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Background: Mixed results surround the accuracy of commonly used prognostic risk scores to predict overall survival (OS) and non‐relapse mortality (NRM) in allogeneic hematopoietic stem cell transplant (allo‐HCT) recipients. We hypothesize that a simple prognostic score performs better than conventional scoring systems. Patients and Methods: OS risk factors, HCT‐CI, age‐HCT‐CI, and augmented‐HCT‐CI were studied in 299 patients who underwent allo‐HCT for myeloid and lymphoid malignancies. A scoring system was developed based on results and validated in a different cohort of 455 patients. Results: Two‐year OS was 51% (95% confidence interval (CI) 0.45–0.56); 2‐year NRM was 34% (95% CI 0.29–0.39). HCT‐CI and associated scores were grouped into 0–2 and ≥3. Age and HLA mismatch status were the only risk factors to affect OS in multivariate analysis (p = 0.02 and 0.05, respectively). HCT‐CI and associated scores were not informative for OS prediction. The weighted scoring system assigned 0 to 2 points for age < 50, 50–64, or ≥65, respectively, and 0–1 points for no HLA mismatch versus any mismatch (except HLA‐DQ). Distinct 2‐year OS (62%, 53%, and 38% [p = <0.001]) and NRM (24%, 34%, and 43% [p = 0.02]) groups were characterized. The scoring system was validated in a second independent cohort with similar results on OS and NRM (p < 0.001). Conclusions: A simple scoring system based on recipient's age and mismatch status accurately predict OS and NRM in two distinct cohorts of allo‐HCT patients. Its simplicity makes it a helpful tool to aid clinicians and patients in clinical decision‐making. [ABSTRACT FROM AUTHOR]

Epstein–Barr virus- (EBV-) induced posttransplantation lymphoproliferative disease (PTLD) is a life-threatening complication following allogeneic stem cell transplantation. The main risk factor is anti-thymocyte globulin (ATG). Patients who fail first-line treatment with rituximab have a poor prognosis. Though adoptive transfer of EBV-specific T cells is a potentially effective option, it is not readily available. In this case report, the patient developed PTLD following transplantation for aplastic anemia using ATG as part of the conditioning. He failed rituximab treatment and developed graft failure. We were aware that the stem cell donor had a recent EBV infection prior to transplantation, whereas the patient most likely was EBV negative before transplant. We describe our strategy to meet the patient's urgent need for EBV-specific T cells, as well as new hematopoietic stem cells. The same donor was used for a second transplant, using peripheral blood stem cells. The conditioning used was thiotepa/busulfan/fludarabin with a single dose of cyclophosphamide after transplant as graft-versus-host disease (GVHD) prophylaxis. The EBV DNA levels fell when conditioning was started, and have been undetectable since day +15 and remained so till 18 months after transplantation. The patient is doing well. This case reports successful use of cyclophosphamide after transplantation as GVHD prophylaxis, preserving virus-specific immunity. [ABSTRACT FROM AUTHOR]