{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T13:16:35Z","timestamp":1778505395827,"version":"3.51.4"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Poor graft function (PGF) with persistent thrombocytopenia is a serious post-transplant complication linked to increased mortality. Active infections can worsen outcomes. We report a case of secondary poor platelet engraftment with refractory pulmonary infection after haploidentical HSCT. A 52-year-old woman developed Rhizopus microsporus infection on day +1. Neutrophil engraftment occurred by day +13, but platelet engraftment was delayed until day +40. She later developed\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    septic shock (day +106) and multidrug-resistant\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    superinfection (day +190). Thrombopoietin receptor agonists showed minimal response, and she died 6 months post-transplant. This case highlights ultra-early mucormycosis, TPO-RA failure during active infection, and a fungal-bacterial cascade, underscoring the need for infection control before PGF-directed therapy.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1814549","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T04:34:23Z","timestamp":1777005263000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Poor platelet engraftment combined with persistent pulmonary infection after haploidentical allogeneic hematopoietic stem cell transplantation: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Ying","family":"He","sequence":"first","affiliation":[{"name":"Department of Hematology, Chinese People\u2019s Liberation Army The General Hospital of Western Theater Command","place":["Chengdu, Sichuan, China"]},{"name":"Sichuan Clinical Research Center for Hematological Disease","place":["Chengdu, Sichuan, China"]},{"name":"Branch of National Clinical Research Center for Hematological Disease","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaxin","family":"Xiong","sequence":"additional","affiliation":[{"name":"School of Public Health, North Sichuan Medical College","place":["Nanchong, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juanjuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Chinese People\u2019s Liberation Army The General Hospital of Western Theater Command","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinyu","family":"Gan","sequence":"additional","affiliation":[{"name":"Department of Blood transfusion, Chinese People\u2019s Liberation Army The General Hospital of Western Theater Command","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangyi","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Hematology, Chinese People\u2019s Liberation Army The General Hospital of Western Theater Command","place":["Chengdu, Sichuan, China"]},{"name":"Sichuan Clinical Research Center for Hematological Disease","place":["Chengdu, Sichuan, China"]},{"name":"Branch of National Clinical Research Center for Hematological Disease","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Hematology, Chinese People\u2019s Liberation Army The General Hospital of Western Theater Command","place":["Chengdu, Sichuan, China"]},{"name":"Sichuan Clinical Research Center for Hematological Disease","place":["Chengdu, Sichuan, China"]},{"name":"Branch of National Clinical Research Center for Hematological Disease","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"11 2040620720948743","DOI":"10.1177\/2040620720948743","article-title":"Advances in the understanding of poor graft function following allogeneic hematopoietic stem-cell transplantation","volume":"11","author":"Chen","year":"2020","journal-title":"Ther Adv Hematol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1053\/j.seminhematol.2018.08.004","article-title":"Poor graft function after allogeneic hematopoietic stem cell transplantation-an old complication with new insights","volume":"56","author":"Kong","year":"2018","journal-title":"Semin Hematol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1898","DOI":"10.1016\/j.bbmt.2019.05.036","article-title":"Incidence, risk factors, and outcomes of primary poor graft function after allogeneic hematopoietic stem cell transplantation","volume":"25","author":"Zhao","year":"2019","journal-title":"Biol Blood Marrow Transplant"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1007\/s00277-015-2440-x","article-title":"The incidence, risk factors, and outcomes of primary poor graft function after unmanipulated haploidentical stem cell transplantation","volume":"94","author":"Sun","year":"2015","journal-title":"Ann Hematol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e405","DOI":"10.1016\/S1473-3099(19)30312-3","article-title":"Global guideline for the diagnosis and management of mucormycosis: an initiative of the European Confederation of Medical Mycology in cooperation with the mycoses study group education and research consortium","volume":"19","author":"Cornely","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1182\/blood-2025-863","article-title":"IFN-\u03b3 drives long-term bone marrow niche dysfunction following chemotherapy","volume":"146","author":"Tikhonova","year":"2025","journal-title":"Blood"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4727","DOI":"10.1182\/bloodadvances.2024013581","article-title":"A boost for poor graft function","volume":"8","author":"Mohty","year":"2024","journal-title":"Blood Adv"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1124","DOI":"10.1016\/j.jcyt.2025.03.004","article-title":"CD34-selected stem cell boost was an effective treatment for refractory poor hematopoietic reconstitution after haploidentical hematopoietic stem cell transplantation","volume":"27","author":"He","year":"2025","journal-title":"Cytotherapy"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"4729","DOI":"10.1182\/bloodadvances.2023012418","article-title":"Active infection at the time of CD34+ selected stem cell boost is associated with treatment failure and poor overall survival","volume":"8","author":"Shapiro","year":"2024","journal-title":"Blood Adv"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1814549\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T12:50:28Z","timestamp":1778503828000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1814549\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,24]]},"references-count":9,"alternative-id":["10.3389\/fmed.2026.1814549"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1814549","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,24]]},"article-number":"1814549"}}