With the exploration of genomic and molecular landscape of hematological malignancies, and the identification of key mutations driving their pathogenesis, novel targeted agents have been rapidly incorporated into the other different classes of therapeutic agents including conventional chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT). With the expansion of therapeutic options, hematologists are increasingly required to adapt their clinical practices to maximize the efficacy of novel therapies while minimizing treatment-related toxicities. Many of these novel targeted agents are metabolized by the cytochrome P450 system, necessitating careful evaluation of potential drug-drug interactions (DDIs) in clinical practice. This is particularly relevant for pharmacokinetic interactions with triazole antifungals, which are moderate to strong CYP3A4 inhibitors. This is particularly relevant for pharmacokinetic interactions with triazole antifungals, which are moderate to strong CYP3A4 inhibitors. The co-administration of triazoles with targeted agents (e.g., venetoclax, gilteritinib, quizartinib), can increase their exposure, presenting a challenge for clinicians. In this review, we will discuss strategies to manage these interactions in the specific clinical setting of concomitant administration of novel anti-leukemia agents and triazoles, and also discuss how to adjust the dosage of anti-leukemic agents, immunosuppressants, and the novel graft-versus-host disease (GVHD) agents when used in combination with triazoles.

 The clinical applications of apheresis, which has historical roots in bloodletting, are extensive. In addition to therapeutic apheresis procedures such as plasma exchange therapy and donor apheresis, which are routinely performed at Red Cross Blood Centers, apheresis is also employed in cell therapy. This includes peripheral blood stem cell collection, initiated in the 1980s, and autologous peripheral blood mononuclear cell collection for CAR-T therapy.

 Apheresis is an invasive procedure that carries inherent risks, necessitating meticulous implementation to ensure the safety of both patients and donors. The Japanese Society for Transplantation and Cellular Therapy Guidelines Committee published the “Hematopoietic Stem Cell Collection”. This guideline emphasizes that the physician responsible for the collection should be affiliated with a relevant professional society. Furthermore, it stipulates the need for continuous monitoring by at least one qualified medical staff member (such as a physician, nurse, clinical laboratory technologist, or clinical engineer) during peripheral blood stem cell collection. It is also recommended that a certified apheresis nurse, accredited by the Japan Society of Transfusion Medicine and Cell Therapy, be present to enhance safety and efficacy.

 The aim of family nursing interventions is to support family members in fulfilling their designated functions and to proactively resolve any issues arising due to injuries or illnesses. In this review, family systems theory, a representative theory for understanding family nursing, is introduced and grief care practice for a case of poor prognosis after related transplantation during the coronavirus disease 2019 (COVID-19) pandemic.

 There are 11 hematopoietic stem cell transplantation (HSCT) centers certified by the Japanese Society for Transplantation and Cellular Therapy in the Tohoku region of Japan, including Fukushima Medical University Hospital (FMU). Approximately 25 adult and 10 pediatric patients undergo HSCT in FMU annually; the Department of Hematology takes care of adult and pediatric patients from the Fukushima Prefecture, whereas the Department of Pediatric Oncology treats pediatric patients with extremely high-risk hematologic malignancies indicated for HLA-haploidentical HSCT from all over Japan. At the time of the 2011 Fukushima disaster, four patients were preparing for HSCT. Thanks to the generous support from the Japan Marrow Donors Program and other HSCT centers, all four patients successfully received their transplants. This experience has enhanced our ability as a team to provide care for our patients. Currently, 18 hematopoietic cell transplant coordinators (HCTCs) are actively engaged in transplant coordination and patient support in this region. Due to its small size, the HCTC community in the Tohoku region is a tight knit one forming one unified HSCT team across several institutions. Building trust and collaboration among all HCTCs is vital to ensuring the effectiveness of the HSCT team as a whole.

 Human leukocyte antigen (HLA)-haploidentical stem cell transplantation using posttransplant cyclophosphamide (PTCy-haplo) is rapidly increasing worldwide. In Japan, the number of HLA-haploidentical stem cell transplantations exceeded that of related HLA-matched transplantations in 2020. In 2024, PTCy was approved for insurance coverage. Recent retrospective studies using Japanese registry data demonstrated that the transplantation outcomes of PTCy-haplo are comparable to those of HLA-matched unrelated and cord blood transplantations. PTCy-haplo was initially developed for bone marrow transplantation after non-myeloablative conditioning; however, it has become widely used in peripheral blood stem cell transplantation and myeloablative conditioning. Several strategies have been attempted to improve transplantation outcomes with PTCy-haplo, including using peripheral blood stem cells, increasing the number of infused CD34-positive cells, younger donors, HLA class Ⅱ mismatches, HLA-B leader matching, reduced PTCy dose, early initiation of calcineurin inhibitors, and posttransplant maintenance therapy. Furthermore, PTCy has shown efficacy in HLA-matched and HLA 1-2 allele mismatched transplantations, with favorable results reported in a prospective Japanese phase Ⅱ trial. We aim to achieve safer allogeneic transplantation by sufficiently suppressing GVHD using PTCy.

 Recent advancements in novel drugs and diagnostic technologies have significantly improved leukemia treatment, leading to ongoing changes in treatment strategies. It has become clear that some types of leukemia, previously considered difficult to cure without allogeneic hematopoietic stem cell transplantation, can now be treated without transplantation. However, there are still leukemias that relapse or become refractory despite various therapeutic approaches, which remains a major challenge for hematologists. For high-relapse-risk leukemia, cord blood transplantation (CBT), which can be rapidly and reliably prepared and is expected to offer a strong graft-versus-leukemia effect (GVL) due to pre-engraftment immune reaction (PIR), combined with maintenance therapy aimed at preventing relapse, holds great potential. These advances are expected to represent a significant step forward in overcoming high-relapse-risk leukemia.

 Allogeneic hematopoietic cell transplantation (allo-HCT) recipients are highly susceptible to various infections due to the myelosuppression caused by conditioning chemoradiotherapy and the use of immunosuppressants. The oral cavity contains a diverse array and substantial number of bacteria, which can lead to infections when oral mucotitis occurs. Therefore, it is crucial to eliminate potential oral infections and improve oral hygiene before transplantation. In our hospital, we perform oral cleansing and remove sources of oral infection for patients scheduled to undergo allo-HCT. Furthermore, during the transplantation process, an oral care support team consisting of dentists and dental hygienists provides oral care support in collaboration with hematologists and nurses. In this context, we have considered the potential impact of the oral environment on transplant outcomes, including oral adverse events, and have particularly focused on the oral microbiota in our ongoing clinical research. In this report, we outline our hospital’s oral management strategies for allo-HCT recipients and present findings from our clinical research on the relationship between the oral microbiota, systemic conditions, and oral adverse events in allo-HCT recipients.

 Here, we investigated the prevalence and clinical characteristics of sarcopenia in hematopoietic stem cell transplant recipients. A total of 105 patients who underwent allogeneic hematopoietic stem cell transplantation at our hematology department were analyzed. Sarcopenia was diagnosed based on grip strength, gait speed, and skeletal muscle index using the 2019 Asian Sarcopenia Working Group diagnostic criteria. Rehabilitation was performed according to the clinical course of the patient. Sarcopenia was present in 12.4 and 27.6% of patients at admission and discharge, respectively. The incidence of sarcopenia after transplantation was 19.6%. It was particularly common in women who developed acute GVHD, were treated with steroids, and were hospitalized for long periods of time. Knowledge regarding the status of sarcopenia in patients with transplants may assist with future treatments and countermeasures.

 Graft-versus-host disease (GVHD) prophylaxis using antithymocyte globulin (ATG) has been well-established in allogeneic hematopoietic stem cell transplantation. We collected data on GVHD prophylaxis from 27,091 cases of hematological malignancies undergoing bone marrow transplantation (BMT) and peripheral blood stem cell transplantation (PBSCT) from 2010 to 2022. Annual trends in GVHD prophylaxis were analyzed based on donor type, stem cell source or HLA compatibility. The number of GVHD prophylaxis using ATG was increased in related-HLA matched-PBSCT [2010: n＝6 (1.6%), 2022: n＝42 (14.1%)], unrelated-HLA matched-PBSCT [2010: n＝0 (0.0%), 2022: n＝80 (43.0%)], unrelated-HLA 1-locus mismatched-BMT [2010: n＝36 (9.6%), 2022: n＝97 (40.4%)], and unrelated-HLA 1-locus mismatched-PBSCT [2010: n＝0 (0.0%), 2022: n＝64 (59.3%)]. Conversely, ATG use decreased in related-HLA haplo-PBSCT [2010: n＝111 (67.7%), 2022: n＝63 (11.2%)] due to the increasing use of posttransplant cyclophosphamide (PTCy). This study highlights the variation in GVHD prophylaxis trends using ATG across transplantation types.