Leukemia & Lymphoma最新文献

Mantle cell lymphoma (MCL) is a rare and aggressive subtype of non-Hodgkin B-cell lymphoma that presents significant clinical management challenges. Recent advancements in treatment strategies, such as Bruton's tyrosine kinase inhibitors (BTKi), chimeric antigen receptor T-cell (CAR-T) therapy, and chemo-free regimens, have transformed the therapeutic landscape. This expert opinion article, based on insights from 14 experts worldwide, explores the evolving role of autologous stem cell transplantation (ASCT) in MCL management, and the treatment approaches for ASCT-ineligible patients. It discusses the benefits and limitations of emerging therapies, emphasizing personalized treatment approaches to optimize clinical outcomes. Tailoring strategies to individual patient profiles, considering genetic markers, comorbidities, and regional healthcare resources, is crucial. The evolving MCL landscape prioritizes personalized care, with BTKi emerging as an effective first-line option for ineligible ASCT patients and a robust alternative to ASCT. Global collaboration and knowledge sharing are essential to advance MCL treatment and ensure optimal care.

Pediatric Hodgkin's lymphoma has a very high cure rate; hence, there is a major focus on minimizing radiation therapy. This study examined the impact of omitting radiotherapy (RT) on patients with rapid early response (RER) and minimizing RT on patients with slow early response (SER). This study included all pediatric Hodgkin's lymphoma patients who were treated with a response-adapted approach (study group). They were compared to a historical cohort who received their treatment with both chemotherapy and classic involved field radiotherapy to all patients regardless of the response (control group). Patients with RER in both groups had excellent OS (100%), and comparable EFS (p = 0.556). Moreover, patients with SER in the two groups showed similar OS (p = 0.646) and EFS (p = 0.699). Omission of RTH may be considered in patients with RER; moreover, in patients with SER, minimizing RTH was not associated with inferior outcome in our study.

Patients newly diagnosed with acute leukemia or lymphoma face an immediate life-threatening condition and the need for rapidly initiated intensive therapy within specialized hematology settings. These circumstances can trigger significant psychological distress and post-traumatic stress symptoms (PTSS), which may influence treatment adherence, patient-clinician communication, and early clinical outcomes. A total of 68 patients with newly diagnosed acute leukemia or lymphoma completed validated questionnaires assessing PTSS and psychosocial risk factors at the time of diagnosis. PTSS were common, with 33% of participants reporting moderate-to-severe PTSS. Regression analyses identified practical difficulties (transportation, childcare, work/school, financial issues) and recent bereavements as risk factors for PTSS beyond age, gender, and diagnosis. These findings highlight the importance of early detection and management of PTSS for psychological care and may have direct clinical implications for overall hematologic care outcomes. Implementing systematic psychological screening at diagnosis could therefore improve patient-centered hematology care.

We retrospectively evaluated the efficacy and safety of zanubrutinib combined with age-adapted bendamustine and rituximab followed by zanubrutinib maintenance in 23 elderly patients with mantle cell lymphoma (MCL). Patients received six induction cycles of this regimen, followed by zanubrutinib maintenance for ≥2 years. After induction, the complete response rate was 73.9% and the overall response rate was 91.3%. The 24-month progression-free survival rate was 75.4% and the overall survival rate was 90.7%. Undetectable minimal residual disease (uMRD) was achieved in 88% of patients after induction and increased to 94% during maintenance. CD4 + T cell and NK cell counts declined to nadir post-induction but recovered by 12 months. Zanubrutinib combined with age-adapted bendamustine and rituximab, followed by zanubrutinib maintenance, is an active and feasible regimen for elderly patients with MCL, offering a potential treatment option in clinical practice.

This study evaluated changes in overall survival (OS) among patients diagnosed with AML from 2004 to 2019 using the National Cancer Database. The analysis included 67,895 patients aged ≥ 18 years, divided into three diagnosis eras: 2004-2010, 2011-2016, and 2017-2019. Median OS steadily improved over time: 7.6 months in 2004-2010, 8.6 months in 2011-2016, and 10.4 months in 2017-2019. The impact of age, AML subtype, chemotherapy, and HCT on OS changed over time, especially showing a stronger positive association with chemotherapy and HCT after 2017. OS remained lower in males, non-Hispanics, racial groups other than Black or White, individuals with a CCI> 0, those with public or no insurance, and those with an annual income <$35000. Our findings demonstrate that survival has improved significantly, coinciding with the introduction of venetoclax-based regimens and targeted therapies for FLT3 and IDH1/2 mutations, although disparities by socioeconomic factors persist.