Hematology, Transfusion and Cell Therapy最新文献

{"title":"Platelet transfusion in end-of-life adult care","authors":"Diana Cibele , Fernanda Trigo , Miguel Barbosa , Jorge Almeida , José Artur Paiva , Edna Gonçalves , João Brito , José Teixeira , Fernando Araújo","doi":"10.1016/j.htct.2025.106228","DOIUrl":"10.1016/j.htct.2025.106228","url":null,"abstract":"","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 1","pages":"Article 106228"},"PeriodicalIF":1.6,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety analysis of the use of ibrutinib associated with rituximab for the first-line treatment of patients with chronic lymphocytic leukaemia","authors":"Aline do Nascimento ,&nbsp;Daniel da Silva Pereira Curado ,&nbsp;Thais Montezuma ,&nbsp;Wallace Breno Barbosa ,&nbsp;Juliana Machado-Rugolo ,&nbsp;Mariana Millan Fachi","doi":"10.1016/j.htct.2025.106234","DOIUrl":"10.1016/j.htct.2025.106234","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic lymphocytic leukaemia, a common blood cancer in adults, particularly affects the elderly and is marked by the accumulation of B lymphocytes. While therapeutic options have expanded, the fludarabine, cyclophosphamide, and rituximab (FCR) regimen remains the standard first-line treatment for fit patients in the Brazilian public health system.</div></div><div><h3>Aim</h3><div>This systematic review aimed to assess the efficacy and safety of ibrutinib plus rituximab (IR) as a first-line therapy for chronic lymphocytic leukaemia.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines and registered in PROSPERO (CRD42023494868), searches were conducted in multiple databases in December 2023 to identify relevant randomized controlled trials comparing the IR and FCR regimens. Eligible studies reported at least one of the following outcomes: progression-free survival, overall survival, severe adverse events, or quality of life.</div></div><div><h3>Results</h3><div>Two double-blind randomized controlled trials (FLAIR and E1912) totalling 1300 patients met inclusion criteria. Meta-analysis showed that the IR regimen significantly improved progression-free survival compared to the FCR regimen (Hazard ratio: 0.41; 95% CI: 0.31–0.53) with moderate certainty of evidence. However, overall survival did not differ substantially (Hazard ratio: 0.71; 95% CI: 0.33–1.49), and the certainty of the evidence was very low. Quality of life data were unavailable. Due to variations in follow-up, results for severe adverse events were not pooled and the individual studies reported results with low certainty of evidence. The global risk of bias was rated as there was some concern due to the lack of concealed allocation in all outcomes.</div></div><div><h3>Conclusion</h3><div>The IR regimen demonstrated superior progression-free survival and comparable safety to the FCR regimen suggesting it is an effective and safe option for first-line treatment of chronic lymphocytic leukaemia.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 1","pages":"Article 106234"},"PeriodicalIF":1.6,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First report of perioperative iptacopan interruption in paroxysmal nocturnal hemoglobinuria without breakthrough hemolysis","authors":"Katsuhiro Tokuda ,&nbsp;Tatsuki Morioka ,&nbsp;Shoya Arai ,&nbsp;Takuji Matsuo ,&nbsp;Kensuke Matsumoto ,&nbsp;Ryosuke Shirasaki ,&nbsp;Jun Ooi ,&nbsp;Haruko Tashiro","doi":"10.1016/j.htct.2025.106235","DOIUrl":"10.1016/j.htct.2025.106235","url":null,"abstract":"","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 1","pages":"Article 106235"},"PeriodicalIF":1.6,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In patients with suspected thrombotic thrombocytopenic purpura, what is the optimal time to therapeutic plasma exchange?","authors":"Alexandre Soares Ferreira Junior ,&nbsp;Kate Sanborn ,&nbsp;Morgana Pinheiro Maux Lessa ,&nbsp;Alexander Gordee ,&nbsp;Maragatha Kuchibhatla ,&nbsp;Allison O. Taylor ,&nbsp;Matthew S. Karafin ,&nbsp;Oluwatoyosi A. Onwuemene","doi":"10.1016/j.htct.2025.106223","DOIUrl":"10.1016/j.htct.2025.106223","url":null,"abstract":"<div><h3>Background</h3><div>In patients with suspected immune thrombotic thrombocytopenic purpura, guidelines suggest that therapeutic plasma exchange should be initiated within eight hours. However, this time threshold may be difficult to attain. This study sought to identify the optimal time to plasma exchange to maximize outcomes.</div></div><div><h3>Study Design and Methods</h3><div>Patients with international classification of disease codes for thrombotic microangiopathy were identified in a retrospective cross-sectional analysis of public use data files from the Recipient Epidemiology and Donor Evaluation Study-III (REDS-III). The assumption of linearity between time to therapeutic plasma exchange and the composite outcome of bleeding, thrombosis, and mortality were evaluated. Subsequently, the optimal time for plasma exchange was identified using a nonparametric approach with bootstrapping.</div></div><div><h3>Results</h3><div>For 149 patients with a suspected diagnosis of thrombotic thrombocytopenic purpura, the association between time to plasma exchange and the primary outcome was non-linear. With regard to the primary composite outcome, this time had a low predictive capacity (area under the curve: 0.62). The optimal time that maximized outcomes was 13.5 h.</div></div><div><h3>Conclusion</h3><div>Although this study found that time to therapeutic plasma exchange did not independently predict outcome, future studies might evaluate how this time interacts with other variables to predict clinical outcomes.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 1","pages":"Article 106223"},"PeriodicalIF":1.6,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cold-stored platelets: A systematic review of recovery in healthy adults and chest drain output in cardiothoracic surgery patients","authors":"Caleb Keane,&nbsp;Heba Sharif,&nbsp;Denise Jackson","doi":"10.1016/j.htct.2025.106226","DOIUrl":"10.1016/j.htct.2025.106226","url":null,"abstract":"<div><div>Cold-stored platelets were abandoned in the 1960s after demonstration of an increased clearance in vivo due to an irreversible activated phenotype. Difficulties in storage, logistics, and the increased requirement of therapeutic platelet transfusions for haemostasis have sparked renewed interest in cold-stored platelets. This systematic review compared two primary outcomes: in vivo recovery for autologous cold-stored platelets <em>versus</em> room-temperature platelets in healthy volunteers, and chest drain output at 24 h for allogeneic cold-stored platelets <em>versus</em> room-temperature platelets after complex cardiothoracic surgery. A total of 4215 articles were found in the ProQuest, PubMed, Scopus, Embase, and Cochrane electronic databases. Seven eligible papers were included in this meta-analysis. Cold-stored platelets showed a decreased in vivo recovery two hours after retransfusion following storage for two to seven days compared to a room-temperature platelet control group (mean difference: −25.85 %; 95 % confidence interval: −41.98 to −9.71 %; p-value = 0.002). Further, cold-stored platelets showed a decreased chest cavity output when transfused within 24 h after complex cardiothoracic surgery (mean difference: 249.68 mL; 95 % confidence interval: 85.68 to 413.67 mL; p-value = 0.003). While cold-stored platelets are not a substitute for room-temperature platelets in a prophylactic scenario, their ability to significantly reduce chest cavity output suggests they may be optimal for the management of bleeding in surgical patients, especially in the context of logistical difficulties.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 1","pages":"Article 106226"},"PeriodicalIF":1.6,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the neutrophil-to-lymphocyte ratio as a prognostic marker in patients with newly diagnosed diffuse large B-cell lymphoma: A Colombian Cohort Study","authors":"Paula María Sánchez,&nbsp;Juan Felipe Combariza-Vallejo","doi":"10.1016/j.htct.2025.106237","DOIUrl":"10.1016/j.htct.2025.106237","url":null,"abstract":"<div><h3>Introduction</h3><div>Diffuse large B-cell lymphoma is a complex disease, and prognostic scores are inadequate for identifying high-risk patients. Recently, leukocyte indices, like the neutrophil-to-lymphocyte ratio, have become a marker of prognosis. The purpose of this study is to evaluate the performance of this marker as a risk predictor in adult patients with newly diagnosed diffuse large B-cell lymphoma in Colombia.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study, calculated the neutrophil-to-lymphocyte ratio and its performance as a predictor for 2-year progression-free survival. Patients were divided into two groups; patients with high ratios in Group One and patients with low ratios in Group Two. Both groups were followed for at least 24 months from diagnosis.</div></div><div><h3>Results</h3><div>The cohort comprised 198 patients with a median age at diagnosis of 61 years. A neutrophil-to-lymphocyte ratio cutoff point of 6.2 was calculated. Patients with ratios higher than 6.2 (<em>n</em> = 45) were placed in Group One, and the patients with ratios below 6.2 (<em>n</em> = 153) in Group Two. The median follow-up time was 45 months. The 24-month progression-free survivals were 55.2 % (95 % confidence interval: 42.3–71.9 %) and 73.2 % (95 % confidence interval: 66.2–81.0 %) for high and low ratios, respectively (Hazard ratio 0.62; 95 % confidence interval: 0.44–0.89; p-value = 0.009). The 24-month overall survivals were 70.7 %; (95 % confidence interval: 58.5 - 85.5 %) and 80.4 %; (95 % confidence interval: 66.2–87.3 %), respectively.</div></div><div><h3>Conclusion</h3><div>A neutrophil-to-lymphocyte ratio with a cutoff point at ≥6.2 could differentiate a diffuse large B-cell lymphoma population with an unfavorable prognosis for progression-free survival.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 1","pages":"Article 106237"},"PeriodicalIF":1.6,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in the microbiota following allogeneic hematopoietic stem cell transplantation: A potential bioguide for clinical outcome?","authors":"Ekin Ece Gurer-Kluge ,&nbsp;Fatma Savran Oguz ,&nbsp;Zerrin Aktas ,&nbsp;Sevgi Kalayoglu Besisik ,&nbsp;Ugur Sezerman ,&nbsp;Oral Oncul ,&nbsp;Zafer Gulbas","doi":"10.1016/j.htct.2025.106074","DOIUrl":"10.1016/j.htct.2025.106074","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aims to support our hypothesis regarding compositional changes in the intestinal microbiota by characterizing these changes through pre- and post-transplantation analyses. Additionally, it seeks to determine whether monitoring the intestinal flora could provide predictive or therapeutic insights into graft versus host disease.</div></div><div><h3>Methods</h3><div>This study included adult patients who underwent allogeneic hematopoietic stem cell transplantation. Microbiota assessments were performed through stool analyses. Stool samples were collected twice: once before transplantation and once after engraftment. Following nucleic acid isolation, the samples were processed using New Generation Sequencing. Microbiota-associated pathways were examined using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Statistical analyses were performed using R statistical software. In addition to microbiota analysis, resistance genes common in Gram-negative bacteria in the region (such as <em>OXA-48-like, KPC-like, NDM-like</em>, and <em>CTX-M-like</em>) were identified via classical polymerase chain reaction in stool samples collected after transplantation. The pathways were analyzed using the KEGG database.</div></div><div><h3>Results</h3><div>Fifteen transplant recipients participated in the study. The Proteobacteria phylum increased in patients who tested positive for the <em>CTXM-1 group</em> and <em>OXA-48-like</em> resistance genes. <em>Blautia caecimuris</em> and <em>Enterococcus</em> exhibited significant changes following transplantation, while <em>Tyzzerella spp.</em> and <em>Dialister spp.</em> showed significant alterations after the onset of graft-versus-host disease. A marked change in <em>Eubacterium spp.</em> was also noted in patients with disease relapse. Two key metabolic pathways—acridone alkaloid biosynthesis and the D-arginine and D-ornithine metabolism—were associated with clinical outcomes.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that allogeneic hematopoietic stem cell transplants lead to significant alterations in intestinal microbiota composition, including increased pathogenic bacteria associated with graft-versus-host disease exacerbation. These findings suggest that microbiota monitoring may be a promising strategy for the prevention and treatment of graft-versus-host disease. Moreover, modulation of specific microbial metabolic pathways may influence disease clinical outcomes. As the first study of its kind conducted within the Turkish population, this research contributes novel insights to the existing literature and highlights the potential of microbiota-based approaches in post-transplant patient management.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 1","pages":"Article 106074"},"PeriodicalIF":1.6,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the crisis: Tracking chronic neuropathic pain in sickle cell disease using Douleur Neuropathique 4 and PainDETECT questionnaires","authors":"Camila Freitas de Andrade Rodrigues,&nbsp;Thiago Alves Rodrigues,&nbsp;Pedro Igor de Sousa Rios,&nbsp;Isabelle Nunes Costa,&nbsp;Bruno Feres de Souza,&nbsp;João Batista Santos Garcia","doi":"10.1016/j.htct.2025.106231","DOIUrl":"10.1016/j.htct.2025.106231","url":null,"abstract":"<div><h3>Background</h3><div>Neuropathic pain represents a complex and often underdetected component of the pain spectrum in Sickle Cell Disease, particularly among individuals with chronic or treatment-resistant symptoms. Despite its clinical relevance, neuropathic pain is not routinely screened for in hematology practice, where pain is frequently attributed solely to vaso-occlusive mechanisms.</div></div><div><h3>Method</h3><div>A cross-sectional study was conducted with 214 individuals diagnosed with Sickle Cell Disease at a hematology referral center in northeastern Brazil. Two validated instruments, <em>Douleur Neuropathique</em> 4 and PainDETECT were utilized to screen for neuropathic pain. Clinical and demographic data were collected, and the correlation between the instruments was assessed using Pearson’s coefficient.</div></div><div><h3>Results</h3><div>The <em>Douleur Neuropathique</em> 4 tool identified neuropathic pain in 29 % of participants. PainDETECT indicated 8.4 %, which increased to 22 % when including uncertain-range scores. The correlation between the two tools was strong (<em>r</em> = 0.87). Neuropathic pain was more prevalent among older individuals, those who reported recurrent painful episodes in the past year (p-value &lt;0.001), and those with recent opioid use (p-value = 0.042). Sensory descriptors such as tingling, numbness, and electric shock sensations were commonly reported.</div></div><div><h3>Conclusion</h3><div>The combined use of <em>Douleur Neuropathique</em> 4 and PainDETECT, both of which are quick and simple to administer, proved to be a complementary strategy for identifying neuropathic pain, with each instrument capturing distinct features. Incorporating this approach into hematology care may facilitate the detection of pain profiles beyond vaso-occlusion and support more individualized treatment decisions.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 1","pages":"Article 106231"},"PeriodicalIF":1.6,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National multiple myeloma cohort: Gaps and opportunities for research in Brazil","authors":"Diogo Moreira do Amaral","doi":"10.1016/j.htct.2025.106229","DOIUrl":"10.1016/j.htct.2025.106229","url":null,"abstract":"","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 1","pages":"Article 106229"},"PeriodicalIF":1.6,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetrical use of intravenous immunoglobulin: A single-centre retrospective study","authors":"Roy Khalife ,&nbsp;Bonnie Niu ,&nbsp;Iris Perelman ,&nbsp;Darine El-Chaâr ,&nbsp;Dean Fergusson ,&nbsp;Alan Karovitch ,&nbsp;Johnathan Mack ,&nbsp;Melanie Tokessy ,&nbsp;Kathryn E. Webert ,&nbsp;Alan Tinmouth","doi":"10.1016/j.htct.2025.106225","DOIUrl":"10.1016/j.htct.2025.106225","url":null,"abstract":"<div><h3>Introduction</h3><div>Intravenous immunoglobulin is widely used for various conditions but faces challenges such as limited supply, high cost, and substantial off-label use. Obstetrical intravenous immunoglobulin use remains underexplored, despite its relevance to maternal and neonatal care and resource management.</div></div><div><h3>Methods</h3><div>This single-center retrospective cohort study examined intravenous immunoglobulin administration in 136 pregnancies (122 patients) from 2007–2020, focusing on adherence to Health Canada licensed indications and Ontario Immunoglobulin Utilization Management Guidelines.</div></div><div><h3>Results</h3><div>Maternal thrombocytopenia (56.6 %) and treatment for fetal/neonatal alloimmune thrombocytopenia (16.2 %) were the most common indications, accounting for 16.9 % and 64.3 % of total intravenous immunoglobulin volume, respectively. Intravenous immunoglobulin use represented 1.6 % of the center's total consumption during the study period, with notable non-adherence to guidelines in 38.2 % (Health Canada) and 17.6 % (provincial guidelines) of pregnancies.</div></div><div><h3>Conclusion</h3><div>Findings highlight the need for optimized intravenous immunoglobulin use in obstetrics and future research to ensure safety, efficacy, and evidence-based guidance in clinical practice and policy.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 1","pages":"Article 106225"},"PeriodicalIF":1.6,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145690338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}