{
  "abstract": "The biological clock plays a central role in hematopoiesis and immune regulation, making circadian rhythms an increasingly important factor in immunotherapies and cellular therapies such as allogeneic hematopoietic stem cell transplantation (allo-HSCT). Previous work by Hou et al suggested that afternoon graft infusions were associated with a higher risk of acute graft-versus-host disease and worse survival, highlighting a potential role for infusion timing in shaping transplant outcomes.To further investigate this, we performed a retrospective analysis of 368 patients who underwent allo-HSCT at Geneva University Hospitals between 2015 and 2024. Observing that infusion timing patterns at our center differed from those reported by Hou et al, we applied a data-driven approach using receiver operating characteristic analysis, which identified 11:17 as the optimal cut-off for overall survival.Stratification using this threshold revealed that patients receiving grafts before 11:00 had significantly improved 2-year overall survival and lower non-relapse mortality compared with those infused later in the day, with no differences in relapse or engraftment rates.These findings suggest that infusion timing may be an important, under-recognized factor influencing allo-HSCT outcomes. Prospective clinical trials are needed to confirm these observations and explore their applicability across different clinical contexts.",
  "authors": [
    {
      "affiliations": [
        "Division of Hematology, Geneva University Hospitals, Geneva, Switzerland",
        "Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Chiara Bernardi"
    },
    {
      "affiliations": [
        "Division of Hematology, Geneva University Hospitals, Geneva, Switzerland",
        "Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Amandine Pradier"
    },
    {
      "affiliations": [
        "Division of Hematology, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Stavroula Masouridi-Levrat"
    },
    {
      "affiliations": [
        "Division of Hematology, Geneva University Hospitals, Geneva, Switzerland",
        "Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Sarah Morin"
    },
    {
      "affiliations": [
        "Division of Hematology, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Anne-Claire Mamez"
    },
    {
      "affiliations": [
        "Division of Hematology, Geneva University Hospitals, Geneva, Switzerland"
      ],
      "name": "Federica Giannotti"
    },
    {
      "affiliations": [
        "Division of Hematology, Geneva University Hospitals, Geneva, Switzerland",
        "Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Yara H Younes"
    },
    {
      "affiliations": [
        "Division of Hematology, Geneva University Hospitals, Geneva, Switzerland",
        "Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Sisi Wang"
    },
    {
      "affiliations": [
        "Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Pragallabh Purwar"
    },
    {
      "affiliations": [
        "Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Constant Tellinga"
    },
    {
      "affiliations": [
        "Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland",
        "Transplantation Immunology Unit and National Reference Laboratory for Histocompatibility, Department of Diagnostic, Geneva University Hospitals, Geneva, Switzerland",
        "Geneva Centre for Inflammation Research (GCIR), University of Geneva, Geneva, Switzerland"
      ],
      "name": "Jean Villard"
    },
    {
      "affiliations": [
        "Division of Hematology, Geneva University Hospitals, Geneva, Switzerland",
        "Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland"
      ],
      "name": "Yves Chalandon"
    },
    {
      "affiliations": [
        "Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland",
        "Geneva Centre for Inflammation Research (GCIR), University of Geneva, Geneva, Switzerland",
        "Institute for Cardiovascular Physiology and Pathophysiology, LMU Hospital Walter Brendel Center of Experimental Medicine, Munich, Germany"
      ],
      "name": "Christoph Scheiermann"
    },
    {
      "affiliations": [
        "Division of Hematology, Geneva University Hospitals, Geneva, Switzerland",
        "Translational Research Center for Oncohematology, Department of Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland",
        "Department of Pathology and Immunology, University of Geneva, Geneva, Switzerland",
        "Geneva Centre for Inflammation Research (GCIR), University of Geneva, Geneva, Switzerland"
      ],
      "name": "Federico Simonetta"
    }
  ],
  "title": "Influence of time-of-day of graft infusion on allogeneic hematopoietic stem cell transplantation outcomes: a validation cohort study",
  "uid": "487a88f9-7e92-51af-9f15-80b5b7be0c8f"
}