{
  "abstract": "Poor graft function (PGF) is a serious complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT), particularly when persistent cytopenia occurs despite complete donor chimerism. We report a 5-year-old girl with transfusion-dependent β-thalassemia major who developed refractory secondary PGF after haploidentical allo-HSCT following cytomegalovirus reactivation. Bone marrow was markedly hypocellular, and and multilineage cytopenias progressively worsened after plasma CMV DNA became undetectable and antiviral therapy was completed. Contributions from infection-related injury, antiviral-associated myelotoxicity, or endothelial injury could not be fully excluded. Multiple supportive and immunomodulatory interventions failed. Because a CD34 ⁺ selected stem cell boost was not feasible, the patient received intentionally low-dose donor lymphocyte infusion (DLI) on days +270 and +284. Multilineage hematopoietic recovery occurred 27 days after the first infusion, and transfusion independence was maintained for more than 14 months. Post-DLI events included manageable grade I cutaneous graft-versus-host disease and transient tachypnea of uncertain etiology. Longitudinal immune profiling showed recovery of naive T-cell compartments, contraction of effector-memory subsets, and expansion of CD8 ⁺ CD28 ⁻ T cells without overt T-cell activation. This observation provides a hypothesis-generating rationale for prospective studies evaluating the efficacy and safety of low-dose DLI in pediatric secondary PGF.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Hematology and Oncology, Shenzhen Children’s Hospital",
    "Department of Laboratory Medicine, Shenzhen Children’s Hospital"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yue Li"
    },
    {
      "affs": [
        1
      ],
      "name": "Liping Luo"
    },
    {
      "affs": [
        0
      ],
      "name": "Dingzhi Heng"
    },
    {
      "affs": [
        0
      ],
      "name": "Chunjing Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaohui Zhou"
    },
    {
      "affs": [
        1
      ],
      "name": "Xiaoying Fu"
    },
    {
      "affs": [
        0
      ],
      "name": "Sixi Liu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9xq62tx192vd6.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1972748",
  "fulltext_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1972748/full",
  "id": "9xq62tx192vd6",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1972748/full",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC581-607"
    ],
    [
      "openalex",
      "2720|Hematopoietic Stem Cell Transplantation"
    ]
  ],
  "openalex": "W7223312116",
  "pdf_url": "https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1972748/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/9xq62tx192vd6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:17Z",
      "native_id": "10.3389/fimmu.2026.1972748",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1972748/full"
    },
    {
      "first_seen": "2026-10-30T13:43:47Z",
      "native_id": "75428d61d81d432ea041b5390c1aa296",
      "source": "doaj",
      "url": "https://doi.org/10.3389/fimmu.2026.1972748"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
    },
    {
      "field": "medicine",
      "origin": "lcc:RC581-607",
      "subfield": "general"
    }
  ],
  "title": "Case Report: Low-dose donor lymphocyte infusion for secondary poor graft function after haploidentical HSCT in a child with β-thalassemia",
  "title_text": "Case Report: Low-dose donor lymphocyte infusion for secondary poor graft function after haploidentical HSCT in a child with β-thalassemia",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:47Z",
  "url": "https://research.draconitic.com/paper/9xq62tx192vd6",
  "venue": "Frontiers in Immunology",
  "versions": []
}