Fred Hutch Cancer Center hematologists took center stage at the 2026 Tandem Meetings, a multidisciplinary meeting of experts in the field of blood stem cell transplantation, held in Salt Lake City from February 4-7.
The Tandem Meetings are co-sponsored by the American Society of Transplantation and Cellular Therapy (ASTCT) and the Center for International Blood and Marrow Transplant Research (CIBMTR). CIBMTR is a research collaboration of the Medical College of Wisconsin and the National Marrow Donor Program (NMDP, formerly known as Be The Match).
Fred Hutch scientists presented research on a range of topics, including an examination of how stem cell transplantation risks can be mitigated for people with risk factors such as obesity, as well as a study on how gene expression in stem cells prior to a bone marrow transplant can change during pre-transplant “conditioning” regimens, when chemotherapy drugs and/or radiation treatments are used to prepare the body to receive the transplant. Additionally, two Fred Hutch researchers were honored with ASTCT New Investigator Awards and a previous New Investigator Award recipient presented research funded by his award.
Boglarka Gyurkocza, MD, an associate professor in the Clinical Research Division, presented research on how people with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) respond differently to treatments used to prepare them to receive stem cell transplants, depending on how specific genes are expressed during this “conditioning” process.
AML is a type of leukemia affecting a subset of blood cells known as myeloid cells, seen most often in people over the age of 45. MDS is a term used for several blood disorders in which some number of abnormal cells are found alongside healthy cells in bone marrow. It can lead to conditions including clotting disorders and anemia, and can also progress to leukemia.
Conditioning protocols that prepare a recipient for a stem cell transplant can differ, depending on several factors, including the overall health of the stem cell transplant recipient. Typically, this regimen includes a combination of drugs, with or without total body irradiation, or TBI (also called total body radiation), in order to reduce the person’s disease burden and suppress the recipient’s immune system before transplanting healthy cells from a donor.
Gyurkocza aimed to investigate potential links between the genes expressed during a specific pre-stem cell conditioning process and the eventual success of the transplant itself. A second aim of the project was to examine how gene expression in stem cells changes as the conditioning regimen, typically administered over several days, progresses from what clinicians refer to as “day negative 6,” six days before the transplant when the first conditioning drugs are given, to “day zero,” the day of the transplant. Gyurkocza’s presentation, titled “Differential Gene Expression during Conditioning Correlates with Outcomes in Allotransplant Recipients with AML and MDS,” summarized research findings showing that the stem cells of people with AML and MDS can in fact express different genes during the conditioning treatment.
“The idea was to see how gene expression changes during the conditioning regimen,” Gyurkocza said. “There were patients [in the study] who did not get total body radiation [as part of their conditioning] and there were patients who did. The whole idea was to try to compare what happened between preconditioning and day zero, and also what happened between the two groups.”
The results of the study reported at the Tandem Meetings were promising. “We were able to find very distinct genes and very distinct gene expression patterns” between the groups studied, she said.
Gyurkocza emphasized that her project is the result of a strong team of researchers working together — and in one case, preserving research samples for more than a decade in a lab freezer. From 2006 until 2013, she worked on an earlier study at Fred Hutch before moving to Memorial Sloan Kettering Cancer Center in New York City. Upon her return to Fred Hutch in 2024, she asked her collaborator Jerald Radich, MD, a professor in the Translational Science and Therapeutics Division and holder of the Kurt Enslein Endowed Chair, if he still had the stem cell samples that had been collected for studying gene expression from her previous study.
They were indeed in one of his lab’s freezers, and with the help of collaborators including research associate Isaac Jenkins, who provided statistical support, Gyurkocza rekindled the project, leading to the research findings she presented in Salt Lake City. She plans to continue this research by further examining the genes whose expression was correlated with higher levels of progression-free survival (PFS) and the genes whose levels of expression were correlated with higher PFS rates in the patients who received radiation in addition to conditioning drugs before their transplants.
“We now have a thousand ideas about how to bring this [research] forward,” Gyurkocza said.
Her ultimate goal is to devise a tool to predict who will benefit from total body irradiation in addition to chemotherapy drugs during pre-transplant conditioning, and who will not.
“And that, by itself, would be beneficial to patients,” she stressed.
Naveed Ali, MD, an assistant professor in the Clinical Research Division, presented research based on historical patient data (known as a retrospective study) on the links between a specific type of conditioning treatment for stem cell transplantation and higher rates of severe acute graft-versus-host disease (GVHD) and non-relapse mortality (NRM) in people with a body mass index (BMI) in the overweight or obese category.
GVHD is a condition in which a stem cell transplantation leads to an immune response against the transplant recipient. The transplanted cells mistakenly target the recipient’s healthy cells, which can lead to serious complications. NRM refers to any cause of death unrelated to a relapse of the disease being treated.
In his presentation, “Higher Incidence of Severe Acute GVHD and NRM Following High Dose Cyclophosphamide Based Conditioning Regimen in Overweight and Obese Patients Undergoing Allogeneic HCT,” Ali reported on his study examining whether the higher doses of the chemotherapy drug cyclophosphamide required for patients with a BMI over 30 were correlated with higher rates of toxicity, which could be implicated in severe GVHD and other causes of non-relapse mortality. Drugs are normally administered in doses measured in milligrams per kilogram of body weight.
Ali noted that cyclophosphamide is a common chemotherapy drug that can be used in two different ways with stem cell transplant recipients: as part of the pre-transplant conditioning regimen, or as a post-transplant “prophylactic” (prevention) drug intended to prevent GVHD. The patients in Ali’s study were those who received the drug as part of a pre-transplant conditioning, with or without total body irradiation (TBI).
“We found that patients with increasing BMI are more likely to develop a severe degree of graft-versus-host disease if they received cyclophosphamide-based conditioning regimens,” with or without TBI prior to transplant, Ali said.
However, some studies have demonstrated that the same risks were not seen when the drug was used in the post-transplant timeframe to prevent GVHD. This could be due, Ali said, to the fact that pre-transplant conditioning involves more than one chemotherapy drug, or TBI in addition to cyclophosphamide — all of which could increase the full regimen’s toxicity, especially for patients who already have higher levels of inflammation.
As a retrospective study, Ali noted that historical data from the last 10 years was examined from patients who had undergone stem cell transplantation in order to discover potential correlations between treatment regimens and survival rates. Cyclophosphamide has become the standard of care for post-transplant GVHD prevention, meaning that Ali’s research could lead to a deeper understanding of how dosing regimens could be changed in order to protect patients with obesity, such as metabolism-based dosing (also known as pharmacokinetic dosing), instead of basing drug dosing on body weight only.
Julie R. Boiko, MD, PhD, a research associate in the lab of Geoffrey Hill, MD, FRACP, FRCPA, senior vice president in the Translational Science and Therapeutics division and holder of the Leonard and Norma Klorfine Endowed Chair for Clinical Research, received an ASTCT 2026 New Investigator Award for her project “Interrogating Macrophage Heterogeneity in Bronchiolitis Obliterans Pathogenesis.” Stosh Ozog, MD, PhD, a pediatric hematology/oncology fellow at Fred Hutch, received a New Investigator Award for his research project “Paired T cell receptor sequencing to profile T cell dynamics after HCT.”
ASTCT New Investigator Awards provide $50,000 per year for two years to support the costs associated with new research.
Albert Yeh, MD, a hematologist and research associate also in the Hill Lab, presented research during an ASTCT Spotlight Session. Yeh discussed findings from his study of how CD4+ T cells, a specific type of immune system cell that helps recruit other cells to fight infection, can modulate GVHD depending on the types of micro-organisms (known collectively as the microbiota) living within the stem cell donor from which the CD4+ T cells are collected. Yeh’s presentation was based on research he conducted with funding he received as a recipient of the 2023 ASTCT New Investigator Award.
In addition to these presentations, the following Fred Hutch researchers presented sessions during the Tandem Meetings:
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Nicole G. Boeck (née Nazzaro) is a science writer based in Edmonds, WA. Her writing has appeared in Nature, Immunology and Cell Biology, Sky & Telescope, the New York Times and many other publications. She has a BA from Harvard University, an MJ in journalism from the University of California-Berkeley and a postbaccalaureate BS in biochemistry from the University of Washington. Nicole is a member of the National Association of Science Writers. Reach her at nicole@impactmedianw.com or @mnicolen.bsky.social.
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