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To investigate the effects of nutritional supportive therapy on hematopoietic stem cell transplantation (HSCT) patients and to analyze its relationship with post-transplant hematopoietic reconstitution, acute graft-versus-host disease (aGVHD). The clinical data of 76 HSCT patients in our hospital were collected from November 2020 to November 2023, included 46 cases in the nutritional intervention group and 30 in the non-intervention group. After assessing the nutritional status of the intervention group, the five-step therapy principle was followed to implement refined nutritional support treatment, the total daily energy requirement by the patients was calculated based on 25-30 kcal/(kg·d) from the first day of pretreatment to 90 days post-transplantation, followed up until March 2024. The nutritional indices and clinical outcomes of both groups pre-transplant and at 30, 60, and 90 days post-transplant was observed. At 30 days and 60 days after transplantation, the total protein level in the intervention group was higher than before transplantation (P<0.05). At 30 days, 60 days, and 90 days after transplan-tation, the triglyceride levels in both groups were higher than before transplantation (P<0.05). At 30 days and 90 days after transplantation, the HDL-C level in the intervention group was lower than before transplantation (P<0.05). At 60 days after transplantation, the BMI level in the intervention group was higher than that in the non-intervention group (P<0.05). At 30, 60, and 90 days after transplantation, the albumin level in the intervention group was higher than that in the non-intervention group (P<0.05). At 30 days after transplantation, the prealbumin level in the intervention group was higher than that in the non-intervention group (P<0.05). At 30 days and 60 days after transplantation, the total protein level in the intervention group was higher than that in the non-intervention group (P<0.05). At 60 days after transplantation, the low density lipoprotein cholesterol (LDL-C) and triglyceride levels in the intervention group were lower than those in the non-intervention group (P<0.05). At 30 days after transplantation, the HDL-C level in the intervention group was lower than that in the non-intervention group (P<0.05). Time of hematopoietic recons-truction after transplantation: the days for granulocyte reconstitution in the intervention group were earlier than those in the non-intervention group (P<0.05), while there was no statistically significant difference in the number of days for megakaryocyte reconstitution between the two groups (P＞0.05). At 30 days after transplantation, the level of soluble growth stimulus expression gene 2 protein (sST2) in the intervention group was significantly lower than that in the non-intervention group (P<0.05). The level of soluble interleukin-2 receptor (sCD25) in the intervention group at 60 days after transplantation was lower than that at 30 days after transplantation (P<0.05). At different time points after transplantation, there was no statistically significant differences between the two groups in regenerative lslet derived protein 3 alpha (REG3α), soluble tumor necrosis factor receptor 1 (sTNFR1), and elastase inhibitory factor (Elafin) (P＞0.05). The implementation of nutritional support therapy not only ameliorates malnutrition and hastens granulopoiesis, but also mitigates the risk of aGVHD and improves the prognosis of patients undergoing hematopoietic stem cell transplantation. 营养干预对造血干细胞移植患者并发症及预后的影响. 探讨营养支持治疗对造血干细胞移植（HSCT）患者的影响，分析其与移植后造血重建、急性移植物抗宿主病（aGVHD）的关系. 收集2020年11月至2023年11月徐州医科大学附属淮安医院76例HSCT患者的临床资料，其中营养干预组46例，未干预组30例。干预组评估营养状况后，遵循五阶梯疗法原则，实施精细化的营养支持治疗，按照25-30 kcal/(kg·d)计算患者每日需要达到的总能量，从预处理开始d 1至移植后90 d，随访至2024年3月。观察两组患者移植前及移植后30、60 和90 d的营养指标及临床疗效. 干预组移植后30和60 d的总蛋白较移植前明显升高（P<0.05）；两组移植后30、60和90 d的甘油三酯较移植前明显升高（P<0.05）；移植后30和90 d干预组的HDL-C较移植前明显下降（P<0.05）。移植后60 d干预组的BMI明显高于未干预组（P<0.05）；移植后30、60和90 d干预组的白蛋白均明显高于未干预组（P<0.05）；移植后30 d干预组的前白蛋白高于未干预组（P<0.05）；移植后30和60 d干预组的总蛋白均高于未干预组（P<0.05）；移植后60 d干预组的低密度脂蛋白胆固醇（LDL-C）、甘油三酯均低于未干预组（P<0.05）；移植后30 d干预组的HDL-C低于未干预组（P<0.05）。在移植后造血重建的时间方面，干预组的粒系重建时间明显早于未干预组（P<0.05），两组巨核系重建天数无明显统计学意义（P＞0.05）。移植后30 d干预组的可溶性生长刺激表达基因2蛋白（sST2）显著低于未干预组（P<0.05），移植后60 d干预组的可溶性白细胞介素-2受体（sCD25）明显低于移植后30 d（P<0.05）。再生胰岛衍生蛋白3α（REG3α）、可溶性肿瘤坏死因子受体1（sTNFR1）、弹性蛋白酶抑制因子（Elafin）在移植后不同时间点对比均无统计学意义（P＞0.05）. 实施营养支持治疗不仅能够改善造血干细胞移植患者的营养不良状况，缩短粒系重建时间，还可减少发生aGVHD的风险进而改善患者的预后.

Muse cell transplantation attenuates neuroinflammation and preserves endothelial reparative responses after radiation-induced brain injury.

PubMed2026-12-01作者：Wang X, Sun Z, Li S

Radiation-induced brain injury (RIBI) is a serious complication of cranial radiotherapy and currently lacks effective disease-modifying treatment. Persistent neuroinflammation and neurovascular dysfunction are considered central to RIBI progression, making them attractive therapeutic targets for regenerative intervention. Multilineage-differentiating stress-enduring (Muse) cells are a non-tumorigenic pluripotent-like cell population with reported reparative and immunomodulatory properties, but their therapeutic potential in RIBI has not been defined. In this study, we evaluated the effects of Muse cell transplantation in experimental RIBI using in vitro neurovascular co-culture systems and in an vivo rat model. Irradiation induced marked activation of inflammasome-related signaling, endothelial injury, and neurological impairment. Muse cells suppressed the expression of NLRP3, AIM2, ASC, Caspase-1, IL-1β, and IL-18 in irradiated co-culture systems, while preserving endothelial proliferative and angiogenic responses. Transcriptomic analysis identified stress-related pathways associated with Muse cell-mediated protection, and PPAN emerged as a candidate regulator linked to the reparative phenotype. In vivo, intracarotid transplantation of Muse cells reduced [18F] DPA-714 uptake in irradiated brain tissue and was accompanied by supportive behavioral trends suggestive of functional improvement. These findings provide exploratory preclinical evidence that Muse cell transplantation attenuates neuroinflammatory activation and preserves endothelial reparative responses after radiation-induced brain injury. Muse cells may therefore represent a potential cell-based strategy for RIBI, although their therapeutic efficacy, neurovascular repair-related effects, and long-term functional benefits require further validation in larger and more comprehensive preclinical studies.

Cell transplantation

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Natural Killer Cell Immunotherapy After Allogeneic Hematopoietic Stem Cell Transplantation in Acute Leukemia Patients: Phase I Clinical Trial.

PubMed2026-08-03作者：Eskandarian S, Izadpanah A, Parkhideh S

Immunotherapy offers a promising approach to prevent relapse and transplant complications. Natural killer (NK) cells play a crucial role in the immune system's initial defense against infections and malignant cells. Activation of NK cells with interleukin-15 enhances anti-leukemic immune responses. We conducted this clinical trial to evaluate the safety and efficacy of CD56 + cell infusion in increasing survival and reducing relapse in patients with acute myeloid leukemia. Three escalating doses of 1 × 106, 3 × 106, and 5 × 106 interleukin-15-activated CD56 + cells/kg derived from peripheral blood of haploidentical donors were injected on days + 7, +14, and + 21 following transplantation. Patients were monitored for adverse events. To evaluate efficacy, bone marrow samples were taken on days + 30 and + 90. On day + 40, the population of NK cells and its correlation with patients' clinical status were evaluated. Besides, immune reconstitution was examined on day + 40. Patients were followed up for one year. The CD56 + cells infusion was safe and not associated with any complications. While survival rates were not statistically different between the intervention and control groups, a trend toward improved survival was observed in the intervention group. Patients with complete remission showed a higher percentage of NK cells on day + 40 than patients who experienced graft rejection, relapse, or death. In this study, we introduce a feasible method for activating CD56 + cells. Although the survival rates of patients in the intervention and control groups did not differ statistically, this study showed that a higher percentage of NK cells on day + 40 is associated with better survival and fewer complications following transplantation. This study was registered at the Iranian Registry of Clinical Trials under code IRCT20230801058996N2 on 2023-09-10.

Stem cell reviews and reports

[Infection Characteristics and Survival Status of Lymphoma Patients after Autologous Hematopoietic Stem Cell Transplantation with the Application of Intravenous Immunoglobulin].

PubMed2026-06-01作者：Lyu B, Gu XJ, Tian MX

To explore the infection characteristics and survival status of lymphoma patients who received intravenous immunoglobulin (IVIG) after autologous hematopoietic stem cell transplantation (AHSCT). The clinical data of 121 lymphoma patients who underwent AHSCT from September 2019 to September 2023 were retrospectively analyzed. A Cox proportional hazards model was used to identify risk factors for post-transplant infection-free survival. The patients were divided into IVIG and non-IVIG group according to whether they received IVIG after transplantation, and their infection and survival outcomes were compared. Within 1 year after transplantation, bacterial, viral, and fungal infections occurred in 37 (30.58%), 18 (14.88%), and 3 (2.48%) of the 121 lymphoma patients, respectively. The 1-year overall infection rate after transplantation was 38.1% in the IVIG group (42 patients) and 44.3% in the non-IVIG group (79 patients). In the IVIG group, median infection time was +55 (9-233) days, with 7 cases of early infection, 5 cases of blood stream infection, and 6 cases of respiratory tract infection. In the non-IVIG group, median infection time was +8 (4-122) days, with 27 cases of early infection, 20 cases of bloodstream infection, and 4 cases of respiratory tract infection. IVIG group had fewer early and bloodstream infections, more respiratory tract infections, and a delayed median infection time compared to non-IVIG group. Multivariate Cox regression analysis indicated that pre-transplant serum IgG< 7 g/L, graft MNC< 8.1×108/kg and CD34+ cells≤2.8×106/kg served as independent risk factors for infection-free duration in AHSCT-treated lymphoma patients. The 3-year progression-free survival rates of the IVIG group and non-IVIG group were 52.3% and 48.4%, respectively, and 3-year overall survival rates were 79.4% and 83.0%. At 1 month post-transplant, 69 patients showed a decline in immunoglobulin levels, and 12 patients developed severe hypogamaglobulinemia (HG) (IgG< 4 g/L), with 4 cases (15.4%) in IVIG group and 8 cases (18.6%) in non-IVIG group. One month after transplantation, patients with serum IgG< 4 g/L had a significantly lower survival rate than those with IgG≥4 g/L (55.0% vs. 83.0%). In lymphoma patients, post-AHSCT early stage sees mainly bacterial infections. Some develop severe HG. The utilization of IVIG is capable of reducing the incidence of early post-transplant infections and severe HG. 淋巴瘤患者自体造血干细胞移植后应用静脉注射免疫球蛋白的感染特征及生存情况. 探讨淋巴瘤患者自体造血干细胞移植（AHSCT）后应用静脉注射免疫球蛋白（IVIG）的感染特征及生存情况。. 回顾性分析2019年9月至2023年9月121例行AHSCT的淋巴瘤患者的临床资料，采用Cox比例风险模型分析影响移植后无感染持续时间的危险因素。根据移植后是否使用IVIG将患者分为IVIG组和non-IVIG组，对比分析两组患者的感染和生存情况。. 121例淋巴瘤患者移植后1年内37例（30.58%）发生细菌感染，18例 （14.88%）发生病毒感染，3例（2.48%）发生真菌感染。IVIG组42例患者与non-IVIG组79例患者移植后1年内总感染发生率分别为38.1%、44.3%。IVIG组患者中位感染时间+55（9-233）d，早期感染7例，血流感染5例，呼吸道感染6例；non-IVIG组患者中位感染时间为+8（4-122）d，早期感染27例，血流感染20例，呼吸道感染4例。与non-IVIG组相比，IVIG组早期感染较少，血流感染减少，呼吸道感染增多，感染中位时间延迟。多因素Cox回归分析结果显示，移植前血清IgG< 7 g/L、移植物MNC计数< 8.1×108/kg、CD34+细胞计数≤2.8×106/kg可作为影响AHSCT治疗淋巴瘤患者无感染持续时间的独立危险因素。IVIG组与non-IVIG组患者3年PFS率分别为52.3%、48.4%，3年OS率分别为79.4%、83.0%。移植后1个月，69例患者免疫球蛋白水平出现不同程度下降，12例患者出现重度低丙种球蛋白血症（IgG< 4 g/L），IVIG组与non-IVIG组分别为4例（15.4%）、8例（18.6%）。移植后1个月血清免疫球蛋白IgG< 4 g/L组较IgG≥4 g/L组患者3年OS率显著降低（55.0% vs. 83.0%）。. 淋巴瘤患者AHSCT后早期以细菌感染为主，部分患者出现重度低丙种球蛋白血症。应用IVIG有助于降低移植后早期感染以及重度低丙种球蛋白血症发生率。.

Zhongguo shi yan xue ye xue za zhi

[Unrelated hematopoietic stem cell transplantation with post-transplant cyclophosphamide for myelodysplastic syndrome with anti-HLA antibodies].

PubMed2026-01-01作者：Sakata M, Saburi M, Kawano K

A 65-year-old woman was diagnosed with myelodysplastic syndrome following the detection of pancytopenia, and allogeneic hematopoietic stem cell transplantation was planned. No HLA-matched related or unrelated donor was available. Anti-HLA antibody screening showed broad, high mean fluorescence intensity (MFI) antibodies against HLA-A, -B, -C, and -DR. The maximum MFI was 21,919, and high-MFI donor-specific antibodies (DSA) against HLA-haploidentical related donors were detected. Because reduced-intensity conditioning and graft-versus-host disease (GVHD) prophylaxis with post-transplant cyclophosphamide were planned, donor selection prioritized avoidance of DSA over HLA compatibility. Consequently, peripheral blood stem cell transplantation was performed from an unrelated donor with two HLA mismatches. Engraftment was achieved promptly, and neither acute nor chronic GVHD developed. The patient remains in complete remission at nine months after transplantation.

[Rinsho ketsueki] The Japanese journal of clinical hematology

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[Predictive Value of a Risk Assessment Model Based on Coagulation Biomarkers for Venous Thromboembolism after Hematopoietic Stem Cell Transplantation in Children with Acute Lymphoblastic Leukemia].

PubMed2026-06-01作者：Wei J, Chen F, Tan QX

To construct a risk assessment model for venous thromboembolism (VTE) in children with acute lymphoblastic leukemia (ALL) after transplantation, and to explore the value of this new model in predicting the risk of post-transplant VTE in children with ALL. A total of 113 children with ALL who underwent allogeneic hematopoietic stem cell transplantation (HSCT) at Children's Hospital of Soochow University were enrolled. According to the occurrence of VTE within 30 days after transplantation, the children were divided into VTE group and non-VTE group. Differences in the levels of coagulation markers and the distribution of other thromboembolism-related clinical risk factors were compared between the two groups. Logistic regression analysis was used to screen independent risk factors for post-transplant VTE. Based on these factors, a new VTE risk assessment model was established, and receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the new model for VTE in children with ALL after transplantation, as well as to compare its advantages over traditional methods. In the VTE group, the plasma levels of tissue plasminogen activator-inhibitor complex (t-PAIC), thrombin-antithrombin complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer (DD) were significantly higher than those in the non-VTE group, while the fibrinogen (FIB) level was significantly lower (all P < 0.05). In the VTE group, the duration of ALL was generally longer, and the detection rates of granulocytopenia, agranulocytosis, and peripherally inserted central catheter (PICC)-related bloodstream infection (CRBSI) were significantly higher than those in the non-VTE group (all P < 0.05). Multivariate analysis showed that t-PAIC >4.3 ng/ml (OR =30.19, P =0.005) and APTT >31.8 s (OR =12.17, P =0.015) were independent risk factors for post-transplant VTE in children with ALL. A new VTE risk assessment model was established based on these two risk factors. The model showed significantly superior performance in predicting post-transplant VTE in children with ALL compared with individual coagulation and fibrinolysis indicators, as well as the traditional Caprini score and DIC score, with an AUC of 0.90 (P =0.001). The novel thrombotic marker t-PAIC has important clinical value in the early prediction of VTE in children with ALL after HSCT. Compared with the traditional thrombosis risk assessment models, the new model established based on t-PAIC and APTT exhibits superior diagnostic performance and clinical applicability in the pediatric ALL population. 基于出凝血标志物构建急性淋巴细胞白血病患儿移植术后静脉血栓栓塞风险预测模型. 构建一种适用于急性淋巴细胞白血病（ALL）患儿移植后静脉血栓栓塞（VTE）风险的评估模型，探究这种新模型在预测患儿移植后VTE风险中的价值。. 纳入于苏州大学附属儿童医院接受同种异基因造血干细胞移植（HSCT）治疗的ALL患儿113例。根据其在移植后30 d内是否发生VTE，将患儿分为VTE组和非VTE组。比较两组在出凝血相关实验室指标及其他临床危险因素分布方面的差异。采用Logistic回归分析筛选移植后并发VTE的独立危险因素，据此构建新的VTE风险评估模型，并绘制受试者工作特征（ROC）曲线，以评估新模型对ALL患儿移植VTE发生风险的预测效能，并比较其与传统方法间的优势。. VTE组组织型纤溶酶原激活物-抑制剂复合物（t-PAIC）、凝血酶-抗凝血酶复合物（TAT）、纤溶酶-α2纤溶酶抑制剂复合物（PIC）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、D-二聚体（DD）水平均明显高于非VTE组，而FIB水平明显低于非VTE组（均P < 0.05）。VTE组ALL病程普遍较长，且粒细胞减少症、粒细胞缺乏症及PICC相关血流感染的检出率也明显高于非VTE组（均P < 0.05）。多因素分析显示，t-PAIC >4.3 ng/ml（OR =30.19，P =0.005）和APTT >31.8 s（OR =12.17，P =0.015）是ALL患儿移植后发生VTE的独立危险因素。基于上述危险因素构建新的VTE风险评估模型，该模型预测移植后患儿并发VTE的效能明显优于单项出凝血指标和传统Carprini评分、DIC评分，其AUC高达0.90（P =0.001）。. 新型血栓标志物t-PAIC对早期预测ALL患儿移植后VTE具有重要的临床价值。相较于传统血栓风险评估模型，基于t-PAIC和APTT构建的新的VTE风险评估模型在ALL儿童群体中展现出更高的诊断效能与临床适用性。.

Zhongguo shi yan xue ye xue za zhi

Body Composition, Nutritional Status, and Dietary Intake in the First 100 Days After Stem Cell Transplantation and Their Link to One-Year Mortality in Leukemia Patients.

PubMed2026-08-02作者：Amiri Khosroshahi R, Mahmoodi S, Zamanian N

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for acute leukemia; however, the first year after transplantation is associated with an increased risk of morbidity and mortality. This study aimed to evaluate changes in nutritional intake and body composition during the first 100 days following allo-HSCT and to examine their associations with one-year all-cause mortality. In this single-center prospective study, 152 adults scheduled to undergo allo-HSCT were assessed at baseline and on days +30 and +100 after transplantation. Assessments included anthropometric and body-composition measurements, dietary intake evaluation, and nutritional risk screening using the Nutritional Risk Screening 2002 (NRS-2002) tool. The prevalence of nutritional risk increased from 8.6% at baseline to 69.1% on day +30. In the primary analysis, a greater decline in fat-free mass (FFM) was associated with an increased risk of death within one year after transplantation (adjusted HR = 1.04 per 1-kg loss). However, this association was no longer observed in the landmark sensitivity analysis. During the first 100 days following allo-HSCT, nutritional status and body composition deteriorated markedly. A greater decline in FFM was associated with higher one-year mortality in the primary analysis; however, this association was attenuated and was no longer statistically significant in the landmark sensitivity analysis.

Nutrition and cancer

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Augmenting immune reconstitution after adult allo-haematopoietic stem cell transplantation: current developments and modifiable determinants.

PubMed2026-07-28作者：Grocott SJ, Novitzky-Basso I

Immune reconstitution after adult allogeneic haematopoietic stem cell transplantation (allo-HSCT) shapes infection risk, vaccine responsiveness, relapse and nonrelapse mortality. Advances in graft-vs.-host disease (GvHD) prophylaxis, serotherapy exposure management, cytomegalovirus (CMV) control, functional immune monitoring and adoptive cellular therapy have changed which aspects of recovery can be modified and which augmentors are realistic in current practice. This review sets out what has evolved in adult practice and where intervention can now improve it. GvHD prophylaxis, serotherapy dosing and CMV prophylaxis can increasingly be tuned to individual risk rather than applied uniformly, and exposure-guided and function-based measures are beginning to supplement simple subset counts. Adoptive approaches such as virus-specific T-cells offer targeted immune replacement in refractory viral disease, while thymic regeneration and cytokine-based strategies remain investigational. Updated vaccination guidance and recent immunogenicity data are sharpening humoral monitoring. Taken together, these developments point towards a move from numerical subset counts to function- and exposure-guided assessment of immune reconstitution. Several determinants, including serotherapy exposure, GvHD prophylaxis, CMV control, microbiome preservation and selective adoptive immune replacement, now support individualised decisions, although prospectively validated intervention thresholds remain few.

Current opinion in hematology

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[Analysis of Risk Factors for Bloodstream Infections in Children with Aplastic Anemia after Allogeneic Hematopoietic Stem Cell Transplantation].

PubMed2026-06-01作者：Chen Y, Xiong H, Chen Z

To investigate the clinical characteristics, pathogenic distribution, and risk factors of bloodstream infection (BSI) in children with aplastic anemia (AA) following allogeneic hematopoietic stem cell transplantation (allo-HSCT), to provide clinical evidence for the early identification of high-risk patients and optimization of empirical antibacterial therapy regimens. The clinical data of 113 children with AA who underwent allo-HSCT at the Pediatric Hematology and Oncology Center of Wuhan Children's Hospital from August 2016 to December 2024 were retrospective collected. The incidence of bloodstream infection, pathogenic distribution, and identify relevant risk factors in these patients was analyzed. Among the 113 children with AA, 23 cases (20.4%) developed bloodstream infection after allo-HSCT. A total of 26 pathogenic strains were isolated, including 13 Gram-negative strains (50.0%), 10 Gram-positive strains (38.5%), and 3 fungal strains (11.5%). The most commonly detected pathogenic bacteria were Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa, with the detection rate of carbapenem-resistant Gram-negative organisms (CRO) reaching 26.1%. Multivariate analysis indicated that active infection prior to transplantation (HR=3.749, 95%CI:1.398-10.055, P=0.009) was an independent risk factor for post-transplant BSI. Moreover, the OS rate of children with agranulocytosis duration >17 days was significantly lower than that of those with agranulocytosis duration ≤17 days. Gram-negative bacteria are the predominant pathogens causing bloodstream infection in children with AA following allo-HSCT. Additionally, the presence of active infection prior to transplantation was identified as an independent risk factor for post-transplant BSI. 儿童再生障碍性贫血异基因造血干细胞移植后血流感染的危险因素分析. 分析儿童再生障碍性贫血（AA）接受异基因造血干细胞移植（allo-HSCT）后血流感染（BSI）的临床特征、病原学分布及危险因素，为早期识别高危患者、优化经验性抗菌治疗方案提供临床依据. 回顾性收集2016年8月至2024年12月期间武汉儿童医院小儿血液肿瘤中心接受allo-HSCT治疗的113例AA患儿临床资料。分析患儿血流感染的发生率、病原菌分布，并筛选相关危险因素. 113例AA患儿中，有23例（20.4%）allo-HSCT移植后发生血流感染，共检出病原菌26株，分别为革兰阴性菌13株（50.0%）、革兰阳性菌10株（38.5%）和真菌3株（11.5%）。检出的常见致病菌为肺炎克雷伯菌、大肠埃希菌及铜绿假单胞菌，耐碳青霉烯类革兰阴性菌（CRO）的检出率为 26.1%。多因素分析结果显示，移植前存在活动性感染(HR＝3.749, 95%CI： 1.398-10.055, P＝0.009)为移植后发生血流感染的独立危险因素。粒缺持续时间>17 d的患儿总生存率显著低于粒缺持续时间≤17 d的患儿. AA患儿allo-HSCT后血流感染病原菌以革兰氏阴性菌为主，移植前存在活动性感染是移植后发生血流感染的独立危险因素.

Zhongguo shi yan xue ye xue za zhi

[Hematopoietic cell transplantation in the era of genome analysis].

PubMed2026-01-01作者：Nannya Y

Genomic information for hematologic malignancies is now routinely available in clinical practice, supporting the adaptation of hematopoietic cell transplantation, selection of conditioning intensity, and implementation of post-transplant maintenance therapy through refinement of disease risk assessment and minimal residual disease (MRD) measurement. This review presents the current evidence on the effective utilization of genomic information for acute myeloid leukemia (AML), myelodysplastic syndromes (MDS), and myeloproliferative neoplasms (MPN). It also presents an up-to-date framework for optimal donor selection based on donor genome information, addressing both donor clonal hematopoiesis of indetermined significance and the risk that related donor candidates may carry the same hereditary predisposition. Finally, it discusses research showing that patient and donor genetic polymorphisms (SNPs) can predict transplant complications such as GVHD, and that reduced gut microbiota diversity, as detected by metagenomic analysis, impacts GVHD severity and survival. These examples illustrate the multifaceted role of genomic information in research efforts to improve hematopoietic cell transplantation outcomes.

[Rinsho ketsueki] The Japanese journal of clinical hematology

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Efficacy of imatinib maintenance after stem cell transplantation for Ph+/BCR::ABL1 positive ALL: long-term outcome of a randomized trial and impact of peritransplant minimal residual disease.

PubMed2026-08-02作者：Pfeifer H, Bethge W, Schönland S

Tyrosine kinase inhibitors are recommended as maintenance therapy following allogeneic stem cell transplantation (HSCT) for Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL), but optimal medication, dose, and duration remain a subject of ongoing study. We provide the final analysis of a prospective randomized trial comparing prophylactic and minimal residual disease (MRD)-triggered imatinib maintenance. The two patient cohorts did not differ significantly in terms of cumulative incidence of relapse (CIR; 14% vs. 18%), non-relapse mortality (NRM; 12% vs. 11%), leukemia-free survival (LFS) 64% vs. 69%, and overall survival (OS) at 10 years (68% vs. 71%). Endpoints were assessed every 6 weeks within the trial from 4 weeks after SCT until EOS at week 55 and after that according to local standards. In summary, this provides a framework for MRD-based treatment of patients for maintenance after HSCT with excellent long-term outcome after 10 years in both groups.

Leukemia & lymphoma

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GSDMD and p-MLKL elevated earlier and higher in M1-captured leukocytes for early detection of bloodstream infection in patients with hematopoietic stem cell transplantation.

PubMed2026-08-03作者：Ze-Yin L, Bo T, Hao Z

Bloodstream infections (BSIs) pose a serious threat to patients undergoing hematopoietic stem cell transplantation (HSCT). However, the low abundance of routine infection markers-including procalcitonin (PCT), C-reactive protein (CRP), and interleukin-6 (IL-6)-limits their diagnostic utility for early detection. Identifying markers that rise earlier than conventional indicators remains a pressing challenge. We previously prepared a recombinant mannan-binding lectin (MBL) termed M1 and found that magnetic beads coated with M1 (M1-beads) primarily enriched abnormal leukocytes from the blood of HSCT patients with BSI within 3 h of fever onset. Compared with leukocytes from normal controls, these M1-captured cells exhibited more pronounced features of PANoptosis, including higher expression levels of gasdermin D (GSDMD), phosphorylated mixed lineage kinase domain-like protein (p-MLKL), and interleukin-18 (IL-18); more evident double staining with Annexin V-FITC/propidium iodide (PI); and more distinct morphological characteristics of PANoptosis under transmission electron microscopy (TEM). At this early time point, however, routine plasma infection markers (PCT, CRP, and IL-6) remained not significantly elevated in BSI patients. Collectively, these findings demonstrated that GSDMD and p-MLKL rose earlier and reached higher levels in M1-captured PANoptotic leukocytes, highlighting their potential as early host-derived biomarkers for the adjunctive diagnosis of BSI in HSCT patients.

Journal of microbiological methods

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Efficacy and Safety of CLAG-Based Sequential Conditioning Followed by Allogeneic Hematopoietic Stem Cell Transplantation in Non-Remission Relapsed or Refractory Acute Leukemia.

PubMed2026-01-01作者：Chen S, Zhang X, Li X

The optimal bridge-to-transplant strategy for patients with relapsed or refractory (R/R) acute leukemia who remain in non-remission (NR) is undefined. We evaluated the strategy-level use of CLAG (cladribine, cytarabine, and granulocyte colony-stimulating factor) as part of sequential conditioning, rather than as stand-alone salvage therapy, before allogeneic hematopoietic stem cell transplantation (allo-HSCT). This single-center retrospective case series included nine consecutive patients with R/R acute leukemia and bone marrow blasts ≥10% who underwent CLAG-based sequential conditioning followed by allo-HSCT between January 2021 and July 2023. Engraftment, transplant-related complications, non-relapse mortality, relapse, disease-free survival (DFS), and overall survival (OS) were evaluated descriptively; no control group was available. All nine patients achieved neutrophil and platelet engraftment and complete donor chimerism at approximately day +30. At a routine MFC/NGF analytical sensitivity of 10-4, all patients had negative bone marrow assessments at day +30 and month +3; abnormal/leukemic cells subsequently re-emerged in all five patients who relapsed, at months 4.1-9.8. Seven of nine patients (77.8%) developed infections during neutropenia, including one severe pulmonary infection with probable Aspergillus that improved with antifungal therapy. GVHD occurred in 3/9 patients (33.3%), and hemorrhagic cystitis occurred in 2/9 (22.2%). No non-relapse mortality occurred. Five patients (55.6%) relapsed, and all five deaths were relapse-related. Estimated 2-year DFS and OS were both 44.4% (95% confidence interval, 13.6-71.9%). In this highly selected cohort of nine NR patients, CLAG-based sequential conditioning permitted engraftment without non-relapse mortality, but infection and relapse remained frequent. These findings support technical feasibility only and should be regarded as exploratory and hypothesis-generating; efficacy or superiority cannot be established without larger prospective, multicenter, controlled studies.

Blood and lymphatic cancer : targets and therapy

Donor-specific immunomodulation is mediated by mechanisms beyond CD4(+) regulatory T cells.

PubMed2026-12-01作者：Kumagai-Braesch M, Ågren N, Watanabe M

Donor-specific immunomodulatory cells (DSIMC) have successfully induced donor-specific tolerance in clinical living donor liver transplantation. These cells are generated from recipient peripheral blood mononuclear cells (PBMCs) stimulated with irradiated donor PBMC in the presence of costimulatory blockade, yielding a heterogeneous population of recipient-derived immune cells including T cells, B cells, and NK cells, in which CD4+ regulatory T cells (Tregs) are thought to play a central role. Here, we examined the cell populations and functions crucial for donor-specific immunomodulation within the DSIMC product. DSIMC were generated from PBMC of healthy volunteers using belatacept to achieve costimulatory blockade. Tregs were enriched by CD4+CD25+ magnetic-cell activated cell sorting (MACS) or CD25+CD127-/low fluorescence-activated cell sorting (FACS). CD4+, CD8+, CD19+, and CD25+CD127-/low fractions were also individually depleted from DSIMC. Immunomodulatory function of each resulting population was assessed by tritium-labelled thymidine incorporation in mixed lymphocyte cultures (MLC), and cytokine-producing capacity was evaluated by ELISA/ELISpot assays. Unsorted DSIMC exhibited donor-specific suppression at lower cell numbers than CD4+CD25+ enriched cells, while CD4+CD25- T cells showed no immunosuppressive effect. Depletion of CD4+, CD8+, or CD19+ cells did not substantially impair immunomodulatory function. In contrast, depletion of the CD25+CD127-/low fraction reduced inhibitory function and abolished donor specificity. Depletion of CD4+ or CD25+CD127-/low reduced IFN-γ and IL-10 production in response to donor stimulation compared with unsorted DSIMC, implicating CD4+ Tregs as important contributors to cytokine production under allogeneic stimulation. Furthermore, Treg expansion following donor antigen restimulation was observed in unsorted DSIMC but not in CD4+CD25+-enriched cells, suggesting that Tregs can be induced from non-Treg CD4+ populations within the DSIMC. In conclusion, CD4+CD25+CD127-/lowFoxP3+-associated cells appear to contribute to donor-specific immunomodulation; however, the enrichment of CD4+CD25+ T cell diminished DSIMC efficacy. Since the unsorted DSIMC showed stronger activity, we suggest that multiple cell populations may act together to mediate the DSIMC effect.

Cell transplantation

CD71 defines functionally active spermatogonial stem cells with enhanced transplantation potential in mouse testes.

PubMed2026-01-01作者：Shin BJ, Ahn JS, Kim J

Spermatogonial stem cells (SSCs) are responsible for lifelong spermatogenesis in adult males; however, their scarcity and inherent heterogeneity, coupled with the lack of robust SSC-specific surface markers, continue to impede isolation and characterization. In the present study, we found CD71, which corresponds to transferrin receptor (TfR1; encoded by Tfrc), a candidate marker capable of enriching for SSC populations from mouse testes. The immunohistochemistry detected co-localization of CD71 with the undifferentiated spermatogonia marker glial cell line-derived neurotrophic factor family receptor alpha 1 (GFRα1) on the seminiferous basement membrane, with approximately 81% co-localization. Consistent with this finding, the expression of Tfrc was up-regulated in SSC-enriched germ cell populations relative to mouse germ cell lines (GC-1 and GC-2) and somatic cell lines from testis (TM3 and TM4). Fluorescence-activated cell sorting (FACS) analysis further showed that GFRα1+ cells exhibited approximately 1.4-fold higher Tfrc mRNA expression than GFRα1- cells. Similarly, CD71+ cells exhibited significantly higher expression of the undifferentiated spermatogonia markers Id4, Lhx1, Gfrα1, Zbtb16, and Etv5. Functional transplantation assays further demonstrate that CD71high cells give rise to approximately 5.5-fold more colonies than freshy isolated, FACS-unsorted donor cells. Moreover, peanut agglutinin (PNA) lectin staining confirmed the normal spermatogenic differentiation within colonies derived from CD71high donor cells. Our findings collectively indicate that CD71high cells represent an SSC-enriched population with enhanced spermatogenic regenerative capacity and support the use of CD71 as a complementary marker for SSC enrichment and fertility restoration.

Animal cells and systems

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Generation of bioengineered liver grafts densely recellularized using human liver organoids.

PubMed2026-12-01作者：Sonoda K, Yagi H, Nagata S

Bioengineered livers using decellularized extracellular matrix (ECM) scaffolds hold promise for transplantation therapies. However, conventional recellularization methods involving cell injection via blood vessels encounter challenges in recapitulating the complexity of hepatic tissues, including high cellularity, differentiation hierarchy, and cellular heterogeneity. Here, we developed a methodology termed "combined single-cell and organoid (CSO) injection." We injected human liver organoids (HLOs) and dispersed organoid cells via direct puncture and vascular injection into a decellularized porcine ECM scaffold, respectively. This process facilitated the construction of densely populated and self-organized liver-like tissues (CSO Livers) that formed cell-cell/cell-ECM interactions. The tissues displayed hepatic characteristics, including ALBUMIN secretion, robust expression of liver-associated genes, and cellular heterogeneity comprising hepatocytes, cholangiocytes, as well as stellate-like and endothelial cells. Furthermore, we demonstrated that CSO-Livers functioned as grafts in immunodeficient mice and in a microminipig model of liver fibrosis through transplantation via vascular anastomosis. These findings indicate the applicability of the combined single-cell and organoid (CSO) injection method for generating bioengineered liver grafts using HLOs.

Cell transplantation

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β-cell-targeted RNA activation of vascular endothelial growth factor-A improves islet transplantation.

PubMed2026-08-04作者：Van Simaeys D, Berggren PO

Pancreatic islet transplantation can restore insulin production in patients with severe diabetes, but donor material is scarce, and early engraftment is constrained by inflammatory and mechanical stress and a prolonged avascular phase, during which oxygen and nutrient delivery are limited by diffusion. Revascularization relies primarily on stress-induced vascular endothelial growth factor A (VEGF-A), prolonging metabolic compromise, increasing autophagic burden, and rendering grafts vulnerable to secondary stress. Accelerating vascular integration during this time window is therefore critical for graft health. We show that β-cell-targeted aptamer-VEGF-A small activating RNA (saRNA) chimeras selectively induce robust VEGF-A expression in mouse and human islets independently of hypoxia- or nutrient-stress pathways, without activating autophagy or stress-responsive genes. In vivo, chimera-primed islets transplanted into anterior chamber and kidney capsule models exhibited accelerated vascular migration, earlier perfusion, and faster resolution of LC3-dependent autophagic stress without altering endpoint vascular density. Functionally, marginal-mass mouse and human grafts restored glucose control more effectively, preserved intra-islet architecture, and delayed hyperglycemia following STZ-induced β-cell loss. The RNA chimera's modular architecture of RNA chimeras allows transient, tissue-adaptable transcriptional activation across species and cell sources. These findings establish that brief, ex vivo RNA-mediated priming preconditions islets to withstand early engraftment stress, enhancing vascular integration and functional outcomes. This scalable, stress-independent strategy may lower the minimum effective transplant mass and expand access to cellular therapies for diabetes.

Signal transduction and targeted therapy

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[The Clinical Significance and in vitro Experimental Study of hnRNP U in Multiple Myeloma].

PubMed2026-06-01作者：Qi WH, Xu CL, Zhang LL

To analyze the expression level of heterogeneous nuclear ribonucleoprotein U (hnRNP U) and its correlation with prognosis in patients with multiple myeloma (MM), and explore the functional role as well as molecular mechanism of hnRNP U, thereby providing a theoretical basis for development of hnRNP U as a novel therapeutic target for MM. Based on Gene Expression Omnibus (GEO) database, the expression of hnRNP U in plasma cell diseases and healthy controls was compared. Based on the GSE9782 dataset (n =264), patients were divided into high expression group (n =114) and low expression group (n =150) according to the median expression level of hnRNP U . Overall survival (OS) between the two groups was compared. RPMI 8226, NCI-H929 and MM.1S cell lines were selected as tool cell lines. Following knockdown of hnRNP U by shRNA, the cell proliferation was detected by CCK-8. The apoptosis of MM cells was analyzed by Annexin V/7-AAD staining, and cell cycle was detected by BrdU/DAPI staining followed by flow cytometric analysis. The effect of hnRNP U on the biological characteristics of human MM cells was explored. The effect of knockdown of hnRNP U on DNA damage response pathways was analyzed by Western blot. Analysis of GSE5900 and GSE2113 datasets showed that the mRNA level of hnRNP U rose with the increased degree of malignancy of plasma cell diseases. Survival curve analysis of GSE9782 dataset showed that the high expression group of hnRNP U had a shorter OS than that of the low expression group. Down-regulation of hnRNP U in MM cell lines RPMI 8226, NCI-H929 and MM.1S could inhibit the cell proliferation, promote cell apoptosis and arrest the cell cycle. After knocking down hnRNP U, the expression levels of cleaved PARP and p-H2A.X, as the important markers of activated DNA damage pathway, were significantly increased in MM cells. hnRNP U is highly expressed in several plasma cell diseases including MM, and the high expression of hnRNP U in MM patients predicts poor prognosis. Knocking down hnRNP U can inhibit the malignant progression of MM cells, which is possibly associated with aggravated DNA damage. hnRNP U对多发性骨髓瘤的临床意义及体外实验研究. 研究异质核糖核蛋白U（hnRNP U）在多发性骨髓瘤（MM）患者中的表达水平及与预后相关性，探索hnRNP U在人MM细胞中的功能性作用及分子作用机制，从而为开发hnRNP U作为MM治疗的新靶点提供理论依据。. 基于GEO数据库比较hnRNP U 在几种浆细胞疾病及健康对照中的表达差异；下载GSE9782数据集（n =264），按照hnRNP U 表达水平中位值分为高表达组（n =114）和低表达组（n =150），分析比较两组间总体生存期的差异；选择RPMI 8226、NCI-H929和MM.1S作为工具细胞系，利用shRNA载体敲低hnRNP U后，再通过CCK-8检测细胞增殖能力，利用Annexin V/7-AAD双染法检测细胞凋亡，BrdU/DAPI流式检测细胞周期，探究hnRNP U对人MM肿瘤细胞生物学特性的影响；利用蛋白免疫印迹实验研究敲低hnRNP U后对DNA损伤应答通路的影响。. 数据集GSE5900和GSE2113的分析结果显示，hnRNP U mRNA含量随着浆细胞疾病恶性化（风险）程度上升而升高，数据集GSE9782生存曲线分析显示hnRNP U 高表达组较低表达组具有更短的总体生存期；在MM细胞系RPMI 8226、NCI-H929和MM.1S中敲低hnRNP U后，可抑制MM细胞增殖，促进细胞凋亡和细胞周期发生阻滞；敲低hnRNP U后，MM细胞中DNA损伤应答通路活化的关键标志物PARP剪切体和p-H2A.X的含量明显升高。. hnRNP U在包括MM等多种浆细胞疾病中高表达，并且高表达hnRNP U的MM患者预后较差。敲低hnRNP U后可抑制MM细胞的恶性化进展，其分子机制可能是抑制hnRNP U后DNA损伤加重。.

Zhongguo shi yan xue ye xue za zhi

Cell-Based Therapies for Type 1 Diabetes: A Narrative Review of Stem Cell-Derived Islets, Encapsulation Strategies, and Recent Clinical Trials.

PubMed2026-07-01作者：Guttikonda S, Machur JC, Matha CP

Type 1 diabetes (T1D) is an autoimmune disease characterized by the destruction of insulin-producing pancreatic β-cells, necessitating lifelong insulin therapy. While islet transplantation has demonstrated efficacy in restoring glycemic control, donor scarcity and the requirement for chronic immunosuppression limit its widespread application. Recent advances in stem cell biology, bioengineering, and immunomodulation have catalyzed a paradigm shift toward stem cell-derived β-cell replacement therapies. This narrative review presents recent clinical trials and technological innovations in cell-based therapies for T1D, with particular emphasis on stem cell-derived islet generation, encapsulation strategies for immunoprotection, and emerging clinical evidence. Landmark clinical trials and pioneering work with chemically induced pluripotent stem cells have demonstrated proof-of-concept for insulin independence and glucose-responsive C-peptide secretion. Encapsulation technologies, ranging from macroencapsulation devices to microencapsulation with bioactive materials, aim to eliminate the need for systemic immunosuppression while protecting grafts from immune rejection. Despite promising early results, challenges including fibrosis, vascularization, long-term graft survival, and scalable manufacturing remain. This review provides a comprehensive overview of the current state of cell-based therapies for T1D and outlines future directions for translating these innovations into routine clinical practice.

Cureus

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EGFR inhibition promotes functional engraftment and graft survival via donor-derived CHI3L1 in fetal RPE suspension transplantation.

PubMed2026-08-03作者：Mao X, Yin W, Xu M

Numerous clinical trials have highlighted the translational potential of retinal pigment epithelial (RPE) cell transplantation in retinal degeneration (RD). However, an unsolved challenge remains in addressing chronic graft dysfunction, primarily due to poor integration and cell loss. Here, we perform a single-cell transcriptomic comparison between grafted RPE cells and host RPE. Our analysis identifies EGFR expression in donor fetal RPE cells as a significant obstacle to functional integration. Through multimodal imaging and spatial transcriptomics, we demonstrate that EGFR inhibition (EGFRi) facilitates effective engraftment of fetal RPE cell suspension, leading to the functional restoration of the outer blood-retinal barrier, and restrains neurodegeneration in preclinical RD models. This effect is mechanistically linked to graft reepithelialization via the activation of intrinsic CHI3L1-IL13RA2 signaling in EGFRi-treated donor cells. Moreover, EGFRi-induced CHI3L1 secretion contributes to immunosuppression that complements anti-lymphocytic therapy, thereby extending graft survival. Thus, repurposing Food and Drug Administration (FDA)-approved EGFR inhibitor offers a safe and cost-effective approach to advancing fetal RPE suspension transplantation into clinical practice.

Cell reports. Medicine

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搜索结果：Cell transplantation

[The Impact of Nutritional Intervention on Complications and Prognosis of Hematopoietic Stem Cell Transplantation Patients].

Muse cell transplantation attenuates neuroinflammation and preserves endothelial reparative responses after radiation-induced brain injury.

Natural Killer Cell Immunotherapy After Allogeneic Hematopoietic Stem Cell Transplantation in Acute Leukemia Patients: Phase I Clinical Trial.

[Infection Characteristics and Survival Status of Lymphoma Patients after Autologous Hematopoietic Stem Cell Transplantation with the Application of Intravenous Immunoglobulin].

[Unrelated hematopoietic stem cell transplantation with post-transplant cyclophosphamide for myelodysplastic syndrome with anti-HLA antibodies].

[Predictive Value of a Risk Assessment Model Based on Coagulation Biomarkers for Venous Thromboembolism after Hematopoietic Stem Cell Transplantation in Children with Acute Lymphoblastic Leukemia].

Body Composition, Nutritional Status, and Dietary Intake in the First 100 Days After Stem Cell Transplantation and Their Link to One-Year Mortality in Leukemia Patients.

Augmenting immune reconstitution after adult allo-haematopoietic stem cell transplantation: current developments and modifiable determinants.

[Analysis of Risk Factors for Bloodstream Infections in Children with Aplastic Anemia after Allogeneic Hematopoietic Stem Cell Transplantation].

[Hematopoietic cell transplantation in the era of genome analysis].

Efficacy of imatinib maintenance after stem cell transplantation for Ph+/BCR::ABL1 positive ALL: long-term outcome of a randomized trial and impact of peritransplant minimal residual disease.

GSDMD and p-MLKL elevated earlier and higher in M1-captured leukocytes for early detection of bloodstream infection in patients with hematopoietic stem cell transplantation.

Efficacy and Safety of CLAG-Based Sequential Conditioning Followed by Allogeneic Hematopoietic Stem Cell Transplantation in Non-Remission Relapsed or Refractory Acute Leukemia.

Donor-specific immunomodulation is mediated by mechanisms beyond CD4(+) regulatory T cells.

CD71 defines functionally active spermatogonial stem cells with enhanced transplantation potential in mouse testes.

Generation of bioengineered liver grafts densely recellularized using human liver organoids.

β-cell-targeted RNA activation of vascular endothelial growth factor-A improves islet transplantation.

[The Clinical Significance and in vitro Experimental Study of hnRNP U in Multiple Myeloma].

Cell-Based Therapies for Type 1 Diabetes: A Narrative Review of Stem Cell-Derived Islets, Encapsulation Strategies, and Recent Clinical Trials.

EGFR inhibition promotes functional engraftment and graft survival via donor-derived CHI3L1 in fetal RPE suspension transplantation.