Pub Date : 2026-01-01DOI: 10.1016/j.clml.2025.05.021
Izidore S. Lossos
Marginal zone lymphoma (MZL) is a heterogeneous disease representing 7% to 10% of non-Hodgkin lymphomas (NHL). There are no clear guidelines defining the need for treatment initiation and no standardized therapeutic approach for patients with MZL. Previously, many treatments were extrapolated from clinical trials that mainly enrolled patients with follicular lymphoma and did not have statistical power to show treatment efficacy specifically in MZL patients. Currently, the field is moving toward conducting specific trials in MZL patients with specific inclusion criteria for each MZL subtype, assessing response distinctively in FDG avid and nonavid MZL tumors and using MZL-relevant primary endpoints. Herein I briefly describe these changes, summarize previous therapeutic studies in MZL and present preliminary publicly available data on novel emerging treatments, including bispecific antibodies, antibody drug conjugates and novel targeted therapies.
{"title":"SOHO State of the Art Updates and Next Questions | Current and Emerging Novel Treatments for Marginal Zone Lymphoma","authors":"Izidore S. Lossos","doi":"10.1016/j.clml.2025.05.021","DOIUrl":"10.1016/j.clml.2025.05.021","url":null,"abstract":"<div><div><span><span><span>Marginal zone lymphoma (MZL) is a heterogeneous disease representing 7% to 10% of non-Hodgkin lymphomas (NHL). There are no clear guidelines defining the need for treatment initiation and no standardized therapeutic approach for patients with MZL. Previously, many treatments were extrapolated from </span>clinical trials that mainly enrolled patients with </span>follicular lymphoma and did not have statistical power to show treatment efficacy specifically in MZL patients. Currently, the field is moving toward conducting specific trials in MZL patients with specific inclusion criteria for each MZL subtype, assessing response distinctively in FDG avid and nonavid MZL tumors and using MZL-relevant primary endpoints. Herein I briefly describe these changes, summarize previous therapeutic studies in MZL and present preliminary publicly available data on novel emerging treatments, including </span>bispecific antibodies<span>, antibody drug conjugates<span> and novel targeted therapies.</span></span></div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages 1-7"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.clml.2025.09.009
F. Cabanillas , J.G. Conde , T. Gutierrez , A. Torres , J. Abreu , F.B. Hagemeister
Background
Classic follicular lymphoma is generally considered incurable. Standard management includes a “watch and wait” strategy for patients with low tumor burden, while those with high tumor burden typically receive chemotherapy.
Objectives
We aimed to evaluate the potential for curability in a cohort of patients managed with systemic therapy, without the use of a watch-and-wait approach.
Methods
This study is a retrospective, real-world analysis of patients treated in routine clinical practice. We analyzed 183 previously untreated patients with low-grade follicular lymphoma (LGFL) treated at Auxilio Mutuo Cancer Center in Puerto Rico between June 2002 and July 2023. All patients began therapy shortly after diagnosis, without observation. We stratified treatment based on the presence or absence of “clinically discordant indolent histology” (CDIH), defined by aggressive clinical features such as B symptoms, high lactic dehydrogenase (LDH), SUV >14 on PET, Ki-67 > 30%, or involvement of atypical sites including lung, pleura, soft-tissue, CNS and bones. Patients with CDIH typically received R-CHOP x6 followed by FND (fludarabine, Novantrone [mitoxantrone] and dexamethasone). Non-CDIH patients mostly received FND-R. All patients received 2 years of rituximab maintenance. The primary endpoint was failure-free survival (FFS).
Results
Among 183 patients, the median follow-up for censored cases was 8.5 years (range: 6 to 261 months). At 10 years, the FFS was 80%; at 15 years, 75%. Of 61 patients followed for more than 10 years, 57 (93%) remain relapse-free, suggesting a potential for cure in those who remain failure-free beyond a decade.
Conclusion
Our findings support the hypothesis that early initiation of chemotherapy may potentially result in cure for patients with classic follicular NHL. These results warrant confirmation in future prospective studies.
{"title":"Curability Potential of Low-Grade Follicular Lymphoma","authors":"F. Cabanillas , J.G. Conde , T. Gutierrez , A. Torres , J. Abreu , F.B. Hagemeister","doi":"10.1016/j.clml.2025.09.009","DOIUrl":"10.1016/j.clml.2025.09.009","url":null,"abstract":"<div><h3>Background</h3><div>Classic follicular lymphoma is generally considered incurable. Standard management includes a “watch and wait” strategy for patients with low tumor burden, while those with high tumor burden typically receive chemotherapy.</div></div><div><h3>Objectives</h3><div>We aimed to evaluate the potential for curability in a cohort of patients managed with systemic therapy, without the use of a watch-and-wait approach.</div></div><div><h3>Methods</h3><div>This study is a retrospective, real-world analysis of patients treated in routine clinical practice. We analyzed 183 previously untreated patients with low-grade follicular lymphoma (LGFL) treated at Auxilio Mutuo Cancer Center in Puerto Rico between June 2002 and July 2023. All patients began therapy shortly after diagnosis, without observation. We stratified treatment based on the presence or absence of “clinically discordant indolent histology” (CDIH), defined by aggressive clinical features such as B symptoms, high lactic dehydrogenase (LDH), SUV >14 on PET, Ki-67 > 30%, or involvement of atypical sites including lung, pleura, soft-tissue, CNS and bones. Patients with CDIH typically received R-CHOP x6 followed by FND (fludarabine, Novantrone [mitoxantrone] and dexamethasone). Non-CDIH patients mostly received FND-R. All patients received 2 years of rituximab maintenance. The primary endpoint was failure-free survival (FFS).</div></div><div><h3>Results</h3><div>Among 183 patients, the median follow-up for censored cases was 8.5 years (range: 6 to 261 months). At 10 years, the FFS was 80%; at 15 years, 75%. Of 61 patients followed for more than 10 years, 57 (93%) remain relapse-free, suggesting a potential for cure in those who remain failure-free beyond a decade.</div></div><div><h3>Conclusion</h3><div>Our findings support the hypothesis that early initiation of chemotherapy may potentially result in cure for patients with classic follicular NHL. These results warrant confirmation in future prospective studies.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages e103-e109"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.clml.2025.06.017
Alberto Guijosa , Alicia de las Heras , Shayna Sarosiek , Jorge J. Castillo
Waldenström macroglobulinemia (WM) is a rare IgM-secreting lymphoplasmacytic lymphoma with recurrent somatic mutations in MYD88 and CXCR4 observed in the malignant cells of >90% and 30% to 40% of the patients. Given its rarity, WM poses specific diagnostic and management challenges. The diagnosis of WM is clinicopathological and no pathognomonic findings exist. The combination of a monoclonal IgM paraproteinemia, lymphoplasmacytic lymphoma in the bone marrow or other organs, and the MYD88 L265P mutation makes a diagnosis of WM with a high specificity. Approximately, a third of the patients will be asymptomatic at diagnosis and the best approach is to observe, as these patients have similar survival rates than age, sex and year of diagnosis-matched individuals of the general population. Eighty percent of patients diagnosed with asymptomatic WM will need treatment within 10 years. Treatment is indicated in symptomatic patients in whom the symptoms affect the patients’ activities and are likely to be caused by the disease process. Multiple standard treatment options are safe and effective in symptomatic patients, including rituximab in combination with alkylating agents or proteasome inhibitors, covalent BTK inhibitors, and BCL2 antagonists. Noncovalent BTK inhibitors have emerged as a novel treatment option. Second-generation BCL2 antagonists, BTK degraders, antibody-drug conjugates and bispecific T-cell engagers are being evaluated in clinical trials. Multinational collaborative consortia to accelerate clinical trial design and execution in WM have emerged in Europe and the United States.
{"title":"SOHO State of the Art Updates and Next Questions | The Optimal Management of Waldenström Macroglobulinemia","authors":"Alberto Guijosa , Alicia de las Heras , Shayna Sarosiek , Jorge J. Castillo","doi":"10.1016/j.clml.2025.06.017","DOIUrl":"10.1016/j.clml.2025.06.017","url":null,"abstract":"<div><div>Waldenström macroglobulinemia (WM) is a rare IgM-secreting lymphoplasmacytic lymphoma with recurrent somatic mutations in <em>MYD88</em> and <em>CXCR4</em> observed in the malignant cells of >90% and 30% to 40% of the patients. Given its rarity, WM poses specific diagnostic and management challenges. The diagnosis of WM is clinicopathological and no pathognomonic findings exist. The combination of a monoclonal IgM paraproteinemia, lymphoplasmacytic lymphoma in the bone marrow or other organs, and the MYD88 L265P mutation makes a diagnosis of WM with a high specificity. Approximately, a third of the patients will be asymptomatic at diagnosis and the best approach is to observe, as these patients have similar survival rates than age, sex and year of diagnosis-matched individuals of the general population. Eighty percent of patients diagnosed with asymptomatic WM will need treatment within 10 years. Treatment is indicated in symptomatic patients in whom the symptoms affect the patients’ activities and are likely to be caused by the disease process. Multiple standard treatment options are safe and effective in symptomatic patients, including rituximab in combination with alkylating agents or proteasome inhibitors, covalent BTK inhibitors, and BCL2 antagonists. Noncovalent BTK inhibitors have emerged as a novel treatment option. Second-generation BCL2 antagonists, BTK degraders, antibody-drug conjugates and bispecific T-cell engagers are being evaluated in clinical trials. Multinational collaborative consortia to accelerate clinical trial design and execution in WM have emerged in Europe and the United States.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages 8-17"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.clml.2025.08.021
Grace M. Ferri , Allison Frank , Daniel Li , Pria Anand , Maya Abdallah , Vanessa Avalone , J. Mark Sloan , Vaishali Sanchorawala , Adam Lerner , Raphael E. Szalat , Fabio Petrocca , Camille V. Edwards , Britney N. Bell
Purpose
Guidelines from the American Society for Transplantation and Cellular Therapy (ASTCT) propose use of the Immune Effector Cell-Associated Encephalopathy (ICE) score as a means by which to grade Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS). However, ICE scoring may not appropriately capture ICANS among patients with limited English proficiency or diverse educational or cultural backgrounds. With the development of protocols for early ICANS treatment and the advent of CAR-T repurposing for solid tumors, creation of an accessible neurotoxicity grading framework (and an accurate clinical correlate) for all patients is paramount.
Methods
Using a quantitative and qualitative descriptive study design, we surveyed staff members at a United States safety-net hospital experienced in grading the ICE score. We then performed an iterative thematic analysis of data embedded within free-text responses and used a modified version of the theoretical framework of acceptability (TFA) to guide evaluation of the anticipated intervention.
Results
Of the 36 survey respondents, most (27/36, 75%) agreed that lack of language concordance could lead to inaccurate ICE scores. While translation services were thought to be used appropriately (33/36, 92%), logistical barriers including availability of interpreter services (in-person, phone, tablet) were thought to impact quality of care for non-native English-speaking patients. Additional barriers to accurate ICE scoring included patient literacy, numeracy (eg, cultural differences in measuring time), education level, or disability status (eg, hearing or vision loss, memory or cognitive impairment).
Conclusion
This needs assessment demonstrated stakeholder perspectives on the standard ICE score; associated challenges among patients with limited English proficiency and illiteracy; and the utility of an alternative language-concordant and culturally humble grading system for neurotoxicity among non-native English speakers.
{"title":"When ICAN(S) Becomes ICAN’T: Clinician and Staff Perspectives on In-Hospital Neurotoxicity Grading","authors":"Grace M. Ferri , Allison Frank , Daniel Li , Pria Anand , Maya Abdallah , Vanessa Avalone , J. Mark Sloan , Vaishali Sanchorawala , Adam Lerner , Raphael E. Szalat , Fabio Petrocca , Camille V. Edwards , Britney N. Bell","doi":"10.1016/j.clml.2025.08.021","DOIUrl":"10.1016/j.clml.2025.08.021","url":null,"abstract":"<div><h3>Purpose</h3><div>Guidelines from the American Society for Transplantation and Cellular Therapy (ASTCT) propose use of the Immune Effector Cell-Associated Encephalopathy (ICE) score as a means by which to grade Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS). However, ICE scoring may not appropriately capture ICANS among patients with limited English proficiency or diverse educational or cultural backgrounds. With the development of protocols for early ICANS treatment and the advent of CAR-T repurposing for solid tumors, creation of an accessible neurotoxicity grading framework (and an accurate clinical correlate) for all patients is paramount.</div></div><div><h3>Methods</h3><div>Using a quantitative and qualitative descriptive study design, we surveyed staff members at a United States safety-net hospital experienced in grading the ICE score. We then performed an iterative thematic analysis of data embedded within free-text responses and used a modified version of the theoretical framework of acceptability (TFA) to guide evaluation of the anticipated intervention.</div></div><div><h3>Results</h3><div>Of the 36 survey respondents, most (27/36, 75%) agreed that lack of language concordance could lead to inaccurate ICE scores. While translation services were thought to be used appropriately (33/36, 92%), logistical barriers including availability of interpreter services (in-person, phone, tablet) were thought to impact quality of care for non-native English-speaking patients. Additional barriers to accurate ICE scoring included patient literacy, numeracy (eg, cultural differences in measuring time), education level, or disability status (eg, hearing or vision loss, memory or cognitive impairment).</div></div><div><h3>Conclusion</h3><div>This needs assessment demonstrated stakeholder perspectives on the standard ICE score; associated challenges among patients with limited English proficiency and illiteracy; and the utility of an alternative language-concordant and culturally humble grading system for neurotoxicity among non-native English speakers.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages e77-e82"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.clml.2025.08.011
Moazzam Shahzad , Muhammad Kashif Amin , Sohaib Irfan , Abhinav Vyas , Rania Ahsan , Sibgha Gull Chaudhary , Iqra Anwar , Matthew McGuirk , Raheel Iftikhar , Haitham Abdelhakim , Anurag K. Singh , Mehdi Hamadani , Joseph P. Mcguirk , Muhammad Umair Mushtaq
Background
Allogeneic hematopoietic stem cell transplantation (allo-HCT) is a key treatment for acute myeloid leukemia (AML). Measurable residual disease (MRD) predicts post-transplant outcomes. This study evaluates the impact of pretransplant MRD status on outcomes in AML patients undergoing allo-HCT.
Methods
We retrospectively analyzed AML patients who underwent allo-HCT from matched related or unrelated donors (2013–2018) using the CIBMTR P-5646 dataset. Patients were stratified by pretransplant MRD status. Outcomes included overall survival (OS), disease-free survival (DFS), relapse, nonrelapse mortality (NRM), acute graft-versus-host disease (aGVHD), GVHD-free relapse-free survival (GRFS), and engraftment. Hazard ratios (HR) with 95% confidence intervals (CI) were calculated using multivariate Cox regression, adjusted for significant univariate variables (P < .05).
Results
Of 2404 AML patients (354 MRD-positive, 2050 MRD-negative), MRD-positive patients had a lower Karnofsky performance status (≥90%: 46.1% vs. 55.1%, P = .004) and were more likely to undergo myeloablative conditioning (66.6% vs. 52.7%, P < .001). MRD positivity predicted worse OS (HR 1.91, 95% CI 1.62-2.23, P < .001), DFS (HR 2.05, 95% CI 1.77–2.36, P < .001), relapse (HR 2.25, 95% CI 1.91-2.64, P < .001), aGVHD grade II to IV (HR 1.24, 95% CI 1.03-1.50, P = .024), GRFS (HR 1.59, 95% CI 1.41-1.81, P < .001), and slower platelet engraftment (HR 0.71, 95% CI 0.63-0.81, P < .001). NRM (P = .387) and neutrophil engraftment (P = .159) were similar.
Conclusion
Pretransplant MRD status predicts post-allo-HCT outcomes, with MRD positivity associated with reduced overall and disease-free survival and increased relapse risk. Personalized MRD-directed strategies are needed to optimize outcomes in AML patients undergoing allogeneic transplantation.
背景：同种异体造血干细胞移植是急性髓系白血病（AML）的关键治疗手段。可测量的残留疾病（MRD）预测移植后的预后。本研究评估移植前MRD状态对接受同种异体hct治疗的AML患者预后的影响。方法：我们使用CIBMTR P-5646数据集回顾性分析了2013-2018年从匹配的相关或非相关供体接受同种异体hct治疗的AML患者。根据移植前MRD状态对患者进行分层。结果包括总生存期（OS）、无病生存期（DFS）、复发、非复发死亡率（NRM）、急性移植物抗宿主病（aGVHD）、无移植物抗宿主病无复发生存期（GRFS）和移植物。采用多变量Cox回归计算风险比（HR）和95%置信区间（CI），并对显著单变量进行校正（P < 0.05）。结果：2404例AML患者（354例mrd阳性，2050例mrd阴性）中，mrd阳性患者的Karnofsky表现状态较低（≥90%:46.1%对55.1%,P = 0.004），更有可能接受清髓调节（66.6%对52.7%,P < 0.001）。MRD阳性预测较差的OS （HR 1.91, 95% CI 1.62-2.23, P < 0.001）、DFS （HR 2.05, 95% CI 1.77-2.36, P < 0.001）、复发（HR 2.25, 95% CI 1.91-2.64, P < 0.001）、aGVHD II至IV级（HR 1.24, 95% CI 1.03-1.50, P = 0.024）、GRFS （HR 1.59, 95% CI 1.41-1.81, P < 0.001）和血小板植入较慢（HR 0.71, 95% CI 0.63-0.81, P < 0.001）。NRM （P = .387）和中性粒细胞移植（P = .159）相似。结论：移植前MRD状态预测同种异体移植后的预后，MRD阳性与总生存率和无病生存率降低以及复发风险增加相关。需要个性化的mrd导向策略来优化接受同种异体移植的AML患者的预后。
{"title":"Impact of Measurable Residual Disease Status on Outcomes After HLA-Matched Donor Allogeneic Hematopoietic Cell Transplantation in Acute Myeloid Leukemia","authors":"Moazzam Shahzad , Muhammad Kashif Amin , Sohaib Irfan , Abhinav Vyas , Rania Ahsan , Sibgha Gull Chaudhary , Iqra Anwar , Matthew McGuirk , Raheel Iftikhar , Haitham Abdelhakim , Anurag K. Singh , Mehdi Hamadani , Joseph P. Mcguirk , Muhammad Umair Mushtaq","doi":"10.1016/j.clml.2025.08.011","DOIUrl":"10.1016/j.clml.2025.08.011","url":null,"abstract":"<div><h3>Background</h3><div>Allogeneic hematopoietic stem cell transplantation (allo-HCT) is a key treatment for acute myeloid leukemia (AML). Measurable residual disease (MRD) predicts post-transplant outcomes. This study evaluates the impact of pretransplant MRD status on outcomes in AML patients undergoing allo-HCT.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed AML patients who underwent allo-HCT from matched related or unrelated donors (2013–2018) using the CIBMTR P-5646 dataset. Patients were stratified by pretransplant MRD status. Outcomes included overall survival (OS), disease-free survival (DFS), relapse, nonrelapse mortality (NRM), acute graft-versus-host disease (aGVHD), GVHD-free relapse-free survival (GRFS), and engraftment. Hazard ratios (HR) with 95% confidence intervals (CI) were calculated using multivariate Cox regression, adjusted for significant univariate variables (<em>P</em> < .05).</div></div><div><h3>Results</h3><div>Of 2404 AML patients (354 MRD-positive, 2050 MRD-negative), MRD-positive patients had a lower Karnofsky performance status (≥90%: 46.1% vs. 55.1%, <em>P</em> = .004) and were more likely to undergo myeloablative conditioning (66.6% vs. 52.7%, <em>P</em> < .001). MRD positivity predicted worse OS (HR 1.91, 95% CI 1.62-2.23, <em>P</em> < .001), DFS (HR 2.05, 95% CI 1.77–2.36, <em>P</em> < .001), relapse (HR 2.25, 95% CI 1.91-2.64, <em>P</em> < .001), aGVHD grade II to IV (HR 1.24, 95% CI 1.03-1.50, <em>P</em> = .024), GRFS (HR 1.59, 95% CI 1.41-1.81, <em>P</em> < .001), and slower platelet engraftment (HR 0.71, 95% CI 0.63-0.81, <em>P</em> < .001). NRM (<em>P</em> = .387) and neutrophil engraftment (<em>P</em> = .159) were similar.</div></div><div><h3>Conclusion</h3><div>Pretransplant MRD status predicts post-allo-HCT outcomes, with MRD positivity associated with reduced overall and disease-free survival and increased relapse risk. Personalized MRD-directed strategies are needed to optimize outcomes in AML patients undergoing allogeneic transplantation.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages e23-e31"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.clml.2025.09.003
Tai-Chung Tseng MD , Yu-Sung Chang MD , Xavier Cheng-Hong Tsai PhD , Ming-En Lin PhD , Feng-Ming Tien MMS , Huai-Hsuan Huang MD , Yun-Chu Lin MD , Jia-Hau Liu MD , Ming-Chih Liu BS , Chien-Chin Lin PhD , Chieh-Lung Cheng PhD , Szu-Chun Hsu MD , Ming Yao MD , Mei-Hsuan Tseng MS , Yen-Ling Peng MS , Bor-Sheng Ko PhD , Yung-Li Yang PhD , Shiann-Tarng Jou PhD , Hsin-An Hou PhD , Wen-Chien Chou PhD
Background
Ponatinib, a third-generation tyrosine kinase inhibitor, has demonstrated its activity against chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). However, real-world data, particularly in Asian populations, remain limited.
Methods
Patients with CML or Ph+ ALL treated with ponatinib in Taiwan between March 2013 and November 2024 were retrospectively collected. Molecular and cytogenetic data, efficacy outcomes (complete hematologic response [CHR], molecular response [MR], progression-free survival [PFS], overall survival [OS]), and adverse events were analyzed.
Results
Among 52 patients (27 CML and 25 Ph+ ALL; median follow-up: 50.7 months), 94% received ponatinib due to relapsed or refractory disease. Among patients without prior CHR, 89% reached CHR at 12 months. Among patients without prior MR, 57% had MR2.0, 53% MR3.0, and 26% MR5.0 at 12 months. MR2.0 at 6 months and MR3.0 at 12 months correlated with improved outcome in patients with CML. Additional chromosomal abnormalities (ACAs) were identified in 36% of patients and were associated with inferior survival, whereas kinase domain mutations in 78% of studied patients, including T315I (57%), did not affect the outcome. MR3.0 at any time predicted superior OS and PFS in patients with CML, and MR5.0 with superior PFS in patients with Ph+ ALL. One patient (1.9%) had an arterial occlusive event.
Conclusion
Ponatinib demonstrated substantial real-world efficacy in pretreated patients with CML and Ph+ ALL, with MR3.0 in CML and MR5.0 in Ph+ ALL emerging as favorable prognostic markers. In contrast, the presence of ACAs was associated with shorter survival.
{"title":"Molecular Milestones and Survival Outcomes of Ponatinib Treatment in Patients With Chronic Myeloid Leukemia and Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia: A Real-World Analysis","authors":"Tai-Chung Tseng MD , Yu-Sung Chang MD , Xavier Cheng-Hong Tsai PhD , Ming-En Lin PhD , Feng-Ming Tien MMS , Huai-Hsuan Huang MD , Yun-Chu Lin MD , Jia-Hau Liu MD , Ming-Chih Liu BS , Chien-Chin Lin PhD , Chieh-Lung Cheng PhD , Szu-Chun Hsu MD , Ming Yao MD , Mei-Hsuan Tseng MS , Yen-Ling Peng MS , Bor-Sheng Ko PhD , Yung-Li Yang PhD , Shiann-Tarng Jou PhD , Hsin-An Hou PhD , Wen-Chien Chou PhD","doi":"10.1016/j.clml.2025.09.003","DOIUrl":"10.1016/j.clml.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Ponatinib, a third-generation tyrosine kinase inhibitor, has demonstrated its activity against chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). However, real-world data, particularly in Asian populations, remain limited.</div></div><div><h3>Methods</h3><div>Patients with CML or Ph+ ALL treated with ponatinib in Taiwan between March 2013 and November 2024 were retrospectively collected. Molecular and cytogenetic data, efficacy outcomes (complete hematologic response [CHR], molecular response [MR], progression-free survival [PFS], overall survival [OS]), and adverse events were analyzed.</div></div><div><h3>Results</h3><div>Among 52 patients (27 CML and 25 Ph+ ALL; median follow-up: 50.7 months), 94% received ponatinib due to relapsed or refractory disease. Among patients without prior CHR, 89% reached CHR at 12 months. Among patients without prior MR, 57% had MR2.0, 53% MR3.0, and 26% MR5.0 at 12 months. MR2.0 at 6 months and MR3.0 at 12 months correlated with improved outcome in patients with CML. Additional chromosomal abnormalities (ACAs) were identified in 36% of patients and were associated with inferior survival, whereas kinase domain mutations in 78% of studied patients, including T315I (57%), did not affect the outcome. MR3.0 at any time predicted superior OS and PFS in patients with CML, and MR5.0 with superior PFS in patients with Ph+ ALL. One patient (1.9%) had an arterial occlusive event.</div></div><div><h3>Conclusion</h3><div>Ponatinib demonstrated substantial real-world efficacy in pretreated patients with CML and Ph+ ALL, with MR3.0 in CML and MR5.0 in Ph+ ALL emerging as favorable prognostic markers. In contrast, the presence of ACAs was associated with shorter survival.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages e92-e102"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.clml.2025.07.002
James Fan Wu , Idayat M. Akinola , Anita D’Souza , Rachel Cusatis
Purpose
We investigated autologous stem cell transplantation (ASCT) barriers in a single-center qualitative study by interviewing patients with multiple myeloma (MM), transplant physicians (TPs), and referring physicians (RPs).
Methods
Patients with MM and referred for ASCT evaluation between January 01, 2021 and December 31, 2022, TPs from 2 Wisconsin transplant centers, and RPs from rural and urban Wisconsin were recruited. Interviews were conducted using a semi-structured interview guide focused on ASCT barriers. Transcripts were double-coded and reviewed. An initial codebook with prespecified themes based on the interview guide was developed and iteratively revised.
Results
Eighteen patients, 5 TPs, and 4 RPs were interviewed. Four major ASCT barriers themes were identified across all stakeholders: caregiver support, patient concerns and knowledge, financial toxicity, and logistics. Unique themes included social support by patients and ASCT referral by physicians. Lacking caregiver support was more common among single, childless, and socially/geographically isolated patients. Patients were most concerned about side effects, long hospital stays, and quality of life. Patients used online websites and support groups to gain knowledge and support. While most patients experienced financial toxicity, care costs were rarely discussed. Distance from transplant center, transportation, and care coordination were barriers. Referrals from community oncologists are a major barrier. Patients never seen at a transplant center may have the most barriers.
Conclusion
This qualitative study of both patients and physicians investigating barriers to access to ASCT in MM, provides a much-needed multistakeholder perspective. Interventional strategies targeting key barriers will be critical in improving ASCT utilization in MM.
{"title":"A Multistakeholder Qualitative Analysis of Barriers to Autologous Stem Cell Transplantation for Multiple Myeloma","authors":"James Fan Wu , Idayat M. Akinola , Anita D’Souza , Rachel Cusatis","doi":"10.1016/j.clml.2025.07.002","DOIUrl":"10.1016/j.clml.2025.07.002","url":null,"abstract":"<div><h3>Purpose</h3><div>We investigated autologous stem cell transplantation (ASCT) barriers in a single-center qualitative study by interviewing patients with multiple myeloma (MM), transplant physicians (TPs), and referring physicians (RPs).</div></div><div><h3>Methods</h3><div>Patients with MM and referred for ASCT evaluation between January 01, 2021 and December 31, 2022, TPs from 2 Wisconsin transplant centers, and RPs from rural and urban Wisconsin were recruited. Interviews were conducted using a semi-structured interview guide focused on ASCT barriers. Transcripts were double-coded and reviewed. An initial codebook with prespecified themes based on the interview guide was developed and iteratively revised.</div></div><div><h3>Results</h3><div>Eighteen patients, 5 TPs, and 4 RPs were interviewed. Four major ASCT barriers themes were identified across all stakeholders: caregiver support, patient concerns and knowledge, financial toxicity, and logistics. Unique themes included social support by patients and ASCT referral by physicians. Lacking caregiver support was more common among single, childless, and socially/geographically isolated patients. Patients were most concerned about side effects, long hospital stays, and quality of life. Patients used online websites and support groups to gain knowledge and support. While most patients experienced financial toxicity, care costs were rarely discussed. Distance from transplant center, transportation, and care coordination were barriers. Referrals from community oncologists are a major barrier. Patients never seen at a transplant center may have the most barriers.</div></div><div><h3>Conclusion</h3><div>This qualitative study of both patients and physicians investigating barriers to access to ASCT in MM, provides a much-needed multistakeholder perspective. Interventional strategies targeting key barriers will be critical in improving ASCT utilization in MM.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages 26-33"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.clml.2025.08.018
Irene Francés Alexandre , Ana Gea Peña , Ana Tobalina García , Juan José Domínguez-García , Elena Alejo Alonso , Ana Pilar González-Rodríguez , Irene Padilla , Maialen Sirvent Auzmendi , Ana Lobo Olmedo , Ana María Vale López , Irene Castaño Caballero , Evelyn Valencia , Paula Melero Valentín , Ianire Etxeguren Urkixo , María de las Mercedes Luque Romero , Javier Larreina Pérez , Borja Puertas Martínez , Fernando Escalante Barrigón , María Oviedo Madrid , Julia Bannatyne Undabeitia , Enrique María Ocio
Introduction
Autologous stem cell transplantation (ASCT) with melphalan 200 mg/m² remains a standard treatment for multiple myeloma (MM). We analyzed the incidence and risk factors associated with the development of mucositis in 1,268 MM patients who underwent ASCT between 2017 and 2022 across 13 national centers.
Results
Median age was 60 years (24-77), and 44% were female. Induction therapy included chemotherapy or cyclophosphamide (principally VCD) in 32%, and 21% had creatinine > 1 mg/dL. Melphalan was administered in a single day (Mel1) in 52% and over 2 days (Mel2) in 48%. Prophylaxis measures included cryotherapy (75%), G-CSF (78%) and antibiotics (37%). Mucositis occurred in 84% of patients, with 26% experiencing severe cases (WHO grade III-IV), which were significantly associated with increased intravenous opioids use, parenteral nutrition, and febrile episodes. Severe mucositis was more common in women (32% vs. 22%), patients over 60 (53% vs. 60%), chemotherapy induction (37% vs. 20%), creatinine > 1 mg/dL (34% vs. 24%), those not receiving G-CSF (35% vs. 24%) or antibiotic (36% vs. 16%). It was also more common with single day melphalan (29% vs. 24%). In the multivariable analysis, all factors except chemotherapy-based induction were identified as independent predictors of severe mucositis.
Conclusion
In our population, an increased incidence of severe mucositis was observed in nonmodifiable factors such as sex and renal function. However, the implementation of modifiable factors, including the use of prophylactic G-CSF or antibiotics and administering melphalan over 2 days could diminish the severity of this complication.
{"title":"Variables Associated With the Risk of Severe Mucositis During Autologous Transplantation in Multiple Myeloma Patients","authors":"Irene Francés Alexandre , Ana Gea Peña , Ana Tobalina García , Juan José Domínguez-García , Elena Alejo Alonso , Ana Pilar González-Rodríguez , Irene Padilla , Maialen Sirvent Auzmendi , Ana Lobo Olmedo , Ana María Vale López , Irene Castaño Caballero , Evelyn Valencia , Paula Melero Valentín , Ianire Etxeguren Urkixo , María de las Mercedes Luque Romero , Javier Larreina Pérez , Borja Puertas Martínez , Fernando Escalante Barrigón , María Oviedo Madrid , Julia Bannatyne Undabeitia , Enrique María Ocio","doi":"10.1016/j.clml.2025.08.018","DOIUrl":"10.1016/j.clml.2025.08.018","url":null,"abstract":"<div><h3>Introduction</h3><div>Autologous stem cell transplantation (ASCT) with melphalan 200 mg/m² remains a standard treatment for multiple myeloma (MM). We analyzed the incidence and risk factors associated with the development of mucositis in 1,268 MM patients who underwent ASCT between 2017 and 2022 across 13 national centers.</div></div><div><h3>Results</h3><div>Median age was 60 years (24-77), and 44% were female. Induction therapy included chemotherapy or cyclophosphamide (principally VCD) in 32%, and 21% had creatinine > 1 mg/dL. Melphalan was administered in a single day (Mel1) in 52% and over 2 days (Mel2) in 48%. Prophylaxis measures included cryotherapy (75%), G-CSF (78%) and antibiotics (37%). Mucositis occurred in 84% of patients, with 26% experiencing severe cases (WHO grade III-IV), which were significantly associated with increased intravenous opioids use, parenteral nutrition, and febrile episodes. Severe mucositis was more common in women (32% vs. 22%), patients over 60 (53% vs. 60%), chemotherapy induction (37% vs. 20%), creatinine > 1 mg/dL (34% vs. 24%), those not receiving G-CSF (35% vs. 24%) or antibiotic (36% vs. 16%). It was also more common with single day melphalan (29% vs. 24%). In the multivariable analysis, all factors except chemotherapy-based induction were identified as independent predictors of severe mucositis.</div></div><div><h3>Conclusion</h3><div>In our population, an increased incidence of severe mucositis was observed in nonmodifiable factors such as sex and renal function. However, the implementation of modifiable factors, including the use of prophylactic G-CSF or antibiotics and administering melphalan over 2 days could diminish the severity of this complication.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages e50-e56"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.clml.2025.08.019
Sawyer Bawek , Nour Nassour , Malak Alharbi , Alan Hutson , Sarah Parker , Joseph D. Tario , Hamza Hassan , Scott I. Abrams , Philip L. McCarthy , Jens Hillengass , Janine M. Joseph
Introduction
Monoclonal gammopathy of undetermined significance (MGUS) is a benign precursor of multiple myeloma, but little is known about the role of comorbidities in progression.
Materials and Methods
A retrospective review of medical records of patients with MGUS (n = 150) or a negative MGUS workup (n = 96) seen at a comprehensive cancer center between 2007 and 2023 was performed. Charlson Comorbidity Index (CCI) scores, descriptive characteristics, and overall (OS) and progression-free (PFS) survival were abstracted. Group differences (MGUS vs negative) in CCI and other characteristics were tested with Student’s t-tests and Pearson’s chi-square tests. Univariate and multivariate Cox proportional hazard models were used to model the association between CCI and OS and PFS in patients with MGUS.
Results
Patients with MGUS had a higher mean CCI (P = .01) and prevalence of diabetes mellitus with end-organ damage (P < .05) and solid tumors (P = .01) than patients with a negative MGUS workup. Each additional CCI point was associated with shorter OS (HR 1.50, P< .01) and PFS (HR 1.25, P < .01). Results were not confounded by age, body mass index, or sex.
Conclusions
Our study suggests that comorbidities are relevant to risk of MGUS and that prevention and management of comorbidities in patients with MGUS is indicated and may be associated with improved outcomes.
{"title":"Association and Prognostic Significance of Comorbidities in Individuals With MGUS","authors":"Sawyer Bawek , Nour Nassour , Malak Alharbi , Alan Hutson , Sarah Parker , Joseph D. Tario , Hamza Hassan , Scott I. Abrams , Philip L. McCarthy , Jens Hillengass , Janine M. Joseph","doi":"10.1016/j.clml.2025.08.019","DOIUrl":"10.1016/j.clml.2025.08.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Monoclonal gammopathy of undetermined significance (MGUS) is a benign precursor of multiple myeloma, but little is known about the role of comorbidities in progression.</div></div><div><h3>Materials and Methods</h3><div>A retrospective review of medical records of patients with MGUS (n = 150) or a negative MGUS workup (n = 96) seen at a comprehensive cancer center between 2007 and 2023 was performed. Charlson Comorbidity Index (CCI) scores, descriptive characteristics, and overall (OS) and progression-free (PFS) survival were abstracted. Group differences (MGUS vs negative) in CCI and other characteristics were tested with Student’s t-tests and Pearson’s chi-square tests. Univariate and multivariate Cox proportional hazard models were used to model the association between CCI and OS and PFS in patients with MGUS.</div></div><div><h3>Results</h3><div>Patients with MGUS had a higher mean CCI (<em>P</em> = .01) and prevalence of diabetes mellitus with end-organ damage (P < .05) and solid tumors (<em>P</em> = .01) than patients with a negative MGUS workup. Each additional CCI point was associated with shorter OS (HR 1.50, <em>P</em>< .01) and PFS (HR 1.25, <em>P</em> < .01). Results were not confounded by age, body mass index, or sex.</div></div><div><h3>Conclusions</h3><div>Our study suggests that comorbidities are relevant to risk of MGUS and that prevention and management of comorbidities in patients with MGUS is indicated and may be associated with improved outcomes.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages e57-e61.e2"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic lymphocytic leukemia (CLL) is the most prevalent adult leukemia. CLL treatment has evolved dramatically from alkylator-based regimens to chemoimmunotherapy and targeted therapies. This study evaluated real-world survival outcomes across treatment eras using population-based data, focusing on patients who received active systemic therapy to assess treatment effectiveness rather than natural disease progression.
Methods
We conducted a retrospective cohort study using surveillance, epidemiology, and end results (SEER) data from 1995 to 2020, restricting analysis to CLL patients who received active systemic treatment. Patients were stratified into three treatment eras based on treatment initiation date: Pre-novel therapy era (1995-2004, alkylator-based regimens), Early novel therapy era (2005-2014, chemoimmunotherapy with anti-CD20 monoclonal antibodies), and modern novel therapy era (2015-2020, targeted therapies including BTK inhibitors and BCL-2 inhibitors). Era boundaries accounted for the lag between regulatory approval and community adoption. Overall survival was calculated from treatment initiation date, with era assignment based on first-line therapy to maintain temporal consistency.
Results
Among 49,056 CLL patients across three treatment eras, median overall survival improved significantly from 3.5 years (95% CI, 3.2-3.8) in the pre-novel therapy era (1995-2004) to 5.2 years (95% CI, 4.9-5.6) in the early novel therapy era (2005-2014), and 7.8 years (95% CI, 6.9-8.7) in the modern novel therapy era (2015-2020). Multivariable Cox regression analysis demonstrated progressive reductions in mortality risk, with adjusted hazard ratios of 0.75 (95% CI, 0.68-0.82, P < .001) for the Early Novel era and 0.45 (95% CI, 0.38-0.53, P < .001) for the Modern era compared to the Pre-Novel era. Complete response rates increased from 15% to20% in the Pre-Novel era to over 60% in the Modern era with targeted therapies.
Conclusions
This analysis demonstrates significant improvements in survival outcomes for CLL patients across treatment eras, with the most pronounced benefits observed in the modern targeted therapy era. By focusing on treated patients and calculating survival from treatment initiation, we isolated the impact of therapeutic advances from disease biology and patient selection factors. However, the COVID-19 pandemic's disproportionate impact on immunocompromised CLL patients, particularly affecting the modern therapy era, represents an important limitation that may underestimate the true survival benefits of contemporary targeted therapies. These findings support the continued development and adoption of novel therapeutic strategies in CLL management.
{"title":"Survival Outcomes in Patients With Chronic Lymphocytic Leukemia: A SEER Analysis","authors":"Shivani Modi , Srinishant Rajarajan , Hardik Jain , Claudia Dourado","doi":"10.1016/j.clml.2025.07.012","DOIUrl":"10.1016/j.clml.2025.07.012","url":null,"abstract":"<div><h3>Survival Outcomes</h3><div>Chronic lymphocytic leukemia (CLL) is the most prevalent adult leukemia. CLL treatment has evolved dramatically from alkylator-based regimens to chemoimmunotherapy and targeted therapies. This study evaluated real-world survival outcomes across treatment eras using population-based data, focusing on patients who received active systemic therapy to assess treatment effectiveness rather than natural disease progression.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using surveillance, epidemiology, and end results (SEER) data from 1995 to 2020, restricting analysis to CLL patients who received active systemic treatment. Patients were stratified into three treatment eras based on treatment initiation date: Pre-novel therapy era (1995-2004, alkylator-based regimens), Early novel therapy era (2005-2014, chemoimmunotherapy with anti-CD20 monoclonal antibodies), and modern novel therapy era (2015-2020, targeted therapies including BTK inhibitors and BCL-2 inhibitors). Era boundaries accounted for the lag between regulatory approval and community adoption. Overall survival was calculated from treatment initiation date, with era assignment based on first-line therapy to maintain temporal consistency.</div></div><div><h3>Results</h3><div>Among 49,056 CLL patients across three treatment eras, median overall survival improved significantly from 3.5 years (95% CI, 3.2-3.8) in the pre-novel therapy era (1995-2004) to 5.2 years (95% CI, 4.9-5.6) in the early novel therapy era (2005-2014), and 7.8 years (95% CI, 6.9-8.7) in the modern novel therapy era (2015-2020). Multivariable Cox regression analysis demonstrated progressive reductions in mortality risk, with adjusted hazard ratios of 0.75 (95% CI, 0.68-0.82, <em>P</em> < .001) for the Early Novel era and 0.45 (95% CI, 0.38-0.53, <em>P</em> < .001) for the Modern era compared to the Pre-Novel era. Complete response rates increased from 15% to20% in the Pre-Novel era to over 60% in the Modern era with targeted therapies.</div></div><div><h3>Conclusions</h3><div>This analysis demonstrates significant improvements in survival outcomes for CLL patients across treatment eras, with the most pronounced benefits observed in the modern targeted therapy era. By focusing on treated patients and calculating survival from treatment initiation, we isolated the impact of therapeutic advances from disease biology and patient selection factors. However, the COVID-19 pandemic's disproportionate impact on immunocompromised CLL patients, particularly affecting the modern therapy era, represents an important limitation that may underestimate the true survival benefits of contemporary targeted therapies. These findings support the continued development and adoption of novel therapeutic strategies in CLL management.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages 42-48"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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