Anna Falcó-Roget, Anna Maria Raiola, Elisa Balletto, Riccardo Varaldo, Massimiliano Gambella, Emanuele Lanino, Chiara Sepulcri, Anna Ghiso, Livia Giannoni, Stefania Bregante, Antonella Laudisi, Monica Passannante, Matteo Bassetti, Emanuele Angelucci, Malgorzata Mikulska
{"title":"Pre-engraftment bloodstream infection after allogeneic haematopoietic cell transplant: 18-year trends in aetiology, resistance and mortality.","authors":"Anna Falcó-Roget, Anna Maria Raiola, Elisa Balletto, Riccardo Varaldo, Massimiliano Gambella, Emanuele Lanino, Chiara Sepulcri, Anna Ghiso, Livia Giannoni, Stefania Bregante, Antonella Laudisi, Monica Passannante, Matteo Bassetti, Emanuele Angelucci, Malgorzata Mikulska","doi":"10.1038/s41409-024-02494-x","DOIUrl":"https://doi.org/10.1038/s41409-024-02494-x","url":null,"abstract":"<p><p>Bloodstream infections (BSI) are frequent complications after allogeneic hematopoietic cell transplant (HCT). This study reports data on pre-engraftment BSI in years 2016-2021 and analyses changes in incidence, aetiology, resistance and mortality compared with two previous periods (2004-2009 and 2010-2015). In years 2004-2021, 1364 patients received HCT. De-escalation strategy for empirical antibiotic therapy was introduced in 2011. In 381 patients from years 2016-2021, the incidence of pre-engraftment BSI was 37.8%. Independent predictors of BSI were older age, AML/MDS and active disease. In 1364 patients, the incidence of BSI increased from 22% in period 1 to 38% in period 3 (p = 0.008), particularly gram-negative BSI: from 10.1% to 19.7% (p = 0.001). Among gram-negatives, resistance to third-generation cephalosporins remained stable (40.2% in period 3), while resistance to carbapenems and fluoroquinolones decreased (respectively, 12.6% and 59.8% in period 3). Seven and 30-day mortality after the first BSI decreased, respectively, from 11% in period 1 to 1.4% in period 3 and from 20.5% to 4.9% (p < 0.001 for both). Less recent transplant period was the only factor associated with higher mortality (p = 0.001). Incidence of pre-engraftment BSI is high and increased overtime, particularly for gram-negatives. Resistance rates remained stable, and mortality decreased overtime, documenting improvements in the BSI management.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edoardo Muratore, Giacomo Gambuti, Davide Leardini, Francesco Baccelli, Francesco Venturelli, Leyna Larcinese, Francesca Gottardi, Antonia Di Battista, Tamara Belotti, Arcangelo Prete, Riccardo Masetti
{"title":"The EASIX score as a predictor of sinusoidal obstruction syndrome and nonrelapse mortality in paediatric patients receiving allogeneic haematopoietic stem cell transplantation.","authors":"Edoardo Muratore, Giacomo Gambuti, Davide Leardini, Francesco Baccelli, Francesco Venturelli, Leyna Larcinese, Francesca Gottardi, Antonia Di Battista, Tamara Belotti, Arcangelo Prete, Riccardo Masetti","doi":"10.1038/s41409-024-02489-8","DOIUrl":"https://doi.org/10.1038/s41409-024-02489-8","url":null,"abstract":"<p><p>The endothelial activation and stress index (EASIX) score, calculated as [lactate dehydrogenase (LDH; U/L) × serum creatinine (mg/dL)]/platelets (10e9/L)], has been shown to be predictive of nonrelapse mortality (NRM) and endothelial complications in adults receiving allogeneic stem cell transplantation (allo-HSCT); however, definitive results are lacking for children. We retrospectively evaluated consecutive paediatric allo-HSCT recipients and calculated the log2 EASIX score every day from admission to day +35. In 167 allo-HSCT recipients, the EASIX score increased from before conditioning (-0.79) to a maximum score on day +20 (2.23). In multivariate analysis, the EASIX score at day +7 was an independent predictor of sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) (OR 1.52; 95% CI, 1.08-2.13; p = 0.017) and NRM (OR 1.68; 95% CI 1.16-2.42; p = 0.006). At several time points between day +0 and day +14, the EASIX score was independently associated with NRM, with the strongest predictive power being observed on day +12 (OR 3.05; 95% CI, 1.53-6.10; p = 0.002). Age correlated linearly with the EASIX score at all analysed time points, but score prediction was confirmed even when age was added to the multivariate model, indicating that age was not a confounding factor in the observed associations. The EASIX score determined shortly after transplantation can be further explored as a predictor of SOS/VOD and NRM in paediatric allo-HSCT recipients.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Guinness 0.0: a miracle!","authors":"Shaun R McCann","doi":"10.1038/s41409-024-02492-z","DOIUrl":"https://doi.org/10.1038/s41409-024-02492-z","url":null,"abstract":"","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nora Grieb, Alexander Oeser, Maximilian Ferle, Franziska Hanke, Sarah Flossdorf, Sandra Sauer, Hartmut Goldschmidt, Carsten Müller-Tidow, Hans-Jürgen Salwender, Roland Fenk, Monika Engelhardt, Robert Zeiser, Vladan Vucinic, Georg-Nikolaus Franke, Igor Wolfgang Blau, Daniel Teschner, Hermann Einsele, Christoph Kimmich, Miriam Kull, Britta Besemer, Nico Gagelmann, Nicolaus Kröger, Thomas Neumuth, Uwe Platzbecker, Maximilian Merz
{"title":"Single versus tandem autologous stem cell transplantation in newly diagnosed multiple myeloma.","authors":"Nora Grieb, Alexander Oeser, Maximilian Ferle, Franziska Hanke, Sarah Flossdorf, Sandra Sauer, Hartmut Goldschmidt, Carsten Müller-Tidow, Hans-Jürgen Salwender, Roland Fenk, Monika Engelhardt, Robert Zeiser, Vladan Vucinic, Georg-Nikolaus Franke, Igor Wolfgang Blau, Daniel Teschner, Hermann Einsele, Christoph Kimmich, Miriam Kull, Britta Besemer, Nico Gagelmann, Nicolaus Kröger, Thomas Neumuth, Uwe Platzbecker, Maximilian Merz","doi":"10.1038/s41409-024-02490-1","DOIUrl":"https://doi.org/10.1038/s41409-024-02490-1","url":null,"abstract":"<p><p>Identifying patients who may benefit from autologous stem cell transplantation (ASCT) in newly diagnosed multiple myeloma is crucial, especially in the era of effective induction and consolidation strategies. We analyzed data from 12763 patients enrolled in the German Registry for Hematopoietic Stem Cell Transplantation and Cell Therapy (DRST), distinguishing those who underwent single (n = 8736) or tandem ASCT (n = 4027) from 1998 to 2021. Our findings show that the median age at first ASCT increased over time, while the use of tandem ASCT declined. The shift in treatment practices coincided with higher rates of complete response (CR) post-induction therapy. Significantly improved overall survival and event-free survival over time were observed across all age groups, especially in older patients, but not in patients under 40. Tandem ASCT showed benefits for patients who did not achieve CR after initial ASCT. However, patients with ISS III and renal impairment had poorer outcomes with tandem ASCT. In conclusion, while ASCT remains an important anti-myeloma tool, careful patient selection for tandem ASCT is essential, particularly avoiding its use in patients with ISS III and renal impairment, older age, and those already achieving CR after initial ASCT.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bingqian Jiang, Tingting Yang, Yanmin Zhao, Yi Luo, Guifang Ouyang, Jian Yu, Yishan Ye, Jianping Lan, Ying Lu, Xiaoyu Lai, Baodong Ye, Yi Chen, Lizhen Liu, Yang Xu, Pengfei Shi, Haowen Xiao, Huixian Hu, Qunyi Guo, Huarui Fu, Xinyu Wang, Jie Sun, Weiyan Zheng, Jingsong He, Yi Zhao, Wenjun Wu, Zhen Cai, Guoqing Wei, He Huang, Jimin Shi
{"title":"Better pre-transplant treatment options for TP53-mutated MDS: cytoreductive or non-cytoreductive therapy?","authors":"Bingqian Jiang, Tingting Yang, Yanmin Zhao, Yi Luo, Guifang Ouyang, Jian Yu, Yishan Ye, Jianping Lan, Ying Lu, Xiaoyu Lai, Baodong Ye, Yi Chen, Lizhen Liu, Yang Xu, Pengfei Shi, Haowen Xiao, Huixian Hu, Qunyi Guo, Huarui Fu, Xinyu Wang, Jie Sun, Weiyan Zheng, Jingsong He, Yi Zhao, Wenjun Wu, Zhen Cai, Guoqing Wei, He Huang, Jimin Shi","doi":"10.1038/s41409-024-02486-x","DOIUrl":"https://doi.org/10.1038/s41409-024-02486-x","url":null,"abstract":"<p><p>Patients with TP53-mutated myelodysplastic neoplasms (MDS) have unfavorable prognoses; the benefit of cytoreductive treatment before hematopoietic stem cell transplantation (HSCT) is debated. We retrospectively analyzed 284 MDS patients undergoing allogeneic HSCT; among which 49 had TP53 mutation, with 38 receiving cytoreduction and 11 treated exclusively with best supportive care (BSC) before transplantation. Regardless of TP53 allelic state, patients with mutated-TP53 had a lower overall survival rate and higher relapse rate than those with wild-type TP53 (P < 0.001, P = 0.002, respectively). Among the TP53-mutated cohort, the 2-year overall survival rate in the cytoreduction group was comparable to that in the BSC group (34.6% vs. 45.5%, P = 0.53), and no other prognostic benefit was observed as well (all P < 0.05). Moreover, no prognostic difference was found among the chemotherapy subgroup, hypomethylating agent subgroup, and BSC subgroup (all P > 0.05). Patients in the pre-HSCT measurable residual disease (MRD) negative subgroup, pre-HSCT MRD-positive subgroup, and BSC subgroup exhibited similar prognoses (all P > 0.05). Multivariate analyses showed that pre-HSCT cytoreduction was not associated with post-transplant survival (all P > 0.05). In conclusion, TP53-mutated MDS patients have poor post-HSCT outcomes; compared to BSC, pre-HSCT cytoreduction doesn't improve prognosis, even in those with MRD negative before transplantation.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joseph P McGuirk, Leland Metheny, Luis Pineiro, Mark Litzow, Scott D Rowley, Batia Avni, Roni Tamari, Hillard M Lazarus, Jacob M Rowe, Michal Sheleg, Daniel Rothenstein, Nitsan Halevy, Tsila Zuckerman
{"title":"Correction: Placental expanded mesenchymal-like cells (PLX-R18) for poor graft function after hematopoietic cell transplantation: A phase I study.","authors":"Joseph P McGuirk, Leland Metheny, Luis Pineiro, Mark Litzow, Scott D Rowley, Batia Avni, Roni Tamari, Hillard M Lazarus, Jacob M Rowe, Michal Sheleg, Daniel Rothenstein, Nitsan Halevy, Tsila Zuckerman","doi":"10.1038/s41409-024-02469-y","DOIUrl":"https://doi.org/10.1038/s41409-024-02469-y","url":null,"abstract":"","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pietro Merli, Sonata Jodele, Eleanor Cook, Kasiani C Myers, Adam Lane, Samppa Ryhänen, Maria Pia Cefalo, Francesco Quagliarella, Stella M Davies, Ashley Teusink-Cross, Paibel Aguayo-Hiraldo, Jessie L Alexander, Paul Szabolcs, Mira Kohorst, Tiziana Corsetti, Franco Locatelli, Anthony Sabulski
{"title":"Emapalumab for the Treatment of Immune-Mediated Graft Failure after HSCT.","authors":"Pietro Merli, Sonata Jodele, Eleanor Cook, Kasiani C Myers, Adam Lane, Samppa Ryhänen, Maria Pia Cefalo, Francesco Quagliarella, Stella M Davies, Ashley Teusink-Cross, Paibel Aguayo-Hiraldo, Jessie L Alexander, Paul Szabolcs, Mira Kohorst, Tiziana Corsetti, Franco Locatelli, Anthony Sabulski","doi":"10.1038/s41409-024-02487-w","DOIUrl":"https://doi.org/10.1038/s41409-024-02487-w","url":null,"abstract":"","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xingchen Wang, Chenmeng Liu, Yunlong Chen, Yang Wan, Wenbin An, Xiaolan Li, Lipeng Liu, Fang Liu, Li Zhang, Yao Zou, Xiaojuan Chen, Yumei Chen, Ye Guo, Xiaofan Zhu, Wenyu Yang
{"title":"Efficacy and prognostic assessment of chemotherapy-bridged transplantation in pediatric patients with advanced myelodysplastic syndromes.","authors":"Xingchen Wang, Chenmeng Liu, Yunlong Chen, Yang Wan, Wenbin An, Xiaolan Li, Lipeng Liu, Fang Liu, Li Zhang, Yao Zou, Xiaojuan Chen, Yumei Chen, Ye Guo, Xiaofan Zhu, Wenyu Yang","doi":"10.1038/s41409-024-02488-9","DOIUrl":"https://doi.org/10.1038/s41409-024-02488-9","url":null,"abstract":"","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Outcomes of allogeneic hematopoietic stem cell transplantation versus intensive chemotherapy in patients with myeloid sarcoma: a nationwide representative multicenter study.","authors":"Jie Sun, Yi-Cheng Zhang, Jia Wei, Ya-Jing Xu, Yue Zhang, Yu-Hua Li, An-Qin Wu, Lei Fan, Yu Zhu, Feng-Qi Liu, Zhong-Xing Jiang, Chao Liu, Ming Jiang, Jian-Hua Qu, Peng-Cheng He, Jie Wang, Xiao-Bing Huang, Rong Xiao, Su-Jun Gao, Qiang Guo, San-Bin Wang, Xiao-Ping Li, Sheng-Jin Fan, Li-Li Sun, Lan-Ping Xu, Xiao-Jun Huang, Xiao-Hui Zhang","doi":"10.1038/s41409-024-02485-y","DOIUrl":"https://doi.org/10.1038/s41409-024-02485-y","url":null,"abstract":"<p><p>Myeloid sarcoma (MS) is a rare hematological neoplasm with poor prognosis, posing a significant clinical challenge due to the absence of effective and standardized treatments. We conducted a retrospective analysis of 162 MS patients treated at 12 centers to compare outcomes between intensive chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT). Our analysis revealed that allo-HSCT demonstrated superior overall survival (OS) within the initial 36 months compared to intensive chemotherapy alone (p = 0.037). However, beyond 36 months (36-60 months), a reverse trend was observed (p = 0.056). Subgroup analysis revealed potential benefit for isolated MS patients with allo-HSCT, but not for those with leukemic MS. Additionally, in patients achieving first complete remission (CR1) after induction chemotherapy, allo-HSCT did not significantly improve 5-year OS compared with intensive chemotherapy alone (p = 0.25). Conversely, allo-HSCT significantly improved 5-year OS in non-CR1 patients (p < 0.001). Notably, HLA-matched HSCT and haploidentical HSCT showed comparable outcomes in terms of OS, disease-free survival, and cumulative incidence of relapse. In conclusion, allo-HSCT improved outcomes for MS patients within 36 months of disease onset, and haploidentical HSCT emerged as a viable treatment option for patients without matched donors.</p>","PeriodicalId":9126,"journal":{"name":"Bone Marrow Transplantation","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}