Leukemia & Lymphoma最新文献

t(14;19)(q32;q13) is found in a fraction of chronic lymphocytic leukemia (CLL) patients and creates the IGH::BCL3 fusion gene, but this translocation has been observed in B-cell lymphomas other than CLL (non-CLL BLs). Ultra-high molecular weight DNA from liquid nitrogen-frozen leukemia cells of one CLL patient and OCT compound-embedded cryopreserved biopsies from two non-CLL BL patients, all of whom carried cytogenetic t(14;19), were subjected to optical genome mapping. In the CLL patient, t(14;19) resulted in fusion between IGHA1 and BCL3, whereas in the non-CLL BL patients, breakpoints on 19q13.32 involved NECTIN2 and BCAM as the IGH partners, both of which were located telomeric to BCL3. On der(19)t(14;19), chromosome 19 sequences centromeric to the breakpoints were fused to the germline IGHVs, or IGHV-D-J rearrangement sequences followed by the 5' Eµ enhancer and IGHM/IGHD constant genes. In the non-CLL BL patients, BCL3 was retained on der(19)t(14;19) and potentially affected by the translocated IGH.

Outcomes for adults with Philadelphia chromosome positive pre-B cell acute lymphoblastic leukemia (Ph + B-ALL) have improved dramatically, but questions remain regarding the optimal induction regimen and role of allogeneic hematopoietic cell transplantation (alloHCT). We analyzed 60 consecutive patients who received reduced-intensity (RII) or hyper-CVAD induction with continuous, second-generation tyrosine kinase inhibitors (TKIs). Reduced hematologic toxicity occurred after RII. Measurable residual disease (MRD) clearance by multicolor flow cytometry (MFC, 61 vs. 94%, p = 0.02) favored hyper-CVAD, but subsequent MRD-directed blinatumomab negated this difference. Four-year relapse-free survival (RFS) was 72.3% (95% confidence interval: 57.4-91.0%) and 79.8% (65.4-97.3%, p = 0.3) in RII and hyper-CVAD groups, respectively. AlloHCT, predominantly using reduced-intensity conditioning, bone marrow grafts, and post-transplant cyclophosphamide, was the only variable associated with improved overall survival on multivariate analysis. Concurrent chemotherapy and TKIs followed by blinatumomab for MRD positivity and alloHCT, all in less intensive forms, yield excellent outcomes for patients with Ph + B-ALL.

Chronic lymphocytic leukemia (CLL) exhibits heterogeneous clinical outcomes influenced by chromosomal aberrations and genetic mutations. NOTCH1 and SF3B1 mutations are critical prognostic markers linked to disease progression and therapy resistance. This study analyzed 60 CLL patients from Hiwa Hospital (Sulaymaniyah, Iraq). Hematological parameters were assessed, and genomic DNA was sequenced for NOTCH1 exon 34 and SF3B1 exons 15-16. In silico pathogenicity was predicted using I-Mutant and PolyPhen-2. Mutations were found in 23.3% of patients (14/60), including the recurrent NOTCH1 c.7541_7542delCT (p.P2514Rfs) (10%) and SF3B1 c.2098A > G (p.K700E) (6.6%). Two novel NOTCH1 variants (PX317668 and PX317669) were also identified. Mutated cases showed advanced Binet stages, elevated LDH, and reduced hemoglobin (HGB) and platelet (PLT) counts. These findings reveal a notable prevalence of NOTCH1 and SF3B1 mutations associated with adverse features, expanding the CLL mutational spectrum and offering valuable prognostic and therapeutic insights.

Use of dietary and herbal supplements (DHS) is common among patients with chronic lymphocytic leukemia (CLL), but data in the era of targeted therapies are limited. We conducted a national prospective survey of Hebrew-speaking adults with CLL in Israel (2025), assessing DHS prevalence, patterns of use, sources of recommendation, reporting to hematologists, and patient expectations. Multivariate logistic regression identified factors associated with DHS use. Among 267 respondents, 49% reported current or past DHS use. Use was independently associated with female gender and residence in Central Israel. Most DHS were used for general or 'immune' strengthening, with high perceived effectiveness. Hematologists were the main advisors for 42% of DHS use, and 65% of patients disclosed DHS use to their physician. DHS use is common among patients with CLL and involves relatively high patient-hematologist communication, underscoring the need for evidence-based integrative counseling.

This study aimed to identify the clinical characteristics, risk factors, and prognostic determinants of intracranial hemorrhage (ICH) in adult patients with acute leukemia (AL). We conducted a retrospective analysis of 3751 AL patients (aged ≥14 years) treated at our institution between 2010 and 2024. Independent risk factors for ICH included AL subtype, platelet count (PLT) <50 × 10⁹/L, leukocytosis (WBC >100 × 10⁹/L), elevated lactate dehydrogenase (LDH >245 IU/L), and prolonged prothrombin time (PT ≥3 s). The median overall survival (OS) in the ICH group was markedly shorter than in the NICH group (1.0 vs. 38.0 months, p < 0.001). Among non-APL patients, leukocytosis (WBC >100 × 10⁹/L), thrombocytopenia (PLT <50 × 10⁹/L), APTT prolongation ≥10 s, and increased D-dimer (DDI) level (≥9 μg/mL) were independent risk factors for ICH, while increased DDI level (≥9 μg/mL) was associated with poor prognosis. These findings emphasize the importance of early risk stratification and targeted interventions to reduce the risk of ICH.