Creatinine Rises on a Breast Cancer Drug, but the Kidneys May Be Fine: Why Cystatin C Should Be Checked Before Treatment

In a study of 976 patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) after myeloablative conditioning, the presence of donor-derived unlicensed natural killer cells (U-NK cells) was associated with faster hematopoietic recovery and improved clinical outcomes. Further experiments explored the potential underlying mechanisms, demonstrating that U-NK cells enhanced the in vitro colony-forming capacity of hematopoietic stem and progenitor cells. In vivo infusion of U-NK cells accelerated donor neutrophil and platelet engraftment after myeloablative conditioning and increased the numbers of granulocyte-monocyte progenitors, megakaryocyte-erythroid progenitors, and multipotent progenitors during the early post-transplantation period. These changes were accompanied by elevated plasma levels of factor VII and serum amyloid A1, providing further clues to the mechanisms by which U-NK cells may promote hematopoietic recovery. In summary, U-NK cells may provide a valuable reference for donor selection in HSCT and may facilitate the development of therapeutic strategies for poor hematopoietic engraftment or graft failure.