{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:02:35Z","timestamp":1785240155293,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"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":["Euro J of Neurology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Irradiation of cellular blood components prevents transfusion\u2010associated graft\u2010versus\u2010host disease (TA\u2010GVHD). UK and Spanish guidance recommend lifelong irradiation for all patients treated with purine analogues, including cladribine, irrespective of indication or dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess whether this approach is justified for people with multiple sclerosis (pwMS) receiving cladribine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Narrative synthesis of immunological data, hemovigilance evidence, and national European transfusion guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cladribine used in pwMS induces transient lymphopenia with modest, reversible T\u2010cell effects and preserved vaccine responsiveness. Since introduction of universal pre\u2010storage leucocyte depletion, hemovigilance data show no reported cases of TA\u2010GVHD in this setting. European guidance is heterogeneous, ranging from indefinite to time\u2010limited or unspecified durations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence does not clearly support the need for lifelong irradiation after cladribine treatment in pwMS. Time\u2010limited or individualized approaches merit consideration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ene.70698","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T09:41:04Z","timestamp":1783330864000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transfusion\u2010Associated Graft\u2010Versus\u2010Host Disease Risk and Transfusion Requirements After Cladribine in Multiple Sclerosis: Time to Revise Irradiation Policy?"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9293-8893","authenticated-orcid":false,"given":"Klaus","family":"Schmierer","sequence":"first","affiliation":[{"name":"The Blizard Institute Queen Mary University of London, Faculty of Medicine &amp; Dentistry  London UK"},{"name":"Clinical Board Medicine (Neuroscience) The Royal London Hospital, Barts Health NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick","family":"Chen","sequence":"additional","affiliation":[{"name":"Clinical Haematology The Royal London Hospital, Barts Health NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6909-5468","authenticated-orcid":false,"given":"David","family":"Paling","sequence":"additional","affiliation":[{"name":"Sheffield Teaching Hospitals NHS Foundation Trust Royal Hallamshire Hospital  Sheffield UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-01-620872"},{"key":"e_1_2_11_3_1","first-page":"2527","article-title":"Transfusion\u2010Associated Graft\u2010Versus\u2010Host Disease: Current Concepts and Future Directions","volume":"62","author":"Treleaven 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\u201cGu\u00eda Sobre la Transfusi\u00f3n de Componentes Sangu\u00edneos \u201d(2015)."},{"key":"e_1_2_11_12_1","unstructured":"Haute Autorit\u00e9 de Sant\u00e9 \u201cTransfusion de Plaquettes: Recommandations \u201d(2015)."},{"key":"e_1_2_11_13_1","unstructured":"SIMTI \u201cRaccomandazioni Per il Corretto Utilizzo Degli Emocomponenti e Plasmaderivati \u201d(2008)."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.17845"},{"key":"e_1_2_11_15_1","unstructured":"Bundes\u00e4rztekammer \u201cCross\u2010Sectional Guidelines for Therapy With Blood Components and Plasma Derivatives \u201d(2020)."},{"key":"e_1_2_11_16_1","unstructured":"Danish Society for Clinical Immunology \u201cTransfusion Medicine Standards \u201d(2020)."}],"container-title":["European Journal of 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