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This study outlined the clinical characteristics, outcomes, and risk factors for coronavirus disease 2019 (COVID-19) of 492 patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) during the Omicron wave. The median follow-up of the whole cohort was 62 days. The commonest underlying disease were myeloid malignancies (58.5%) and acute lymphocytic leukemia (30.5%). Of the 492 patients, 415, 67, and 10 had mild, moderate, and severe COVID-19, respectively. The incidence of moderate-to-severe COVID-19 was 15.7% (77/492). The 60-day overall survival and complete resolution rates were 98.1% and 80.6%, respectively. Risk factors for moderate-to-severe COVID-19 were corticosteroid use within 3 months before diagnosis (Odds ratio [OR], 2.115; 95% confidence interval [CI], 1.262-3.546; P=0.004), interval between allo-HSCT and coronavirus disease diagnosis <6 months (OR, 2.234; 95% CI, 1.259-3.969; P=0.006), and anti-thymocyte globulin use for graft-versus-host disease prophylaxis (OR, 3.450; 95% CI, 1.040-11.444; P=0.043). In conclusion, during the Omicron wave, patients with allo-HSCT had a low coronavirus disease-related mortality, and there was a high rate of moderate-to-severe disease and prolonged disease. Prevention in the early post-transplantation period is critical for allo-HSCT recipients receiving corticosteroids.

Background: Though the prognosis of Philadelphia-positive (Ph-positive) acute lymphoblastic leukemia (ALL) has been improved since the introduction of tyrosine kinase inhibitors (TKIs) and combined with allogeneic stem cell transplantation (allo-HSCT), relapse after HSCT remains a concern. Prophylactic TKIs after allo-HSCT seemed a promising strategy to prevent relapse. But the optimal choice of the agent is still obscure.Methods: We retrospectively analyzed the clinical data of Ph-positive ALL patients who underwent allo-HSCT in CR1 from 6 medical centers in China between September 2010 and October 2021. Patients were divided into two cohorts according to different choice of TKI after allo-HSCT, namely Ima cohort with imatinib prophylaxis and Das cohort with dasatinib prophylaxis. Survival and safety outcomes of two cohorts were compared, and prognostic factors were determined by univariate and multivariate analyses.Results: One hundred and forty-one patients, with median age of 37 years (range, 14-61 years), were included, of whom 91 were in Ima cohort and 50 were in Das cohort. After median follow-up of 50.6 months, 5-year cumulative relapse rate (CIR), non-relapse mortality rate (NMR), leukemia-free time (LFS) and overall survival (OS) in Ima and Das cohort were 16.1% and 12.5%; 5.2% and 9.8%; 78.8% and 77.6%; 86.5% and 77.6%, respectively, with no significant difference. Mild cGVHD was higher in Das cohort compared to Ima cohort, while the total, moderate or severe cGVHD were similar. The most common adverse event was neutropenia (66.4%). Das cohort owned higher incidence of gastrointestinal bleeding and gastrointestinal reaction than Ima cohort. The proportion of patients treated on schedule was 30% in Das cohort, lower than that of in Ima cohort (p<0.001). Drug intolerance was the main reason for not completed treatment as intended.Conclusions: For patients with Ph-positive ALL receiving allo-HSCT in CR1, imatinib prophylaxis after transplantation could obtain the same long-term outcome compared to dasatinib, showing better tolerance.

Background:The nucleophosmin 1( NPM1) gene mutations are the most common gene alteration in acute myeloid leukemia (AML) patients, occurring in approximately 30%-35% of adult AML cases. However, molecular and response to therapy heterogeneity are existed in this distinct group. Response to therapy, differing patterns of co-mutation and the prognosis of NPM1-mutated AML patients receving allogeneic hematopoietic stem cell transplantation (allo-HSCT) treatment were unknown.

Aims: Reduced-intensity conditioning (RIC) regimens allogeneic hematopoietic stem cell transplantation (HSCT) was developed for older patients or those with poor functional status. Haploidentical donor was appropriate alternative donor for patients without matched donors or patients with emergency disease state. However, there was few studies report the outcomes of RIC regimen of ATG based haploidentical HSCT. The selection of the appropriate RIC regimen based on age and comorbidities in ATG based haploidentical HSCT remains poorly described. To investigate the safety and efficacy of RIC regimen ATG-based haploidentical HSCT in elderly or unfit patients. Additionally, to explore the potential factors that impact the prognosis of RIC regimen of ATG based haploidentical HSCT.