Pub Date : 2026-01-11DOI: 10.1016/j.clml.2026.01.004
Piyatida Chumnumsiriwath, Polina Bellman, Minh-Ha Tran, Christina Golly, Stefan O Ciurea, Piyanuch Kongtim
Background: Autologous stem cell transplantation (ASCT) remains the standard consolidation therapy for multiple myeloma (MM). Peripheral blood stem cell mobilization, performed using G-CSF alone or in combination with chemotherapy (chemo-mobilization), is a crucial step in this process. Although chemo-mobilization enhances CD34⁺ yields, its effect on disease control and post-transplant outcomes in the era of novel agents remains unclear.
Patients and methods: We retrospectively analyzed 67 MM patients who underwent ASCT at our institution. Thirty-two patients (47.8%) received chemo-mobilization with cyclophosphamide (37.5%) or KD-PACE plus G-CSF (62.5%) and 35 (52.2%) received G-CSF alone. The primary endpoint was overall response rate (ORR) at day 90 post-transplant, while transplant outcomes were analyzed as secondary endpoints. Propensity score-adjusted Cox models were used to assess prognostic factors.
Results: Chemo-mobilization yielded a higher median CD34⁺ collection (7.9 × 10⁶/kg vs. 6.6 × 10⁶/kg; P = .035), fewer apheresis sessions (P = .005), and reduced plerixafor use (P = .005) compared with G-CSF alone. Among chemo-mobilized patients, 89% showed decreased tumor burden and 21% achieved improved response pre-ASCT. ORR at day 90 post-ASCT was comparable between groups (90.6% vs. 94.3%; P = .569). Complete remission (CR+sCR) and MRD negativity were higher in the G-CSF cohort (65.7% vs. 43.8%, P = .008; 90% vs. 60%, P = .007). At 20-month median follow-up, 3-year PFS was 48.4% versus 89.6% (P = .031); OS did not differ significantly (P = .230). Achieving ≥ VGPR pre-ASCT predicted improved PFS (HR 4.04, 95% CI, 1.04-15.71; P = .044).
Conclusion: Chemo-mobilization improves stem cell yield and reduces tumor burden without added toxicity. Achieving ≥ VGPR before ASCT was associated with lower relapse risk and superior PFS.
背景：自体干细胞移植（ASCT）仍然是多发性骨髓瘤（MM）的标准巩固治疗。单独使用G-CSF或联合化疗（化疗动员）进行外周血干细胞动员是这一过程中的关键步骤。尽管化学动员提高了CD34 +的产量，但在新药物时代，它对疾病控制和移植后预后的影响仍不清楚。患者和方法：我们回顾性分析了在我院接受ASCT治疗的67例MM患者。32例（47.8%）患者接受环磷酰胺化疗动员（37.5%）或KD-PACE + G-CSF化疗动员（62.5%），35例（52.2%）患者单独接受G-CSF化疗动员。主要终点是移植后第90天的总缓解率（ORR），而移植结果作为次要终点进行分析。采用倾向评分校正Cox模型评估预后因素。结果：与单独使用G-CSF相比，化学动员产生了更高的中位数CD34 +收集量（7.9 × 10⁶/kg vs. 6.6 × 10⁶/kg; P = 0.035），更少的单采次数（P = 0.005）和更少的plerixafor使用（P = 0.005）。在化疗动员的患者中，89%的患者肿瘤负荷减轻，21%的患者在asct前得到改善。asct后第90天的ORR组间具有可比性（90.6% vs. 94.3%; P = 0.569）。完全缓解（CR+sCR）和MRD阴性在G-CSF队列中更高（65.7% vs. 43.8%, P = 0.008; 90% vs. 60%, P = 0.007）。在20个月的中位随访中，3年PFS为48.4%对89.6% (P = 0.031)；OS差异无统计学意义（P = 0.230）。asct前达到≥VGPR预测PFS改善（HR 4.04, 95% CI, 1.04-15.71; P = 0.044）。结论：化学动员可提高干细胞产量，减轻肿瘤负担，且不增加毒性。ASCT前达到≥VGPR与较低的复发风险和较好的PFS相关。
{"title":"Impact of Stem Cell Mobilization with Chemotherapy Versus G-CSF Alone for Multiple Myeloma Patients with Suboptimal Response Before Autologous Stem Cell Transplant.","authors":"Piyatida Chumnumsiriwath, Polina Bellman, Minh-Ha Tran, Christina Golly, Stefan O Ciurea, Piyanuch Kongtim","doi":"10.1016/j.clml.2026.01.004","DOIUrl":"https://doi.org/10.1016/j.clml.2026.01.004","url":null,"abstract":"<p><strong>Background: </strong>Autologous stem cell transplantation (ASCT) remains the standard consolidation therapy for multiple myeloma (MM). Peripheral blood stem cell mobilization, performed using G-CSF alone or in combination with chemotherapy (chemo-mobilization), is a crucial step in this process. Although chemo-mobilization enhances CD34⁺ yields, its effect on disease control and post-transplant outcomes in the era of novel agents remains unclear.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed 67 MM patients who underwent ASCT at our institution. Thirty-two patients (47.8%) received chemo-mobilization with cyclophosphamide (37.5%) or KD-PACE plus G-CSF (62.5%) and 35 (52.2%) received G-CSF alone. The primary endpoint was overall response rate (ORR) at day 90 post-transplant, while transplant outcomes were analyzed as secondary endpoints. Propensity score-adjusted Cox models were used to assess prognostic factors.</p><p><strong>Results: </strong>Chemo-mobilization yielded a higher median CD34⁺ collection (7.9 × 10⁶/kg vs. 6.6 × 10⁶/kg; P = .035), fewer apheresis sessions (P = .005), and reduced plerixafor use (P = .005) compared with G-CSF alone. Among chemo-mobilized patients, 89% showed decreased tumor burden and 21% achieved improved response pre-ASCT. ORR at day 90 post-ASCT was comparable between groups (90.6% vs. 94.3%; P = .569). Complete remission (CR+sCR) and MRD negativity were higher in the G-CSF cohort (65.7% vs. 43.8%, P = .008; 90% vs. 60%, P = .007). At 20-month median follow-up, 3-year PFS was 48.4% versus 89.6% (P = .031); OS did not differ significantly (P = .230). Achieving ≥ VGPR pre-ASCT predicted improved PFS (HR 4.04, 95% CI, 1.04-15.71; P = .044).</p><p><strong>Conclusion: </strong>Chemo-mobilization improves stem cell yield and reduces tumor burden without added toxicity. Achieving ≥ VGPR before ASCT was associated with lower relapse risk and superior PFS.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146130629","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 : 2026-01-03DOI: 10.1016/j.clml.2025.12.018
Hannah Goulart, Elias Jabbour
The treatment landscape of B-cell acute lymphoblastic leukemia (B-ALL) has been transformed by the incorporation of immunotherapy and potent tyrosine kinase inhibitors (TKIs) into frontline regimens, resulting in meaningful improvements in long-term survival. Such advances have allowed for a reduction in both the intensity and duration of chemotherapy without compromising outcomes, a particularly important goal for older adults, who are less tolerant to intensive chemotherapy and often harbor higher-risk disease features, including TP53 mutations that confer resistance to traditional chemotherapy. Largely chemotherapy-free regimens may alleviate some of the poor outcomes that older patients experience; such regimens are under investigation. While the risk factors that portend inferior outcomes for patients with Philadelphia (Ph)-positive B-ALL are still being defined in the setting of immunotherapy-based regimens and more potent TKIs, it is evident that an elevated baseline white blood cell count is a strong predictor of relapse. The role of chimeric antigen receptor (CAR) T-cell therapy as consolidation for patients with high-risk Ph-positive B-ALL is actively being explored, alongside efforts to identify factors that influence CAR T-cell expansion and persistence as determinants of response durability. Advances in more sensitive assessments of measurable residual disease (MRD) using next generation sequencing (NGS) will help inform which patients may benefit from additional consolidative strategies. Novel agents under development include the subcutaneous (SC) form of blinatumomab, which has demonstrated efficacy even in patients with prior blinatumomab exposure. Altogether, these developments frame the next set of questions in ALL, which will be addressed in this review.
{"title":"SOHO State of the Art Updates and Next Questions | SOHO 2025 Next Questions: Acute Lymphoblastic Leukemia.","authors":"Hannah Goulart, Elias Jabbour","doi":"10.1016/j.clml.2025.12.018","DOIUrl":"https://doi.org/10.1016/j.clml.2025.12.018","url":null,"abstract":"<p><p>The treatment landscape of B-cell acute lymphoblastic leukemia (B-ALL) has been transformed by the incorporation of immunotherapy and potent tyrosine kinase inhibitors (TKIs) into frontline regimens, resulting in meaningful improvements in long-term survival. Such advances have allowed for a reduction in both the intensity and duration of chemotherapy without compromising outcomes, a particularly important goal for older adults, who are less tolerant to intensive chemotherapy and often harbor higher-risk disease features, including TP53 mutations that confer resistance to traditional chemotherapy. Largely chemotherapy-free regimens may alleviate some of the poor outcomes that older patients experience; such regimens are under investigation. While the risk factors that portend inferior outcomes for patients with Philadelphia (Ph)-positive B-ALL are still being defined in the setting of immunotherapy-based regimens and more potent TKIs, it is evident that an elevated baseline white blood cell count is a strong predictor of relapse. The role of chimeric antigen receptor (CAR) T-cell therapy as consolidation for patients with high-risk Ph-positive B-ALL is actively being explored, alongside efforts to identify factors that influence CAR T-cell expansion and persistence as determinants of response durability. Advances in more sensitive assessments of measurable residual disease (MRD) using next generation sequencing (NGS) will help inform which patients may benefit from additional consolidative strategies. Novel agents under development include the subcutaneous (SC) form of blinatumomab, which has demonstrated efficacy even in patients with prior blinatumomab exposure. Altogether, these developments frame the next set of questions in ALL, which will be addressed in this review.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046296","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.2025.08.009
Trung Minh Nguyen , Jason Lu , Danielle Guffey , Rockbum Kim , Abiodun Oluyomi , Omar Rosales , Raka Bandyo , Courtney N. Miller-Chism , Mark M. Udden , Martha P. Mims , Tareq Abuasab , Akiva Diamond , Purnima S. Teegavarapu , Chijioke Nze , Christopher R. Flowers , Ang Li , Jun Yang Jiang
Background
There is limited data on outcomes and patterns of care for patients with classical Hodgkin lymphoma (cHL) who are uninsured or have adverse social determinants of health.
Methods
We conducted a retrospective cohort study of patients with newly diagnosed cHL treated in a large safety-net hospital system between January 2011 and December 2021.
Results
Of the 231 patients aged ≥18 years diagnosed with cHL at Harris Health, Houston, TX, the median age was 39 years, 82% were uninsured, and 87% lived in a neighborhood with an Area Deprivation Index below the national median. Most (73%) had stage III/IV disease; 19% had a history of HIV. The median diagnosis-to-treatment interval was 24 days. The median follow-up interval was 72.3 months. Among 217 evaluable patients, 67% achieved a complete response, and 7% had a partial response. Twenty-two (61%) of 36 eligible patients underwent hematopoietic stem cell transplantation. At 5 years, event-free and overall survival (OS) rates were 62.7% and 79.6%, respectively. Factors associated with OS in multivariable analysis included age (hazard ratio [HR] 1.34 per 10-year increase, P = .007), Eastern Cooperative Oncology Group performance status (HR 2.35 for 2-4 vs. 0-1, P = .026), serum creatinine (HR 2.94 per mg/dL increase, P = .006), and serum albumin (HR 0.59 per g/dL increase, P = .014).
Conclusion
In this health system with financial assistance and access to cell therapies, uninsurance was not associated with inferior outcomes. Small survival differences may be due to a greater proportion of patients with advanced-stage, higher-risk, and HIV-associated disease.
{"title":"Clinical Outcomes and Patterns of Care Among Patients With Newly Diagnosed Classical Hodgkin Lymphoma in a Safety-Net Health System","authors":"Trung Minh Nguyen , Jason Lu , Danielle Guffey , Rockbum Kim , Abiodun Oluyomi , Omar Rosales , Raka Bandyo , Courtney N. Miller-Chism , Mark M. Udden , Martha P. Mims , Tareq Abuasab , Akiva Diamond , Purnima S. Teegavarapu , Chijioke Nze , Christopher R. Flowers , Ang Li , Jun Yang Jiang","doi":"10.1016/j.clml.2025.08.009","DOIUrl":"10.1016/j.clml.2025.08.009","url":null,"abstract":"<div><h3>Background</h3><div>There is limited data on outcomes and patterns of care for patients with classical Hodgkin lymphoma (cHL) who are uninsured or have adverse social determinants of health.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of patients with newly diagnosed cHL treated in a large safety-net hospital system between January 2011 and December 2021.</div></div><div><h3>Results</h3><div>Of the 231 patients aged ≥18 years diagnosed with cHL at Harris Health, Houston, TX, the median age was 39 years, 82% were uninsured, and 87% lived in a neighborhood with an Area Deprivation Index below the national median. Most (73%) had stage III/IV disease; 19% had a history of HIV. The median diagnosis-to-treatment interval was 24 days. The median follow-up interval was 72.3 months. Among 217 evaluable patients, 67% achieved a complete response, and 7% had a partial response. Twenty-two (61%) of 36 eligible patients underwent hematopoietic stem cell transplantation. At 5 years, event-free and overall survival (OS) rates were 62.7% and 79.6%, respectively. Factors associated with OS in multivariable analysis included age (hazard ratio [HR] 1.34 per 10-year increase, <em>P</em> = .007), Eastern Cooperative Oncology Group performance status (HR 2.35 for 2-4 vs. 0-1, <em>P</em> = .026), serum creatinine (HR 2.94 per mg/dL increase, <em>P</em> = .006), and serum albumin (HR 0.59 per g/dL increase, <em>P</em> = .014).</div></div><div><h3>Conclusion</h3><div>In this health system with financial assistance and access to cell therapies, uninsurance was not associated with inferior outcomes. Small survival differences may be due to a greater proportion of patients with advanced-stage, higher-risk, and HIV-associated disease.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages e12-e20.e5"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058472","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.2025.08.020
Jelena Jelicic , Karen Juul-Jensen , Zoran Bukumiric , Mikkel Runason Simonsen , Michael Roost Clausen , Ahmed Ludvigsen Al-Mashhadi , Robert Schou Pedersen , Christian Bjørn Poulsen , Anne Ortved Gang , Peter Brown , Tarec Christoffer El-Galaly , Thomas Stauffer Larsen
Background
The International prognostic index (IPI) is a widely used model for identifying trial-eligible patients with diffuse large B-cell lymphoma (DLBCL). However, the applicability of prognostic models in identifying trial-eligible high-intermediate (HI) and high-risk (H), particularly younger patients, has not been extensively studied.
Methods
Patients with newly diagnosed DLBCL were identified in the Danish Lymphoma Registry (LYFO). To evaluate the impact of IPI and age-adjusted IPI (aaIPI) on identifying higher-risk (HI and H-risk) trial-eligible patients, we retrieved the eligibility criteria for the frontMIND trial (NCT04824092).
Results
Of 6252 patients with DLBCL registered in the LYFO, 3725 (59.6%) were trial-eligible. The dataset included all IPI/aaIPI groups. However, 46% of 3725 patients would meet trial eligibility if IPI and aaIPI higher-risk patients were selected. The 5-year progression-free (PFS) and overall survival (OS) were 61.7% and 70.5%, respectively. Among patients aged ≤ 60 years (35.5%; 1321/3725), 29.5% were frontMIND-eligible based on aaIPI, with 5-year PFS and OS of 72.3% and 82.8%, respectively. Combining IPI and aaIPI did not improve the identification of patients who did not respond to standard treatment, and utilizing this strategy for trial selection was not superior to using IPI or NCCN-IPI alone.
Conclusions
Prognostic models can help in selecting trial-eligible HI and H-risk patients, thereby increasing the chances of identifying those who do not respond to standard treatment. However, the currently used prognostic indices fail to accurately recognize some high-risk patients, particularly young patients. Therefore, additional risk factors beyond prognostic models are needed to improve patient selection for trial participation.
{"title":"International Prognostic Models as Tools for Selection of Higher-risk Trial-eligible Patients With Diffuse Large B-Cell lymphoma","authors":"Jelena Jelicic , Karen Juul-Jensen , Zoran Bukumiric , Mikkel Runason Simonsen , Michael Roost Clausen , Ahmed Ludvigsen Al-Mashhadi , Robert Schou Pedersen , Christian Bjørn Poulsen , Anne Ortved Gang , Peter Brown , Tarec Christoffer El-Galaly , Thomas Stauffer Larsen","doi":"10.1016/j.clml.2025.08.020","DOIUrl":"10.1016/j.clml.2025.08.020","url":null,"abstract":"<div><h3>Background</h3><div>The International prognostic index (IPI) is a widely used model for identifying trial-eligible patients with diffuse large B-cell lymphoma (DLBCL). However, the applicability of prognostic models in identifying trial-eligible high-intermediate (HI) and high-risk (H), particularly younger patients, has not been extensively studied.</div></div><div><h3>Methods</h3><div>Patients with newly diagnosed DLBCL were identified in the Danish Lymphoma Registry (LYFO). To evaluate the impact of IPI and age-adjusted IPI (aaIPI) on identifying higher-risk (HI and H-risk) trial-eligible patients, we retrieved the eligibility criteria for the frontMIND trial (NCT04824092).</div></div><div><h3>Results</h3><div>Of 6252 patients with DLBCL registered in the LYFO, 3725 (59.6%) were trial-eligible. The dataset included all IPI/aaIPI groups. However, 46% of 3725 patients would meet trial eligibility if IPI and aaIPI higher-risk patients were selected. The 5-year progression-free (PFS) and overall survival (OS) were 61.7% and 70.5%, respectively. Among patients aged ≤ 60 years (35.5%; 1321/3725), 29.5% were frontMIND-eligible based on aaIPI, with 5-year PFS and OS of 72.3% and 82.8%, respectively. Combining IPI and aaIPI did not improve the identification of patients who did not respond to standard treatment, and utilizing this strategy for trial selection was not superior to using IPI or NCCN-IPI alone.</div></div><div><h3>Conclusions</h3><div>Prognostic models can help in selecting trial-eligible HI and H-risk patients, thereby increasing the chances of identifying those who do not respond to standard treatment. However, the currently used prognostic indices fail to accurately recognize some high-risk patients, particularly young patients. Therefore, additional risk factors beyond prognostic models are needed to improve patient selection for trial participation.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages e62-e76"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136640","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.2025.07.008
Julia Llinares , Sofía Toribio-Castelló , Luis Fernando García , Tamara Iglesias , Ana Heredero , Pablo Rebollo , Isabel Ricote , María-Victoria Mateos
Objective
We aim to describe multiple myeloma (MM) characteristics and treatment patterns in Spain, focusing on triple-class exposed (TCE) population.
Methods
In this non-interventional, cross-sectional, retrospective study, real-world treatment data between October 2022 and September 2023 were collected from Oncology Dynamics and Oncology Advantage datasets. The proportion of TCE patients was described by line of therapy (LOT).
Results
In total, 1206 MM patients were analyzed. Of them, 717 patients were newly diagnosed MM and 489 were relapsed and refractory MM (RRMM) patients. In RRMM patients, treatment patterns were heterogeneous, mainly with lenalidomide- and pomalidomide-based regimens in the second and third/subsequent LOT, respectively. Among patients with ≥ 3 LOT, 82 different treatment sequences were identified. Currently, a total of 331 (27.4%) patients were TCE, with a notably increase by LOT: 15.9% receiving triple-class agents in the first, 56.9% in the second and 62.1% in the third/subsequent LOTs. To note, only a 7.13% of patients (n = 86) were TCE at the beginning of their current treatment.
Conclusions
This study shows the increasingly incidence of TCE-MM patients, appearing from the first LOT. TCE treatment is challenging and identifying treatments with new mechanism of actions regardless of LOTs, will be key to optimize the management of this population.
{"title":"Treatment Patterns of Patients With Multiple Myeloma in a Real-World Setting in Spain. How are Triple-Class Exposed Patients Being Managed?","authors":"Julia Llinares , Sofía Toribio-Castelló , Luis Fernando García , Tamara Iglesias , Ana Heredero , Pablo Rebollo , Isabel Ricote , María-Victoria Mateos","doi":"10.1016/j.clml.2025.07.008","DOIUrl":"10.1016/j.clml.2025.07.008","url":null,"abstract":"<div><h3>Objective</h3><div>We aim to describe multiple myeloma (MM) characteristics and treatment patterns in Spain, focusing on triple-class exposed (TCE) population.</div></div><div><h3>Methods</h3><div>In this non-interventional, cross-sectional, retrospective study, real-world treatment data between October 2022 and September 2023 were collected from Oncology Dynamics and Oncology Advantage datasets. The proportion of TCE patients was described by line of therapy (LOT).</div></div><div><h3>Results</h3><div>In total, 1206 MM patients were analyzed. Of them, 717 patients were newly diagnosed MM and 489 were relapsed and refractory MM (RRMM) patients. In RRMM patients, treatment patterns were heterogeneous, mainly with lenalidomide- and pomalidomide-based regimens in the second and third/subsequent LOT, respectively. Among patients with ≥ 3 LOT, 82 different treatment sequences were identified. Currently, a total of 331 (27.4%) patients were TCE, with a notably increase by LOT: 15.9% receiving triple-class agents in the first, 56.9% in the second and 62.1% in the third/subsequent LOTs. To note, only a 7.13% of patients (<em>n</em> = 86) were TCE at the beginning of their current treatment.</div></div><div><h3>Conclusions</h3><div>This study shows the increasingly incidence of TCE-MM patients, appearing from the first LOT. TCE treatment is challenging and identifying treatments with new mechanism of actions regardless of LOTs, will be key to optimize the management of this population.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages 34-41"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944962","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}
Carfilzomib (K) is approved in France to treat multiple myeloma in second line or later (2L+) with dexamethasone (Kd), lenalidomide and dexamethasone (KRd), daratumumab and dexamethasone (D-Kd). We assessed K utilization and outcomes in a French real-world cohort (2017-2022).
Results
Overall, 972 patients-initiated K treatment in 2L (21%), 3L (23%) and 4L+ (56%). Patients were largely exposed (96%) and refractory (75%) to immunomodulatory drugs. The most frequent regimens in 2L were KRd (33%) and D-Kd (24%), in 3L were Kd (27%) and K with pomalidomide and dexamethasone (KPd; 27%) and in 4L+ was Kd (49%). Of the 224 elderly patients (≥ 75 years), 45% received Kd in 4L+. Since 2018, KRd and Kd use declined in favor of D-Kd and KPd. The recommended K dose was mostly used despite some variability. In 2022, once-weekly dosing was used in most D-Kd and KRd patients, and half of Kd and KPd patients. Effectiveness of K-based regimens was similar regardless of starting K once-weekly and twice-weekly. Overall response rate (ORR) for KRd in 2L was 81%, with median overall survival (mOS) not reached (NR). ORR for D-Kd was 76% (78% in 2L) and mOS 32.0 months (NR in 2L). For KPd, ORR was 69% with mOS of 26.4 months. For Kd, ORR was 54% in 4L, 51% among elderly patients, and mOS was 15.5 months.
Conclusions
This real-world study confirms carfilzomib effectiveness at both dosing frequencies. K triplets resulted in long survivals and Kd remained satisfactory to treat heavily pretreated patients.
{"title":"Real-World Utilization of Carfilzomib (Once or Twice Weekly) Initiated in Patients After a First Relapse Between 2017 and 2022 in France: An Analysis From a Large-Scale Epidemiology of Multiple MYeloma (EmmY) Cohort","authors":"Cyrille Hulin MD , Karim Belhadj Merzoug , Bruno Royer , Denis Caillot , Arthur Bobin , Margaret Macro , Lionel Karlin , Mohamad Mohty , Laurent Frenzel , Aurore Perrot , Laure Vincent , Mammoun Dib , Frédérique Orsini Piocell , Riad Benramdane , Claire Calmettes , Thomas Chalopin , Ronan Garlantézec , Gaëlle Désaméricq , Hakima Mechiche , Olivier Decaux","doi":"10.1016/j.clml.2025.08.002","DOIUrl":"10.1016/j.clml.2025.08.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Carfilzomib (K) is approved in France to treat multiple myeloma in second line or later (2L+) with dexamethasone (Kd), lenalidomide and dexamethasone (KRd), daratumumab and dexamethasone (D-Kd). We assessed K utilization and outcomes in a French real-world cohort (2017-2022).</div></div><div><h3>Results</h3><div>Overall, 972 patients-initiated K treatment in 2L (21%), 3L (23%) and 4L+ (56%). Patients were largely exposed (96%) and refractory (75%) to immunomodulatory drugs. The most frequent regimens in 2L were KRd (33%) and D-Kd (24%), in 3L were Kd (27%) and K with pomalidomide and dexamethasone (KPd; 27%) and in 4L+ was Kd (49%). Of the 224 elderly patients (≥ 75 years), 45% received Kd in 4L+. Since 2018, KRd and Kd use declined in favor of D-Kd and KPd. The recommended K dose was mostly used despite some variability. In 2022, once-weekly dosing was used in most D-Kd and KRd patients, and half of Kd and KPd patients. Effectiveness of K-based regimens was similar regardless of starting K once-weekly and twice-weekly. Overall response rate (ORR) for KRd in 2L was 81%, with median overall survival (mOS) not reached (NR). ORR for D-Kd was 76% (78% in 2L) and mOS 32.0 months (NR in 2L). For KPd, ORR was 69% with mOS of 26.4 months. For Kd, ORR was 54% in 4L, 51% among elderly patients, and mOS was 15.5 months.</div></div><div><h3>Conclusions</h3><div>This real-world study confirms carfilzomib effectiveness at both dosing frequencies. K triplets resulted in long survivals and Kd remained satisfactory to treat heavily pretreated patients.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages e1-e11.e4"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085232","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.2025.09.001
Sonia Morè , Massimo Offidani , Laura Corvatta , Silvia Aloisi , Tommaso Za , Francesca Fazio , Martina Gherardini , Velia Bongarzoni , Barbara Anaclerico , Luca Franceschini , Silvia Ferraro , Luca Cupelli , Carmine Liberatore , Francesca Fioritoni , Laura De Padua , Angela Rago , Silvia Gentili , Roberto Latagliata , Mariagrazia Garzia , Giancarlo Discepoli , Maria Teresa Petrucci
We retrospectively analysed cytogenetics by fluorescence in situ hybridization (FISH) in 1.026 patients with multiple myeloma treated in real-world with the aim to establish its role in daily clinical practice. Thirty-seven percent of patients had no FISH data available. Based on median PFS of each cytogenetic abnormality found, we identified 3 group of patients with a significantly different PFS and determined which patients can best benefit from anti-CD38 regimens and double transplant. These findings support cytogenetic testing in all patients at diagnosis.
Background
Cytogenetics by fluorescence in situ hybridization (FISH) plays an increasing prognostic role in multiple myeloma (MM).
Methods
we analysed cytogenetics and its implications in 1.026 patients treated in real-world from 2019 to 2023. Low-risk (LR) patients had normal cytogenetic or del(13q); intermediate-risk (IR) had t(11;14), hyperdiploidy, gain(1q) or del(1p); high-risk (HR) group had del(17p)/TP53, amp1q21, t(4;14), t(14:16) or t(14;20). Co-existence of 2 high risk abnormalities was named double hit.
Results
FISH data were not evaluable in 383 patients (37%). Out of 643 evaluable patients, chromosome 1 alterations were observed in 119 (18.5%), high risk chromosome 14 translocations in 65 (10%), del(17p)/TP53 in 37 (6%) and double-hit in 7 patients (1%). Cytogenetic was normal or hyperdiploid in 252 (39%) and 59 (13%) patients, respectively. Median PFS of LR, IR and HR group were 57.5, 43.2 and 30.5 months, respectively (P < .001). Although anti-CD38 regimens resulted in significantly longer PFS in both TE and NTE pts, in the former significant benefit was documented in the LR and IR group but not in HR group while in the latter only in the LR group. Tandem transplantation did not improve PFS both overall and in the 3 risk groups. Multivariate Cox regression analysis selected ECOG-PS ≥2, R-ISS II-III and our cytogenetic score HR as factors affecting PFS.
Conclusions
in real world, more than one third of MM patients do not have baseline FISH data. Nevertheless, cytogenetics and ECOG PS can be used for prognostic staging and for tailoring therapy.
{"title":"Cytogenetic Features and Their Implications in Clinical Practice: A Real-World Analysis of a Large Cohort of Multiple Myeloma Patients","authors":"Sonia Morè , Massimo Offidani , Laura Corvatta , Silvia Aloisi , Tommaso Za , Francesca Fazio , Martina Gherardini , Velia Bongarzoni , Barbara Anaclerico , Luca Franceschini , Silvia Ferraro , Luca Cupelli , Carmine Liberatore , Francesca Fioritoni , Laura De Padua , Angela Rago , Silvia Gentili , Roberto Latagliata , Mariagrazia Garzia , Giancarlo Discepoli , Maria Teresa Petrucci","doi":"10.1016/j.clml.2025.09.001","DOIUrl":"10.1016/j.clml.2025.09.001","url":null,"abstract":"<div><div>We retrospectively analysed cytogenetics by fluorescence in situ hybridization (FISH) in 1.026 patients with multiple myeloma treated in real-world with the aim to establish its role in daily clinical practice. Thirty-seven percent of patients had no FISH data available. Based on median PFS of each cytogenetic abnormality found, we identified 3 group of patients with a significantly different PFS and determined which patients can best benefit from anti-CD38 regimens and double transplant. These findings support cytogenetic testing in all patients at diagnosis.</div></div><div><h3>Background</h3><div>Cytogenetics by fluorescence <em>in situ</em> hybridization (FISH) plays an increasing prognostic role in multiple myeloma (MM).</div></div><div><h3>Methods</h3><div>we analysed cytogenetics and its implications in 1.026 patients treated in real-world from 2019 to 2023. Low-risk (LR) patients had normal cytogenetic or del(13q); intermediate-risk (IR) had t(11;14), hyperdiploidy, gain(1q) or del(1p); high-risk (HR) group had del(17p)/TP53, amp1q21, t(4;14), t(14:16) or t(14;20). Co-existence of 2 high risk abnormalities was named double hit.</div></div><div><h3>Results</h3><div>FISH data were not evaluable in 383 patients (37%). Out of 643 evaluable patients, chromosome 1 alterations were observed in 119 (18.5%), high risk chromosome 14 translocations in 65 (10%), del(17p)/TP53 in 37 (6%) and double-hit in 7 patients (1%). Cytogenetic was normal or hyperdiploid in 252 (39%) and 59 (13%) patients, respectively. Median PFS of LR, IR and HR group were 57.5, 43.2 and 30.5 months, respectively (<em>P</em> < .001). Although anti-CD38 regimens resulted in significantly longer PFS in both TE and NTE pts, in the former significant benefit was documented in the LR and IR group but not in HR group while in the latter only in the LR group. Tandem transplantation did not improve PFS both overall and in the 3 risk groups. Multivariate Cox regression analysis selected ECOG-PS ≥2, R-ISS II-III and our cytogenetic score HR as factors affecting PFS.</div></div><div><h3>Conclusions</h3><div>in real world, more than one third of MM patients do not have baseline FISH data. Nevertheless, cytogenetics and ECOG PS can be used for prognostic staging and for tailoring therapy.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 1","pages":"Pages e83-e91"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205701","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号