{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:28:43Z","timestamp":1776126523456,"version":"3.50.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Hematol"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Immune checkpoint inhibitors (CPIs) targeting PD-1, such as nivolumab and pembrolizumab, have become integral to the treatment of relapsed or refractory classical Hodgkin lymphoma (cHL), frequently serving as a bridge to autologous stem cell transplantation (ASCT). However, recent reports suggest that CPI exposure prior to ASCT may increase the risk of engraftment syndrome (ES), an inflammatory complication that emerges during neutrophil recovery. We present three cases of cHL treated by ASCT was performed following anti PD-1-based salvage therapy. Two of the three patients developed ES, with one case requiring high-dose corticosteroid pulse therapy due to severe respiratory symptoms. We examined lymphocyte counts and the interval between the final CPI dose and transplantation as potential contributing factors. While lymphocyte counts did not correlate with ES severity, the patient with the highest ES severity had the shortest CPI-to-transplant interval. These findings suggest that recent CPI exposure may contribute to ES, possibly via prolonged immune activation. As CPIs become more widely used in pre-ASCT regimens, clinicians should remain alert to the potential for delayed inflammatory toxicities and consider the timing of transplantation when planning post-CPI management strategies.<\/jats:p>","DOI":"10.1007\/s12185-025-04094-x","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T10:41:56Z","timestamp":1761907316000},"page":"135-140","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Engraftment syndrome after PD-1 blockade in classical Hodgkin lymphoma treated by autologous stem cell transplantation"],"prefix":"10.1007","volume":"123","author":[{"given":"Huiyeon","family":"Choi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6238-3145","authenticated-orcid":false,"given":"Takuji","family":"Yamauchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuo","family":"Mori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chie","family":"Matsuo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hakuei","family":"Nishihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetoshi","family":"Irifune","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumihiko","family":"Nakao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Ishihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Imanaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kensuke","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teppei","family":"Sakoda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumiaki","family":"Jinnouchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohta","family":"Miyawaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Shima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshikane","family":"Kikushige","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Akashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koji","family":"Kato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"issue":"4","key":"4094_CR1","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1056\/NEJMoa1411087","volume":"372","author":"SM Ansell","year":"2015","unstructured":"Ansell SM, Lesokhin AM, Borrello I, Halwani A, Scott EC, Gutierrez M, et al. PD-1 blockade with nivolumab in relapsed or refractory Hodgkin\u2019s lymphoma. N Engl J Med. 2015;372(4):311\u20139. https:\/\/doi.org\/10.1056\/NEJMoa1411087.","journal-title":"N Engl J Med"},{"issue":"9","key":"4094_CR2","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1016\/S1470-2045(16)30167-X","volume":"17","author":"A Younes","year":"2016","unstructured":"Younes A, Santoro A, Shipp M, Zinzani PL, Timmerman JM, Ansell S, et al. Nivolumab for classical Hodgkin\u2019s lymphoma after failure of both autologous stem-cell transplantation and brentuximab vedotin: a multicentre, multicohort, single-arm phase 2 trial. Lancet Oncol. 2016;17(9):1283\u201394. https:\/\/doi.org\/10.1016\/S1470-2045(16)30167-X.","journal-title":"Lancet Oncol"},{"issue":"14","key":"4094_CR3","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1182\/blood.2019000324","volume":"134","author":"R Chen","year":"2019","unstructured":"Chen R, Zinzani PL, Lee HJ, Armand P, Johnson NA, Brice P, et al. Pembrolizumab in relapsed or refractory Hodgkin lymphoma: 2-year follow-up of KEYNOTE-087. Blood. 2019;134(14):1144\u201353. https:\/\/doi.org\/10.1182\/blood.2019000324.","journal-title":"Blood"},{"issue":"3","key":"4094_CR4","doi-asserted-by":"publisher","first-page":"1757","DOI":"10.1007\/s00277-025-06255-8","volume":"104","author":"C Pellegrini","year":"2025","unstructured":"Pellegrini C, Casadei B, Broccoli A, Cantelli M, Gugliotta G, Gentilini M, et al. Further strategies after immune checkpoint inhibitors in relapsed\/refractory Hodgkin lymphoma: salvage treatments and consolidation with transplantation, experience in daily clinical practice. Ann Hematol. 2025;104(3):1757\u201364. https:\/\/doi.org\/10.1007\/s00277-025-06255-8.","journal-title":"Ann Hematol"},{"issue":"6","key":"4094_CR5","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1182\/blood.2020009178","volume":"138","author":"RH Advani","year":"2021","unstructured":"Advani RH, Moskowitz AJ, Bartlett NL, Vose JM, Ramchandren R, Feldman TA, et al. Brentuximab vedotin in combination with nivolumab in relapsed or refractory Hodgkin lymphoma: 3-year study results. 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Int J Hematol. 2018;108(5):510\u20135. https:\/\/doi.org\/10.1007\/s12185-018-2508-1.","journal-title":"Int J Hematol"},{"key":"4094_CR19","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.59125","author":"A Osa","year":"2018","unstructured":"Osa A, Uenami T, Koyama S, Fujimoto K, Okuzaki D, Takimoto T, et al. Clinical implications of monitoring nivolumab immunokinetics in non-small cell lung cancer patients. 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Yamauchi (No. 20796213), from the Ministry of Education, Culture, Sports, Science and Technology of Japan. This study was also supported in part by research grants from Shin-nihon Foundation of Advanced Medical Treatment Research, Chugai Foundation for Innovative Drug Discovery Science, and Japanese Society of Hematology (to T. Yamauchi).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the Institutional Review Board of Kyushu University Hospital. All patients provided written informed consent prior to treatment, in accordance with the Declaration of Helsinki (1975, as revised in 1983). As the use of nivolumab in combination with cytotoxic chemotherapy is not approved under the national insurance system in Japan, the treatment was conducted under IRB oversight. No animal studies were involved. Study registration was not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics statement"}}]}}