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Time to diagnosis and treatment in lymphoma and implications for health-related outcomes: a systematic review. 淋巴瘤的诊断和治疗时间及其对健康相关结果的影响:一项系统综述
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2025-12-30 DOI: 10.1080/10428194.2025.2598663
Priyanka G Vithanage, Meena Rafiq, Allison Drosdowsky, Georgia Ramsay, Carole Smith, Karen E Lamb, Jon Emery

Timely diagnosis and treatment are important in lymphoma care. This systematic review examined articles published up to April 2025 which reported intervals from symptom onset to treatment initiation and a subset examining associations with health-related outcomes. Of 11,606 articles screened, 67 were included (23 reported associations). Significant heterogeneity was noted, with 27 intervals reported across various lymphoma subtypes. Methodological issues included poor reporting of interval variability, small sample sizes, and arbitrary interval categorization. Commonly reported intervals included symptom onset to diagnosis (articles; median range), (27; 26-217 days), symptom onset to first presentation (23; 9-91 days), first presentation to diagnosis (17; 15-126 days), and diagnosis to treatment start (25; 1-42 days). Most association studies considered treatment interval and survival, finding inconsistencies. Only few examined the length of diagnostic or patient interval impacts on health outcomes. Future research should apply the Aarhus Checklist - a tool designed to enhance precision and transparency in early cancer diagnosis research to improve the consistency and quality of interval reporting. Further, non-linear interval-survival associations should be explored to capture paradoxical effects.

及时诊断和治疗是淋巴瘤护理的重要内容。本系统综述研究了截至2025年4月发表的文章,这些文章报道了从症状发作到治疗开始的时间间隔,并研究了与健康相关结果的关联。在筛选的11,606篇文章中,67篇被纳入(23篇报道有关联)。注意到显著的异质性,在不同的淋巴瘤亚型中有27个间隔。方法学问题包括区间变异性报告不佳、样本量小和任意区间分类。通常报告的时间间隔包括症状发作至诊断(文章;中位数范围)、(27;26-217天)、症状发作至首次出现(23;9-91天)、首次出现至诊断(17;15-126天)、诊断至治疗开始(25;1-42天)。大多数关联研究考虑了治疗间隔和生存,发现不一致。只有少数研究考察了诊断或患者间隔时间的长短对健康结果的影响。未来的研究应该应用Aarhus Checklist——一种旨在提高早期癌症诊断研究的准确性和透明度的工具,以提高间隔报告的一致性和质量。此外,应该探索非线性生存期关联以捕获矛盾效应。
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引用次数: 0
Axicabtagene ciloleucel demonstrates superior outcomes over historically available treatments in relapsed/refractory follicular lymphoma: 5-year comparative analysis between ZUMA-5 and SCHOLAR-5. Axicabtagene ciloleucel在治疗复发/难治性滤泡性淋巴瘤方面的疗效优于历史上可用的治疗方法:ZUMA-5和SCHOLAR-5的5年比较分析
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2025-12-30 DOI: 10.1080/10428194.2025.2604306
John G Gribben, M Lia Palomba, Eve Limbrick-Oldfield, Madhu Palivela, Steve Kanters, Alana M Stilla, Caron A Jacobson, Sattva S Neelapu, Olga Nikolajeva, Jiali H Yan, Markqayne D Ray, Paola Ghione
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引用次数: 0
T-cell/histiocyte-rich large B-cell lymphoma, insights into prognosis and treatment complexity in the context of immunotherapeutics. t细胞/组织细胞丰富的大b细胞淋巴瘤,在免疫治疗背景下的预后和治疗复杂性的见解。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2025-12-29 DOI: 10.1080/10428194.2025.2607549
Mostafa F Mohammed Saleh, Ahmed Kotb, Abdullah Alamer, Abdulwahab A Albabtain, Mahmoud Aljurf, Riad El Fakih

T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a rare and biologically distinct subtype of diffuse large B-cell lymphoma (DLBCL). It is marked by rare neoplastic B-cells within a prominent inflammatory microenvironment. Historically it was associated with poor prognosis but contemporary reports show outcomes comparable if not better than DLBCL-NOS, especially with the use of chemo-immunotherapies. Autologous stem cell transplantation (auto-HCT) demonstrated favorable progression-free and overall survival in relapsed patients in comparison to matched DLBCL cohorts. The efficacy of CD19-directed CAR T-cell therapy in THRLBCL has been limited, with high relapse rates and poor durability of response, likely due to an immunosuppressive tumor microenvironment characterized by PD-1/PD-L1 pathway activation. Several case series and translational studies support the use of immune checkpoint blockade in selected patients, although prospective validation is needed. While bispecific antibodies, tafasitamab-lenalidomide, and antibody-drug conjugates show promise in R/R DLBCL, THRLBCL patients remain underrepresented in these pivotal trials. This review summarizes current insights into the prognosis of THRLBCL and underscores the need for novel, biologically informed strategies to improve outcomes in the relapsed setting through a deeper understanding of its biology and immune evasion mechanisms.

t细胞/组织细胞丰富的大b细胞淋巴瘤(THRLBCL)是弥漫性大b细胞淋巴瘤(DLBCL)的一种罕见且生物学上独特的亚型。它的特点是在一个突出的炎症微环境中有罕见的肿瘤b细胞。从历史上看,它与预后不良有关,但当代报告显示,结果与DLBCL-NOS相当,如果不是更好,特别是使用化学免疫疗法。与匹配的DLBCL队列相比,自体干细胞移植(auto-HCT)在复发患者中显示出有利的无进展和总生存期。cd19靶向CAR - t细胞治疗THRLBCL的疗效有限,复发率高,反应持久性差,可能是由于PD-1/PD-L1通路激活的免疫抑制肿瘤微环境。一些病例系列和转化研究支持在选定的患者中使用免疫检查点阻断,尽管需要前瞻性验证。虽然双特异性抗体、他法西他单抗-来那度胺和抗体-药物偶联物在R/R DLBCL中显示出希望,但在这些关键试验中,THRLBCL患者的代表性仍然不足。这篇综述总结了目前对THRLBCL预后的见解,并强调需要通过更深入地了解其生物学和免疫逃避机制来改善复发患者的预后。
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引用次数: 0
Treatment kinetics and local response during and after bridging radiotherapy prior to CAR-T cell therapy for lymphomas. CAR-T细胞治疗淋巴瘤前桥接放疗期间和之后的治疗动力学和局部反应。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2025-12-26 DOI: 10.1080/10428194.2025.2602880
Daniella Klebaner, Natalie J Park, Mallika Marar, Matthew Frank, Susan M Hiniker, Richard T Hoppe, Joseph Schroers-Martin, Ranjana H Advani, Ash A Alizadeh, Sushma Bharadwaj, David Miklos, Saurabh Dahiya, Michael Sargent Binkley

Bridging radiotherapy (BR) prior to CAR-T for non-Hodgkin lymphoma (NHL) can achieve durable cytoreduction, but optimal dosing remains undefined. We evaluated correlates of local progression (LP) among 33 patients (25 large B-cell lymphoma [LBCL], 8 Mantle Cell Lymphoma [MCL]) with relapsed/refractory NHL who received BR at our institution. Using image-guided radiotherapy (IGRT), we defined 'rapid bridging response' (RBR) as ≥10% volume reduction within 5 fractions. We estimated the cumulative incidence of LP with death as a competing risk. Five of 19 LBCL and 5/7 MCL patients with IGRT experienced RBR. LP occurred in 6 patients (all LBCL, 18-month cumulative incidence 19%), none of whom had RBR, and was increased for tumors with metabolic tumor volume > 100 mL. Among LBCL patients, median volume change during radiation for tumors with LP was 0% vs -4% for those without. Histology, radiomic features, and real-time radiotherapy response may guide a personalized approach to BR.

CAR-T治疗非霍奇金淋巴瘤(NHL)之前的桥接放疗(BR)可以实现持久的细胞减少,但最佳剂量仍未确定。我们评估了33例复发/难治性NHL患者(25例大b细胞淋巴瘤[LBCL], 8例套细胞淋巴瘤[MCL])局部进展(LP)的相关因素,这些患者在我们机构接受了BR治疗。使用图像引导放疗(IGRT),我们将“快速桥接反应”(RBR)定义为5个分数内体积减少≥10%。我们估计LP的累积发生率与死亡为竞争风险。19例LBCL和5/7接受IGRT的MCL患者中有5例发生RBR。6例患者发生LP(均为LBCL, 18个月累计发病率19%),均无RBR,代谢性肿瘤体积bbb100 mL时LP发生率增高。在LBCL患者中,LP肿瘤在放疗期间的中位体积变化为0%,而无LP肿瘤的中位体积变化为-4%。组织学、放射学特征和实时放疗反应可以指导BR的个性化治疗方法。
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引用次数: 0
Relapsed/refractory mycosis fungoides and Sezary syndrome: biology, clinical manifestations and therapeutic options. 复发/难治性蕈样真菌病和seary综合征:生物学、临床表现和治疗选择。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2025-12-25 DOI: 10.1080/10428194.2025.2598662
Friyana Bhabha, H Miles Prince, Belinda Campbell, Carrie Van Der Weyden, XiaoJing Ong, Joshua Casan, Christopher McCormack

Primary cutaneous T-cell lymphomas (CTCL) are a rare and heterogeneous group, associated with significant morbidity and mortality. Mycosis fungoides (MF), the most common subtype, typically follows an indolent course, whereas Sézary syndrome (SS) is a leukemic and aggressive variant. Treatment strategies for MF are diverse, stage-dependent, and individualized to the patient. While early-stage disease can be effectively managed with skin-directed therapies, advanced or relapsed/refractory disease is associated with a poorer prognosis and frequently necessitates multiple sequential therapies. Current systemic therapeutic options include immunomodulatory drugs, targeted therapies, and chemotherapy, and are aimed at achieving disease control rather than disease cure. Presently, the only potentially curative treatment option is allogeneic stem-cell transplantation. Regional variation in drug access impacts treatment decisions, whilst the evolving landscape of novel agents continues to challenge current paradigms. This review discusses the underlying biology, clinical features, current and emerging therapeutic strategies for relapsed or refractory MF/SS.

原发性皮肤t细胞淋巴瘤(CTCL)是一种罕见且异质性的肿瘤,具有显著的发病率和死亡率。蕈样真菌病(MF)是最常见的亚型,通常是惰性病程,而ssamzary综合征(SS)是一种白血病和侵袭性变体。MF的治疗策略是多种多样的,依赖于阶段,并对患者个性化。虽然早期疾病可以通过皮肤定向治疗有效地管理,但晚期或复发/难治性疾病的预后较差,通常需要多次序贯治疗。目前的系统治疗方案包括免疫调节药物、靶向治疗和化疗,目的是实现疾病控制,而不是治愈疾病。目前,唯一可能治愈的治疗选择是同种异体干细胞移植。药物可及性的区域差异影响治疗决策,而新型药物的发展前景继续挑战当前的范例。本文综述了复发或难治性MF/SS的潜在生物学、临床特征、当前和新兴的治疗策略。
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引用次数: 0
Reclassifying T-cell lymphomas in human T-lymphotropic virus 1 carriers: a familial case of adult T-cell leukemia/lymphoma with diagnostic and pathogenetic implications. 人类嗜t淋巴病毒1携带者t细胞淋巴瘤的重新分类:一例具有诊断和病理意义的成人t细胞白血病/淋巴瘤家族性病例
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2025-12-25 DOI: 10.1080/10428194.2025.2606948
Christos Stafylidis, Eleftheria Lakiotaki, Niki Rougala, Nefeli Giannakopoulou, Sevastianos Chatzidavid, Nora-Athina Viniou, Eleni Variami, Panagiotis Diamantopoulos
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引用次数: 0
Reduced dose and shorter duration venetoclax regimens are effective for newly diagnosed acute myeloid leukemia patients not considered fit for intensive treatment. 减少剂量和缩短疗程的venetoclax方案是有效的新诊断急性髓系白血病患者认为不适合强化治疗。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2025-12-25 DOI: 10.1080/10428194.2025.2604566
Satoko Oka, Yuina Ueda-Akagi, Takaya Mitsuyoshi, Kazuo Ono

We classified 45 AML patients not considered fit for intensive treatment into 3 groups: standard dose VEN (Group A), shorter duration of VEN (Group B), and dose reduction of VEN (Group C). CRc rates were 58, 73, and 72% in Groups A, B, and C, respectively. EFS and OS were significantly shorter in Group A than in Groups B and C. The incidence of FN and severe neutropenia was lower in Groups B (73% and 27%) and C (78% and 44%) than in Group A (92% and 67%). The number of treatment cycles was lower in Group A (7.5) than in Groups B (10.2) and C (15.5). The present study showed that shortening the duration and reducing the dose of VEN may reduce the risk of complications and be as effective as standard dose VEN for the treatment of AML patients not considered fit for intensive treatment.

我们将45例不适合强化治疗的AML患者分为3组:标准剂量VEN (A组),较短时间VEN (B组)和减少VEN剂量(C组)。A组、B组和C组的结直肠癌发生率分别为58%、73%和72%。A组EFS和OS明显短于B组和C组。FN和严重中性粒细胞减少的发生率B组(73%和27%)和C组(78%和44%)低于A组(92%和67%)。A组治疗周期数(7.5)低于B组(10.2)和C组(15.5)。本研究表明,对于不适合强化治疗的AML患者,缩短VEN持续时间和减少VEN剂量可以降低并发症的风险,并且与标准剂量VEN一样有效。
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引用次数: 0
Cord blood versus bone marrow/peripheral blood stem cell transplantation under reduced-intensity conditioning in high-risk acute myeloid leukemia and myelodysplastic syndromes. 低强度条件下脐带血与骨髓/外周血干细胞移植在高危急性髓性白血病和骨髓增生异常综合征中的对比
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2025-12-25 DOI: 10.1080/10428194.2025.2604565
Kaito Harada, Shino Iwata, Shunsuke Tomita, Miina Nasukawa, Shinichi Tsunoda, Sawako Shiraiwa, Ryujiro Hara, Hidetsugu Kawai, Daisuke Ogiya, Rikio Suzuki, Masako Toyosaki, Shinichiro Machida, Ken Omachi, Yoshiaki Ogawa, Hiroshi Kawada, Makoto Onizuka

Cord blood transplantation (CBT) is an alternative donor option for patients lacking suitable matched donors, particularly in high-risk acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS). We retrospectively analyzed 76 adults undergoing reduced-intensity conditioning allogeneic transplantation using one of five donor types: CBT with ultra-low-dose methotrexate (uldMTX; n = 47), matched related donor (MRD), matched unrelated donor (MUD), mismatched unrelated donor (MMUD), or mismatched related donor (MMRD) (n = 29 across the four donor types). Two-year overall survival (OS) with uldMTX-CBT (58.8%) was significantly superior to MRD, MUD, and MMRD transplantation, with similar patterns for disease-free survival (DFS). In multivariate analyses, CBT remained independently associated with improved OS and DFS. Neutrophil and platelet recovery were comparable across donor types, as were the incidences of graft-versus-host disease and non-relapse mortality. These findings indicate that CBT provides a safe and effective donor platform with competitive outcomes across diverse alternative donor settings in high-risk AML/MDS.

脐带血移植(CBT)是缺乏合适匹配供体的患者的替代供体选择,特别是在高风险急性髓性白血病(AML)或骨髓增生异常综合征(MDS)中。我们回顾性分析了76名接受低强度调节同种异体移植的成人,他们使用五种供体类型之一:CBT加超低剂量甲氨蝶呤(uldMTX, n = 47),匹配相关供体(MRD),匹配非相关供体(MUD),错配非相关供体(MMUD),或错配相关供体(MMRD)(四种供体类型中n = 29)。uldMTX-CBT的两年总生存率(OS)(58.8%)显著优于MRD、MUD和MMRD移植,无病生存(DFS)模式相似。在多变量分析中,CBT仍然与改善的OS和DFS独立相关。不同供体类型的中性粒细胞和血小板恢复具有可比性,移植物抗宿主病的发生率和非复发死亡率也具有可比性。这些发现表明,CBT提供了一个安全有效的供体平台,在高风险AML/MDS的不同替代供体设置中具有竞争性结果。
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引用次数: 0
Donor-derived acute myeloid leukemia after solid organ transplant: evidence for leukemic stem cell transmission. 实体器官移植后供体来源的急性髓系白血病:白血病干细胞传递的证据。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2025-12-23 DOI: 10.1080/10428194.2025.2604563
Alok Swaroop, Timothy Oh, Kristy Wolniak, Madina Sukhanova, Xinyan Lu, Jessica K Altman, Yasmin Abaza
{"title":"Donor-derived acute myeloid leukemia after solid organ transplant: evidence for leukemic stem cell transmission.","authors":"Alok Swaroop, Timothy Oh, Kristy Wolniak, Madina Sukhanova, Xinyan Lu, Jessica K Altman, Yasmin Abaza","doi":"10.1080/10428194.2025.2604563","DOIUrl":"https://doi.org/10.1080/10428194.2025.2604563","url":null,"abstract":"","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":" ","pages":"1-4"},"PeriodicalIF":2.2,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145819871","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
Prognostic impact of procarbazine in R-MPV followed by reduced-dose whole-brain radiotherapy and cytarabine for primary central nervous system lymphoma. 原卡嗪对R-MPV后小剂量全脑放疗和阿糖胞苷治疗原发性中枢神经系统淋巴瘤预后的影响。
IF 2.2 4区 医学 Q3 HEMATOLOGY Pub Date : 2025-12-22 DOI: 10.1080/10428194.2025.2604305
Shuhei Matsumoto, Yuya Kurihara, Yasutaka Masuda, Katsuhiko Nara, Mitsuhiro Yuasa, Akira Honda, Tappei Takada, Mineo Kurokawa

The R-MPV regimen-comprising rituximab, methotrexate, procarbazine (PCZ), and vincristine-followed by reduced-dose whole-brain radiotherapy and high-dose cytarabine, is an established treatment for primary central nervous system lymphoma (PCNSL). However, PCZ is occasionally omitted due to adverse events, and its prognostic impact remains unclear. Among 91 patients with PCNSL treated at our institution between 2008 and 2020, we analyzed 60 adults who completed the R-MPV regimen. The 5-year progression-free survival (PFS) rate for the entire cohort was 67.6%. PCZ was discontinued in 17 of the 60 patients. The 5-year PFS rate was significantly higher in patients who completed PCZ compared with those who discontinued it (81.2% vs. 46.3%; p = 0.00487). PCZ discontinuation was associated with inferior PFS in both univariable and multivariable analyses. These findings suggest that maintaining the full PCZ dose during R-MPV treatment may be critical for achieving favorable survival outcomes in patients with PCNSL.

R-MPV方案包括利妥昔单抗、甲氨喋呤、丙卡嗪(PCZ)和长春新碱,然后是低剂量全脑放疗和高剂量阿糖胞苷,是原发性中枢神经系统淋巴瘤(PCNSL)的一种既定治疗方法。然而,由于不良事件,PCZ偶尔被忽略,其预后影响尚不清楚。在我们机构2008年至2020年间治疗的91例PCNSL患者中,我们分析了60例完成R-MPV方案的成年人。整个队列的5年无进展生存率(PFS)为67.6%。60例患者中有17例停用PCZ。完成PCZ治疗的患者的5年PFS率明显高于停止PCZ治疗的患者(81.2% vs 46.3%; p = 0.00487)。在单变量和多变量分析中,停用PCZ与较差的PFS相关。这些研究结果表明,在R-MPV治疗期间保持完整的PCZ剂量可能对PCNSL患者获得有利的生存结果至关重要。
{"title":"Prognostic impact of procarbazine in R-MPV followed by reduced-dose whole-brain radiotherapy and cytarabine for primary central nervous system lymphoma.","authors":"Shuhei Matsumoto, Yuya Kurihara, Yasutaka Masuda, Katsuhiko Nara, Mitsuhiro Yuasa, Akira Honda, Tappei Takada, Mineo Kurokawa","doi":"10.1080/10428194.2025.2604305","DOIUrl":"https://doi.org/10.1080/10428194.2025.2604305","url":null,"abstract":"<p><p>The R-MPV regimen-comprising rituximab, methotrexate, procarbazine (PCZ), and vincristine-followed by reduced-dose whole-brain radiotherapy and high-dose cytarabine, is an established treatment for primary central nervous system lymphoma (PCNSL). However, PCZ is occasionally omitted due to adverse events, and its prognostic impact remains unclear. Among 91 patients with PCNSL treated at our institution between 2008 and 2020, we analyzed 60 adults who completed the R-MPV regimen. The 5-year progression-free survival (PFS) rate for the entire cohort was 67.6%. PCZ was discontinued in 17 of the 60 patients. The 5-year PFS rate was significantly higher in patients who completed PCZ compared with those who discontinued it (81.2% vs. 46.3%; <i>p</i> = 0.00487). PCZ discontinuation was associated with inferior PFS in both univariable and multivariable analyses. These findings suggest that maintaining the full PCZ dose during R-MPV treatment may be critical for achieving favorable survival outcomes in patients with PCNSL.</p>","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804985","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
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Leukemia & Lymphoma
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