Hematopoietic stem cell transplantation for malignant lymphoma is performed to improve prognosis of the patients with relapsed/refractory disease or untreated patients with poor prognostic features. High-dose therapy followed by autologous hematopoietic stem cell transplantation (ASCT) for the patients with chemosensitive relapsed/refractory diffuse large B-cell lymphoma (DLBCL) is given based on the result of a randomized phase 3 trial. Salvage chemotherapy followed by ASCT is still an effective salvage strategy in the patients with late relapse after first-line therapy; however, the probability of achieving response to salvage chemotherapy is very limited in the patients with early relapse. Such a conventional salvage treatment is likely to be replaced by CD19-directed chimeric antigen receptor T-cell therapy (CAR-T) in the patients with DLBCL with early relapse. Allogeneic transplantation has been an option for third-line therapy for DLBCL and classic Hodgkin lymphoma (cHL). In DLBCL, the role of allogeneic transplantation is decreasing with the introduction of CAR-T. In cHL, higher risk of immune-related complications after allogeneic transplantation followed by anti-PD-1 antibody is recognized as an emerging challenge.

 Allogeneic hematopoietic stem cell transplantation (AHSCT) is the only curative therapy for patients with primary and secondary myelofibrosis (MF). The majority patients with MF are aged and fragile, resulting high risk problematic of transplant-related mortality and comorbidities. Advances in transplant procedures, including reduced intensity conditioning regimen, alternative donor selection, post-transplant administration cyclophosphamide, and pre-transplant administration JAK inhibitors have led to increased suitability of AHSCT for a larger number of candidates. Mutation screening, and risk classification models such as the Dynamic International Prognostic Scoring System aid appropriate classification of an individual candidate’s risk profile and predict transplantation results. MF is a heterogenous disorder in terms of disease phenotypes, speed of progression and the associated mutational landscape. Physicians must therefore carefully assess decide the indications for transplant, timing of transplant, donor selection, intensity of the conditioning regimen and pre-transplant management of splenomegaly according to every individual’s risk-benefit balance.

 In 2019, defibrotide (DF) was approved for use to treat sinusoidal obstruction syndrome in Japan. However, few studies in the literature report on its use in children. We retrospectively analyzed cases of pediatric patients who underwent hematopoietic cell transplantation and developed sinusoidal obstruction syndrome, which was treated with DF in our center. Four patients with myelodysplastic syndrome (n=1), X-linked inhibitor of apoptosis protein (XIAP) deficiency (n=1), neuroblastoma (n=1), and acute lymphoblastic leukemia (n=1) were included in the study. Total bilirubin levels decreased after the start of DF therapy in all cases, except in the patient with acute lymphoblastic leukemia, who died immediately after starting DF therapy owing to worsening of the primary disease. Of the three patients whose total bilirubin levels decreased, two recovered and one died because of multiple organ failure. Apparent adverse events with DF administration were not observed, and a decrease in total bilirubin levels early in the treatment period tended to be a predictor of treatment response. It is hoped that more reports of patients with DF administration in Japan will be accumulated in the future.

 This study aimed to identify psychosocial and behavioral factors associated with attitudes of unrelated donors during coordination. A qualitative survey was performed using semistructured interviews employing social marketing methods. Unrelated donors who received notification of a match within a year before the start of this survey and were aged between 20 and 40 years at the time were targeted, and consequently 8 donors who donated stem cells (the donation group) and 10 who did not donate stem cells (the non-donation group) were enrolled. The interviewer determined that the non-donation group included donors with and without a high intention to donate. The donation group and the individuals in the non-donation group with a high intention to donate fully recognized the importance of being a match and of donating stem cells, and did not express strong concerns over physical burdens such as associated complications. On the other hand, those without a high intention to donate demonstrated a low acceptance of physical burdens, as expressed by statements such as “I would accept donation of peripheral blood stem cells, but not bone marrow”. Among donors with a high intention to donate, the most common reasons for discontinuing donor coordination were “work” and “family”.

 Improving the post-treatment quality of life (QOL) of patients with acute leukemia is an important treatment outcome. The purpose of this study was to explore how patients with acute leukemia cope post-treatment with challenges presented by chemotherapy and hematopoietic cell transplantation. Four aspects of health-related QOL were examined: physical, emotional, functional, and social. We analyzed open-ended data from a cross-sectional QOL survey of 524 patients treated for acute leukemia to identify challenges and coping ability according to treatment method. Patients in the post-transplant graft-versus-host disease (GVHD) group reported greater physical challenges, while those in the chemotherapy group reported greater emotional challenges. The patients in the chemotherapy group and the post-transplant GVHD group experienced greater challenges related to returning to work, while the patients without post-transplant GVHD experienced greater difficulty continuing to work after returning. It is important to support patients with unpredictable long-term course, their vulnerability to infection, and late post-treatment complications, in gaining confidence in coping with physical and emotional difficulties and uncertainties caused by treatment and complications, and gaining the ability to seek the support they need to return to work.

 Relapsed or refractory peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) and angioimmunoblastic T-cell lymphoma (AITL) are associated with a poor prognosis and recommended for allogeneic stem cell transplantation (SCT). However, there is no consensus on salvage chemotherapy prior to allogeneic SCT. Here, we describe three patients with relapsed or refractory PTCL-NOS or AITL successfully treated with EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) before allogeneic SCT. Despite receiving pirarubicin as part of the initial therapy, no patient developed cardiac failure throughout allogeneic SCT, possibly due to the continuous infusion schedule of EPOCH and conditioning regimen. To date, the patients remain in CR over 5 years after allogeneic SCT with no significant complications. We suggest that the EPOCH regimen is one of the treatment options available as salvage therapy prior to allogeneic SCT to reduce the tumor burden of lymphoma without severe adverse events.