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Introduction: After the first appearance of peripheral blood neutrophils, recipients from adult donor sources have a rapid increase in neutrophil recovery, whereas cord blood transplantation (CBT) recipients have a slow increase. However, the momentum of neutrophil recovery after CBT varies widely among individuals, but optimal methods to evaluate the momentum of neutrophil recovery and their clinical impacts are yet to be clarified. Methods: We retrospectively examined the prognostic effect of the momentum of neutrophil recovery in the last 7 days until neutrophil engraftment, which was calculated by an exponential growth model, after single CBT following myeloablative conditioning for 207 adults. Results: Among patients who achieved each hematopoietic lineage recovery by day 100, the momentum of neutrophil recovery, which was represented as a growth constant, was associated with the day of neutrophil engraftment (P <.0001), red blood cell engraftment (P <.0001), and platelet engraftment (P <.0001) using the Spearman's rank correlation coefficient test. More importantly, overall survival was superior with a higher growth constant compared with a lower growth constant (P <.001). In the multivariate analysis, a higher growth constant showed a lower overall mortality compared with a lower growth constant (hazard ratio: 0.48, P =.014). Conclusion: Our data demonstrated that the momentum of neutrophil recovery during the last 7 days before neutrophil engraftment, which was measured using an exponential growth model, was associated not only with hematopoietic recovery but also with a better prognosis after single CBT. [ABSTRACT FROM AUTHOR]

Keywords: busulfan; cord blood transplantation; cyclophosphamide; fludarabine; hematopoietic cell transplantation; myeloablative conditioning EN busulfan cord blood transplantation cyclophosphamide fludarabine hematopoietic cell transplantation myeloablative conditioning 374 376 3 08/05/21 20210901 NES 210901 ACKNOWLEDGEMENTS The authors thank all of the physicians and staff at the hospital and the cord blood banks in Japan for their help in this study. This retrospective study included 31 adult patients who underwent unrelated single-unit CBT (SCBT) following a radiation-free myeloablative conditioning regimen, consisting of fludarabine added to full-dose busulfan and cyclophosphamide for the treatment of hematological malignancies at our hospital between 2002 and 2020. Radiation-free myeloablative conditioning consisting of fludarabine added to full-dose busulfan and cyclophosphamide in single-unit cord blood transplantation for adults. [Extracted from the article]

Introduction: The appearance of erythroblasts (EBLs) in peripheral blood occurs in a variety of serious conditions and has been associated with mortality in critically ill patients. However, the incidence, risk factor, and outcomes of EBLs after cord blood transplantation (CBT) remain unclear. Methods: We have investigated the impact of EBLs on transplant outcomes on 225 adult patients who underwent single‐unit CBT at our single institute. Results: The cumulative incidences of EBL ≥200 × 106/L and EBL ≥1000 × 106/L at 60 days after CBT were 17% and 4%, respectively, detected after a median of 35 days and 36.5 days. Multivariate analysis using erythroblastosis as time‐dependent covariates demonstrated the significant association of EBL ≥1000 × 106/L, but not EBL ≥200 × 106/L, with the development of grade III‐IV acute graft‐versus‐host disease (GVHD, hazard ratio [HR]: 18.56; P <.001), higher nonrelapse mortality (HR: 13.38; P <.001), and overall mortality (HR: 4.97; P =.001). Conclusion: These data suggested that higher levels of EBLs were recognized as a significant risk factor for severe acute GVHD and mortality after single‐unit CBT. Higher levels of EBLs may serve as a surrogate marker for poor single CBT outcomes. [ABSTRACT FROM AUTHOR]

Summary: T memory stem cells (TSCMs) are a subset of primitive T cells capable of both self‐renewal and differentiation into all subsets of memory and effector T cells. Therefore, TSCMs may play a role in immune reconstitution and graft‐versus‐host disease (GVHD) in patients receiving allogeneic haematopoietic cell transplantation (HCT). We conducted a cross‐sectional study to evaluate the proportions, absolute counts, phenotypes and functions of TSCMs in 152 adult patients without disease recurrence at least 12 months after undergoing HCT. CD4+TSCMs were negatively correlated with number of months after transplantation in HCT patients that received cord blood transplantation, but not in patients that received bone marrow transplantation or peripheral blood stem cell transplantation. The proportions and absolute counts of CD4+TSCMs and expression levels of inducible co‐stimulator (ICOS) in CD8+TSCMs were significantly higher in patients with mild and moderate/severe cGVHD compared to patients without cGVHD. These data suggested that, more than 12 months after allogeneic HCT, the kinetics of CD4+TSCMs were dependent on the type of donor source, and further that CD4+TSCMs and ICOS levels in CD8+TSCMs were associated with cGVHD. [ABSTRACT FROM AUTHOR]

Telomere length in CD4+ and CD8+ T cells among long-term survivors of adults after single cord blood transplantation Relative telomere length in CD4+ T cells and CD8+ T cells according to the NIH grade of cGVHD (F). Correlation between time since CBT to TL assessment and relative telomere length in CD4+ T cells (H) or CD8+ T cells (I). [Extracted from the article]

Candida colonization is associated with severe acute GVHD in adult patients undergoing single-unit cord blood transplantation Our study showed that candidemia occurred in two previous I Candida i -colonized patients, indicating that I Candida i colonization is not useful predictor for the development of candidemia after CBT. This is consistent with previous studies.[[2]] However, this result should be interpreted with caution because antifungal therapy was changed based on the results of an antifungal susceptibility test of the isolated I Candida i during neutropenic episode. [Extracted from the article]

The front cover image is based on the Letter to Editor* I Telomere length in CD4 SP + sp and CD8 SP + sp T cells among long-term survivors of adults after single cord blood transplantation i by Takaaki Konuma** et al., https://doi.org/10.1111/ejh.13385.*** GLO:8DW/01may20:ejh13415-toc-0001.jpg PHOTO (COLOR): . gl. [Extracted from the article]