The Allogeneic Hematopoietic Stem Cell Transplantation (HSCT), since the experiments in rodents in the 50’s, has become a complex procedure increasingly used for the treatment of an increasing number of malignant and non-malignant disorders. Progress has been made in the last three decades in selection of donors, conditioning regimens, supportive care and prophylaxis of infections, rejection and Graft Versus Host disease (GVHD). These advances have made it possible to offer HSCT to a growing number of patients, including people for whom the transplant-option was previously very difficult, such as the elderly and patients lacking a Human Leukocyte Antigens (HLA)-fully-matched donor. If this progress has improved the treatment outcome and increased the number of patients who could undergo HSCT, on the other hand, the advances have been coupled with new challenges. The possibility to source stem cells from both bone marrow or from the mobilized peripheral blood hematopoietic stem cells requires the selection of the most appropriate stem cell source based on a patient-targeted risk assessment. The increased options for donor-recipient pairing require online platforms and artificial intelligence tools to source the best match for each patient. Furthermore, the mounting evidence that the gut microbiome could affect the HSCT outcome, call for further investigations to better understand the role of the microbiome in this procedure in order to use it as a prognostic marker and act on it to influence the transplantation outcome.Despite the recent advances, acute and chronic GVHD and infections still account for 15-20 % of non-relapse mortality. About 30-40 % of transplant-failure is due to relapse of the hematological malignancy and the prognosis of relapsed patients after HSCT is extremely poor. Both Cytomegalovirus (CMV) and non-CMV viral infections are frequent complications after HSCT, which require prevention strategies, risk factors analysis, and treatments. In addition, the growing number of long-term transplant survivors requires careful monitoring of the long-term sequelae by a multidisciplinary approach resulting in a pronounced use of resources by the transplant center. The main purposes of the Research Topic are the three followings:1. to provide transplant-physicians and onco-hematologists with a description of the current “state of the art” of the clinical practice in the main topics of the hematopoietic transplantation activity;2. to provide an update of the current knowledge regarding the biological background underlining acute and chronic GVHD, immune-deficiency correlated to transplantation and relapse of hematological malignancy;3. to provide an overview about the novel therapies (including cellular therapies) in the field of acute leukemia, acute and chronic GVHD, conditioning regimen, and on how in the future they could be integrated with each other and with the transplantation to improve the patient care and survival. We welcome Original Articles and Review Articles focus on, but are not limited to, the following areas:- the evolution of conditioning regimens;- mobilization of peripheral blood hematopoietic stem cells: advances up to date and future perspectives;- therapeutic options for relapse of hematologic malignancies after HSCT;-new perspectives in the treatment of acute GVHD and chronic;-poor graft function and graft rejection: biological background and current strategies for prevention and treatment;-allogeneic Hematopoietic Stem Cell Transplantation in the elderly. Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.
The Allogeneic Hematopoietic Stem Cell Transplantation (HSCT), since the experiments in rodents in the 50’s, has become a complex procedure increasingly used for the treatment of an increasing number of malignant and non-malignant disorders. Progress has been made in the last three decades in selection of donors, conditioning regimens, supportive care and prophylaxis of infections, rejection and Graft Versus Host disease (GVHD). These advances have made it possible to offer HSCT to a growing number of patients, including people for whom the transplant-option was previously very difficult, such as the elderly and patients lacking a Human Leukocyte Antigens (HLA)-fully-matched donor. If this progress has improved the treatment outcome and increased the number of patients who could undergo HSCT, on the other hand, the advances have been coupled with new challenges. The possibility to source stem cells from both bone marrow or from the mobilized peripheral blood hematopoietic stem cells requires the selection of the most appropriate stem cell source based on a patient-targeted risk assessment. The increased options for donor-recipient pairing require online platforms and artificial intelligence tools to source the best match for each patient. Furthermore, the mounting evidence that the gut microbiome could affect the HSCT outcome, call for further investigations to better understand the role of the microbiome in this procedure in order to use it as a prognostic marker and act on it to influence the transplantation outcome.Despite the recent advances, acute and chronic GVHD and infections still account for 15-20 % of non-relapse mortality. About 30-40 % of transplant-failure is due to relapse of the hematological malignancy and the prognosis of relapsed patients after HSCT is extremely poor. Both Cytomegalovirus (CMV) and non-CMV viral infections are frequent complications after HSCT, which require prevention strategies, risk factors analysis, and treatments. In addition, the growing number of long-term transplant survivors requires careful monitoring of the long-term sequelae by a multidisciplinary approach resulting in a pronounced use of resources by the transplant center. The main purposes of the Research Topic are the three followings:1. to provide transplant-physicians and onco-hematologists with a description of the current “state of the art” of the clinical practice in the main topics of the hematopoietic transplantation activity;2. to provide an update of the current knowledge regarding the biological background underlining acute and chronic GVHD, immune-deficiency correlated to transplantation and relapse of hematological malignancy;3. to provide an overview about the novel therapies (including cellular therapies) in the field of acute leukemia, acute and chronic GVHD, conditioning regimen, and on how in the future they could be integrated with each other and with the transplantation to improve the patient care and survival. We welcome Original Articles and Review Articles focus on, but are not limited to, the following areas:- the evolution of conditioning regimens;- mobilization of peripheral blood hematopoietic stem cells: advances up to date and future perspectives;- therapeutic options for relapse of hematologic malignancies after HSCT;-new perspectives in the treatment of acute GVHD and chronic;-poor graft function and graft rejection: biological background and current strategies for prevention and treatment;-allogeneic Hematopoietic Stem Cell Transplantation in the elderly. Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.