Blood cell therapy最新文献

{"title":"Early Secondary Graft Failure After Complete Donor Chimerism with Autologous Recovery Following Haploidentical HSCT for Relapsed B-ALL.","authors":"Rene A Amadore, Lynn B Bonifacio","doi":"10.31547/bct-2026-026","DOIUrl":"10.31547/bct-2026-026","url":null,"abstract":"<p><p>Secondary graft failure after initial donor engraftment is a rare complication of allogeneic hematopoietic stem cell transplantation (HSCT). We report a 47-year-old man with Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia (B-ALL) who underwent haploidentical sibling peripheral blood HSCT after second complete remission. Neutrophil engraftment occurred by Day +14 with platelet engraftment by Day +18. Beginning Day +22, recurrent fever with progressive cytopenias developed. Day +30 peripheral blood short tandem repeat (STR) analysis showed complete donor chimerism; however, cytomegalovirus (CMV) DNAemia increased to 3,736 IU/mL, prompting therapeutic valganciclovir. Bone marrow biopsy on Day +37 showed hypocellular marrow without residual disease, although bone marrow X/Y fluorescence in situ hybridization (FISH) demonstrated 100% XY signals despite a female donor, indicating graft loss. Septic shock developed on Day +48. Management included growth factors, temporary tacrolimus withdrawal, antibiotics, granulocyte infusions, and a stem cell boost on Day +62. Repeat peripheral blood chimerism by Day +95 showed complete recipient genotype, confirming secondary graft failure with autologous reconstitution. Follow-up through Day +183 confirmed sustained autologous hematopoiesis with no relapse or graft-versus-host disease (GVHD). This case highlights an uncommon transition from donor-type marrow failure to autologous recovery and underscores the importance of bone marrow-based chimerism monitoring in cytopenic post-transplant patients.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 3","pages":"131-136"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world survey of hematopoietic stem cell transplantation in Japan using a nationwide administrative claims database.","authors":"Yachiyo Kuwatsuka, Kikue Sato, Yoshiko Atsuta, Tetsuya Nishida, Yukiyasu Ozawa, Masayuki Hino, Koichi Miyamura","doi":"10.31547/bct-2026-016","DOIUrl":"10.31547/bct-2026-016","url":null,"abstract":"<p><p>According to data from the Japanese registry managed by the Transplant Registry Unified Management Program, the number of autologous stem cell transplantations (auto-SCT) in 2018 was approximately 60% of that of allogeneic SCT (allo-SCT). The opposite trend has been reported in the United States. Thus, we hypothesized that auto-SCT is underreported in the registry. We analyzed anonymized aggregated data from the Diagnosis Procedure Combination (DPC) database, a nationwide administrative claims database in Japan. Counts for fiscal years (FY) 2017 and 2018 were obtained for autologous collections, auto-SCT, and allo-SCT by graft source, and summarized by key demographic and clinical characteristics, including disease category and in-hospital outcomes. In FY2018, the DPC data recorded 23 autologous bone marrow transplantations (BMT), 2,590 autologous peripheral blood stem cell transplantations (PBSCT), 1,238 allogeneic BMT, 1,072 allogeneic PBSCT, and 1,353 cord blood transplantations (CBT). Similar findings were observed in FY2017. We identified plasma cell neoplasms (48%) and lymphoma (43%) as the primary indications for autologous PBSCT. Compared with the Japanese transplant registry, allogeneic SCT counts were similar across graft sources, whereas autologous PBSCT counts were approximately 500 higher. However, due to differences in aggregation rules, these findings should be interpreted as approximate rather than precise estimates. Our analysis of nationwide claims-based DPC data indicates potential underreporting of autologous PBSCT in the Japanese registry. Our findings support the complementary use of DPC data with registry data to characterize real-world hematopoietic cell transplantation practice in Japan.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 3","pages":"125-130"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to Work After Hematopoietic Stem Cell Transplantation: A Longitudinal Analysis of Fatigue and Organ-Specific Chronic Graft-versus-Host Disease.","authors":"Meng-Kuan Chiang, Ye-Mei Hsiao, Abdiwahab M Ali, Tran-Der Tan, Lun-Wei Chiou","doi":"10.31547/bct-2026-007","DOIUrl":"10.31547/bct-2026-007","url":null,"abstract":"<p><strong>Background: </strong>Return to work (RTW) indicates long-term functional recovery following hematopoietic stem cell transplantation (HSCT), yet the impact of organ-specific chronic graft-versus-host disease (cGvHD) remains understudied.</p><p><strong>Objective: </strong>To determine the probability and timing of RTW and identify its predictors, specifically fatigue and organ-specific cGvHD, using longitudinal nursing data.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 2,334 longitudinal nursing assessment records from 80 HSCT recipients (2016-2021). The probability of RTW over time was estimated using the Kaplan-Meier method. Time-dependent Cox regression models were used to identify predictors while adjusting for age, sex, and clinical confounders.</p><p><strong>Results: </strong>The median follow-up was 507 days (interquartile range [IQR] 224-797). The median time to RTW was 312.5 days (IQR 144.0-567.2). The Kaplan-Meier-estimated probability of RTW was 17.8%, 34.1%, and 53.3% at 6, 12, and 24 months, respectively. Multivariable analysis revealed that allogeneic HSCT (hazard ratio [HR]=0.17, <i>p</i> < 0.001) and high fatigue (≥ 4) (HR=0.67, <i>p</i>=0.029) were significant predictors of delayed RTW. Among allogeneic recipients, joint/fascia involvement (HR=0.39, <i>p</i>=0.003) was associated with reduced RTW likelihood.</p><p><strong>Conclusions: </strong>RTW after HSCT is a delayed and symptom-driven recovery process. Fatigue was a universal barrier across transplant types, while allogeneic recipients faced additional obstacles from organ-specific cGvHD. Systematic assessment and targeted rehabilitation for fatigue and musculoskeletal manifestations are essential to support vocational reintegration. Although pulmonary involvement did not reach statistical significance, it showed a trend toward delayed RTW and warrants further investigation.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 3","pages":"114-124"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ruxolitinib-associated pulmonary alveolar proteinosis successfully managed by switching to belumosudil in chronic graft-versus-host disease.","authors":"Hiroaki Araie, Kohei Ishigiwa, Tatsunori Goto, Yuko Waseda, Takahiro Yamauchi","doi":"10.31547/bct-2026-011","DOIUrl":"10.31547/bct-2026-011","url":null,"abstract":"<p><p>Secondary pulmonary alveolar proteinosis (PAP) is a rare but serious complication that can occur during immunosuppressive therapy for chronic graft-versus-host disease (GVHD). It is characterized by the intra-alveolar accumulation of surfactant due to drug-induced alveolar macrophage dysfunction. Managing PAP while maintaining control of active chronic GVHD represents a significant clinical challenge, particularly with regard to the optimal strategy for transitioning between immunosuppressive agents. A 25-year-old male with severe chronic GVHD developed a dry cough and bilateral ground-glass opacities (GGOs) after 2.8 years of ruxolitinib treatment. A lung biopsy confirmed secondary PAP. Ruxolitinib was tapered and replaced with belumosudil. Following the switch, the GGOs resolved rapidly within one month, and chronic GVHD remained stable, eventually allowing for successful corticosteroid tapering. Unlike ruxolitinib, belumosudil is thought to preserve the signaling pathways essential for alveolar macrophage activation. Transitioning to belumosudil may therefore represent a promising therapeutic strategy for managing secondary PAP in patients with chronic GVHD who require ongoing immunosuppressive therapy.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 3","pages":"109-113"},"PeriodicalIF":0.0,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent expression of recipient-type ABH antigen following ABO-incompatible stem cell transplantation despite complete donor-type chimerism.","authors":"Najla Haneefa Basheela, Aniruddha Hazra, Durba Biswas, Debapriya Basu, Suvro Sankha Datta","doi":"10.31547/bct-2026-005","DOIUrl":"10.31547/bct-2026-005","url":null,"abstract":"<p><p>Patients undergoing ABO-incompatible hematopoietic stem cell transplantation (ABOi-HSCT) demonstrate a gradual transition from their original blood group to that of the donor in the post-transplantation period. However, ABH antigens present on non-hematopoietic tissues continue to express the recipient's antigens for life. These soluble ABH antigens may adsorb from the plasma onto the donor-derived red blood cells. This phenomenon not only complicates the interpretation of the recipient's blood typing and transfusion decision after transplantation but also impacts the assessment of the patient's clinical conditions, which includes raising concerns about transplant outcomes and the potential for relapse. Herein, we report two cases of persistent weak A antigen expression in recipients following minor ABOi-HSCT, despite achieving complete donor-type chimerism. In Case 1, a 35-year-old male, AB, RhD-positive, with T-cell acute lymphoblastic leukemia (ALL), was transplanted with an HLA-matched sibling carrying the B, RhD-positive blood group. In Case 2, a 4-year-old boy, A, RhD-positive, with B-cell ALL, was transplanted with an HLA-matched related group O, RhD-positive donor. Both patients exhibited persistent antigen A in forward typing more than 18 months post-HSCT, without any sequelae. These two cases underscore the necessity of performing detailed serological investigations to accurately determine blood type following ABOi-HSCT.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 3","pages":"104-108"},"PeriodicalIF":0.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Etanercept in Steroid-Refractory Acute Graft Versus Host Disease: Clinical Response, Toxicity, and Long-Term Outcomes.","authors":"Akanksha Chichra, Sachin Punatar, Anant Gokarn, Sumeet Mirgh, Nishant Jindal, Gaurav Bain, Vijay Shirure, Vinodhini M, Avinash Bonda, Lingaraj Nayak, Bhausaheb Bagal, Sadhana Kannan, Libin Mathew, Navin Khattry","doi":"10.31547/bct-2026-003","DOIUrl":"10.31547/bct-2026-003","url":null,"abstract":"<p><p>Steroid refractory acute graft versus host disease (SR-aGVHD) is seen in 30%-40% of patients undergoing allogeneic hematopoietic stem cell transplant (allo HSCT). We report our experience with etanercept (ETA) as a first-line treatment for SR-aGVHD during a period when ruxolitinib was not available in India. We retrospectively analysed 43 allo HSCT patients from 2010 to 2019 who received ETA for SR-aGVHD. The primary objective was to assess the overall response rate with etanercept. Secondary objectives included overall survival (OS), organ specific responses, causes of mortality and identification of factors associated with survival and see its utility in the current ruxolitinib era. The response rates (overall response rate [ORR] - complete response [CR] + very good partial response [VGPR] + partial response [PR]) at Day 28 was 69%. The organ-specific ORR was 70% (lower gut), 67% (skin), and 50% (liver). The median OS of responders at Day 28 from ETA start was 6.8 months versus 2.8 months in non-responders (<i>p</i>=0.0008). Patients in whom a reduction in the systemic steroid dose of ≥ 30% by Day 28 from ETA start was possible had a significantly longer median OS (9.5 months versus 3.5 months; <i>p</i>=0.0001). In multivariate analysis, steroid dose reduction of ≥ 30% by Day 28 of the start of ETA was a significant factor for survival (<i>p</i>=0.015). The cause of death in the majority was infection (90%). ETA, used as a second-line agent, has shown an acceptable ORR for SR-aGVHD in our cohort. Despite the good response rates, the group had a high transplantation-related mortality. Infections were the major cause of mortality, and early tapering of systemic steroids may be the key to improving outcomes. In the current ruxolitinib era, etanercept may hold a place in patients where ruxolitinib has failed or is not feasible.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 3","pages":"95-103"},"PeriodicalIF":0.0,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Donor and stem cell source selection in hematopoietic cell transplantation in the Asia-Pacific region: results from the APBMT Activity Survey 2022-2023.","authors":"Minako Iida, Xiao Jun Huang, Meng Lv, Kaiyan Liu, Yachiyo Kuwatsuka, Yoon Seok Choi, Hee-Je Kim, Seong-Kyu Park, Sadhana Kannan, Bor-Sheng Ko, Chi-Cheng Li, Kim Wah Ho, Gin Gin Gan, Suradej Hongeng, Usanarat Anurathapan, Aloysius Ho, Michelle Poon, Tasneem Farzana, Shafaq Samad, Joycelyn Sim, Garret Leung Man Kit, Phu Chi Dung, Vo Thi Thanh Binh, Mafruha Akter, Lallindra Gooneratne, Marjorie Rose Bravo, Teresita Dumagay, Aye Aye Gyi, Damai Santosa, Desta Ardini, Bishesh Sharma Poudyal, Khishigjargal Batsukh, Mikhail Drokov, Takanori Teshima, Yoshiko Atsuta, Alok Srivastava, Navin Khattry","doi":"10.31547/bct-2026-012","DOIUrl":"10.31547/bct-2026-012","url":null,"abstract":"<p><strong>Background: </strong>Donor selection strategies for allogeneic hematopoietic cell transplantation (HCT) have evolved with the increasing use of haploidentical transplantation. However, contemporary patterns of donor and stem cell source selection according to disease category in the Asia-Pacific (AP) region remain insufficiently characterized.</p><p><strong>Methods: </strong>Aggregated data from the APBMT Activity Survey 2022-2023 were analyzed to evaluate donor type and stem cell source distributions for allogeneic HCT. Donors were categorized as HLA-identical sibling, haploidentical (including other related donors), or unrelated donor. Stem cell sources were classified as bone marrow (BM), peripheral blood (PB), cord blood (CB), or mixed graft sources. Malignant and non-malignant diseases were compared, and disease-specific analyses were performed for acute myeloid leukemia, myelodysplastic syndrome/myeloproliferative neoplasms, severe aplastic anemia, and hemoglobinopathy. Sensitivity analyses excluding data from China were conducted.</p><p><strong>Results: </strong>Donor selection differed between malignant and non-malignant diseases, with haploidentical donors accounting for approximately 45%-60% of allogeneic HCTs, followed by unrelated donors (20%-30%) and HLA-identical sibling donors (15%-25%). Regarding stem cell source, PB was the predominant source across disease categories, accounting for approximately 60%-70% of allogeneic HCTs. BM accounted for approximately 5%-17% of transplants, with somewhat higher use in non-malignant diseases. CB accounted for approximately 10%-12% of transplants in malignant diseases and 3%-4% in non-malignant diseases. These patterns were consistent in disease-specific analyses; however, exclusion of China resulted in a relative decrease in haploidentical transplantation and an increase in unrelated donor use, particularly in malignant diseases, as well as a marked reduction in mixed graft sources with a corresponding increase in bone marrow use. Despite these shifts, the overall predominance of peripheral blood as the stem cell source and the disease-specific trends were maintained.</p><p><strong>Conclusions: </strong>Across AP region, donor and stem cell source selection for allogeneic HCT demonstrates modest but consistent disease-specific differences, reflecting adaptation of transplantation strategies to disease context in contemporary clinical practice.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 3","pages":"86-94"},"PeriodicalIF":0.0,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Stratification of Non-Relapse Mortality After Allogeneic Hematopoietic Stem Cell Transplantation Based on Pre-Transplant Sarcopenia and HCT-CI.","authors":"Kensaku Kashima, Ayumi Kuzume, Wataru Kitamura, Tomohiro Urata, Haruka Akamatsu, Kako Hamasaki, Ken Matsumoto, Hiroki Iriyoshi, Satoshi Oka, Takuya Machida, Toshi Imai","doi":"10.31547/bct-2026-001","DOIUrl":"10.31547/bct-2026-001","url":null,"abstract":"<p><p>Non-relapse mortality (NRM) remains a major and often unavoidable adverse event following allogeneic hematopoietic stem cell transplantation (allo-HSCT), particularly among older adults and patients with multiple comorbidities. Although the hematopoietic cell transplantation-specific comorbidity index (HCT-CI) is widely used for risk assessment, its predictive performance for NRM is limited, particularly for capturing functional status and physiological reserve. Sarcopenia, a marker of physical frailty and reduced physiological reserve, has recently emerged as a potential prognostic marker in transplant populations. This study aimed to determine whether combining pre-transplant sarcopenia with the HCT-CI improves NRM risk stratification after allo-HSCT. We retrospectively analyzed 95 adult patients who underwent their first allo-HSCT at our institution between May 2017 and December 2024. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria using standardized assessments of handgrip strength, gait speed, and skeletal muscle mass index. Patients were classified into high-risk (sarcopenia plus HCT-CI ≥ 3) or low-risk (others) groups. Compared with the low-risk group, the high-risk group showed significantly higher 2-year cumulative incidence of NRM (41.7% vs. 16.1%, <i>p</i>=0.026) and poorer overall survival (33.3% vs. 71.0%, <i>p</i>=0.002). In multivariable analysis, the composite high-risk classification independently predicted NRM (subdistribution hazard ratio 3.48, 95% confidence interval, 1.26-9.64, <i>p</i>=0.018), while sarcopenia or HCT-CI alone did not. These findings suggest that integrating physical reserve and comorbidity potentially enhances NRM risk stratification after allo-HSCT. The composite index may provide a practical framework to help optimize conditioning intensity, guide prehabilitation strategies, and personalize post-transplant management.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 2","pages":"69-76"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of PTCY-Based Haploidentical Transplants and Donor Factors Affecting Outcomes: A 12-year Experience from India.","authors":"Nishant Jindal, Anant Gokarn, Malini Garg, Komal Kumbhalwar, Selma D Silva, Meenakshi Singh, Sadhana Kannan, Libin Jacob Mathew, Sumeet Mirgh, Akanksha Chichra, Lingaraj Nayak, Avinash Bonda, Sachin Punatar, Bhausaheb Bagal, Navin Khattry","doi":"10.31547/bct-2025-029","DOIUrl":"10.31547/bct-2025-029","url":null,"abstract":"<p><p>Outcomes of haploidentical transplantation have been reported to be comparable to HLA-matched transplants in several studies; however, data from low- and middle-income countries remain limited. In this retrospective study, we evaluated outcomes of 71 patients who underwent haploidentical transplantation for malignant indications using post-transplant cyclophosphamide (PTCy) between July 2010 and March 2022 and analyzed donor factors influencing outcomes. All patients received peripheral blood stem cell grafts with standard PTCy/calcineurin inhibitor/mycophenolate mofetil prophylaxis. Graft failure occurred in seven patients (9.8%), with a higher incidence observed in those with 0-1 mismatch in the graft versus host direction (<i>p</i>=0.011). The incidences of grade II-IV acute graft versus host disease (GVHD) and chronic GVHD were 42.3% and 47.7%, respectively. Overall transplant related mortality (TRM) was 42.3%. Donor killer-cell immunoglobulin-like receptor haplotype BX with 2DS2 and the Bw6Bw6 ligand in recipients were associated with a reduced risk of relapse. The 5-year overall survival was 31.9%. On multivariate analysis, female donors were associated with improved overall survival (hazard ratio 0.465 [95% confidence interval 0.222-0.974], <i>p</i>=0.042). Transplant outcomes were primarily limited by a high incidence of TRM. These findings warrant validation in larger multicenter studies.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 2","pages":"77-85"},"PeriodicalIF":0.0,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful allogeneic stem cell transplantation for a patient with high titers of donor-specific antibody after multiple desensitization procedures.","authors":"Kiyotaka Izumi, Kazuki Yoshioka, Yuto Ueda, Bunta Kakihara, Kensuke Nakao, Tomoya Kitagawa, Kenichi Nagai, Katsuhiro Io","doi":"10.31547/bct-2026-004","DOIUrl":"10.31547/bct-2026-004","url":null,"abstract":"<p><p>A 66-year-old woman who was diagnosed with acute myeloid leukemia, myelodysplasia-related underwent allogeneic peripheral blood stem cell transplantation (PBSCT) from her human leukocyte antigen (HLA)-mismatched daughter after primary induction failure. The patient had a high donor-specific antibody (DSA) titer to the mismatched HLA antigen and received multiple desensitization treatments including rituximab, intravenous immunoglobulin, and random platelet concentrate transfusions, which resulted in a slight decrease in the DSA titer. The donor was a poor mobilizer and the patient could have received a limited number of CD34-positive cells in the PBSCT with a relatively high CD34-negative fraction. Although the graft rejection was a great concern, the patient achieved delayed but successful engraftment and complete remission. The extent of the DSA reduction was greatest after transplantation, indicating that a relatively greater number of infused CD34-negative cells had a certain effect on antagonizing the DSAs. The DSAs were detected even after engraftment, suggesting that other factors, such as HLA expression levels and HLA epitopes, might affect the engraftment outcome.</p>","PeriodicalId":72423,"journal":{"name":"Blood cell therapy","volume":"9 2","pages":"65-68"},"PeriodicalIF":0.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}