{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:13:09Z","timestamp":1788513189874,"version":"build-2803163510"},"reference-count":72,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"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":["European J of Haematology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Post\u2010transplant cyclophosphamide (PT\u2010CY) remains the standard of care for graft\u2010versus\u2010host disease (GvHD) prophylaxis in haploidentical hematopoietic cell transplantation (HCT), yet relapse, delayed immune reconstitution, infections, and organ toxicity represent persistent and clinically meaningful limitations. Post\u2010transplant bendamustine (PT\u2010BEN) has been investigated as a biologically distinct alternative. In stringent haploidentical murine models, PT\u2010BEN uncoupled GvHD from graft\u2010versus\u2010leukemia (GvL) effects through mechanisms centered on myeloid modulation and preservation of innate immunity rather than regulatory T\u2010cell expansion. These findings were extended in humanized xenogeneic models, where PT\u2010BEN combined with calcineurin inhibition demonstrated superior survival compared to PT\u2010CY. Clinical translation began with a phase I partial\u2010substitution platform (PT\u2010CY day +3\/PT\u2010BEN day +4), demonstrating safety, accelerated hematopoietic recovery, reduced chronic GvHD, and improved GvHD\u2010free relapse\u2010free survival in a small non\u2010randomized cohort. Immune profiling revealed earlier CD4\n                    <jats:sup>+<\/jats:sup>\n                    reconstitution, restrained CD8\n                    <jats:sup>+<\/jats:sup>\n                    effector skewing, and preserved T\u2010cell receptor diversity. Independent studies from multiple international centers have provided preliminary corroboration of these signals and clarified a dose\u2010 and platform\u2010dependent cytokine release syndrome as the principal emerging toxicity. The accumulating preclinical consistency and early multi\u2010institutional clinical signals now provide sufficient biological plausibility to justify formal randomized evaluation of PT\u2010BEN against the PT\u2010CY standard. PT\u2010BEN appears to be a mechanistically distinct strategy with immunomodulatory properties that requires randomized validation before platform\u2010level conclusions can be drawn. A multicenter randomized trial incorporating a reduced\u2010dose PT\u2010CY comparator arm will be essential to establish PT\u2010BEN's independent contribution and define its role in improving long\u2010term HCT outcomes.\n                  <\/jats:p>","DOI":"10.1111\/ejh.70215","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T11:44:06Z","timestamp":1778672646000},"page":"739-749","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Post\u2010Transplant Bendamustine as a Platform for Immune Modulation After Allogeneic Hematopoietic Cell Transplantation"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2427-8925","authenticated-orcid":false,"given":"Megan J.","family":"Cracchiolo","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of Arizona  Tucson Arizona 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