Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Longitudinal outcome over four decades of allogeneic stem cell transplantation: a single center experience

Bone Marrow Transplantation volume 59, pages 1376–1386 (2024)Cite this article

Subjects

Abstract

This 45-year study (1978–2022) at a single institution evaluated HSCT outcomes and complications, emphasizing recent advances, with to provide insights into HSCT’s evolving field and ongoing efforts to enhance patient outcomes. Involving 1707 patients, the study revealed an initial phase (1978–1987) with a limited activity that yielded modest outcomes, a nearly three-decade span (1988–2016) with a substantial increase in transplant activity, emphasizing umbilical cord blood transplantation (UCBT) for patients lacking a suitable matched sibling donor. In addition to a gradual increase in recipient age, significant improvement in outcomes emerged in the recent period (2017–2022), marked by UCBT replacement with haploidentical transplants, introduction of PTCY-based GVHD prophylaxis for all type of transplants, and increased use of conditioning regimens with thiotepa, busulfan, and fludarabine. In this period, reductions in GVHD, non-relapse mortality, and relapse rates significantly contributed to improved overall survival, event-free survival, and GVHD-free/relapse-free survival. The study identified specific factors, including GVHD prophylaxis and donor selection changes, associated with these positive trends. This four-decade study provides a unique perspective on allogeneic HSCT, showcasing the dynamic evolution of transplantation practices and their impact on outcomes, offering valuable insights for personalized treatment approaches and emphasizing continual innovation in this critical therapeutic modality.

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Cumulative incidence of acute and chronic GVHD by time periods.
Fig. 2: Cumulative incidence of non-relapse mortality and relapse by time periods.
Fig. 3

Similar content being viewed by others

Data availability

Materials described in the manuscript, including all relevant raw data, will be freely available to any researcher wishing to use them for non-commercial purposes, without breaching participant confidentiality.

References

  1. Gratwohl A, Baldomero H, Aljurf M, Pasquini MC, Bouzas LF, Yoshimi A, et al. Hematopoietic Stem Cell Transplantation: A Global Perspective. JAMA. 2010;303:1617–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Niederwieser D, Baldomero H, Bazuaye N, Bupp C, Chaudhri N, Corbacioglu S, et al. One and a half million hematopoietic stem cell transplants: continuous and differential improvement in worldwide access with the use of non-identical family donors. Haematologica. 2021;107:1045–53.

    Article  PubMed Central  Google Scholar 

  3. McSweeney PA, Niederwieser D, Shizuru JA, Sandmaier BM, Molina AJ, Maloney DG, et al. Hematopoietic cell transplantation in older patients with hematologic malignancies: replacing high-dose cytotoxic therapy with graft-versus-tumor effects. Blood. 2001;97:3390–400.

    Article  CAS  PubMed  Google Scholar 

  4. Bacigalupo A. Second EBMT Workshop on reduced intensity allogeneic hemopoietic stem cell transplants (RI-HSCT). Bone Marrow Transplant. 2002;29:191–5.

    Article  CAS  PubMed  Google Scholar 

  5. Giralt S, Ballen K, Rizzo D, Bacigalupo A, Horowitz M, Pasquini M, et al. Reduced-Intensity Conditioning Regimen Workshop: Defining the Dose Spectrum. Report of a Workshop Convened by the Center for International Blood and Marrow Transplant Research. Biol Blood Marrow Transplant. 2009;15:367–9.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Passweg JR, Baldomero H, Bader P, Bonini C, Duarte RF, Dufour C, et al. Use of haploidentical stem cell transplantation continues to increase: the 2015 European Society for Blood and Marrow Transplant activity survey report. Bone Marrow Transplant. 2017;52:811–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Auletta J, Kou J, Chen M, Shaw B. Current use and outcome of hematopoietic stem cell transplantation: CIBMTR US summary slides. 2021. https://www.cibmtr.org/ReferenceCenter/SlidesReports/SummarySlides/pages/index.aspx. Accessed 2 Aprl 2023.

  8. Passweg JR, Baldomero H, Chabannon C, Basak GW, de la Cámara R, Corbacioglu S, et al. Hematopoietic cell transplantation and cellular therapy survey of the EBMT: monitoring of activities and trends over 30 years. Bone Marrow Transplant. 2021;56:1651–64.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Shouval R, Fein JA, Labopin M, Kröger N, Duarte RF, Bader P, et al. Outcomes of allogeneic haematopoietic stem cell transplantation from HLA-matched and alternative donors: a European Society for Blood and Marrow Transplantation registry retrospective analysis. Lancet Haematol. 2019;6:e573–e584.

    Article  PubMed  Google Scholar 

  10. Penack O, Peczynski C, Mohty M, Yakoub-Agha I, Styczynski J, Montoto S, et al. How much has allogeneic stem cell transplant–related mortality improved since the 1980s? A retrospective analysis from the EBMT. Blood Adv. 2020;4:6283–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Remberger M, Ackefors M, Berglund S, Blennow O, Dahllöf G, Dlugosz A, et al. Improved Survival after Allogeneic Hematopoietic Stem Cell Transplantation in Recent Years. A Single-Center Study. Biol Blood Marrow Transplant. 2011;17:1688–97.

    Article  PubMed  Google Scholar 

  12. Jiang J, Sigmund AM, Zhao Q, Elder P, Benson DM, Vasu S, et al. Longitudinal Survival Outcomes in Allogeneic Stem Cell Transplantation: An Institutional Experience. Cancers. 2022;14:5587.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Solomon SR, Sanacore M, Zhang X, Brown S, Holland K, Morris LE, et al. Calcineurin Inhibitor–Free Graft-versus-Host Disease Prophylaxis with Post-Transplantation Cyclophosphamide and Brief-Course Sirolimus Following Reduced-Intensity Peripheral Blood Stem Cell Transplantation. Biol Blood Marrow Transplant. 2014;20:1828–34.

    Article  CAS  PubMed  Google Scholar 

  14. Cieri N, Greco R, Crucitti L, Morelli M, Giglio F, Levati G, et al. Post-transplantation Cyclophosphamide and Sirolimus after Haploidentical Hematopoietic Stem Cell Transplantation Using a Treosulfan-based Myeloablative Conditioning and Peripheral Blood Stem Cells. Biol Blood Marrow Transplant. 2015;21:1506–14.

    Article  CAS  PubMed  Google Scholar 

  15. Sanz J, Boluda JCH, Martín C, González M, Ferrá C, Serrano D, et al. Single-unit umbilical cord blood transplantation from unrelated donors in patients with hematological malignancy using busulfan, thiotepa, fludarabine and ATG as myeloablative conditioning regimen. Bone Marrow Transplant. 2012;47:1287–93.

    Article  CAS  PubMed  Google Scholar 

  16. Raiola AM, Dominietto A, Ghiso A, Grazia CD, Lamparelli T, Gualandi F, et al. Unmanipulated Haploidentical Bone Marrow Transplantation and Posttransplantation Cyclophosphamide for Hematologic Malignancies after Myeloablative Conditioning. Biol Blood Marrow Transplant. 2013;19:117–22.

    Article  CAS  PubMed  Google Scholar 

  17. Pagliardini T, Castagna L, Harbi S, Porta MD, Rey J, Fürst S, et al. Thiotepa, Fludarabine, and Busulfan Conditioning Regimen before T Cell–Replete Haploidentical Transplantation with Post-Transplant Cyclophosphamide for Acute Myeloid Leukemia: A Bicentric Experience of 100 Patients. Biol Blood Marrow Transplant. 2019;25:1803–9.

    Article  CAS  PubMed  Google Scholar 

  18. Sanz J, Montoro J, Solano C, Valcárcel D, Sampol A, Ferrá C, et al. Prospective Randomized Study Comparing Myeloablative Unrelated Umbilical Cord Blood Transplantation versus HLA-Haploidentical Related Stem Cell Transplantation for Adults with Hematologic Malignancies. Biol Blood Marrow Transplant. 2020;26:358–66.

    Article  CAS  PubMed  Google Scholar 

  19. Glucksberg H, Storb R, Fefer A, Buckner CD, Neiman PE, Clift RA, et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation. 1974;18:295–304.

    Article  CAS  PubMed  Google Scholar 

  20. Przepiorka D, Weisdorf D, Martin P, Klingemann HG, Beatty P, Hows J et al. 1994 Consensus Conference on Acute GVHD Grading. Bone Marrow Transplant. 1995;15:825–8.

  21. Shulman HM, Sullivan KM, Weiden PL, McDonald GB, Striker GE, Sale GE, et al. Chronic graft-versus-host syndrome in man. A long-term clinicopathologic study of 20 Seattle patients. Am J Med. 1980;69:204–17.

    Article  CAS  PubMed  Google Scholar 

  22. Jagasia MH, Greinix HT, Arora M, Williams KM, Wolff D, Cowen EW, et al. National Institutes of Health Consensus Development Project on Criteria for Clinical Trials in Chronic Graft-versus-Host Disease: I. The 2014 Diagnosis and Staging Working Group report. Biol Blood Marrow Transplant. 2015;21:389–401.e1.

    Article  PubMed  Google Scholar 

  23. Harris AC, Young R, Devine S, Hogan WJ, Ayuk F, Bunworasate U, et al. International, Multicenter Standardization of Acute Graft-versus-Host Disease Clinical Data Collection: A Report from the Mount Sinai Acute GVHD International Consortium. Biol Blood Marrow Transplant. 2016;22:4–10.

    Article  PubMed  Google Scholar 

  24. Bacigalupo A, Ballen K, Rizzo D, Giralt S, Lazarus H, Ho V, et al. Defining the Intensity of Conditioning Regimens: Working Definitions. Biol Blood Marrow Transplant. 2009;15:1628–33.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Gooley TA, Chien JW, Pergam SA, Hingorani S, Sorror ML, Boeckh M, et al. Reduced Mortality after Allogeneic Hematopoietic-Cell Transplantation. New Engl J Med. 2010;363:2091–101.

    Article  CAS  PubMed  Google Scholar 

  26. Jiang J. Longitudinal Survival Outcomes in Allogeneic Stem Cell Transplantation: An Institutional Experience. Cancers. 2022;14:5587.

  27. Luznik L, O’Donnell PV, Symons HJ, Chen AR, Leffell MS, Zahurak M, et al. HLA-haploidentical bone marrow transplantation for hematologic malignancies using nonmyeloablative conditioning and high-dose, posttransplantation cyclophosphamide. Biol Blood Marrow Transplant. 2008;14:641–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Luznik L, Bolanos-Meade J, Zahurak M, Chen AR, Smith BD, Brodsky R, et al. High-dose cyclophosphamide as single-agent, short-course prophylaxis of graft-versus-host disease. Blood. 2010;115:3224–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Solomon SR, Sizemore CA, Sanacore M, Zhang X, Brown S, Holland HK, et al. Haploidentical transplantation using T cell replete peripheral blood stem cells and myeloablative conditioning in patients with high-risk hematologic malignancies who lack conventional donors is well tolerated and produces excellent relapse-free survival: results of a prospective phase II trial. Biol Blood Marrow Transplant. 2012;18:1859–66.

    Article  PubMed  Google Scholar 

  30. Bashey A, Zhang X, Sizemore CA, Manion K, Brown S, Holland HK, et al. T-cell-replete HLA-haploidentical hematopoietic transplantation for hematologic malignancies using post-transplantation cyclophosphamide results in outcomes equivalent to those of contemporaneous HLA-matched related and unrelated donor transplantation. J Clin Oncol. 2013;31:1310–6.

    Article  CAS  PubMed  Google Scholar 

  31. Ruggeri A, Labopin M, Bacigalupo A, Afanasyev B, Cornelissen JJ, Elmaagacli A, et al. Post-transplant cyclophosphamide for graft-versus-host disease prophylaxis in HLA matched sibling or matched unrelated donor transplant for patients with acute leukemia, on behalf of ALWP-EBMT. J Hematol Oncol. 2018;11:40.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Sugita J, Kagaya Y, Miyamoto T, Shibasaki Y, Nagafuji K, Ota S, et al. Myeloablative and reduced-intensity conditioning in HLA-haploidentical peripheral blood stem cell transplantation using post-transplant cyclophosphamide. Bone Marrow Transplant. 2019;54:432–41.

    Article  CAS  PubMed  Google Scholar 

  33. Ciurea SO, Zhang M-J, Bacigalupo AA, Bashey A, Appelbaum FR, Aljitawi OS, et al. Haploidentical transplant with posttransplant cyclophosphamide vs matched unrelated donor transplant for acute myeloid leukemia. Blood. 2015;126:1033–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Greco R, Lorentino F, Morelli M, Giglio F, Mannina D, Assanelli A, et al. Posttransplantation cyclophosphamide and sirolimus for prevention of GVHD after HLA-matched PBSC transplantation. Blood. 2016;128:1528–31.

    Article  CAS  PubMed  Google Scholar 

  35. Montoro J, Piñana JL, Hernández-Boluda JC, Hernani R, Lorenzo I, Pérez A, et al. Uniform graft-versus-host disease prophylaxis with posttransplant cyclophosphamide, sirolimus, and mycophenolate mofetil following hematopoietic stem cell transplantation from haploidentical, matched sibling and unrelated donors. Bone Marrow Transplant. 2020;55:2147–59.

    Article  CAS  PubMed  Google Scholar 

  36. Greco R, Lorentino F, Albanese S, Stanghellini MTL, Giglio F, Piemontese S, et al. Post-Transplant Cyclophosphamide and Sirolimus based Graft-versus-Host-Disease Prophylaxis in Allogeneic Stem Cell Transplant. Transplant Cell Ther. 2021. https://doi.org/10.1016/j.jtct.2021.05.023.

    Article  PubMed  Google Scholar 

  37. Sanz J, Wagner JE, Sanz MA, Defor T, Montesinos P, Bachanova V, et al. Myeloablative cord blood transplantation in adults with acute leukemia: comparison of two different transplant platforms. Biol Blood Marrow Transplant. 2013;19:1725–30.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Sanz J, Kwon M, Bautista G, Sanz MA, Balsalobre P, Piñana JL, et al. Single umbilical cord blood with or without CD34+ cells from a third-party donor in adults with leukemia. Blood Adv. 2017;1:1047–55.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Dholaria B, Labopin M, Sanz J, Ruggeri A, Cornelissen J, Labussière-Wallet H, et al. Allogeneic hematopoietic cell transplantation with cord blood versus mismatched unrelated donor with post-transplant cyclophosphamide in acute myeloid leukemia. J Hematol Oncol. 2021;14:76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Ruggeri A, Galimard J-E, Labopin M, Rafii H, Blaise D, Ciceri F, et al. Comparison of Outcomes after Unrelated Double-Unit Cord Blood and Haploidentical Peripheral Blood Stem Cell Transplantation in Adults with Acute Myelogenous Leukemia: A Study on Behalf of Eurocord and the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Transplant Cell Ther. 2022;28:710.e1–710.e10.

    Article  PubMed  Google Scholar 

  41. Baron F, Nagler A, Galimard J, Sanz J, Versluis J, Forcade E, et al. Cord blood transplantation for AML: Comparable LFS in patients with de novo versus secondary AML in CR1, an ALWP/EBMT study. Br J Haematol. 2024;204:250–9.

    Article  CAS  PubMed  Google Scholar 

  42. Wagner JE, Ballen KK, Zhang M-J, Johnson MH, Karanas C, Milano F, et al. Comparison of Haploidentical Related Donor with Post-Transplant Cyclophosphamide (PTCy) and Umbilical Cord Blood (UCB) Transplantation after Myeloablative Conditioning for Hematological Malignancy. Biol Blood Marrow Transplant. 2020;26:S291.

    Article  Google Scholar 

  43. Fuchs EJ, Network on behalf of the B and MTCT, O’Donnell PV, Eapen M, Logan B, Antin JH, et al. Double unrelated umbilical cord blood versus HLA-haploidentical bone marrow transplantation (BMT CTN 1101). Blood. 2020;137:420–8.

    Article  Google Scholar 

  44. Marco-Ayala J, Sanz J, Gómez-Seguí I, Balaguer-Rosello A, Montoro J, Guerreiro M, et al. Impact of Post-Transplantation Cyclophosphamide on Transfusion Requirements in HLA-Matched Sibling Peripheral Blood Stem Cell Transplantation. Transplant Cell Ther. 2023;29:313.e1–313.e10.

    Article  CAS  PubMed  Google Scholar 

  45. McDonald GB, Sandmaier BM, Mielcarek M, Sorror M, Pergam SA, Cheng G-S, et al. Survival, Nonrelapse Mortality, and Relapse-Related Mortality After Allogeneic Hematopoietic Cell Transplantation: Comparing 2003–2007 Versus 2013–2017 Cohorts. Ann Intern Med. 2020;172:229.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Stone RM, Mandrekar SJ, Sanford BL, Laumann K, Geyer S, Bloomfield CD, et al. Midostaurin plus Chemotherapy for Acute Myeloid Leukemia with a FLT3 Mutation. N Engl J Med. 2017;377:454–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Larson RA, Mandrekar SJ, Huebner LJ, Sanford BL, Laumann K, Geyer S, et al. Midostaurin reduces relapse in FLT3-mutant acute myeloid leukemia: the Alliance CALGB 10603/RATIFY trial. Leukemia. 2021;35:2539–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Lancet JE, Uy GL, Cortes JE, Newell LF, Lin TL, Ritchie EK, et al. CPX-351 (cytarabine and daunorubicin) Liposome for Injection Versus Conventional Cytarabine Plus Daunorubicin in Older Patients With Newly Diagnosed Secondary Acute Myeloid Leukemia. J Clin Oncol. 2018;36:2684–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Lancet JE, Uy GL, Newell LF, Lin TL, Ritchie EK, Stuart RK, et al. CPX-351 versus 7+3 cytarabine and daunorubicin chemotherapy in older adults with newly diagnosed high-risk or secondary acute myeloid leukaemia: 5-year results of a randomised, open-label, multicentre, phase 3 trial. Lancet Haematol. 2021;8:e481–e491.

    Article  CAS  PubMed  Google Scholar 

  50. Mohty R, Hamed RE, Brissot E, Bazarbachi A, Mohty M. New drugs before, during, and after hematopoietic stem cell transplantation for patients with acute myeloid leukemia. Haematologica. 2023;108:321–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Bazarbachi A, Bug G, Baron F, Brissot E, Ciceri F, Dalle IA, et al. Clinical practice recommendation on hematopoietic stem cell transplantation for acute myeloid leukemia patients with FLT3-internal tandem duplication: a position statement from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Haematologica. 2020;105:1507–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hematology Department, Hospital Universitari i Politècnic La Fe, València, Spain

    Miguel Ángel Sanz, Juan Montoro, Aitana Balaguer-Roselló, Pedro Chorão, Marta Villalba, Inés Gómez, Pilar Solves, Marta Santiago, Pedro Asensi, Brais Lamas, Ana Bataller, Pablo Granados, Juan Eiris, David Martinez, Pilar Lloret, Alberto Louro, Paula Rebollar, Aurora Perla, Javier de la Rubia & Jaime Sanz

  2. Department of Medicine, University of Valencia, València, Spain

    Miguel Ángel Sanz & Jaime Sanz

  3. Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain

    Juan Montoro, Aitana Balaguer-Roselló, Inés Gómez, Pilar Solves, Marta Santiago, Javier de la Rubia & Jaime Sanz

  4. School of Medicine and Dentistry, Catholic University of Valencia, València, Spain

    Juan Montoro & Javier de la Rubia

Authors
  1. Miguel Ángel Sanz
    View author publications

    Search author on:PubMed Google Scholar

  2. Juan Montoro
    View author publications

    Search author on:PubMed Google Scholar

  3. Aitana Balaguer-Roselló
    View author publications

    Search author on:PubMed Google Scholar

  4. Pedro Chorão
    View author publications

    Search author on:PubMed Google Scholar

  5. Marta Villalba
    View author publications

    Search author on:PubMed Google Scholar

  6. Inés Gómez
    View author publications

    Search author on:PubMed Google Scholar

  7. Pilar Solves
    View author publications

    Search author on:PubMed Google Scholar

  8. Marta Santiago
    View author publications

    Search author on:PubMed Google Scholar

  9. Pedro Asensi
    View author publications

    Search author on:PubMed Google Scholar

  10. Brais Lamas
    View author publications

    Search author on:PubMed Google Scholar

  11. Ana Bataller
    View author publications

    Search author on:PubMed Google Scholar

  12. Pablo Granados
    View author publications

    Search author on:PubMed Google Scholar

  13. Juan Eiris
    View author publications

    Search author on:PubMed Google Scholar

  14. David Martinez
    View author publications

    Search author on:PubMed Google Scholar

  15. Pilar Lloret
    View author publications

    Search author on:PubMed Google Scholar

  16. Alberto Louro
    View author publications

    Search author on:PubMed Google Scholar

  17. Paula Rebollar
    View author publications

    Search author on:PubMed Google Scholar

  18. Aurora Perla
    View author publications

    Search author on:PubMed Google Scholar

  19. Javier de la Rubia
    View author publications

    Search author on:PubMed Google Scholar

  20. Jaime Sanz
    View author publications

    Search author on:PubMed Google Scholar

Contributions

MS, JS, JM, and AB: designed the study. MS: performed statistical analysis and wrote the manuscript. PC, MV, IG, PS, MS, PA, BL, AB, PG, JE, DM, PL, AL, PR, AP and JR reviewed and approved the manuscript.

Corresponding author

Correspondence to Jaime Sanz.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

Written informed consent was obtained from all patients according to the principles of the Declaration of Helsinki. The study was approved by the Research Ethics Board of Hospital Universitari i Politècnic La Fe with reference code 09/2019-465.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sanz, M.Á., Montoro, J., Balaguer-Roselló, A. et al. Longitudinal outcome over four decades of allogeneic stem cell transplantation: a single center experience. Bone Marrow Transplant 59, 1376–1386 (2024). https://doi.org/10.1038/s41409-024-02319-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41409-024-02319-x

This article is cited by

Search

Advanced search

Quick links