Alberto Cardoso M. Lima, PhD

I am thrilled that our invited review article, "Donor Selection in Allogeneic Stem Cell Transplantation," just came out in Current Opinion in Hematology! Thanks to Dr. Francisco Barriga for the invitation and @CarmemBonfim1 for several thoughtful discussions on this topic.

@GonzaloBentoli1 Very nice paper! Congratulations @GonzaloBentoli1

I am especially happy that an idea born during a meeting among friends eventually became this project. A great collaborative effort with colleagues and friends.

@IztfE @ConferenceEfi @BSHIconference Very well-deserved recognition!! 👏👏👏

We are delighted to be in Edinburgh 🏴󠁧󠁢󠁳󠁣󠁴󠁿 for the @ConferenceEfi. We are also honored that Prof Fleischhauer was the recipient of this year’s @BSHIconference Hilliard Festenstein Award, which was delivered after her lecture at the HSCT Plenary Session. #EFI2026

Joy Division's TV debut. Shadowplay on Granada Reports in 1978. #FactoryFriday

@MuratoriMD The Best Ones!! ❤️🙌

Brazilian Pediatric BMT team at #EBMT26 ❤️

@IztfE @TheEBMT Congratulations on the paper! Very interesting data on it!

Hot off the press: Landscapes of HLA Mismatching in Contemporary Unrelated Haematopoietic Cell Transplantation, our latest research presenting a granular analysis of HLA mismatching in a very large cohort of contemporary HCT from the @TheEBMT Registry. doi.org/10.1111/tan.70…

O V Multirregional SBTMO reunirá especialistas nacionais e internacionais de destaque no TCTH e na terapia celular para discutir prevenção e tratamento de recaídas pós-transplante. Inscreva-se: multirregionalsbtmo.com.br 🔹 Associados SBTMO adimplentes têm inscrição gratuita.

@BrianShafferMD @MSKCancerCenter Congratulations on this very interesting review! 👏👏👏

One of my favorite things to write with two colleagues from whom I’ve learned a great deal. @MSKCancerCenter ashpublications.org/blood/article/…

🧬 Why Cyclophosphamide (PTCy) is given on D+3 (±D+4) — NOT D+2 post allo-SCT 🧵 Thread (mechanism-based, guideline-driven): 🕒 Day 0 = graft infusion ➡️ Donor T cells enter host ➡️ Antigen recognition starts but most alloreactive T cells are NOT yet dividing 🔄 Day +1 to +2 ❌ Alloreactive T cells still in early activation phase ❌ Many NOT in S-phase ❌ Cyclophosphamide would MISS key pathogenic clones 🧪 Cyclophosphamide = cell-cycle dependent cytotoxicity ➡️ Kills rapidly dividing T cells ➡️ Needs cells in active DNA synthesis 📈 Peak alloreactive T-cell proliferation = Day +3 ✅ Pathogenic GVHD-causing T cells enter rapid cycling ✅ Maximum susceptibility to cyclophosphamide 🎯 Day +3 (± Day +4) = SWEET SPOT 🔥 Deletes alloreactive donor T cells 🛡️ Preserves: •🧫 Hematopoietic stem cells (↑ ALDH expression) •🧑‍⚕️ Regulatory T cells (ALDH-high, slower cycling) •🦠 Pathogen-specific memory T cells ❌ Why NOT Day +2? ⚠️ Too early ⚠️ Incomplete deletion of alloreactive clones ⚠️ → Higher risk of acute GVHD ❌ Why NOT later (D+5 or beyond)? ⚠️ Alloreactive T cells exit peak proliferation ⚠️ Less cyclophosphamide sensitivity ⚠️ Loss of selectivity → ↑ GVHD, ↑ toxicity ⚖️ Clinical balance achieved at D+3: ✔️ GVHD prevention ✔️ Engraftment preserved ✔️ GVL effect maintained ✔️ Immune reconstitution spared 📌 Bottom line: 🧠 PTCy timing is biologically timed to T-cell kinetics — not arbitrary ⏱️ D+3 targets the enemy when it’s most vulnerable #PTCy #AlloSCT #GVHD #BMT #TransplantImmunology #Hematology #KFSHRC #SOHO_KSA #ESH_Emirates_Hematology_Society

We kick off our participation at this year’s Tandem Meetings with an overview of the @TheEBMT perspective on donor selection in current HCT by Prof Fleischhauer, discussing similarities and differences with @CIBMTR and @nmdp_org data. #tandem2026

Sobre o caso do cão Orelha, me veio a cabeça a célebre frase de Schopenhauer: “A compaixão pelos animais está intimamente ligada a bondade de caráter, e quem é cruel com os animais não pode ser um bom homem.”

EDITORIAL | "Se a morte do Orelha fica impune, ela representa uma falência para todos nós. Falhamos como sociedade na proteção dos animais. Falhamos na educação dos nossos jovens”, avalia Luciana Barreto, editora-chefe do #RepórterBrasilTarde.

@DelegadoUlisses @jorginhomello Quero ver esses vermes psicopatas serem prontamente responsabilizados, bem como os parentes cúmplices! Mais resultados concretos e menos retórica

Com @jorginhomello SC é o Estado que + investiu na proteção animal. Em 2023 foi criada a Delegacia de Proteção Animal da Capital (Florianópolis). Em 2024 em Joinville e Blumenau (+de 300 mil hab.). Próximas serão em Criciúma, São José, Itajaí, Palhoça e Chapecó (+de 200 mil hab.)

#JustiçaPorOrelha

Donor selection in HSCT: ABO 🩸 compatibility and CMV serostatus @Mohty_EBMT @UsuarezMD @TheIACH

📏 The Innovation | Beyond Donor Age: Leukocyte Telomere Length as a New Metric for Optimizing Donor Selection in Acute Leukemia Transplantation 🔗 Full article: sciencedirect.com/science/articl…

🧬⚖️ GVL vs GVHD — Finding the Balance in Allo-SCT 🔥 GVL (Graft-versus-Leukemia) 🧠 Donor T/NK cells attack residual malignant cells 🎯 Main curative mechanism of allo-SCT 📉 ↓ Relapse risk 💊 Boosted by: ⬆️ Full donor chimerism ⬆️ DLI ⬆️ Reduced immunosuppression ⚔️ GVHD (Graft-versus-Host Disease) 🔥 Donor immune cells attack normal tissues 🩺 Targets: 🧴Skin | 🍽️Gut | 🫁Liver 📈 ↑ TRM, ↓ QoL 🛑 Triggered by: ⬆️ HLA mismatch ⬆️ Older age ⬆️ Infections / inflammation ⚖️ The Balance (the art of transplant) 🟢 Enough GVL → disease control 🔴 Too much GVHD → morbidity & mortality 🧠 How we optimize the balance 🎯 Tailored conditioning (MAC vs RIC) 🧬 Donor selection (MSD > MUD > Haplo) 🛡️ GVHD prophylaxis (PTCy / ATG / CNI + MTX/MMF) 📉 Careful taper of immunosuppression 💉 DLI only when safe 📌 Clinical Pearls ✨ Mild chronic GVHD = protective relapse effect 🚫 Severe GVHD ≠ better GVL 🧠 Goal: immune control, not immune chaos #Hematology #AlloSCT #GVL #GVHD #BoneMarrowTransplant #HemeOnc #TransplantPearls

🧬🩸 Allo-SCT Donor Choice (MSD vs MUD vs Haplo) — When Genetic/Familial Predisposition Is Suspected 🧠 Why this matters? ⚠️ Germline mutations (e.g. DDX41, TP53, RUNX1, GATA2, SAMD9/9L) ⚠️ High risk of donor-derived leukemia, graft failure, or toxicity ⚠️ Siblings may silently carry the same mutation ⸻ 👨‍👩‍👧 MSD (Matched Sibling Donor) ❗ NOT automatically safest if familial predisposition suspected 🚫 Avoid sibling donor until germline testing is negative ⚠️ Risk of: 🧬 Donor-derived MDS/AML 📉 Poor graft function 🎯 Use only if: ✅ Sibling tested & mutation excluded ⸻ 🌍 MUD (Matched Unrelated Donor) ✅ Preferred option when germline predisposition suspected 🧬 Lower risk of shared pathogenic variant 📊 More reliable long-term safety ❌ Longer search time 🎯 Best choice for: 🟢 DDX41-associated MDS/AML 🟢 Familial cytopenias 🟢 Young patients with strong family history ⸻ 🧬 Haploidentical Donor (Haplo) 🚫 Avoid related haplo donors if hereditary syndrome suspected 🛡️ PTCy controls GVHD ❌ does NOT fix genetic risk 🎯 Consider only if: ⏱️ Life-threatening urgency 🧬 Donor genetically tested & cleared 🌱 Or non-related haplo (rare) ⸻ ⚖️ Practical Transplant Rule 🧠 Suspected familial syndrome = test first, transplant second 🥇 MUD > MSD > Haplo (unless related donors fully cleared) 📌 Red flags to trigger germline testing BEFORE SCT 🚨 Young age MDS/AML 👨‍👩‍👧 Multiple affected relatives 🔁 Long-standing cytopenias 🧬 MDS/AML with normal karyotype 🧂 Therapy-related features without exposure ⸻ 🧠 Key Pearl ❗ GVHD prophylaxis ≠ protection from inherited leukemia risk 🧬 Donor genetics are as important as HLA #Hematology #AlloSCT #MSD #MUD #HaploSCT #FamilialMDS #GermlinePredisposition #BoneMarrowTransplant #HemeOnc