{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:25:20Z","timestamp":1786123520370,"version":"build-2736575974"},"reference-count":9,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:italic>TP53<\/jats:italic>\n                    \u2010altered myeloid neoplasms are associated with an extremely high risk of relapse even after allogeneic hematopoietic cell transplantation (allo\u2010HCT), and the optimal pretransplant and posttransplant strategies remain undefined. We report the cases of three patients with\n                    <jats:italic>TP53<\/jats:italic>\n                    \u2010altered myeloid neoplasms who achieved durable complete remission after a sequential strategy consisting of limited pretransplant therapy, prompt allo\u2010HCT after reduction of the\n                    <jats:italic>TP53<\/jats:italic>\n                    \u2010positive clone, and early dose\u2010adjusted azacitidine (Aza) maintenance. At presentation, Cases 1 and 2 had\n                    <jats:italic>TP53<\/jats:italic>\n                    abnormalities detectable by both fluorescence in situ hybridization (FISH) and sequencing, whereas Case 3 had a\n                    <jats:italic>TP53<\/jats:italic>\n                    single\u2010nucleotide variant and an Intron 1 structural variant detectable only by molecular testing. Pretransplant treatment was intentionally limited to 2\u20133 cycles: three cycles of Aza in Case 1, intensive induction chemotherapy followed by one cycle of Aza in Case 2, and two cycles of venetoclax plus Aza in Case 3. In all cases, serial molecular monitoring demonstrated a reduction of\n                    <jats:italic>TP53<\/jats:italic>\n                    \u2010altered clones before transplantation, followed by complete disappearance after allo\u2010HCT. Aza maintenance was initiated approximately 1.5\u20132 months after transplantation at 30\u201335\u00a0mg\/m\n                    <jats:sup>2<\/jats:sup>\n                    for 5 days and was subsequently escalated according to tolerability. Maintenance was continued for 53, 37, and 27 cycles, respectively. All three patients remain in complete remission more than 4 years after transplantation. These cases highlight two clinically relevant points. First, in\n                    <jats:italic>TP53<\/jats:italic>\n                    \u2010altered myeloid neoplasms, pretransplant therapy may be best viewed as a bridge to transplantation, and transplantation should be considered promptly once the\n                    <jats:italic>TP53<\/jats:italic>\n                    \u2010positive clone has decreased, rather than prolonging non\u2010curative therapy. Second, posttransplant Aza maintenance may be more beneficial when initiated early, individualized according to tolerability and disease status, and continued as long as feasible. In addition, for patients with FISH\u2010detectable\n                    <jats:italic>TP53<\/jats:italic>\n                    abnormalities, serial FISH may provide a practical adjunct for pretransplant decision\u2010making in routine practice.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration<\/jats:bold>\n                    : The authors have confirmed clinical trial registration is not needed for this submission\n                  <\/jats:p>","DOI":"10.1002\/jha2.70315","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T11:16:36Z","timestamp":1779362196000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Transplantation After Pretransplant Reduction of\n                    <i>TP53<\/i>\n                    \u2010Altered Clones and Prolonged Dose\u2010Adjusted Azacitidine Maintenance: A Three\u2010Case Series"],"prefix":"10.1002","volume":"7","author":[{"given":"Fuyuki","family":"Yamagata","sequence":"first","affiliation":[{"name":"Department of Hematology Hyogo Medical University School of Medicine  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Yoshihara","sequence":"additional","affiliation":[{"name":"Department of Hematology Hyogo Medical University School of Medicine  Nishinomiya Japan"},{"name":"Department of Transfusion Medicine and Cellular Therapy Hyogo Medical University Hospital  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhito","family":"Nannya","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology The Institute of Medical Science The University of Tokyo  Tokyo Japan"},{"name":"Department of Pathology and Tumor Biology Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mami","family":"Samori","sequence":"additional","affiliation":[{"name":"Department of Hematology Hyogo Medical University School of Medicine  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saki","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Hematology Hyogo Medical University School of Medicine  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Kumamoto","sequence":"additional","affiliation":[{"name":"Department of Hematology Hyogo Medical University School of Medicine  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Hematology Hyogo Medical University School of Medicine  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuto","family":"Utsunomiya","sequence":"additional","affiliation":[{"name":"Department of Hematology Hyogo Medical University School of Medicine  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Yoshihara","sequence":"additional","affiliation":[{"name":"Department of Hematology Hyogo Medical University School of Medicine  Nishinomiya Japan"},{"name":"Department of Transfusion Medicine and Cellular Therapy Hyogo Medical University Hospital  Nishinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010020\u20101008\u2010z"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2024.104310"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.7290"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020002544"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010025\u201002625\u20103"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414799"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409\u2010025\u201002511\u20107"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13215502"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtct.2025.09.036"}],"container-title":["eJHaem"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.70315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jha2.70315","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jha2.70315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:53:24Z","timestamp":1786114404000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jha2.70315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,21]]},"references-count":9,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/jha2.70315"],"URL":"https:\/\/doi.org\/10.1002\/jha2.70315","archive":["Portico"],"relation":{},"ISSN":["2688-6146","2688-6146"],"issn-type":[{"value":"2688-6146","type":"print"},{"value":"2688-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,21]]},"assertion":[{"value":"2026-03-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70315"}}