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This retrospective cohort study analysed 58 consecutive patients undergoing second allo\u2010HSCT, predominantly haploidentical, to determine indications and identify predictive factors. All evaluable patients achieved successful and sustained haematopoietic reconstitution, with confirmed complete donor chimerism. As of the data cut\u2010off, two patients died at 1.3 and 2\u2009months post second transplantation with persistent non\u2010response (NR). Twelve of the remaining 56 patients relapsed after the second transplantation, with a median relapse time of 5.5 (3.0\u201313.5) months. One\u2010year overall survival (OS), disease\u2010free survival and cumulative incidence of relapse rates after the second transplant were 52.1%, 46.5% and 21.8% respectively. Treatment\u2010related mortality (TRM) following the second transplant was 5.3% and 31.9% at 3\u2009months and 1\u2009year respectively. Age &gt;55 and\/or HCT\u2010CI \u22653 and short initial remission duration (\u22648\u2009months) contributed to significantly inferior OS and higher TRM. This study implemented a strategy combining donor switching and post\u2010transplant maintenance therapy for second transplantation in haematological malignancy patients with post\u2010transplant relapse. Prospective studies are warranted to validate prognostic factors affecting outcomes after second transplantation.<\/jats:p>","DOI":"10.1111\/bjh.70259","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T08:45:49Z","timestamp":1763455549000},"page":"620-629","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes and risk factors of second allogeneic haematopoietic stem cell transplantation in patients with relapsed haematological malignancy after first transplantation"],"prefix":"10.1111","volume":"208","author":[{"given":"Xiaolu","family":"Zhu","sequence":"first","affiliation":[{"name":"Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Centre for Haematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Haematologic Malignancies Peking University  Beijing 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