首页 > 最新文献

Hematology最新文献

英文 中文
Nomogram models predicting prognosis for patients with t(8;21) acute myeloid leukemia: a SEER-based study. 预测 t(8;21) 急性髓性白血病患者预后的提名图模型:基于 SEER 的研究。
IF 2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-24 DOI: 10.1080/16078454.2024.2381169
Jiapeng Yang, Xiaohua Zhu, Honghong Zhang, Yang Fu, Zifeng Li, Ziping Xing, Yi Yu, Ping Cao, Jun Le, Junye Jiang, Jun Li, Hongsheng Wang, Maoxiang Qian, Xiaowen Zhai

Background: Acute myeloid leukemia (AML) with t(8;21) manifests as a diverse hematological malignancy. Although it was categorized into a favorable subtype, 30-40% of patients experience relapse. The objective of this research was to devise a nomogram for the accurate anticipation of both overall survival (OS) and cancer-specific survival (CSS) in t(8;21) AML.

Methods: From the Surveillance, Epidemiology, and End Results (SEER) database, individuals diagnosed with t(8;21) AML from 2000 to 2018 were selected. Prognostic factors for t(8;21) AML were identified using Cox regression analysis and Akaike Information Criterion (AIC), forming the basis for constructing prognostic nomograms.

Results: Key variables, including first primary tumor, age group, race, and chemotherapy, were identified and integrated into the nomogram. The C-index values for the nomograms predicting OS and CSS were 0.753 (validation: 0.765) and 0.764 (validation: 0.757), respectively. Ultimately, based on nomogram scores, patients were stratified into high-risk and low-risk groups, revealing significant disparities in both OS and CSS between these groups (P < 0.001).

Conclusion: This study innovatively crafted nomograms, incorporating clinical and therapeutic variables, to forecast the 1-, 3-, and 5-year survival rates for individuals with t(8;21) AML.

背景:带有t(8;21)的急性髓性白血病(AML)是一种多样化的血液恶性肿瘤。虽然它被归类为有利亚型,但仍有 30%-40% 的患者会复发。本研究的目的是设计一个提名图,用于准确预测t(8;21) AML患者的总生存期(OS)和癌症特异性生存期(CSS):从监测、流行病学和最终结果(SEER)数据库中选取了2000年至2018年期间诊断为t(8;21)急性髓细胞性白血病的患者。利用Cox回归分析和阿凯克信息标准(AIC)确定了t(8;21) AML的预后因素,为构建预后提名图奠定了基础:结果:确定了包括第一原发肿瘤、年龄组、种族和化疗在内的关键变量,并将其整合到预后图中。预测OS和CSS的提名图C指数值分别为0.753(验证:0.765)和0.764(验证:0.757)。最终,根据提名图评分将患者分为高风险组和低风险组,结果显示,这两组患者的OS和CSS均存在显著差异(P 结论:该研究创新性地制作了提名图,并将其用于预测癌症的OS和CSS:本研究结合临床和治疗变量,创新性地制作了提名图,用于预测 t(8;21)急性髓细胞性白血病患者的 1 年、3 年和 5 年生存率。
{"title":"Nomogram models predicting prognosis for patients with t(8;21) acute myeloid leukemia: a SEER-based study.","authors":"Jiapeng Yang, Xiaohua Zhu, Honghong Zhang, Yang Fu, Zifeng Li, Ziping Xing, Yi Yu, Ping Cao, Jun Le, Junye Jiang, Jun Li, Hongsheng Wang, Maoxiang Qian, Xiaowen Zhai","doi":"10.1080/16078454.2024.2381169","DOIUrl":"https://doi.org/10.1080/16078454.2024.2381169","url":null,"abstract":"<p><strong>Background: </strong>Acute myeloid leukemia (AML) with t(8;21) manifests as a diverse hematological malignancy. Although it was categorized into a favorable subtype, 30-40% of patients experience relapse. The objective of this research was to devise a nomogram for the accurate anticipation of both overall survival (OS) and cancer-specific survival (CSS) in t(8;21) AML.</p><p><strong>Methods: </strong>From the Surveillance, Epidemiology, and End Results (SEER) database, individuals diagnosed with t(8;21) AML from 2000 to 2018 were selected. Prognostic factors for t(8;21) AML were identified using Cox regression analysis and Akaike Information Criterion (AIC), forming the basis for constructing prognostic nomograms.</p><p><strong>Results: </strong>Key variables, including first primary tumor, age group, race, and chemotherapy, were identified and integrated into the nomogram. The C-index values for the nomograms predicting OS and CSS were 0.753 (validation: 0.765) and 0.764 (validation: 0.757), respectively. Ultimately, based on nomogram scores, patients were stratified into high-risk and low-risk groups, revealing significant disparities in both OS and CSS between these groups (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>This study innovatively crafted nomograms, incorporating clinical and therapeutic variables, to forecast the 1-, 3-, and 5-year survival rates for individuals with t(8;21) AML.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"29 1","pages":"2381169"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751557","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}
引用次数: 0
A comparative retrospective study of pre-fibrotic primary myelofibrosis versus overtly fibrotic stage in Qatar: clinicopathological, genetic landscape, risk stratification and survival data (2008-2021) - a single center experience.
IF 2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-12-01 Epub Date: 2024-09-18 DOI: 10.1080/16078454.2024.2392467
Sarah A ElKourashy, Dina Soliman, Abdelfatteh El Omri, Ruba Y Taha, Hesham Elsabah, Hind Alashi, Prem Chandra, Halima El Omri

Background: In MENA region, there is a lack of evidence on Primary Myelofibrosis (PMF), leading to its underrepresentation in medical literature. This study marks the first comprehensive report on PMF data in Qatar, presenting findings from a single-center study spanning 13 years (2008-2021).

Methods: Clinicopathological data, genetic features, and disease progression parameters of pre-PMF and overt PMF subgroups were collected. Overall survival (OS), progression-free survival (PFS), DIPSS plus four categories and merged low and high-risk DIPSS scoring groups were assessed.

Results: Pre-PMF patients showed higher hemoglobin (P < 0.001), and platelet counts (P < 0.05) but lower blast counts, LDH levels, constitutional symptoms (P < 0.0001), and splenomegaly (P < 0.010) than overt PMF patients. JAK2 V617F mutation was more common in pre-PMF (P = 0.059), while unfavorable karyotypes were exclusive to overt PMF (P = 0.028). Median overall survival was significantly longer at 276.9 months (IQR: 315.9, 276.9 months) to what was previously reported. Overt PMF patients predominantly fell into the higher DIPSS risk category (P < 0.001) and showed greater disease progression than pre-PMF (P < 0.0001). Complications including refractory anaemia (P < 0.001) and leukemic transformation (P = 0.043), increased notably in the high-risk group. Furthermore, 86.2% of high-risk patients required treatment versus 59.4% of the lower-risk group (P = 0.020).

Conclusions: To the best of our knowledge our research represents the first and largest published dataset on PMF in MENA region to be published. Merged DIPSS plus scoring came to be a pragmatic tool for defining high-risk patients who significantly differ in mortality, progression, need for treatment and leukemic transformation.

{"title":"A comparative retrospective study of pre-fibrotic primary myelofibrosis <i>versus</i> overtly fibrotic stage in Qatar: clinicopathological, genetic landscape, risk stratification and survival data (2008-2021) - a single center experience.","authors":"Sarah A ElKourashy, Dina Soliman, Abdelfatteh El Omri, Ruba Y Taha, Hesham Elsabah, Hind Alashi, Prem Chandra, Halima El Omri","doi":"10.1080/16078454.2024.2392467","DOIUrl":"https://doi.org/10.1080/16078454.2024.2392467","url":null,"abstract":"<p><strong>Background: </strong>In MENA region, there is a lack of evidence on Primary Myelofibrosis (PMF), leading to its underrepresentation in medical literature. This study marks the first comprehensive report on PMF data in Qatar, presenting findings from a single-center study spanning 13 years (2008-2021).</p><p><strong>Methods: </strong>Clinicopathological data, genetic features, and disease progression parameters of pre-PMF and overt PMF subgroups were collected. Overall survival (OS), progression-free survival (PFS), DIPSS plus four categories and merged low and high-risk DIPSS scoring groups were assessed.</p><p><strong>Results: </strong>Pre-PMF patients showed higher hemoglobin (<i>P</i> < 0.001), and platelet counts (<i>P</i> < 0.05) but lower blast counts, LDH levels, constitutional symptoms (<i>P</i> < 0.0001), and splenomegaly (<i>P</i> < 0.010) than overt PMF patients. <i>JAK2</i> V617F mutation was more common in pre-PMF (<i>P</i> = 0.059), while unfavorable karyotypes were exclusive to overt PMF (<i>P</i> = 0.028). Median overall survival was significantly longer at 276.9 months (IQR: 315.9, 276.9 months) to what was previously reported. Overt PMF patients predominantly fell into the higher DIPSS risk category (<i>P</i> < 0.001) and showed greater disease progression than pre-PMF (<i>P</i> < 0.0001). Complications including refractory anaemia (<i>P</i> < 0.001) and leukemic transformation (<i>P</i> = 0.043), increased notably in the high-risk group. Furthermore, 86.2% of high-risk patients required treatment versus 59.4% of the lower-risk group (<i>P</i> = 0.020).</p><p><strong>Conclusions: </strong>To the best of our knowledge our research represents the first and largest published dataset on PMF in MENA region to be published. Merged DIPSS plus scoring came to be a pragmatic tool for defining high-risk patients who significantly differ in mortality, progression, need for treatment and leukemic transformation.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"29 1","pages":"2392467"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812909","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}
引用次数: 0
Sweet syndrome induced by FLT3 inhibitors: case report and literature review. FLT3抑制剂诱发的甜味综合征:病例报告和文献综述。
IF 1.9 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-12-01 Epub Date: 2024-04-02 DOI: 10.1080/16078454.2024.2337230
Linhui Yang, Ran Zhang, Hongbing Ma

Background: Acute febrile neutrophilic dermatosis, also commonly referred to as Sweet syndrome, is often associated with tumors, infections, immune disorders and medications. FLT3 inhibitor-induced Sweet syndrome is a rare complication.

Methods and results: We report a patient with relapsed and refractory acute monocytic leukemia harboring high-frequency FLT3-ITD and DNMT3a mutations. The FLT3 inhibitor gilteritinib was administered for reinduction therapy after failure of chemotherapy with a combination of venetoclax, decitabine, aclarubicin, cytarabine and granulocyte colony-stimulating factor. The leukemia patient achieved remission after 1 month of treatment. However, Sweet syndrome induced by gilteritinib, which was confirmed by skin biopsy, developed during induction therapy. Similar cases of Sweet syndrome following FLT3 inhibitor therapy for acute myeloid leukemia were reviewed.

Conclusion: Attention should be given to this rare complication when FLT3 inhibitors are used for acute myeloid leukemia therapy, and appropriate treatments need to be administered in a timely manner.

背景:急性发热性嗜中性粒细胞皮肤病通常也被称为斯威特综合征,常与肿瘤、感染、免疫紊乱和药物有关。FLT3抑制剂诱发的斯威特综合征是一种罕见的并发症:我们报告了一名携带高频FLT3-ITD和DNMT3a突变的复发性和难治性急性单核细胞白血病患者。在文尼妥昔、地西他滨、阿克拉比星、阿糖胞苷和粒细胞集落刺激因子联合化疗失败后,患者接受了FLT3抑制剂吉特替尼的恢复治疗。该白血病患者在治疗 1 个月后病情得到缓解。然而,在诱导治疗期间,患者出现了由吉特替尼诱发的斯威特综合征,皮肤活检证实了这一情况。本文回顾了类似的急性髓性白血病患者在接受FLT3抑制剂治疗后出现斯威特综合征的病例:结论:在使用FLT3抑制剂治疗急性髓性白血病时,应注意这种罕见的并发症,并及时采取适当的治疗措施。
{"title":"Sweet syndrome induced by FLT3 inhibitors: case report and literature review.","authors":"Linhui Yang, Ran Zhang, Hongbing Ma","doi":"10.1080/16078454.2024.2337230","DOIUrl":"10.1080/16078454.2024.2337230","url":null,"abstract":"<p><strong>Background: </strong>Acute febrile neutrophilic dermatosis, also commonly referred to as Sweet syndrome, is often associated with tumors, infections, immune disorders and medications. FLT3 inhibitor-induced Sweet syndrome is a rare complication.</p><p><strong>Methods and results: </strong>We report a patient with relapsed and refractory acute monocytic leukemia harboring high-frequency FLT3-ITD and DNMT3a mutations. The FLT3 inhibitor gilteritinib was administered for reinduction therapy after failure of chemotherapy with a combination of venetoclax, decitabine, aclarubicin, cytarabine and granulocyte colony-stimulating factor. The leukemia patient achieved remission after 1 month of treatment. However, Sweet syndrome induced by gilteritinib, which was confirmed by skin biopsy, developed during induction therapy. Similar cases of Sweet syndrome following FLT3 inhibitor therapy for acute myeloid leukemia were reviewed.</p><p><strong>Conclusion: </strong>Attention should be given to this rare complication when FLT3 inhibitors are used for acute myeloid leukemia therapy, and appropriate treatments need to be administered in a timely manner.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"29 1","pages":"2337230"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140335497","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}
引用次数: 0
The characteristics of CALR mutations in myeloproliferative neoplasms: a clinical experience from a tertiary care center in Qatar and a literature review. 骨髓增生性肿瘤中 CALR 基因突变的特点:卡塔尔一家三级医疗中心的临床经验和文献综述。
IF 1.9 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-12-01 Epub Date: 2024-05-28 DOI: 10.1080/16078454.2024.2360246
Mostafa Najim, Mohammad Abu-Tineh, Awni Alshurafa, Mohamed Izham Mohamed Ibrahim, Soubiya Ansari, Hazem Faraj, Saif Alateeg, Susanna Jane Akiki, Mohamed A Yassin

Background: Myeloproliferative neoplasms (MPNs) are hematological disorders characterized by abnormal production of myeloid cells due to genetic mutations. Since 2013, researchers have identified somatic mutations in the Calreticulin (CALR) gene, primarily insertions or deletions, in two Philadelphia chromosome-negative MPNs; essential thrombocytosis (ET) and primary myelofibrosis (PMF), and occasionally in chronic myelomonocytic leukemia (CMML). This study aims to identify the various types of CALR mutations and their impact on CALR-positive MPN patients' clinical manifestations and outcomes.

Methods: A single-center retrospective study was conducted. The data was collected from pre-existing records. The study was carried out on Philadelphia-negative MPN patients who were being followed up on at the NCCCR (National Center for Cancer Care and Research) to assess the clinical manifestation and outcome of disease treatment. All patients included, were followed in our center between January 1, 2008, and November 20, 2021.

Results: A total of 50 patients with CALR-positive MPN were reviewed with a median follow-up of three years (1-11). This cohort included 31 (62%) patients with ET, 10 (20%) patients with PMF, and 9 (18%) patients with prefibrotic myelofibrosis (pre-MF). The study involved 38 (76%) male and 12 (24%) female patients. There were 16 (32%) patients diagnosed before the age of 40, 24 (48%) patients diagnosed between the ages of 40 and 60; and 10 (20%) patients diagnosed after the age of 60. Molecular analysis showed 24 (48%) patients with CALR type 1, 21 (42%) patients with CALR type 2, and 5 (10%) patients with none Type 1, none Type 2 CALR mutations. Two patients have double mutations; 1(2%) with none Type 1, none Type 2 CALR and JAK2 mutations, and 1(2%) with CALR type 1 and MPL mutations. The thrombotic events were 3 (6%) venous thromboembolisms, 3 (6%) abdominal veins thromboses, 2 (4%) strokes, and 4 (8%) ischemic cardiac events. Only 4 (8%) patients progressed to Myelofibrosis and were carrying CALR 1 mutations, and 1 (2%) patient progressed to AML with CALR 2 mutation.

Conclusion: The data shows a significant rise in CALR-positive MPN diagnoses in younger people, emphasizing the need for a better assessment tool to improve disease management and reduce complications.

背景:骨髓增殖性肿瘤(MPN)是一种血液病,其特征是由于基因突变导致骨髓细胞生成异常。自2013年以来,研究人员在两种费城染色体阴性的骨髓增殖性肿瘤(必需血小板增多症(ET)和原发性骨髓纤维化(PMF))中发现了钙粘蛋白(CALR)基因的体细胞突变,主要是插入或缺失,在慢性粒细胞白血病(CMML)中也偶有发现。本研究旨在确定各种类型的CALR突变及其对CALR阳性MPN患者临床表现和预后的影响:方法:进行了一项单中心回顾性研究。方法:这是一项单中心回顾性研究,数据来自已有记录。研究对象为费城阴性 MPN 患者,这些患者在 NCCCR(国家癌症护理和研究中心)接受随访,以评估临床表现和疾病治疗效果。所有纳入的患者均于2008年1月1日至2021年11月20日期间在本中心接受随访:共对 50 名 CALR 阳性 MPN 患者进行了随访,中位随访时间为三年(1-11 年)。其中包括31例(62%)ET患者、10例(20%)PMF患者和9例(18%)纤维化前骨髓纤维化(pre-MF)患者。研究涉及 38 名(76%)男性患者和 12 名(24%)女性患者。其中,16 名(32%)患者在 40 岁之前确诊,24 名(48%)患者在 40 至 60 岁之间确诊,10 名(20%)患者在 60 岁之后确诊。分子分析显示,24 名(48%)患者为 CALR 1 型,21 名(42%)患者为 CALR 2 型,5 名(10%)患者无 1 型和 2 型 CALR 突变。2名患者有双重突变;1人(2%)无1型、无2型CALR和JAK2突变,1人(2%)有1型CALR和MPL突变。血栓事件包括3例(6%)静脉血栓栓塞、3例(6%)腹腔静脉血栓、2例(4%)中风和4例(8%)缺血性心脏事件。只有4例(8%)患者进展为骨髓纤维化并携带CALR 1突变,1例(2%)患者进展为AML并携带CALR 2突变:数据显示,CALR阳性骨髓增生性疾病的诊断率在年轻人中明显上升,这说明需要一种更好的评估工具来改善疾病管理和减少并发症。
{"title":"The characteristics of <i>CALR</i> mutations in myeloproliferative neoplasms: a clinical experience from a tertiary care center in Qatar and a literature review.","authors":"Mostafa Najim, Mohammad Abu-Tineh, Awni Alshurafa, Mohamed Izham Mohamed Ibrahim, Soubiya Ansari, Hazem Faraj, Saif Alateeg, Susanna Jane Akiki, Mohamed A Yassin","doi":"10.1080/16078454.2024.2360246","DOIUrl":"https://doi.org/10.1080/16078454.2024.2360246","url":null,"abstract":"<p><strong>Background: </strong>Myeloproliferative neoplasms (MPNs) are hematological disorders characterized by abnormal production of myeloid cells due to genetic mutations. Since 2013, researchers have identified somatic mutations in the Calreticulin (CALR) gene, primarily insertions or deletions, in two Philadelphia chromosome-negative MPNs; essential thrombocytosis (ET) and primary myelofibrosis (PMF), and occasionally in chronic myelomonocytic leukemia (CMML). This study aims to identify the various types of CALR mutations and their impact on CALR-positive MPN patients' clinical manifestations and outcomes.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted. The data was collected from pre-existing records. The study was carried out on Philadelphia-negative MPN patients who were being followed up on at the NCCCR (National Center for Cancer Care and Research) to assess the clinical manifestation and outcome of disease treatment. All patients included, were followed in our center between January 1, 2008, and November 20, 2021.</p><p><strong>Results: </strong>A total of 50 patients with <i>CALR</i>-positive MPN were reviewed with a median follow-up of three years (1-11). This cohort included 31 (62%) patients with ET, 10 (20%) patients with PMF, and 9 (18%) patients with prefibrotic myelofibrosis (pre-MF). The study involved 38 (76%) male and 12 (24%) female patients. There were 16 (32%) patients diagnosed before the age of 40, 24 (48%) patients diagnosed between the ages of 40 and 60; and 10 (20%) patients diagnosed after the age of 60. Molecular analysis showed 24 (48%) patients with <i>CALR</i> type 1, 21 (42%) patients with <i>CALR</i> type 2, and 5 (10%) patients with none Type 1, none Type 2 <i>CALR</i> mutations. Two patients have double mutations; 1(2%) with none Type 1, none Type 2 <i>CALR</i> and <i>JAK2</i> mutations, and 1(2%) with <i>CALR</i> type 1 and <i>MPL</i> mutations. The thrombotic events were 3 (6%) venous thromboembolisms, 3 (6%) abdominal veins thromboses, 2 (4%) strokes, and 4 (8%) ischemic cardiac events. Only 4 (8%) patients progressed to Myelofibrosis and were carrying <i>CALR</i> 1 mutations, and 1 (2%) patient progressed to AML with <i>CALR</i> 2 mutation.</p><p><strong>Conclusion: </strong>The data shows a significant rise in CALR-positive MPN diagnoses in younger people, emphasizing the need for a better assessment tool to improve disease management and reduce complications.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"29 1","pages":"2360246"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158353","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}
引用次数: 0
Treatment of minimal residual disease in myeloid malignancies after allo-HSCT with venetoclax-based regimens in patients ineligible for or failed in the immunotherapy. 用基于 venetoclax 的方案治疗不符合免疫疗法条件或免疫疗法失败的髓系恶性肿瘤allo-HSCT 后的极小残留病。
IF 2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-12-01 Epub Date: 2024-11-12 DOI: 10.1080/16078454.2024.2418653
Wen-Jing Yu, Jun Kong, Feng-Mei Zheng, Xiao-Dong Mo, Xiao-Hui Zhang, Lan-Ping Xu, Yuan-Yuan Zhang, Yu-Qian Sun, Jian Jin, Xiao-Jun Huang, Yu Wang

Background: Relapse was the major cause of treatment failure in patients with myeloid malignancies after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients who still suffer from the disease while cannot be detected by morphological analysis can be identified by the minimal residual disease (MRD) monitoring. The most used first-line regimens for MRD are immunotherapies. However, for patients who were ineligible for or failed in first-line immunotherapies, options were limited.

Methods: A total of 20 patients with myeloid malignancies with recurrent MRD after allo-HSCT were included in this study. The safety and efficacy of venetoclax-based regimens were analyzed.

Results: There were 13 patients (65%) treated with venetoclax combined with hypomethylating agents concomitantly and seven patients (35%) treated with venetoclax monotherapy. After venetoclax-based regimens, MRD was eliminated in 11 patients (55%) with 6 subsequently developing recurrent MRD and 5 remaining in molecular remission. MRD declined in two patients (10%), and no responses in seven patients (35%). Among the two patients with declined MRD, one patient finally eliminated MRD after two cycles of the venetoclax-based regimen, and the other patient's MRD further declined after the second regimen. The objective response rate (ORR) was 65%. The median duration of response was 103 (12-313) days. The incidences of grades 3-4 neutropenia, anemia, and thrombocytopenia independently of pretreatment status were 30%, 20% and 20%, respectively.

Conclusion: Venetoclax-based regimens are efficient and safe for MRD in patients with myeloid malignancies ineligible for or failed in the first-line immunotherapies after allo-HSCT.

背景:复发是异基因造血干细胞移植(allo-HSCT)后髓系恶性肿瘤患者治疗失败的主要原因。形态学分析无法检测到的仍在患病的患者,可通过最小残留病(MRD)监测来识别。治疗MRD最常用的一线疗法是免疫疗法。然而,对于不符合一线免疫疗法条件或一线免疫疗法失败的患者来说,可供选择的方案非常有限:方法:本研究共纳入了20名接受allo-HSCT治疗后复发MRD的髓系恶性肿瘤患者。分析了基于 venetoclax 的治疗方案的安全性和有效性:结果:13名患者(65%)接受了venetoclax联合低甲基化药物同时治疗,7名患者(35%)接受了venetoclax单药治疗。采用文替曲塞治疗方案后,11 名患者(55%)的 MRD 消失,其中 6 名患者随后复发 MRD,5 名患者保持分子缓解。2名患者(10%)的MRD下降,7名患者(35%)无反应。在两名MRD下降的患者中,一名患者在接受了两个周期的基于venetoclax的方案治疗后最终消除了MRD,另一名患者在接受第二个方案治疗后MRD进一步下降。客观反应率(ORR)为65%。中位应答持续时间为103(12-313)天。与治疗前状态无关的3-4级中性粒细胞减少、贫血和血小板减少的发生率分别为30%、20%和20%:基于Venetoclax的治疗方案对于不符合条件或经allo-HSCT后一线免疫治疗失败的髓系恶性肿瘤患者的MRD治疗是有效和安全的。
{"title":"Treatment of minimal residual disease in myeloid malignancies after allo-HSCT with venetoclax-based regimens in patients ineligible for or failed in the immunotherapy.","authors":"Wen-Jing Yu, Jun Kong, Feng-Mei Zheng, Xiao-Dong Mo, Xiao-Hui Zhang, Lan-Ping Xu, Yuan-Yuan Zhang, Yu-Qian Sun, Jian Jin, Xiao-Jun Huang, Yu Wang","doi":"10.1080/16078454.2024.2418653","DOIUrl":"https://doi.org/10.1080/16078454.2024.2418653","url":null,"abstract":"<p><strong>Background: </strong>Relapse was the major cause of treatment failure in patients with myeloid malignancies after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Patients who still suffer from the disease while cannot be detected by morphological analysis can be identified by the minimal residual disease (MRD) monitoring. The most used first-line regimens for MRD are immunotherapies. However, for patients who were ineligible for or failed in first-line immunotherapies, options were limited.</p><p><strong>Methods: </strong>A total of 20 patients with myeloid malignancies with recurrent MRD after allo-HSCT were included in this study. The safety and efficacy of venetoclax-based regimens were analyzed.</p><p><strong>Results: </strong>There were 13 patients (65%) treated with venetoclax combined with hypomethylating agents concomitantly and seven patients (35%) treated with venetoclax monotherapy. After venetoclax-based regimens, MRD was eliminated in 11 patients (55%) with 6 subsequently developing recurrent MRD and 5 remaining in molecular remission. MRD declined in two patients (10%), and no responses in seven patients (35%). Among the two patients with declined MRD, one patient finally eliminated MRD after two cycles of the venetoclax-based regimen, and the other patient's MRD further declined after the second regimen. The objective response rate (ORR) was 65%. The median duration of response was 103 (12-313) days. The incidences of grades 3-4 neutropenia, anemia, and thrombocytopenia independently of pretreatment status were 30%, 20% and 20%, respectively.</p><p><strong>Conclusion: </strong>Venetoclax-based regimens are efficient and safe for MRD in patients with myeloid malignancies ineligible for or failed in the first-line immunotherapies after allo-HSCT.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"29 1","pages":"2418653"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619263","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}
引用次数: 0
When Chinese patients with plasma cell disorders encountered the nationwide Omicron outbreak (December 2022): a real-world multicenter and multiregional study. 当中国浆细胞疾病患者遭遇全国范围的 "欧米茄 "疫情爆发(2022 年 12 月)时:一项多中心、多区域的真实世界研究。
IF 2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-07 DOI: 10.1080/16078454.2024.2411741
Xincheng Jiang, Xiaoyan Han, Fengyan Jin, Gang An, Jian Hou, Jingsong He, Qingming Wang, Wenjun Wu, Yi Zhao, Songfu Jiang, Shuchan Li, Zhenshu Xu, Gaofeng Zheng, Yang Yang, Qingxiao Chen, Donghua He, Yi Li, Zhen Cai

Objectives: This study aims to assess the impact of the nationwide Omicron outbreak in December 2022 on Chinese patients with plasma cell disorders (PCD), focusing on the clinical characteristics of PCD patients with COVID-19 and the risk factors contributing to adverse clinical courses (severity and hospitalization) and outcomes.

Methods: A multicenter retrospective study was performed from December 1, 2022, to January 19, 2023. The study population includes 404 PCD patients, divided into a COVID-19 group (n = 342) and an uninfected group (n = 62).

Results: The frequency of COVID-19 infection was 84.7% (342/404), and 16.4% (56/342) were severe COVID-19. Among the 277 patients with complete follow-up, 2 deaths (0.7%) were reported, while 231 (83.4%) recovered from COVID-19. Age > 65 (P = 0.02) and prior anti-CD38 monoclonal antibody (mAb) treatment within six months (P = 0.03) were independent risk factors for severe infection. Additionally, previous chimeric antigen receptor T-cell (CAR-T) therapy within six months was correlated with a higher risk of hospitalization (P = 0.04) and prolonged recovery time (P = 0.03). No significant protective effect of vaccination on infection or severe infection was observed (P > 0.05).

Conclusions: The latest Omicron outbreak results in higher rates of severe infection and mortality in PCD patients compared with the general population in China, highlighting the need to protect this vulnerable population during the pandemic. Recent use of anti-CD38 mAb and CAR-T therapy are associated with poorer clinical courses and outcomes of PCD patients with COVID-19.

研究目的本研究旨在评估2022年12月在全国范围内爆发的Omicron疫情对中国浆细胞疾病(PCD)患者的影响,重点关注COVID-19型PCD患者的临床特征以及导致不良临床过程(严重程度和住院治疗)和结局的风险因素:多中心回顾性研究于2022年12月1日至2023年1月19日进行。研究对象包括404名PCD患者,分为COVID-19感染组(342人)和未感染组(62人):结果:COVID-19感染率为84.7%(342/404),其中16.4%(56/342)为重度COVID-19感染。在完成随访的 277 名患者中,有 2 人死亡(0.7%),231 人(83.4%)从 COVID-19 中康复。年龄大于 65 岁(P = 0.02)和曾在 6 个月内接受过抗 CD38 单克隆抗体 (mAb) 治疗(P = 0.03)是导致严重感染的独立风险因素。此外,6个月内接受过嵌合抗原受体T细胞(CAR-T)治疗与较高的住院风险(P = 0.04)和较长的恢复时间(P = 0.03)相关。接种疫苗对感染或严重感染没有明显的保护作用(P > 0.05):结论:与中国普通人群相比,最近一次奥米克龙疫情导致 PCD 患者的严重感染率和死亡率较高,这凸显了在大流行期间保护这一易感人群的必要性。最近使用的抗 CD38 mAb 和 CAR-T 疗法与 COVID-19 PCD 患者较差的临床病程和预后有关。
{"title":"When Chinese patients with plasma cell disorders encountered the nationwide Omicron outbreak (December 2022): a real-world multicenter and multiregional study.","authors":"Xincheng Jiang, Xiaoyan Han, Fengyan Jin, Gang An, Jian Hou, Jingsong He, Qingming Wang, Wenjun Wu, Yi Zhao, Songfu Jiang, Shuchan Li, Zhenshu Xu, Gaofeng Zheng, Yang Yang, Qingxiao Chen, Donghua He, Yi Li, Zhen Cai","doi":"10.1080/16078454.2024.2411741","DOIUrl":"10.1080/16078454.2024.2411741","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to assess the impact of the nationwide Omicron outbreak in December 2022 on Chinese patients with plasma cell disorders (PCD), focusing on the clinical characteristics of PCD patients with COVID-19 and the risk factors contributing to adverse clinical courses (severity and hospitalization) and outcomes.</p><p><strong>Methods: </strong>A multicenter retrospective study was performed from December 1, 2022, to January 19, 2023. The study population includes 404 PCD patients, divided into a COVID-19 group (<i>n</i> = 342) and an uninfected group (<i>n</i> = 62).</p><p><strong>Results: </strong>The frequency of COVID-19 infection was 84.7% (342/404), and 16.4% (56/342) were severe COVID-19. Among the 277 patients with complete follow-up, 2 deaths (0.7%) were reported, while 231 (83.4%) recovered from COVID-19. Age > 65 (<i>P </i>= 0.02) and prior anti-CD38 monoclonal antibody (mAb) treatment within six months (<i>P</i> = 0.03) were independent risk factors for severe infection. Additionally, previous chimeric antigen receptor T-cell (CAR-T) therapy within six months was correlated with a higher risk of hospitalization (<i>P </i>= 0.04) and prolonged recovery time (<i>P</i> = 0.03). No significant protective effect of vaccination on infection or severe infection was observed (<i>P </i>> 0.05).</p><p><strong>Conclusions: </strong>The latest Omicron outbreak results in higher rates of severe infection and mortality in PCD patients compared with the general population in China, highlighting the need to protect this vulnerable population during the pandemic. Recent use of anti-CD38 mAb and CAR-T therapy are associated with poorer clinical courses and outcomes of PCD patients with COVID-19.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"29 1","pages":"2411741"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380710","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}
引用次数: 0
The mediating effect of stigma on the relationship between fear of disease progression and social alienation in patients with haematological malignancies. 污名化对血液恶性肿瘤患者对疾病进展的恐惧与社会疏离之间关系的中介效应。
IF 2 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-12-01 Epub Date: 2024-10-28 DOI: 10.1080/16078454.2024.2416723
Dan Shi, Run Li, PeiXin Chen, JiaQing Zhong, KuiLi Wang, Dan Wang, HuiJuan Zhu

Objective: To explore the mediating effect of shame in patients with malignant haematological diseases between fear of disease progression and social alienation.

Methods: Recruiting 310 patients with haematological malignancies as the research population, the convenience sampling method was used to investigate the general information questionnaire, the fear of disease progression scale, the social influence scale and the general alienation scale.

Results: The patients with haematological malignancies scored (36.02 ± 9.74) points for fear of disease progression, (58.02 ± 9.52) points for stigma and (31.31 ± 5.85) points for social alienation. Social alienation in patients with haematologic malignancies was positively correlated with stigma (r = 0.500, P < 0.01) and fear of disease progression (r = 0.424, P < 0.01), and fear of disease progression was also positively correlated with stigma (r = 0.405, P < 0.01). Bootstrap test results showed that the mediating effect of stigma on the relationship between fear of disease progression and social alienation in patients with haematological malignancies was 0.159, accounting for 37.5% of the total effect.

Conclusion: The sense of shame plays an intermediary role between fear of disease progression and social alienation in patients with malignant haematological diseases. Clinical nurses should pay attention to the current situation of fear and shame in patients with such diseases and take appropriate intervention measures to reduce the occurrence of negative emotions such as social alienation.

目的探讨羞耻感在恶性血液病患者对疾病进展的恐惧和社会疏离感之间的中介作用:方法:以 310 名血液恶性肿瘤患者为研究对象,采用便利抽样法,对一般信息问卷、疾病进展恐惧量表、社会影响量表和一般疏离感量表进行调查:结果:血液恶性肿瘤患者对疾病进展的恐惧得分为(36.02±9.74)分,耻辱感得分为(58.02±9.52)分,社会疏离感得分为(31.31±5.85)分。血液恶性肿瘤患者的社会疏离感与耻辱感呈正相关(r = 0.500,P P P 结论:羞耻感在恶性血液病患者对疾病进展的恐惧和社会疏离感之间起着中介作用。临床护士应关注此类疾病患者的恐惧感和羞耻感现状,并采取适当的干预措施,减少社会疏离感等负面情绪的发生。
{"title":"The mediating effect of stigma on the relationship between fear of disease progression and social alienation in patients with haematological malignancies.","authors":"Dan Shi, Run Li, PeiXin Chen, JiaQing Zhong, KuiLi Wang, Dan Wang, HuiJuan Zhu","doi":"10.1080/16078454.2024.2416723","DOIUrl":"https://doi.org/10.1080/16078454.2024.2416723","url":null,"abstract":"<p><strong>Objective: </strong>To explore the mediating effect of shame in patients with malignant haematological diseases between fear of disease progression and social alienation.</p><p><strong>Methods: </strong>Recruiting 310 patients with haematological malignancies as the research population, the convenience sampling method was used to investigate the general information questionnaire, the fear of disease progression scale, the social influence scale and the general alienation scale.</p><p><strong>Results: </strong>The patients with haematological malignancies scored (36.02 ± 9.74) points for fear of disease progression, (58.02 ± 9.52) points for stigma and (31.31 ± 5.85) points for social alienation. Social alienation in patients with haematologic malignancies was positively correlated with stigma (r = 0.500, <i>P</i> < 0.01) and fear of disease progression (r = 0.424, <i>P</i> < 0.01), and fear of disease progression was also positively correlated with stigma (r = 0.405, <i>P</i> < 0.01). Bootstrap test results showed that the mediating effect of stigma on the relationship between fear of disease progression and social alienation in patients with haematological malignancies was 0.159, accounting for 37.5% of the total effect.</p><p><strong>Conclusion: </strong>The sense of shame plays an intermediary role between fear of disease progression and social alienation in patients with malignant haematological diseases. Clinical nurses should pay attention to the current situation of fear and shame in patients with such diseases and take appropriate intervention measures to reduce the occurrence of negative emotions such as social alienation.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"29 1","pages":"2416723"},"PeriodicalIF":2.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499426","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}
引用次数: 0
Combination of venetoclax and azacitidine in relapsed/refractory acute B-cell lymphoblastic leukemia: a case series from a single center. 复发/难治性急性B细胞淋巴细胞白血病患者联合使用venetoclax和阿扎胞苷:来自单一中心的病例系列。
IF 1.9 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-12-01 Epub Date: 2024-04-26 DOI: 10.1080/16078454.2024.2344998
Ziyi Hao, Yingying Fei, Juan Chen, Sailan Huang, Li Wang, Youhuan Yu, Meiru Bian, Yejun Si, Xingxia Zhang, Xiaotian Yang, Bing Zhang, Yan Wan, Yanming Zhang, Guoqiang Lin

Objectives: Relapsed/refractory acute B-cell lymphoblastic leukemia (R/R B-ALL) often responds poorly to induction chemotherapy. However, recent research has shown a novel and effective drug treatment for R/R B-ALL.

Methods: A total of eight patients with R/R B-ALL were enrolled in the study from November 2021 to August 2022. All patients received chemotherapy based on a combination regimen of venetoclax and azacitidine. The regimen was as follows venetoclax 100 mg d1, 200 mg d2, 400 mg d3-14, azacitidine 75 mg/m2 d1-7.

Results: Five of eight patients achieved very deep and complete remission (CR) with minimal residual disease (MRD) less than 0.1%. One patient achieved partial remission. Two patients did not achieve remission. There were no serious adverse events and all patients were well tolerated. Three patients were eligible for consolidation chemotherapy and were bridged to CAR-T therapy.

Conclusions: The combined regimen of venetoclax and azacitidine may be beneficial for patients with R/R B-ALL.

研究目的复发/难治性急性B细胞淋巴细胞白血病(R/R B-ALL)通常对诱导化疗反应不佳。然而,最近的研究显示了一种治疗 R/R B-ALL 的新型有效药物:方法:2021年11月至2022年8月,共有8名R/R B-ALL患者被纳入研究。所有患者均接受了基于文尼他克(venetoclax)和阿扎胞苷联合方案的化疗。方案如下 Venetoclax 100 mg d1、200 mg d2、400 mg d3-14,阿扎胞苷 75 mg/m2 d1-7:结果:8名患者中有5名获得深度完全缓解(CR),最小残留病灶(MRD)小于0.1%。一名患者获得部分缓解。两名患者未达到缓解。所有患者均无严重不良反应,耐受性良好。三名患者符合巩固化疗的条件,并接受了CAR-T疗法:结论:venetoclax和阿扎胞苷联合方案可能对R/R B-ALL患者有益。
{"title":"Combination of venetoclax and azacitidine in relapsed/refractory acute B-cell lymphoblastic leukemia: a case series from a single center.","authors":"Ziyi Hao, Yingying Fei, Juan Chen, Sailan Huang, Li Wang, Youhuan Yu, Meiru Bian, Yejun Si, Xingxia Zhang, Xiaotian Yang, Bing Zhang, Yan Wan, Yanming Zhang, Guoqiang Lin","doi":"10.1080/16078454.2024.2344998","DOIUrl":"https://doi.org/10.1080/16078454.2024.2344998","url":null,"abstract":"<p><strong>Objectives: </strong>Relapsed/refractory acute B-cell lymphoblastic leukemia (R/R B-ALL) often responds poorly to induction chemotherapy. However, recent research has shown a novel and effective drug treatment for R/R B-ALL.</p><p><strong>Methods: </strong>A total of eight patients with R/R B-ALL were enrolled in the study from November 2021 to August 2022. All patients received chemotherapy based on a combination regimen of venetoclax and azacitidine. The regimen was as follows venetoclax 100 mg d<sub>1</sub>, 200 mg d<sub>2</sub>, 400 mg d<sub>3-14,</sub> azacitidine 75 mg/m<sup>2</sup> d<sub>1-7</sub>.</p><p><strong>Results: </strong>Five of eight patients achieved very deep and complete remission (CR) with minimal residual disease (MRD) less than 0.1%. One patient achieved partial remission. Two patients did not achieve remission. There were no serious adverse events and all patients were well tolerated. Three patients were eligible for consolidation chemotherapy and were bridged to CAR-T therapy.</p><p><strong>Conclusions: </strong>The combined regimen of venetoclax and azacitidine may be beneficial for patients with R/R B-ALL.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"29 1","pages":"2344998"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854960","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}
引用次数: 0
A retrospective study of an irradiation-based conditioning regimen and chidamide maintenance therapy in T-ALL/LBL. 对T-ALL/LBL采用基于辐照的调理方案和利多酰胺维持疗法的回顾性研究。
IF 1.9 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-12-01 Epub Date: 2024-05-22 DOI: 10.1080/16078454.2024.2356300
Xueying Wang, Yan Deng, Guangcui He, Sihan Lai, Yecheng Li, Shan Zhang, Ying He, Ying Han, Lilan Zhang, Yi Su, Fang Liu, Hai Yi

Objectives: T-cell acute lymphoblastic leukemia/lymphoblastic lymphoma (T-ALL/LBL) are highly malignant and aggressive hematologic tumors for which there is no standard first-line treatment. Chidamide, a novel histone deacetylase inhibitor, shows great promise. We assessed the efficacy and safety of an irradiation-containing conditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) and post-transplantation chidamide maintenance in patients with T-ALL/LBL.

Methods: We retrospectively analyzed the clinical data of six patients with T-ALL/LBL who underwent allo-HSCT with a radiotherapy-containing pretreatment regimen and post-transplant chidamide maintenance therapy. The endpoints were relapse, graft-versus-host disease (GVHD), transplant-related mortality (TRM), progression-free survival (PFS), overall survival (OS), and adverse events (AEs).

Results: All of the patients had uneventful post-transplant hematopoietic reconstitution, and all achieved complete molecular remission within 30 days. All six patients survived, and two relapsed with a median relapse time of 828.5 (170-1335) days. The 1-year OS rate was 100%, the 2-year PFS rate was 66.7%, and the TRM rate was 0%. After transplantation, two patients developed grade I-II acute GVHD (2/6); grade III-IV acute and chronic GVHD were not observed. The most common AEs following chidamide administration were hematological AEs, which occurred to varying degrees in all patients; liver function abnormalities occurred in two patients (grade 2), and symptoms of malaise occurred in one patient (grade 1).

Conclusion: Chidamide maintenance therapy after T-ALL/LBL transplantation is safe, but the efficacy needs to be further investigated.

治疗目标T细胞急性淋巴细胞白血病/淋巴细胞淋巴瘤(T-ALL/LBL)是高度恶性的侵袭性血液肿瘤,目前尚无标准的一线治疗方法。新型组蛋白去乙酰化酶抑制剂 Chidamide 前景广阔。我们评估了T-ALL/LBL患者异基因造血干细胞移植(allo-HSCT)中含辐照的调理方案和移植后奇达胺维持治疗的有效性和安全性:我们回顾性分析了接受异基因造血干细胞移植(allo-HSCT)的6例T-ALL/LBL患者的临床数据,这些患者接受了含放疗的预处理方案和移植后的奇达酰胺维持治疗。研究终点为复发、移植物抗宿主病(GVHD)、移植相关死亡率(TRM)、无进展生存期(PFS)、总生存期(OS)和不良事件(AEs):结果:所有患者移植后造血重建顺利,并在30天内实现了完全分子缓解。六名患者全部存活,两名患者复发,中位复发时间为 828.5 (170-1335) 天。1年OS率为100%,2年PFS率为66.7%,TRM率为0%。移植后,两名患者出现了I-II级急性GVHD(2/6);未观察到III-IV级急性和慢性GVHD。服用利多酰胺后最常见的不良反应是血液学不良反应,所有患者都出现了不同程度的不良反应;2名患者出现肝功能异常(2级),1名患者出现乏力症状(1级):结论:T-ALL/LBL 移植后的氯达酰胺维持治疗是安全的,但疗效有待进一步研究。
{"title":"A retrospective study of an irradiation-based conditioning regimen and chidamide maintenance therapy in T-ALL/LBL.","authors":"Xueying Wang, Yan Deng, Guangcui He, Sihan Lai, Yecheng Li, Shan Zhang, Ying He, Ying Han, Lilan Zhang, Yi Su, Fang Liu, Hai Yi","doi":"10.1080/16078454.2024.2356300","DOIUrl":"https://doi.org/10.1080/16078454.2024.2356300","url":null,"abstract":"<p><strong>Objectives: </strong>T-cell acute lymphoblastic leukemia/lymphoblastic lymphoma (T-ALL/LBL) are highly malignant and aggressive hematologic tumors for which there is no standard first-line treatment. Chidamide, a novel histone deacetylase inhibitor, shows great promise. We assessed the efficacy and safety of an irradiation-containing conditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) and post-transplantation chidamide maintenance in patients with T-ALL/LBL.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of six patients with T-ALL/LBL who underwent allo-HSCT with a radiotherapy-containing pretreatment regimen and post-transplant chidamide maintenance therapy. The endpoints were relapse, graft-versus-host disease (GVHD), transplant-related mortality (TRM), progression-free survival (PFS), overall survival (OS), and adverse events (AEs).</p><p><strong>Results: </strong>All of the patients had uneventful post-transplant hematopoietic reconstitution, and all achieved complete molecular remission within 30 days. All six patients survived, and two relapsed with a median relapse time of 828.5 (170-1335) days. The 1-year OS rate was 100%, the 2-year PFS rate was 66.7%, and the TRM rate was 0%. After transplantation, two patients developed grade I-II acute GVHD (2/6); grade III-IV acute and chronic GVHD were not observed. The most common AEs following chidamide administration were hematological AEs, which occurred to varying degrees in all patients; liver function abnormalities occurred in two patients (grade 2), and symptoms of malaise occurred in one patient (grade 1).</p><p><strong>Conclusion: </strong>Chidamide maintenance therapy after T-ALL/LBL transplantation is safe, but the efficacy needs to be further investigated.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"29 1","pages":"2356300"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081237","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}
引用次数: 0
High- vs regular-dose recombinant human thrombopoietin plus cyclosporine A in patients with newly diagnosed non-severe aplastic anemia: a retrospective cohort study. 新诊断的非重度再生障碍性贫血患者使用大剂量与常规剂量重组人血小板生成素加环孢素 A:一项回顾性队列研究。
IF 1.9 4区 医学 Q3 HEMATOLOGY Pub Date : 2024-12-01 Epub Date: 2023-12-29 DOI: 10.1080/16078454.2023.2298523
Yuan Yang, Qinglin Hu, Chen Yang, Miao Chen, Bing Han

Background: Cyclosporine A (CsA) and regular doses of recombinant human thrombopoietin (rhTPO) can accelerate platelet recovery in patients with non-severe aplastic anemia (NSAA). However, it is unclear whether CsA plus rhTPO at a higher dose can further increase the efficacy.

Methods: Data from patients with newly diagnosed NSAA, who had been treated with CsA in combination with different doses of rhTPO between February 2021 and August 2021 at Peking Union Medical College Hospital, were reviewed. All the enrolled patients had been treated with CsA at 3-5 mg/(kg/d), and patients were further classified into high-dose (with rhTPO 30000U qd × 14 days for 2 months) group or regular-dose (with rhTPO 15000U qd × 7days for 3 months) group. The treatment response and therapy-related adverse events were compared.

Results: 36 patients including 16 (44.4%) in the high-dose and 20 (55.6%) in the regular-dose group were enrolled. The baseline characteristics were compatible between the two groups. The platelet counts were significantly higher at 1/3/6 months in the high-dose group (p = 0.028, 0.0063 and p = 0.040, respectively). The high-dose group had a significantly shorter time to platelet transfusion independence ([1 (0.5-6) months vs 2.5 (1-12) months, p = 0.040]). There was no significant difference in overall response and complete response rate between the two groups at 1/3/6/12 months (p > 0.05). Treatment-related morbidities were similar between the two groups (p > 0.05).

Conclusions: Adding a higher dose of rhTPO can further accelerate platelet recovery and platelet transfusion independence in patients with newly diagnosed NSAA.

背景:环孢素 A(CsA)和常规剂量的重组人血小板生成素(rhTPO)可加速非重型再生障碍性贫血(NSAA)患者的血小板恢复。然而,目前尚不清楚 CsA 加上更大剂量的 rhTPO 是否能进一步提高疗效:回顾性分析了北京协和医院 2021 年 2 月至 2021 年 8 月间新诊断的非重型再生障碍性贫血(NSAA)患者接受 CsA 联合不同剂量 rhTPO 治疗的数据。所有入组患者均接受了3-5 mg/(kg/d)的CsA治疗,并被进一步分为高剂量组(rhTPO 30000U qd × 14天,共2个月)和常规剂量组(rhTPO 15000U qd × 7天,共3个月)。比较了治疗反应和治疗相关不良事件:36 名患者入组,其中大剂量组 16 人(44.4%),常规剂量组 20 人(55.6%)。两组患者的基线特征一致。大剂量组在 1/3/6 个月时血小板计数明显更高(分别为 p = 0.028、0.0063 和 p = 0.040)。大剂量组独立输注血小板的时间明显更短([1 (0.5-6) 个月 vs 2.5 (1-12) 个月,p = 0.040])。在1/3/6/12个月时,两组的总体反应和完全反应率无明显差异(P > 0.05)。两组的治疗相关发病率相似(P > 0.05):结论:在新诊断为非甾体抗炎药的患者中,增加rhTPO的剂量可进一步加快血小板的恢复,并使患者不再需要输注血小板。
{"title":"High- vs regular-dose recombinant human thrombopoietin plus cyclosporine A in patients with newly diagnosed non-severe aplastic anemia: a retrospective cohort study.","authors":"Yuan Yang, Qinglin Hu, Chen Yang, Miao Chen, Bing Han","doi":"10.1080/16078454.2023.2298523","DOIUrl":"10.1080/16078454.2023.2298523","url":null,"abstract":"<p><strong>Background: </strong>Cyclosporine A (CsA) and regular doses of recombinant human thrombopoietin (rhTPO) can accelerate platelet recovery in patients with non-severe aplastic anemia (NSAA). However, it is unclear whether CsA plus rhTPO at a higher dose can further increase the efficacy.</p><p><strong>Methods: </strong>Data from patients with newly diagnosed NSAA, who had been treated with CsA in combination with different doses of rhTPO between February 2021 and August 2021 at Peking Union Medical College Hospital, were reviewed. All the enrolled patients had been treated with CsA at 3-5 mg/(kg/d), and patients were further classified into high-dose (with rhTPO 30000U qd × 14 days for 2 months) group or regular-dose (with rhTPO 15000U qd × 7days for 3 months) group. The treatment response and therapy-related adverse events were compared.</p><p><strong>Results: </strong>36 patients including 16 (44.4%) in the high-dose and 20 (55.6%) in the regular-dose group were enrolled. The baseline characteristics were compatible between the two groups. The platelet counts were significantly higher at 1/3/6 months in the high-dose group (<i>p</i> = 0.028, 0.0063 and <i>p</i> = 0.040, respectively). The high-dose group had a significantly shorter time to platelet transfusion independence ([1 (0.5-6) months vs 2.5 (1-12) months, <i>p</i> = 0.040]). There was no significant difference in overall response and complete response rate between the two groups at 1/3/6/12 months (<i>p</i> > 0.05). Treatment-related morbidities were similar between the two groups (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Adding a higher dose of rhTPO can further accelerate platelet recovery and platelet transfusion independence in patients with newly diagnosed NSAA.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"29 1","pages":"2298523"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139073891","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}
引用次数: 0
期刊
Hematology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1