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Chronic graft-versus-host disease (cGVHD) is a major complication following unmanipulated haploidentical hematopoietic stem cell transplantation (haplo-HSCT). We aimed to identify the risk factors for cGVHD in patients who underwent anti-thymocyte globulin-based haplo-HSCT for acute myeloid leukemia (n = 280). The diagnosis of cGVHD was in accordance with the National Institutes of Health consensus criteria. A total of 169 patients suffered from cGVHD. The patients who had 3 loci mismatched had a higher 8-year incidence of cGVHD (total, 66.0% vs. 53.7%, P = 0.031; moderate to severe, 42.4% vs. 30.1%, P = 0.036) than the patients who had 1 to 2 loci mismatched. The patients who had maternal donors had a higher 8-year incidence of moderate to severe cGVHD (49.2% vs. 32.9%, P = 0.024) compared with the patients who had other donors. The patients who had grades III to IV acute GVHD (aGVHD) had higher 8-year incidence of cGVHD (total, 88.0% vs. 50.4%, P < 0.001; moderate to severe, 68.0% vs. 27.0%, P < 0.001) compared with the patients without aGVHD. In multivariate analysis, grades III to IV aGVHD was the only independent risk factor for cGVHD. Thus, further interventions should be considered in patients with severe aGVHD to prevent cGVHD.

Background Haploidentical transplantation has been proposed as an effective treatment for severe aplastic anemia (SAA). The majority of patients have more than one HLA-haploidentical donor. Herein, we compared the outcomes between different donor-recipient relationships for optimal haploidentical donor selection in acquired SAA. Methods We conducted a multicenter study based on a registered database of 392 patients with SAA treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT) between 2006 and 2018. In total, 223 patients received grafts from father donors, 47 from mother donors, 91 from siblings, 29 from children, and 2 from collateral donors. Results Of the 381 patients who survived more than 28 days, 379 (99.5%) recipients were engrafted. The 2-year overall survival (OS) was 86.6 ± 2.5%, 87.1 ± 4.9%, 84.3 ± 3.9%, and 92.2 ± 5.1% for recipients of father, mother, sibling, and child grafts, respectively, (P = 0.706). The 2-year failure-free survival (FFS) was 82.8 ± 2.7%, 86.7 ± 5.1%, 80.8 ± 4.2%, and 92.5 ± 5.1% for recipients of father, mother, sibling, and child grafts, respectively, (P = 0.508). There was no difference in the incidence of either acute or chronic graft-versus-host disease (GVHD) among the different donor sources in multivariate analyses. There were also no differences in the OS or FFS among the different donor sources in the Cox regression analysis. However, OS was significantly better in the patients with a shorter history of aplastic anemia (< 12 months), better performance status (ECOG scores 0–1), or moderate graft mononuclear cell (MNC) counts (6–10 × 108/kg), and in female recipients with male donors. The FFS was also higher in patients with a shorter history of aplastic anemia (< 12 months) and better performance status (ECOG scores 0–1). Conclusions Fathers, mothers, siblings, and children are all suitable haploidentical donors for patients with SAA.

BACKGROUND This study aimed to determine the impact of the pre- and post-minimal residual disease (MRD) status as well as the peri-transplant MRD kinetics on clinical outcomes in pediatric ALL patients who received haploidentical allografts. METHODS A retrospective study (n = 166) was performed. MRD was determined using multiparameter flow cytometry. RESULTS Pediatric ALL patients with pre-MRDneg had a lower cumulative incidences of relapse (CIR) compared to those with pre-MRDpos (19.7% vs. 41.2%, P = 0.009). Compared to post-MRDneg group, patients with post-MRDpos experienced higher CIR (81.0% vs. 15.9%, P

The role of allogeneic hematopoietic stem cell transplantation (allo-HSCT), particularly haploidentical (haplo)-HSCT, in pediatric patients with Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL) in the tyrosine kinase inhibitor (TKI) era is unclear. This study aimed to identify prognostic factors and explore the role of haplo-HSCT in the treatment of Ph+ ALL in the TKI era. We analyzed clinical data of Ph+ ALL patients aged 1 to 18 years who received imatinib added to intensive chemotherapy at the start of induction therapy. Among the 68 patients who completed at least 2 consolidation cycles, 44 underwent transplantation (transplant arm) and 24 received continuous TKI with chemotherapy (nontransplant arm). At the 3-year follow-up the cumulative incidence of relapse (CIR), event-free survival (EFS), and overall survival (OS) were 23.5%, 73.4%, and 80.3%, respectively. Multivariate analysis showed that hematologic response (whether complete remission [CR] was achieved) at the induction end, BCR-ABL levels (whether major molecular response [MMR] was achieved) at 3 months, and transplantation were independent affecting factors for CIR, EFS, and OS. In the risk stratification analysis based on the first 2 prognostic factors mentioned above, no significant difference existed between the transplant and nontransplant arms for the probabilities of 3-year OS, EFS, and CIR in the standard-risk group (no poor prognostic factors). Meanwhile, OS, EFS, and CIR rates were significantly better in the transplant arm in the high-risk group (≥1 poor prognostic factor). Among the 44 patients in the transplant arm, 37 underwent haplo-HSCT. Achieving CR at the induction end, MMR at 3 months, and haplo-transplant were also independent favorable factors of CIR, EFS, and OS in the nontransplant and haplo-HSCT arms. Haplo-HSCT showed a significant survival advantage in the high-risk group only. Hematologic response at the induction end and BCR-ABL levels at 3 months are likely to be useful for identifying pediatric Ph+ ALL patients at a high risk of relapse in the TKI era. Children with Ph+ ALL in first CR may benefit from allo-HSCT, particularly those at high risk. Haplo-HSCT could achieve good long-term survival for pediatric Ph+ ALL. Thus, haplo-HSCT can be an alternative approach for high-risk Ph+ ALL patients.

The efficacy of minimal residual disease (MRD)-directed immunotherapy, including interferon-α (IFN- α) treatment and chemotherapy plus granulocyte colony-stimulating factor-primed donor leukocyte infusion (chemo-DLI), was investigated in patients with high-risk myelodysplastic syndrome (MDS) who were MRD-positive after allogeneic hematopoietic stem cell transplantation (allo-HSCT). High-risk MDS patients who received non-T-cell-depleted allo-HSCT at the Peking University Institute of Hematology and were MRD-positive after allo-HSCT were studied (n = 47). The MRD-positive status was considered if leukemia-associated aberrant immune phenotypes or Wilms' tumor gene 1 expression is present in a single bone marrow sample. The cumulative incidence of the relapse and non-relapse mortality 2 years after immunotherapy were 14.5% and 21.4% (P = 0.377) and 9.1% and 0.0% (P = 0.985) for patients in the IFN-α and chemo-DLI groups, respectively. The probability of disease-free and overall survival 2 years after immunotherapy were 76.4% and 78.6% (P = 0.891) and 84.3% and 84.6% (P = 0.972) for patients in the IFN-α and chemo-DLI groups, respectively. Persistent MRD after immunotherapy was associated with poor survival. Thus, the MRD-directed immunotherapy was effective for patients with high-risk MDS who were MRD-positive after allo-HSCT, and the efficacy was comparable between chemo-DLI and IFN-α treatment.

The aim of this study was to investigate the occurrence and severity of chemotherapy plus donor lymphocyte infusion (Chemo-DLI)-associated chronic graft-versus-host disease (cGVHD) in a consecutive cohort of patients with acute leukemia who experienced relapse after allogeneic hematopoietic stem cell transplantation (n = 104). The 5-year cumulative incidence of complete remission after Chemo-DLI was 81.0% (95% CI, 73.3% to 88.7%) and 84.6% (95% CI, 74.5% to 94.7%) in the moderate and severe cGVHD groups, respectively, which was significantly higher than that of the mild cGVHD group at 40.9% (95% CI, 29.3% to 52.5%) and non-cGVHD group at 29.2% (95% CI 23.1% to 35.3%). The cumulative incidence of nonrelapse mortality was comparable between patients with and without cGVHD. The 5-year probabilities of progression-free survival after Chemo-DLI were 42.9% (95% CI, 26.2% to 70.2%) and 34.6% (95% CI, 15.3% to 78.2%) in the moderate and severe cGVHD groups, respectively, which were both significantly higher than those of the mild cGVHD group at 9.1% (95% CI, 2.4% to 34.1%) and non-cGVHD group at 8.3% (95% CI 3.3% to 21.3%). The 5-year probabilities of overall survival after Chemo-DLI were 56.7% (95% CI, 38.9% to 82.7%) and 43.1% (95% CI, 22.1% to 84.0%) in the moderate and severe cGVHD groups, respectively, which were both significantly higher than those of the mild cGVHD group at 9.1% (95% CI 1.8% to 47.1%) and non-cGVHD group at 14.9% (95% CI, 7.3% to 30.2%). Our observations highlight the close relationship between cGVHD and immune-mediated graft-versus-leukemia (GVL) effect in patients with relapse receiving Chemo-DLI; however, mild cGVHD may not be associated with a sufficiently strong GVL effect to induce remission and improve survival.

We aimed to identify the effect of positive stool cultures (PSCs) on the clinical outcomes of patients undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT) (n = 332). PSCs were observed in 61 patients (PSC group, 18.4%). Enterobacteriaceae in stool specimens was associated with a higher risk of bloodstream infection, and Candida in stool specimens was related to a higher risk of platelet engraftment failure. The cumulative incidence of infection-related mortality 1 year after haplo-HSCT in the PSC group was higher than that of the patients who showed persistently negative stool cultures (NSC group; 19.2% vs. 8.9%, P = 0.017). The probabilities of overall survival (71.4% vs. 83.8%, P = 0.031) and disease-free survival (69.6% vs. 81.0%, P = 0.048) 1 year after haplo-HSCT for the PSC group were significantly lower than those for the NSC group, particularly for patients who had Candida in their stool specimens. In multivariate analysis, Candida in stool specimens significantly increased the risk of mortality and was associated with poorer survival. Our results showed that PSC influenced the clinical outcomes after haplo-HSCT, particularly those who had Candida in their stool specimens.

Purpose: Although myeloablative HLA haploidentical hematopoietic stem cell transplantation (haplo-HSCT) following pretransplant anti-thymocyte globulin (ATG) and granulocyte colony-stimulating factor (G-CSF) stimulated grafts (ATG+G-CSF) has been confirmed as an alternative to HSCT from HLA-matched sibling donors (MSD), the effect of haplo-HSCT on postremission treatment of patients with acute myeloid leukemia (AML) with intermediate risk (int-risk AML) who achieved first complete remission (CR1) has not been defined. Patients and Methods: In this prospective trial, among 443 consecutive patients ages 16–60 years with newly diagnosed de novo AML with int-risk cytogenetics, 147 patients with molecular int-risk AML who achieved CR1 within two courses of induction and remained in CR1 at 4 months postremission either received chemotherapy (n = 69) or underwent haplo-HSCT (n = 78). Results: The 3-year leukemia-free survival (LFS) and overall survival (OS) were significantly higher in the haplo-HSCT group than in the chemotherapy group (74.3% vs. 47.3%; P = 0.0004 and 80.8% vs. 53.5%; P = 0.0001, respectively). In the multivariate analysis with propensity score adjustment, postremission treatment (haplo-HSCT vs. chemotherapy) was an independent risk factor affecting the LFS [HR 0.360; 95% confidence interval (CI), 0.163–0.793; P = 0.011], OS (HR 0.361; 95% CI, 0.156–0.832; P = 0.017), and cumulative incidence of relapse (HR 0.161; 95% CI, 0.057–0.459; P = 0.001) either in entire cohort or stratified by minimal residual disease after the second consolidation. Conclusions: Myeloablative haplo-HSCT with ATG+G-CSF is superior to chemotherapy as a postremission treatment in patients with int-risk AML during CR1. Haplo-HSCT might be a first-line postremission therapy for int-risk AML in the absence of HLA-MSDs. Haplo-HSCT might be superior to chemotherapy as a first-line postremission treatment of intermediate-risk AML in CR1.

Leukemia relapse is still the leading cause of treatment failure after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for B cell acute lymphoblastic leukemia (B-ALL). Relapsed patients with B-ALL after allo-HSCT have a very short median survival. Minimal residual disease (MRD) is predictive of forthcoming hematological relapse after hematopoietic stem cell transplantation (HSCT); furthermore, eliminating MRD effectively prevents relapse. Donor lymphoblastic infusion (DLI) is the main established approach to treat B-ALL with MRD after allo-HSCT. However, about one-third of patients with MRD are non-responsive to DLI and their prognosis worsens. Although donor-derived cluster of differentiation (CD)19-directed chimeric antigen receptor-modified (CAR) T cells (CART19s) can potentially cure leukemia, the efficiency and safety of infusions with these cells have not yet been investigated in patients with MRD after HSCT. Between September 2014 and February 2018, six patients each received one or more infusions of CART19s from HSCT donors. Five (83.33%) achieved MRD-negative remission, and one case was not responsive to the administration of CAR T cells. Three of the six patients are currently alive without leukemia. No patient developed acute graft-versus-host disease (aGVHD), and no patient died of cytokine release syndrome. Donor-derived CAR T cell infusions seem to be an effective and safe intervention for patients with MRD in B-ALL after allo-HSCT and for those who were not responsive to DLI. Keywords: Donor-derived CD19-targeted T cell infusion, Hematopoietic stem cell transplantation, B cell acute lymphoblastic leukemia, Minimal residual disease

Acute myelogenous leukemia (AML) patients with fetal liver tyrosine kinase 3 (FLT3) internal tandem duplications (ITDs) have poor prognoses if treated with chemotherapy only, primarily as they experience increased relapse rates. To determine whether this alteration also affects outcomes after haploidentical donor (HID) allogeneic hematopoietic stem cell transplantation (allo-HSCT), we compared 334 consecutive FLT3-ITD-positive vs -negative patients with AML (other than acute promyelocytic leukemia) who underwent HID-HSCT. FLT3-ITD was detected in 39 of 334 patients (11.7%). The 2-year relapse rates for FLT3-ITD-positive and -negative patients were 16% and 17%, respectively (P = 0.774). The 3-year disease-free survival (DFS) rates for FLT3-ITD-positive and -negative patients were 74% (95% confidence interval [CI]: 64-81) and 73% (95% CI: 70-81), respectively; P = 0.872); while the 3-year overall survival (OS) rates were 72% (95% CI: 67-81) and 77% (95% CI: 72-84), respectively (P = 0.862). FLT3-ITD mutation had no influence on non-relapse mortality (NRM 15% vs 14%, P = 0.463). Multivariate analyses showed that disease status at HSCT and white blood cell count at diagnosis were independent risk factors associated with relapse, DFS, and OS. In conclusion, FLT3 mutation status has no impact on outcomes after HID-HSCT in patients with AML. HID-HSCT is therefore a valid option for AML patients with FLT3-ITD mutation.

Refractory thrombocytopenia is a frequent and severe complication after haploidentical allogeneic hematopoietic stem cell transplantation (haplo-HSCT) and lacks effective treatment strategies. Eltrombopag has shown promising results in several thrombocytopenia disorders. We report 38 patients treated with eltrombopag for refractory thrombocytopenia after haplo-HSCT. Eight patients had delayed platelet engraftment, 15 patients had secondary failure of platelet recovery, and 15 patients had poor graft function (PGF). Eltrombopag was initiated at 25 or 50 mg daily, and the dosage was adjusted to a maximum of 50–100 mg daily to maintain platelet between 50 × 109/L and 100 × 109/L. The cumulative incidence of platelet recovery to transfusion independence was 63.2% and to ≥50 × 109/L without transfusion support was 52.3%. Furthermore, neutrophil counts and hemoglobin were also increased in the nine responders with PGF. Nineteen (79.2%) of the 24 responders were able to taper off eltrombopag, and the remaining 5 patients were able to begin a taper. The median duration of treatment was 64 (range 14–195) days. The presence of megakaryocyte before initiation was the only independent factor influencing the efficacy of eltrombopag (P = 0.044). Eltrombopag was well tolerated in all patients. In summary, eltrombopag was a safe and effective therapy for refractory thrombocytopenia after haplo-HSCT.

This study investigated the prognostic factors in patients (n = 89) who experienced relapse and received chemotherapy plus donor leukocyte infusion (Chemo-DLI) after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). Patients with early relapse ( 6 vs. 6 months after haplo-HSCT), higher bone marrow blast count before chemo-DLI ( 20% vs. 5-19%), and without chronic graft-versus-host disease (cGVHD) after chemo-DLI had a higher rate of progressive disease (PD) and worse progression-free survival (PFS) and overall survival (OS). In multivariate analysis, non-cGVHD after Chemo-DLI and high blast count predicted a higher risk of PD and poorer PFS, and non-cGVHD after Chemo-DLI and early relapse predicted poorer OS. The patients were stratified into three groups according to these three risk factors. Patients with all three risk factors (n = 14) had the highest PD rate and poorest survival compared with those with one or two risk factors (n = 63) or no risk factors (n = 12). Thus, early relapse, high leukemia burden before Chemo-DLI, and non-cGVHD after Chemo-DLI can predict outcomes in patients who have experienced relapse and received Chemo-DLI after haplo-HSCT. New therapeutic strategies should be identified for these patients.

We performed a retrospective analysis to investigate dynamic peri-hematopoietic stem cell transplantation (HSCT) minimal/measurable residual disease (MRD) on outcomes in patients with T-cell acute lymphoblastic leukemia (T-ALL). A total of 271 patients were enrolled and classified into three groups: unchanged negative MRD pre- and post-HSCT group (group A), post-MRD non-increase group (group B), and post-MRD increase group (group C). The patients in group B and group C experienced a higher cumulative incidence of relapse (CIR) (42% vs. 71% vs. 16%, P0.001) and lower leukemia-free survival (LFS) (46% vs. 21% vs. 70%, P0.001) and overall survival (OS) (50% vs. 28% vs. 72%, P0.001) than in group A, but there was no significant difference in non-relapse mortality (NRM) among three groups (14% vs. 12% vs. 8%, P=0.752). Multivariate analysis showed that dynamic peri-HSCT MRD was associated with CIR (HR=2.392, 95% CI, 1.816-3.151, P0.001), LFS (HR=1.964, 95% CI, 1.546-2.496, P0.001) and OS (HR=1.731, 95% CI, 1.348-2.222, P0.001). We also established a risk scoring system based on dynamic peri-HSCT MRD combined with remission status pre-HSCT and onset of chronic graft-versus-host disease (GVHD). This risk scoring system could better distinguish CIR (c=0.730) than that for pre-HSCT MRD (c=0.562), post-HSCT MRD (c=0.616) and pre- and post-MRD dynamics (c=0.648). Our results confirm the outcome predictive value of dynamic peri-HSCT MRD either alone or in combination with other variables for patients with T-ALL.

G-CSF-mobilized peripheral blood (G-PB) harvest is the predominant graft for identical sibling donor and unrelated donor allogeneic hematopoietic stem cell transplantation (HSCT) recipients, but it was controversial in haploidentical related donor (HID) HSCT. In this registry study, we aimed to identify the efficacy of HID G-PB HSCT (HID-PBSCT) for acute leukemia (AL) patients in first complete remission (CR1). Also, we reported the outcomes for the use of G-PB grafts in comparison with the combination of G-BM and G-PB grafts in HID HSCT recipients. Sixty-seven AL patients in CR1 who received HID-PBSCT were recruited at Institute of Hematology, Peking University. Patients who received haploidentical HSCT using the combination of G-BM and G-PB harvests in the same period were enrolled as controls (n=392). The median time from HSCT to neutrophil and platelet engraftment was 12 days (range, 9–19 days) and 12 days (range, 8–171 days), respectively. The 28-day cumulative incidence of neutrophil and platelet engraftment after HSCT was 98.5% and 95.5%, respectively. The cumulative incidences of grade II–IV and grade III–IV acute graft-versus-host disease (GVHD) were 29.9% (95%CI 18.8–40.9%) and 7.5% (95%CI 1.1–13.8%), respectively. The cumulative incidences of total and moderate-severe chronic GVHD were 54.9% (95%CI 40.9–68.8%) and 17.4% (95%CI 6.7–28.0%), respectively. The cumulative incidences of relapse and non-relapse mortality were 13.9% (95%CI 5.4–22.5%) and 3.4% (95%CI 0–8.1%), respectively. The probabilities of overall survival (OS) and leukemia-free survival (LFS) were 84.7% (95%CI 74.7–94.7%) and 82.7% (95%CI 73.3–92.1%) respectively. Compared with the HID HSCT recipients using the combination of G-BM and G-PB grafts, the engraftments of neutrophil and platelet were both significantly faster for the G-PB group, and the other clinical outcomes were all comparable between the groups. In multivariate analysis, graft types did not influence the clinical outcomes. Overall, for the patients with AL CR1, G-PB graft could be considered an acceptable graft for HID HSCT recipients. This study was registered at https://clinicaltrials.gov as NCT03756675.

BACKGROUND Human herpesvirus 6 (HHV-6) reactivation is relatively common after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the incidence of HHV-6 reactivation and the clinical outcomes following unmanipulated haploidentical HSCT (haplo-HSCT) remain unknown. METHOD We prospectively monitored blood HHV-6 DNA using real-time quantitative polymerase chain reaction weekly until day 100 post unmanipulated haplo-HSCT in patients with hematological malignancies. RESULTS From November 2016 to March 2017, 102 patients (58 male and 44 female, median age 25(2-58) years old) were enrolled. Within 100 days post-transplantation, 27 patients (27/136, 19.9%) developed HHV-6 viremia with a median onset time of 14 (7-98) days. The cumulative incidence of HHV-6 reactivation on day 100 post-HSCT was 25.5 ± 4.3% in haplo-HSCT. The median HHV-6 copy number was 1.45 × 103 (5.48 × 102 -2.00 × 104 ) copies/ml. The HHV-6 viremia duration time was 7 days in 23 patients, 14 days in one patient and 21 days in one patient. In multivariate analysis, prior HHV-6 reactivation was an independent risk factor for grade 2-4 graft-versus-host disease (GVHD). But it did not influence the overall survival (OS)(HR 1.624, 95%CI 0.768-3.432, P = .204), disease-free survival (DFS) (HR 1.640, 95%CI 0.799-3.367, P = .177) and non-relapse mortality (NRM) (HR 1.644, 95%CI 0.670-4.038, P = .278). CONCLUSION The reactivation of HHV-6 after unmanipulated haploidentical transplantation predicts the occurrence of grade 2-4 a-GVHD, but it may not influence the overall survival (OS), disease-free survival (DFS) and non-relapse mortality (NRM).

Background: Minimal/measurable residual disease (MRD) determined by multiparameter flow cytometry (MFC) is an important variable for relapse prediction and treatment approach selection in patients with acute myeloid leukemia (AML). We aimed to investigate whether leukemia-stem cell (LSC)-based assay is superior to traditional MFC methods, including LAIP and D-F-N assays, for MRD evaluation in predicting clinical outcomes. Methods: In this cohort study, a total of 360 AML patients who received allogeneic stem cell transplantation (allo-SCT) between July 2018 and November 2019 were prospectively enrolled. The patients were randomized (1:1) and classified into a training set (n=180) and a validation set (n=180). Posttransplantation MRD were according to LSC based assay, mainly including a cocktail of CD7, CD11b, CD22, CD56, Tim-3, and CLL-1 on CD34+CD38- cells, and traditional assay determined by MFC, respectively. Findings: In the training set, patients were classified as LSC positive group (group A) and LSC negative group (group B) according to a cutoff value of CD34+CD38- cocktail+ LSCs as 0.004%. Subjects in group A had a higher cumulative incidence of relapse (CIR, 42.7% vs. 2.6%, P

Phanuromyia ricaniae Nam, Lee & Talamas, sp. n. urn:lsid:zoobank.org:act:xxxx https://bioguid.osu.edu/xbiod_concepts/509748 Figures 3–18 Description. Color of body: light brown to black. Female body length: 0.9–1.09 mm (n=22). Male body length: 0.9–1.06 mm (n=13). Head. Claval formula: 1-2-2-1. Shape of clypeus: convex, with obtuse point medially. Number of clypeal setae: 6. Central keel: absent. Antennal scrobe: absent, undifferentiated from remainder of frons. Sculpture of frons: reticulate microsculpture. Sculpture of gena: reticulate microsculpture. Setation of compound eye: absent. Position of lateral ocellus: contiguous with compound eye. Shape of vertex: broadly rounded. Anterior margin of occipital carina: weakly crenulate. Hyperoccipital carina: absent. Mesosoma. Epomial carina: present, short and often obscured by head in lateral view. Pronotal cervical sulcus: present as a smooth furrow. Sculpture of lateral pronotal area: obliquely rugose. Pronotal suprahumeral sulcus: indicated by punctures. Netrion sulcus: foveate, complete dorsally. Prespecular sulcus: foveate, extending from subalar pit to mesopleural pit. Sculpture of speculum: transversely rugulose. Anterior mesepisternal area: present as an elevated, smooth area. Sculpture of femoral depression: smooth. Mesopleural carina: absent. Episternal foveae: present, forming a continuous line with foveae of postacetabular sulcus that extends to mesopleural pit. Postacetabular sulcus: comprised of distinct foveae. Sculpture of anteroventral mesopleuron: with microsculpture directly ventral to femoral depression, otherwise smooth. Mesopleural epicoxal sulcus: foveate. Posterior mesepimeral area: narrow, present as a strip of lesser width than mesepimeral sulcus. Paracoxal sulcus: foveate, present along entire anterior margin of metapleuron. Transverse portion of metapleural sulcus: indicated by furrow extending to the anterior and posterior margins of the metapleuron. Sculpture of ventral metapleural area: smooth. Sculpture of dorsal metapleural area: smooth. Microsculpture of mesoscutum: reticulate microsculpture. Notaulus: absent. Mesoscutal suprahumeral sulcus: present as a distinct line of cells. Mesoscutal humeral sulcus: present as a distinct line of foveae. Sculpture of mesoscutellum: smooth, sometimes with reticulate microsculpture laterally. Metascutellum: line of foveae. Sculpture of metanotal trough: foveate. Length of postmarginal vein: about 3 times as long as stigmal vein. Length of marginal vein: short, about 1/4 length of stigmal vein. Sculpture of lateral propodeal area: foveate along anterior margin of lateral propodeal carina. Sculpture of metasomal depression: with line of fovea along periphery and surrounding propodeal foramen, otherwise smooth. Metasoma. Sculpture of T1 between basal costae and median band of foveae: striate between basal costae and median band of foveae, striae sometimes incomplete medially. Median band of foveae on T1: present. Sculpture of T1 posterior to median band of foveae: smooth. Setation of laterotergite 1: present as a patch in anterodorsal portion. Sculpture of T2 posterior to basal foveae: longitudinally strigose, reticulate posteriorly. Setation of laterotergite 2: present along dorsal margin. Sculpture of T3–T5: covered in cuticular pores, otherwise smooth. Setation of T3–T7: with sparse, long setae. Sculpture of S2: longitudinally striate. Sculpture of S3–S4: covered in cuticular pores, otherwise smooth. Setation of S3–S6: with long setae laterally. Etymology. The epithet “ricaniae” is the genitive case form of Ricania, the genus from which this species has been reared. Material Examined. Holotype, female: SOUTH KOREA: Dong-gu Daejeon, Jungang-ro, 36°19’56.3”N 127°26’02.5”, Daejeon St. 215, 8.VIII.2016, sweeping, S. Nam, SNUP0010003 (deposited in SNU). Paratypes: (63 females, 12 males) CHINA: 44 females, 10 males, SCAU 3040575–3040583, 3048582–3048583 (SYSBM), SCAU 3044143–3044185 (SYSBM) SOUTH KOREA: 19 females, 2 males, CNC1558300–CNC1558302 (CNCI); SNUP0010001 – SNUP0010002, SNUP0010004 – SNUP0010019 (SNU). Diagnosis. In the absence of a large-scale revision of Asian Phanuromyia, we compared P. ricaniae to the images of Phanuromyia species presented in Veenakumari & Mohanraj (2014) and Veenakumari & Mohanraj (2019), the description of P. bidentata by Johnson & Musetti (2003), and holotype images of three other Asian species: P. flaviventris (Kozlov & Kononova) (Figs 19–21), P. nioba (Kozlov & Kononova) (Figs 22–25), and P. marshakovi (Kozlov & Kononova) (Figs 26–29). Among these, P. ricaniae is most similar to P. andamanensis and P. nabakovi Veenakumari, which share a similar pattern of mesosomal sulci, coloration, and surface sculpture. Phanuromyia ricaniae and P. andamanensis can easily be separated by the length of striae on S2. These striae extend nearly to the end of the sternite in P. ricaniae and are only half the length of the sternite in P. andamanensis (see Figure 8 in Veenakumari & Mohanraj 2014). Separating P. ricaniae from P. nabakovi is less straightforward because the sculpture of S2 is not described or illustrated in Veenakumari & Mohanraj (2014). Figure 29 in Veenakumari & Mohanraj (2014) illustrates a paracoxal sulcus comprised of very small foveae that are small and poorly defined, particularly in the ventral half of the metapleuron whereas in P. ricaniae these foveae are robust and tend to be elongate. Metasomal tergite 1 is described as “weakly costate” in P. nabakovi and an image of the holotype illustrates that T1 is smooth medially (Fig. 30). Metasomal tergite 1 in P. ricaniae is variable in the degree to which it is dorsally humped in lateral view and in the size of the posterior smooth area, but the costae that transversely bisect the tergite are consistently distinct.

Nam, Sanghyeok, Chen, Hua-Yan, Talamas, Elijah J., Lee, Gwan-Seok, Dong, Wei, Sun, Li-Juan, Lee, Seunghwan (2020): Phanuromyia ricaniae Nam, Lee & Talamas sp. n. (Hymenoptera: Scelionidae) reared from the eggs of Ricania shantungensis Chou & Lu (Hemiptera: Ricaniidae) in Asia. Zootaxa 4890 (1): 109-118, DOI: https://doi.org/10.11646/zootaxa.4890.1.6

Reactivation of cytomegalovirus (CMV) or Epstein-Barr virus (EBV) is common after hematopoietic stem cell transplantation (HSCT). Previous researches have demonstrated that either CMV or EBV reactivation is associated with poor outcomes of HSCT. However, few studies investigate the impact of CMV and EBV co-reactivation after HSCT. In this study, we described the clinical characteristics of HSCT recipients with CMV and EBV co-reactivation (defined as CMV and EBV viremia occur at the same period of time). We conducted a longitudinal study of 247 patients who underwent HSCT in our center. A total of 24 (9.7%) patients had CMV and EBV co-reactivation. These patients showed higher incidence of viral pneumonitis (P=0.005). Patients with CMV and EBV co-reactivation had significant lower 1-year overall survival (OS) (P=0.004) and lower 1-year leukemia free survival (LFS) (P=0.016). Our further analysis suggested that duration of CMV (P=0.014), EBV (P

Although chimeric antigen receptor T-cell (CAR-T) therapy produces a high complete remission rate among patients with relapsed/refractory B-cell acute lymphoblastic leukemia, relapse remains an urgent issue. It is uncertain whether consolidative haploidentical-allogeneic hematopoietic stem cell transplantation (haplo-HSCT) is suitable for achieving sustainable remission. Therefore, we aimed to assess the efficacy and safety of bridging CAR-T therapy to haplo-HSCT. Fifty-two patients with relapsed/refractory Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia who underwent haplo-HSCT after CAR-T therapy were analyzed. The median time from CAR-T therapy to haplo-HSCT was 61 days. After a median follow-up of 24.6 months, the 1-year probabilities of event-free survival, overall survival, and cumulative incidence of relapse were 80.1% (95% confidence interval (CI), 69.0-90.9), 92.3% (95% CI, 85.0-99.5), and 14.1% (95% CI, 10.7-17.4), respectively, while the corresponding 2-year probabilities were 76.0% (95% CI, 64.2-87.7), 84.3% (95% CI, 74.3-94.3), and 19.7% (95% CI, 15.3-24.0), respectively. No increased risk of 2-year cumulative incidence of graft-versus-host disease, treatment-related mortality, or infection was observed. A pre-HSCT measurable residual disease-positive status was an independent factor associated with poor overall survival (hazard radio: 4.201, 95% CI: 1.034-17.063; P = 0.045). Haplo-HSCT may be a safe and effective treatment strategy to improve event-free survival and overall survival after CAR-T therapy.

Acute cholecystitis (AC) is a potentially fatal complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT); however, only limited information is available on its clinical features, outcomes, and risk management strategies. This retrospective, nested, case–control study included 6701 patients undergoing allo-HSCT at our center from January 2004 to June 2019. In total, 72 patients (1.1%) were diagnosed with AC; among these, acute acalculous cholecystitis had a slightly higher prevalence (42 patients, 58.3%). Patients with moderate and severe AC exhibited remarkably worse overall survival (P = .001) and non-relapse mortality (P = .011) than others. Survival of haploidentical HSCT recipients with AC was comparable to that for patients with human leukocyte antigen (HLA)-identical donors. Age ≥ 18 years, antecedent stage II to IV acute graft-versus-host disease, and total parenteral nutrition were identified as potential risk factors for AC following allo-HSCT, while haploidentical transplantations were not more susceptible to AC than HLA-identical HSCT. Based on these criteria, a risk score model was developed and validated to estimate the probability of AC following allo-HSCT. The model separates all patients into low-, intermediate-, and high-risk groups and thereby provides a basis for early detection of this complication in the management of allo-HSCT.

Myelodysplastic syndrome (MDS) is a heterogeneous group of clonal disorders and is rare in children. Allogeneic hematopoietic stem cell transplantation (HSCT) is commonly used in children with MDS with excess blasts and in patients with refractory cytopenia of childhood (RCC) associated with monosomy 7, complex karyotype, severe neutropenia, or transfusion dependence. We recruited 27 children with MDS who received haploidentical hematopoietic stem cell transplantation (haplo-HSCT). At transplantation, 10 patients had RCC, 12 patients had advanced MDS (RAEB and RAEB-T), and 5 patients had myelodysplasia-related acute myeloid leukemia (MDR-AML). All patients received granulocyte colony-stimulating factor (G-CSF)-mobilized bone marrow cells and peripheral blood stem cells. At a median follow-up of 24.1 months (range: 2.0-74.5 months) after HSCT, the estimated probabilities of 3-year disease-free survival (DFS) and overall survival (OS) were both 81.9% (95% CI, 66.8-100.0%). The estimated 3-year incidences of relapse (CIR) and non-relapse mortality (NRM) were both 7.4% (95% CI, 1.2%-21.4%). The 100-day cumulative incidence of grade II-IV aGVHD was 52.6% (95% CI, 42.9-62.3%), while that of grade III-IV aGVHD was 11.1% (95% CI, 5.1-17.1%). The 3-year cumulative incidences of overall and extensive cGVHD were 42.3% (95% CI, 19.8%-57.5%) and 21.1% (95% CI, 2.5%-63.2%), respectively. Univariate analysis showed that chronic GVHD significantly affected OS and DFS. Haploidentical HSCT may be an effective treatment option with easier donor availability for pediatric patients with MDS.

The specific description, risk factors, and outcomes of aGVHD in pediatric haplo-HSCT using TCR protocols without PT-Cy have not been well described previously. We evaluated the incidence, risk factors, and outcomes of aGVHD in 350 consecutive pediatric patients receiving TCR haplo-HSCT without PT-Cy according to the Glucksberg and NIH aGVHD classifications between January 2015 and December 2017 at Peking University Institute of Hematology. The cumulative incidences of grade I, II, III, and IV aGVHD were 28%, 29.7%, 8.3%, and 5.1%, respectively. The type of aGVHD onset was classic in 243 patients (97.2%), and persistent/recurrent/late-onset aGVHD was in seven patients (2.8%). None of the considered variables significantly influenced the incidence of grade III-IV aGVHD. The 3-year OS, DFS, cumulative incidence of NRM, and relapse in malignant disease between severe aGVHD (III-IV) group and grade 0-II aGVHD group were 61.5% vs 77.2% (P = .027), 58.6% vs 75.1% (P = .014), 19.8% vs 5.3% (P = .002), and 21.6% vs 19.6% (P = .59), respectively; in non-malignant diseases, the 3-year OS, DFS, and NRM were 81.8% vs 97.4% (P = .05), 81.8% vs 97.4% (P = .05), and 18.2% vs 2.6% (P = .05), respectively. Under the protocol of pediatric TCR haplo-HSCT without PT-Cy, the persistent/recurrent/late-onset aGVHD was rare, and the incidence of severe aGVHD was acceptable and significantly contributed to NRM and lower survival in both malignant disease and non-malignant diseases.

Background The role of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) for children with intermediate-risk acute myeloid leukemia (IR-AML) in first complete remission has been controversial. The present study compared the effect of chemotherapy with unmanipulated haplo-HSCT as treatment of patients with IR-AML in first complete remission (CR1). Patients and Methods We retrospectively analyzed the outcomes of 80 children with IR-AML and compared the effects of chemotherapy (n = 47) with those of haplo-HSCT (n = 33) as treatment in CR1. Results The 3-year overall survival, event-free survival (EFS), and cumulative incidence of relapse (CIR) was 85.4% ± 4.1%, 73.2% ± 5.0%, and 25.4% ± 4.5%, respectively. Compared with the chemotherapy group, the patients in the haplo-HSCT group had a lower CIR (P = .059) and better EFS (P = .108), but roughly equivalent overall survival (P = .841). Multivariate analysis revealed chemotherapy and minimal residual disease (MRD) of ≥ 10−3 after induction therapy as independent risk factors affecting CIR and EFS. EFS (P = .045) and CIR (P = .045) differed significantly between the 2 treatment groups in patients with MRD of ≥ 10−3 after induction therapy. Conclusion Haplo-HSCT might be a feasible option for children with IR-AML in CR1, especially for patients with MRD of ≥ 10−3 after induction therapy.

Oxyscelio mesiodentis Burks http://zoobank.org/ DB58BA09-A681-4F93-8BC4-138E993E54DE Figures 6, 183–188 Oxyscelio mesiodentis Burks, 2013: 15, 26, 185 (original description, keyed, placed in cuculli species group). Material Examined. Other material: (1 female) CHINA: 1 female, Hainan, Mt. Diaoluoshan, 18°39’N 109°53’E, 28–30.V.2007, Jingxian Liu, SCAU 3018688 (SCAU). Note. This species is newly recorded from China, Hainan Province., Published as part of Mo, Wen-Hui, Chen, Hua-Yan, Johnson, Norman F., Pang, Hong, Ma, Li & Liu, Jing-Xian, 2020, Revision of the genus Oxyscelio Kieffer (Hymenoptera, Scelionidae) from China, pp. 251-310 in Zootaxa 4816 (3) on page 291, DOI: 10.11646/zootaxa.4816.3.1, http://zenodo.org/record/3954285

Oxyscelio flabelli Burks http://zoobank.org/ 8AB217B0-511B-432F-BD59-E6B267AC1C9D Figures 101–106 Oxyscelio flabelli Burks, 2013: 18, 23, 123 (original description, keyed, placed in ogive species group). Material Examined. Other material:(1 female) CHINA: 1 female, Yunnan, Xishuangbanna, Jinghong, 22°00.761’N 100°247’E, 31.VII.2003, Jingxian Liu, SCAU 3040600 (SCAU). Note. This species is newly recorded from China, Yunnan Province., Published as part of Mo, Wen-Hui, Chen, Hua-Yan, Johnson, Norman F., Pang, Hong, Ma, Li & Liu, Jing-Xian, 2020, Revision of the genus Oxyscelio Kieffer (Hymenoptera, Scelionidae) from China, pp. 251-310 in Zootaxa 4816 (3) on page 275, DOI: 10.11646/zootaxa.4816.3.1, http://zenodo.org/record/3954285

Oxyscelio perpensus Kononova http://zoobank.org/ 8323BFBD-BFC7-4DA7-9C8A-767CECA029EC Figures 241–246 Oxyscelio perpensum Kononova: Kononova and Fursov 2007: 104 (description); Kononova and Fursov 2007: 63 (original description). Oxyscelio perpensus Kononova: Kononova and Kozlov 2008: 190, 192 (description, keyed). Material Examined. Other material: CHINA: 1 female, Zhejiang, Tianmushan, Xianrending, 30°20.56’N 119°26.03’E, 25–29.VII.2011, sweeping, Huayan Chen, SCAU 2011000072 (SCAU). Comments. Johnson et al. (2013) reported a male specimen (SCAU 2011000072) from Zhejiang, but it is a female (see Figures 241–246). Therefore, the male of this species is still unknown., Published as part of Mo, Wen-Hui, Chen, Hua-Yan, Johnson, Norman F., Pang, Hong, Ma, Li & Liu, Jing-Xian, 2020, Revision of the genus Oxyscelio Kieffer (Hymenoptera, Scelionidae) from China, pp. 251-310 in Zootaxa 4816 (3) on pages 304-305, DOI: 10.11646/zootaxa.4816.3.1, http://zenodo.org/record/3954285, {"references":["Kononova, S. V. & Fursov, V. N. (2007) A review of the genera Calotelea, Calliscelio, and Oxyscelio (Scelioninae, Scelionidae, Proctotrupoidea) from the Palaearctic fauna. Entomological Review, 87, 92 - 105.","Kononova, S. V. & Kozlov, V. N. (2008) [Scelionids of the Palearctic (Hymenoptera, Scelionidae). Subfamily Scelioninae]. Tovarishchestvo Nauchnykh Izdanii KMK, Saint Petersburg, 489 pp.","Johnson, N. F., Burks, R. A., Austin, A. & Xu, Z. (2013) Chinese species of egg-parasitoids of the genera Oxyscelio Kieffer, Heptascelio Kieffer and Platyscelio Kieffer (Hymenoptera: Platygastridae s. l., Scelioninae). Biodiversity Data Journal, 1, e 987. https: // doi. org / 10.3897 / BDJ. 1. e 987"]}

Oxyscelio nasolabii Burks http://zoobank.org/ 2F28C6E0-F926-4350-966C-EB8B4344D118 Figures 13–14, 209–214 Oxyscelio nasolabii Burks, 2013: 17, 26, 193 (original description, keyed, placed in foveatus species group). Material Examined. Other material: CHINA: 1 female, Zhejiang, Mt. Qingliangfeng, 30°04’N 118°52’E, 11.VIII.2005, Min Shi, SCAU 3013726 (SCAU). Note. This species is newly recorded from China, Zhejiang Province., Published as part of Mo, Wen-Hui, Chen, Hua-Yan, Johnson, Norman F., Pang, Hong, Ma, Li & Liu, Jing-Xian, 2020, Revision of the genus Oxyscelio Kieffer (Hymenoptera, Scelionidae) from China, pp. 251-310 in Zootaxa 4816 (3) on page 296, DOI: 10.11646/zootaxa.4816.3.1, http://zenodo.org/record/3954285

Oxyscelio cordis Burks http://zoobank.org/ ED24C4B5-414C-4D6A-8713-14766B7DDB19 Figures 11–12, 53–62 Oxyscelio cordis Burks, 2013: 14, 21, 87 (original description, keyed, placed in crateris species group); Johnson et al. 2013: 13 (new distribution record for China). Material Examined. Other material: (1 female, 1 male) CHINA: 1 female, Yunnan, Yingjiang, Tongbiguan, 17. V.2009, Manman Wang, SCAU 200901544 (SCAU); 1 male, Yunnan, Yingjiang, Tongbiguan, 16. V.2009, Manman Wang, SCAU 200906462 (SCAU). Comments. This species was originally described based on a singleton female (Burks et al. 2013a). Here we record the male: Body length 3.98 mm (n=1); A5 tyloid: carina-like, not expanded; A11: longer than broad; Median tooth of frontal depression: absent; Median lobe of T1: with 4 longitudinal carinae; Metasomal apex: with acuminate lateral corners., Published as part of Mo, Wen-Hui, Chen, Hua-Yan, Johnson, Norman F., Pang, Hong, Ma, Li & Liu, Jing-Xian, 2020, Revision of the genus Oxyscelio Kieffer (Hymenoptera, Scelionidae) from China, pp. 251-310 in Zootaxa 4816 (3) on page 265, DOI: 10.11646/zootaxa.4816.3.1, http://zenodo.org/record/3954285, {"references":["Johnson, N. F., Burks, R. A., Austin, A. & Xu, Z. (2013) Chinese species of egg-parasitoids of the genera Oxyscelio Kieffer, Heptascelio Kieffer and Platyscelio Kieffer (Hymenoptera: Platygastridae s. l., Scelioninae). Biodiversity Data Journal, 1, e 987. https: // doi. org / 10.3897 / BDJ. 1. e 987","Burks, R. A., Masner, L., Johnson, N. F. & Austin, A. (2013 a) Systematics of the parasitic wasp genus Oxyscelio Kieffer (Hymenoptera: Platygastridae s. l.), Part I: Indo-Malayan and Palearctic fauna. ZooKeys, 292, 1 - 263. https: // doi. org / 10.3897 / zookeys. 292.3867"]}