Publications by authors named "Juan-Carlos Hernandez-Boluda"

Background: Studies on late community-acquired respiratory virus (CARV) infections in long-term allogeneic hematopoietic stem cell transplantation (allo-HCT) survivors are scarce, creating knowledge gaps on the epidemiology, risk of progression to lower respiratory tract disease (LRTD), and conditions linked to poor outcomes.

Patients And Methods: We included consecutive CARV infection episodes occurring up to six months after allo-HCT registered in our database from December 2013 to June 2023 at two Spanish transplant centers.

Results: Among 426 allo-HCT recipients, 1070 CARV episodes were recorded, 791 (74%) with only upper respiratory tract disease (URTD) and 279 (15%) progressing to LRTD, at a median of 18.

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Heterogeneous approaches exist in regard to the management of disease-related co-morbidities in potential allogeneic haematopoietic cell transplantation (allo-HCT) candidates with myelofibrosis (MF). The EBMT Chronic Malignancies Working Party launched an electronic survey to evaluate how MF-specific comorbidities are approached and whether they ultimately affect the decision to transplant. A total of 41/63 (65%) Centers, all of whom were experienced in the management of MF allo-HCT, responded.

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Significant efforts have been made to effectively select myelofibrosis (MF) patients who can benefit from allogeneic hematopoietic cell transplantation (allo-HCT), the only current cure for MF. The recent EBMT/ELN 2024 recommendations offer valuable guidance for hematologists and transplant physicians. However, several grey areas remain in day-to-day clinical practice regarding the feasibility and optimal preparation for transplantation in patients with this disease.

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  • Hydroxyurea (HU) is the primary treatment for essential thrombocythemia (ET), but there are no clear guidelines for when to switch therapies.
  • In a study of 1080 patients, 67% achieved a complete hematological response (CHR) after five years, with high-risk patients showing lower risks of arterial thrombosis if they achieved CHR.
  • Patients with HU resistance or intolerance had a higher chance of developing myelofibrosis, but this did not significantly impact overall survival or thrombotic risk; CHR is linked to improved outcomes and may guide future treatment decisions.
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  • * Bosutinib has been proven effective in inducing sustained molecular responses, even in advanced stages of CML, making it suitable for second- and later-line therapies.
  • * Its favorable safety profile, particularly the low occurrence of vascular complications, positions bosutinib as a strong option for optimizing treatment in CML, especially for patients intolerant or resistant to other TKIs.
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  • Haploidentical hematopoietic stem cell transplantation (haploSCT) is gaining traction as a viable option for patients without suitable donors, especially following the advent of post-transplantation cyclophosphamide (PTCy).
  • This study analyzed 372 adult haploSCT patients who received different GVHD prophylaxis strategies, finding no significant differences in acute GVHD rates among the groups, but noted lower chronic GVHD rates in patients treated with single-agent tacrolimus.
  • The results indicate that while all three prophylaxis methods (single-agent tacrolimus, CNI + MMF, sirolimus + MMF) produced similar short-term outcomes, further research is needed to explore differences in chronic GVHD
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  • - A new framework for defining anemia severity and treatment response in myelofibrosis (MF) aims to improve clinical studies and comparisons as new drugs emerge in this area.
  • - The revised criteria will address gender differences in hemoglobin levels and update the definition of transfusion-dependent anemia (TDA) to align with current practices.
  • - The updated guidelines introduce specific eligibility thresholds for hemoglobin levels and establish distinct response criteria (major vs. minor) while maintaining a 12-week observation period on treatment.
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Chimeric antigen receptor (CAR)-T cell therapy is approved for the treatment of relapsed/refractory (R/R) large B cell lymphoma (LBCL). However, elderly patients might not be candidates for this therapy due to its toxicity, and criteria for candidate selection are lacking. Our aim was to analyze efficacy and toxicity results of CAR-T cell therapy in the population of patients 70 years and older as compared to those obtained in younger patients in the real-world setting.

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  • Some JAK inhibitors like ruxolitinib can worsen anemia in myelofibrosis patients; switching to momelotinib may be more beneficial for managing anemia while maintaining symptom control.
  • The SIMPLIFY-2 trial compared momelotinib with best available therapy (mostly ruxolitinib) in JAK inhibitor-experienced patients, revealing better transfusion independence rates in those switched to momelotinib.
  • Patients with lower baseline hemoglobin levels experienced greater improvements in mean hemoglobin and overall outcomes with momelotinib, suggesting it's a better option for those struggling with anemia.
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Background: Immune effector cell-associated neurotoxicity syndrome (ICANS) is common after chimeric antigen receptor T-cell (CAR-T) therapy.

Objective: This study aimed to assess the impact of preinfusion electroencephalography (EEG) abnormalities and EEG findings at ICANS onset for predicting ICANS risk and severity in 56 adult patients with refractory lymphoma undergoing CAR-T therapy.

Study Design: EEGs were conducted at the time of lymphodepleting chemotherapy and shortly after onset of ICANS.

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  • This study analyzed the impact of community-acquired respiratory viruses (CARVs) on lower respiratory tract diseases in 235 adult recipients of allogeneic stem cell transplants (allo-SCT).
  • It found no significant differences in 100-day overall survival rates among different CARVs, which ranged from 78% to 90%.
  • Key risk factors for all-cause mortality included corticosteroid use and low absolute lymphocyte counts, suggesting that the level of immunosuppression is more critical than the virulence of the viruses themselves.
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Background: This retrospective study focused on analyzing community-acquired respiratory virus (CARV) infections, in particular human parainfluenza virus (hPIV) after allogeneic stem cell transplant (allo-SCT) in adults recipients. It aimed to assess the impact of ribavirin treatment, clinical characteristics, and risk factors associated with lower respiratory tract disease (LRTD) progression and all-cause mortality.

Patients And Methods: The study included 230 allo-SCT recipients diagnosed with hPIV between December 2013 and June 2023.

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Essential thrombocythaemia (ET) is a myeloproliferative neoplasm characterized by an increased risk of vascular complications and a tendency to progress to myelofibrosis and acute leukaemia. ET patients have traditionally been stratified into two thrombosis risk categories based on age older than 60 years and a history of thrombosis. More recently, the revised IPSET-thrombosis scoring system, which accounts for the increased risk linked to the JAK2 mutation, has been incorporated into most expert recommendations.

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We aimed to compare outcomes following treosulfan (TREO) or busulfan (BU) conditioning in a large cohort of myelofibrosis (MF) patients from the EBMT registry. A total of 530 patients were included; 73 received TREO and 457 BU (BU ≤ 6.4 mg/kg in 134, considered RIC, BU > 6.

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Systemic Mastocytosis (SM) is a multifaceted clinically heterogeneous disease. Advanced SM (AdvSM) comprises three entities: aggressive SM (ASM), mast cell leukaemia (MCL) and SM with an associated hematologic neoplasm (SM-AHN), the latter accounting for 60-70% of all AdvSM cases. Detection of a disease-triggering mutation in the KIT gene (esp.

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Investigating the evaluation of eligibility for transplant in myelofibrosis (MF): The role of HCT-CI and BMI. HCT-CI emerges as a key prognostic factor, while BMI shows limited impact. This study expands insights for better clinical decision-making in MF allo-HCT.

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  • e13a2 and e14a2 are the most common transcript types of the fusion gene in chronic myeloid leukemia (CML), influencing treatment outcomes.
  • The study found that patients who received at least 119 months of imatinib (IM) treatment had lower relapse rates after stopping treatment and that those with the e14a2 transcript type had better treatment-free remission (TFR) outcomes.
  • While transcript type did not impact the response to second-generation tyrosine kinase inhibitors (2G-TKI), 2G-TKI treatment was linked to improved and quicker deep molecular responses for patients with the e14a2 transcript.
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Prognostic impact of non-MPN driver gene mutations in primary myelofibrosis. MIPSS70: Mutation-Enhanced International Prognostic Score System.

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To elucidate the role of splanchnic vein thrombosis (SVT) and genomic characteristics in prognosis and survival, we compared patients with polycythemia vera (PV) or essential thrombocythemia (ET) presenting SVT at diagnosis (n = 69, median age 43 years) or during follow-up (n = 21, median age 46 years) to a sex- and age-matched control group of PV/ET without SVT (n = 165, median age 48 years). The majority of patients presenting with SVT at diagnosis were classified as myeloproliferative neoplasm with heterozygous JAK2 mutation (87% of cases vs. 69% in PV/ET control group, p < 0.

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New options for medical therapy and risk scoring systems containing molecular data are leading to increased complexity in the management of patients with myelofibrosis. To inform patients' optimal care, we updated the 2015 guidelines on indications for and management of allogeneic haematopoietic stem-cell transplantation (HSCT) with the support of the European Society for Blood and Marrow Transplantation (EBMT) and European LeukemiaNet (ELN). New recommendations were produced using a consensus-building methodology after a comprehensive review of articles released from January, 2015 to December, 2022.

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