>Material and methods</h3><div>Retrospective analysis of the UNOS database in adults who received a kidney transplant from January 2000 to June 2022. Analysis focused on induction regimens including anti-thymocyte globulin (ATG), alemtuzumab and basiliximab with maintenance immunosuppression of calcineurin inhibitors, mycophenolate with or without prednisone. Multivariable logistic regression was performed to identify factors correlating with outcomes. Kaplan-Meier product limit method assessed survival.</div></div><div><h3>Results</h3><div>Alemtuzumab correlated with increased graft failure in deceased-donor and living-donor kidney transplants (HR 1.075 [1.015–1.138] <em>p</em> = 0.013 and HR 1.096 [1.011–1.188] <em>p</em> = 0.026 respectively) and with increased mortality in living-donor kidney transplants (HR 1.215 [1.107–1.332] <em>p</em> &lt; 0.001). Steroids maintenance was associated with fewer acute rejections in both deceased-donor and living-donor kidney transplants (HR = 0.875 [0.84–0.90] <em>p</em> &lt; 0.001 and HR = 0.88 [0.83–0.93] <em>p</em> &lt; 0.001 respectively). Odds of CMV was lower with alemtuzumab. Induction with alemtuzumab was associated with shorter length of stay in both deceased-donor and living-donor kidney transplants and longer time to first hospitalization in living-donor kidney transplants compared to ATG.</div></div><div><h3>Conclusions</h3><div>Alemtuzumab correlated with shorter length of stay, fewer re-hospitalizations and less CMV infections. However, it was associated with higher odds of graft failure and mortality in adult kidney transplant recipients.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"89 ","pages":"Article 102198"},"PeriodicalIF":1.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the best premedication regimen to prevent rabbit anti-human thymocyte globulin infusion-associated reactions: A retrospective study comparing two hematopoietic stem cell transplant centers","authors":"Keven Vachon ,&nbsp;Marc-Antoine Tardif ,&nbsp;Étienne Paillé ,&nbsp;Marie-Helene Leblanc ,&nbsp;Guy Cantin ,&nbsp;Christopher Lemieux ,&nbsp;Geneviève Gallagher","doi":"10.1016/j.trim.2025.102178","DOIUrl":"10.1016/j.trim.2025.102178","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Thymoglobulin® (ATG), a rabbit anti-human thymocyte globulin, is used in allogeneic hematopoietic stem cell transplantation (HSCT) mainly to prevent the development of graft-versus-host disease (GVHD). Three doses (ATG1, ATG2, and ATG3) are administered on separate days, apart from the graft day. Since infusion-associated reactions (IAR) are frequent, patients were treated with acetaminophen, antihistamine, and corticosteroids (CS) as premedication (PR); however, the best PR regimen remains to be defined.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The study compared the incidence and severity of IAR related to ATG according to the different PR therapy. This descriptive retrospective cohort study included patients receiving ATG in two HSCT transplant centers (Hospitals A and B). The data cut-off was in March 2020, but the period of interest was different between the two hospitals to balance the two groups. Four PR regimens were compared, one from Hospital A (PR-A) and three from Hospital B (PR-B1, B2, and B3), which have changed twice in the last decade. Along with PR therapy, the indication and method of administration of ATG also differed between hospitals.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 132 patients were included from May 2011 to March 2020. Groups PR-A, B1, B2, and B3 had, respectively, 61, 22, 26, and 23 patients. Of them, 115 (87 %) had at least one IAR, and 86 (65 %) had at least one severe IAR during any ATG infusions. ATG3 had the lowest incidence of IAR (39 %), and it seemed better tolerated when given after graft infusion than before (32 % vs. 46 %, respectively; &lt;em&gt;p&lt;/em&gt; = 0.11). Almost three-quarters of patients had at least one IAR that occurred after the end of an ATG infusion, but there was less IAR with PR-B3 protocol where acetaminophen and diphenhydramine were regularly administered beyond ATG infusion. Hospital A used a progressive rate of infusion, but early IAR was seen compared to Hospital B (&lt;em&gt;p&lt;/em&gt; = 0.03), where a fixed rate was used. No direct association was found between the CS dose received and IAR incidence (&lt;em&gt;p&lt;/em&gt; = 0.21) or severity (&lt;em&gt;p&lt;/em&gt; = 0.61). However, there was a recurrent signal for less severe IAR in the PR-B3 group compared to its predecessors, B1 and B2 groups (&lt;em&gt;p&lt;/em&gt; = 0.12), and the key difference was an increased CS dose. The mean total CS therapy received was nearly double at Hospital A compared with Hospital B (1182 vs. 692 mg prednisone equivalent; &lt;em&gt;p&lt;/em&gt; &lt; 0.01). Fungal infection rate was higher in Hospital A compared to Hospital B (33 % vs. 13 %; &lt;em&gt;p&lt;/em&gt; &lt; 0.01). The infection rate correlated with a higher dose of CS received on days of ATG therapy (p &lt; 0.01).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;ATG3 given the day after HSCT appears to play a key role in reducing the incidence and severity of IAR. Infusion over six hours at a fixed rate was safe. Frequent, regular, and extended doses of acetaminophen and antihistamines b","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"89 ","pages":"Article 102178"},"PeriodicalIF":1.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of liver transplant mortality scales in a Mexican population","authors":"Alejandra Nuñez-Venzor ,&nbsp;Asya Zubillaga-Mares ,&nbsp;Aczel I. Sánchez-Cedillo ,&nbsp;Josué I. Olivares del Moral ,&nbsp;Carlos Florez-Zorrilla ,&nbsp;Elizabeth Buganza-Torio ,&nbsp;Francisco E. Alvarez-Bautista ,&nbsp;Mario Trejo-Avila ,&nbsp;Manuel Martínez-Meraz","doi":"10.1016/j.trim.2025.102185","DOIUrl":"10.1016/j.trim.2025.102185","url":null,"abstract":"<div><h3>Background</h3><div>Liver transplantation is the treatment of choice in patients with chronic liver disease and acute liver failure of any etiology. Scales such as the Survival Outcome Following Transplantation (SOFT) score and the Balance of Risk (BAR) score can be used to predict survival. In this study, we compared these scales in the Mexican population.</div></div><div><h3>Methods</h3><div>A cross-sectional analytical study was carried out in a Mexican third-level transplant center. The MELD, SOFT, and BAR scales were adopted. The ROC curves of the three predictive scores were constructed, and the areas under the curve were obtained and compared. A bivariate analysis and Cox regression were performed. Finally, a survival analysis was performed using Kaplan–Meier curves.</div></div><div><h3>Results</h3><div>We analyzed 123 liver transplant (LT) recipients. The bivariate analysis and Cox regression indicated that portal thrombosis, with an HR of 3.36 (IC 1.069–10.59, <em>p</em> = 0.038), and the number of red blood cells transfused, with an HR of 1.084 (CI 1.039–1.130, <em>p</em> &lt; 0.000), were significantly associated with mortality. The receiver height was a protective factor, with an HR of 0.001 (CI 0.000–0.761, <em>p</em> = 0.041). Regarding the Pearson correlation analysis, the BAR scale had a coefficient of 0.199 (<em>p</em> = 0.032) for transfusion, while the SOFT scale's correlation coefficients for cold ischemia and transfusion were 0.236 (<em>p</em> = 0.011) and 0.274 (<em>p</em> = 0.003), respectively, all indicating weak correlations. The areas under the curve (AUCs) of MELD, SOFT, and BAR in predicting 3-month mortality were 0.495 (<em>P</em> = 0.94), 0.608 (<em>p</em> = 0.129), and 0.502 (<em>p</em> = 0.97), respectively. Finally, in the survival analysis using Kaplan–Meier curves, an estimated mean survival period of 71.52 months was obtained, with a survival rate of 89.3 % at 30 days and 81.1 % at five years.</div></div><div><h3>Conclusion</h3><div>In this study, it was found that all three scales were deficient in discriminating among the outcomes obtained in the Mexican population.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"89 ","pages":"Article 102185"},"PeriodicalIF":1.6,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of outcomes following subcutaneous or intravenous alemtuzumab administered prior to reduced intensity conditioning for transplantation in pediatric sickle cell disease","authors":"Alexandra Plavsa ,&nbsp;Tara Suresh ,&nbsp;Stuti Dalal ,&nbsp;Lucia Mirea ,&nbsp;Roberta H. Adams ,&nbsp;Shalini Shenoy ,&nbsp;Alexander Ngwube","doi":"10.1016/j.trim.2025.102179","DOIUrl":"10.1016/j.trim.2025.102179","url":null,"abstract":"<div><h3>Background</h3><div>Alemtuzumab-containing conditioning regimens are used for allogeneic hematopoietic stem cell transplantation (HSCT) to reduce acute and chronic graft-versus-host disease (GVHD) and the risk of graft rejection. Alemtuzumab is typically administered intravenously but is often accompanied by infusion-related side effects, including injection site reactions and anaphylaxis. Little is known about the routes of administration and if they differ in safety and efficacy in pediatric patients, especially when used in transplant conditioning.</div></div><div><h3>Objectives</h3><div>To compare adverse effects and efficacy outcomes between intravenous and subcutaneous alemtuzumab administration in pediatric patients with sickle cell disease who have undergone HSCT.</div></div><div><h3>Study design</h3><div>A retrospective cohort of 49 pediatric patients with sickle cell disease aged 4–16 years underwent HSCT and received either intravenous or subcutaneous alemtuzumab at St. Louis Children's Hospital or Phoenix Children's Hospital. The incidence of infusion-related reactions, neutrophil and platelet recovery, graft failure, and immune reconstitution were compared.</div></div><div><h3>Results</h3><div>We found that subcutaneous alemtuzumab administration elicited fewer infusion-related reactions than intravenously administered drug (<em>p</em> = 0.038). No significant differences in engraftment rates, graft failure rates, infectious complications, acute GVHD, and immune reconstitution were found between the two groups.</div></div><div><h3>Conclusion</h3><div>Subcutaneous administration of alemtuzumab for children undergoing transplant for sickle cell disease is safe and effective.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"89 ","pages":"Article 102179"},"PeriodicalIF":1.6,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143180721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose emapalumab combined with chemotherapy for adult patients with Epstein–Barr virus-associated hemophagocytic lymphohistiocytosis","authors":"Wenjuan Zhu ,&nbsp;Fei Zhou ,&nbsp;Yue Song ,&nbsp;Shiyuan Zhou ,&nbsp;Feng Du ,&nbsp;Qian Zhu ,&nbsp;Ziyi Wang ,&nbsp;Liyun Bai ,&nbsp;Jianhong Fu ,&nbsp;Xiao Ma ,&nbsp;Xiaojin Wu ,&nbsp;Xuefeng He","doi":"10.1016/j.trim.2024.102162","DOIUrl":"10.1016/j.trim.2024.102162","url":null,"abstract":"<div><div>Hemophagocytic lymphohistiocytosis (HLH) is a severe disorder with poor clinical outcomes. Use of emapalumab, an IFN-γ inhibitor, enables primary HLH control in over 85 % of affected children. However, data on emapalumab use for Epstein–Barr virus-associated HLH (EBV-HLH) are limited. This report presents the cases of three patients with EBV-HLH, highlighting the successful integration of low-dose emapalumab in combination with chemotherapy as a novel therapeutic approach for patients diagnosed with EBV-HLH. This regimen resulted in rapid disease symptom control and hematological parameter improvement and facilitated successful stem cell transplantation. This report highlights the potential of low-dose emapalumab combined with chemotherapy as an effective bridging therapy to allogenic hematopoietic stem cell transplantation in EBV-HLH patients.</div></div>","PeriodicalId":23304,"journal":{"name":"Transplant immunology","volume":"88 ","pages":"Article 102162"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}