Cytomegalovirus (CMV) infection post‐hematopoietic cell transplantation (HCT) remains a significant cause of morbidity and mortality. While letermovir prophylaxis is available for CMV‐seropositive recipients, optimal donor selection for CMV‐seronegative recipients remains unclear, with donor age often prioritized over CMV serostatus. We investigated the relative impact of donor age and CMV serostatus in CMV‐seronegative recipients (n = 1013) with either CMV‐seropositive (n = 318) or CMV‐seronegative donors (n = 695), who underwent HCT with HLA‐matched sibling donors with calcineurin inhibitor‐based or post‐transplant cyclophosphamide (PTCy)‐based graft‐versus‐host disease prophylaxis, or haploidentical donors with PTCy. Multiple conventional and machine‐learning approaches were employed to account for confounding factors. Across all analyses, CMV‐seropositive donor status was consistently associated with significantly inferior overall survival (OS) and disease‐free survival, primarily driven by increased non‐relapse mortality (NRM). Older donor age showed a statistically significant association with OS and DFS in some but not all models, and its effect size was small (about 1% increased hazard per year in Cox proportional hazard model) compared to the substantial impact of CMV‐seropositive donors (about 27%–33% increased hazards for worse OS, approximately 50%–60% higher NRM in Cox proportional hazard model). However, our machine learning model revealed a more nuanced and complex non‐linear effect of donor age, further demonstrating the adverse impact of donor CMV serostatus. Our findings suggest that prioritizing a CMV‐seronegative donor may be associated with improved outcomes in CMV‐seronegative recipients. Further research is needed to validate these findings and explore underlying mechanisms.

Hodgkin’s lymphoma is a rare yet highly curable disease in the majority of patients treated with modern chemotherapy regimens. For patients who fail to respond to or relapse after initial systemic therapies, treatment with high-dose chemotherapy and autologous hematopoietic stem cell transplantation can provide a cure for many with chemotherapy-responsive lymphoma. Patients who relapse after autologous transplant or those with chemorefractory disease have poor prognosis and represent a high unmet need. Allogeneic hematopoietic stem cell transplantation provides a proven curative therapy for these patients and should be considered, especially in young and medically fit patients. The use of newer agents in this disease such as brentuximab vedotin and immune checkpoint inhibitors can help bring more patients to transplantation and should be considered as well.

Blastic Plasmacytoid Dendritic Cell Neoplasm (BPDCN) is a rare and often life-threatening complex hematologic malignancy that can commonly infiltrate the skin, lymph nodes, central nervous system, and bone marrow. In the setting of the infrequency of confirmed diagnoses of BPDCN, and given limited prospective studies, it has been associated with lackluster outcomes with a median overall survival between 9 and 23 months. We herein discuss our experience treating five consecutive patients with BPDCN at our center since the approval of TAG. We also present some of the challenges that face oncology providers treating this disease due to exceptional rarity and aggressive nature of this disease in addition to overall limited experience and effective therapies