Pub Date : 2024-08-08DOI: 10.1080/10428194.2024.2376166
Alexandra E Kovach, Daria Komova, Albert Itov, Maria Gaskova, Irina Kalinina, Kirill Voronin, Yulia Rumiantseva, Alexander Karachunskii, Michael Maschan, Alexey Maschan, Galina Novichkova, Yulia Olshanskaya, Deepa Bhojwani, Gordana Raca, Elena Zerkalenkova
In children, therapy-related hematologic neoplasms (t-HN) are uncommon. Many are driven by genetic events independent of clonal hematopoiesis. We sought to understand the clinical and genetic factors of pediatric t-HN in a large independent cohort. Fifty-six t-HN were retrospectively identified. Chromosome microarray, next-generation and/or RNA sequencing were performed. Patients had primary hematologic, solid, or central nervous system tumors. t-HN included myeloid (t-MN) and lymphoblastic (t-ALL) phenotypes. Approximately half of the cases harbored KMTA2A rearrangement (KMT2Ar). Among t-HN without KMT2Ar, genetic drivers were heterogeneous, including diverse fusions or aneuploidy. Approximately 18% harbored 17p deletions and/or TP53 mutations. EFS/OS was not associated with t-HN lineage or KMT2Ar, but HSCT was associated with improved EFS and OS. We detail one of the largest cohorts to date of pediatric t-HN, confirming frequent KMT2Ar and t-ALL.
{"title":"Pediatric therapy-related hematologic neoplasms show enrichment for <i>KMT2A</i> rearrangement and lymphoblastic phenotype.","authors":"Alexandra E Kovach, Daria Komova, Albert Itov, Maria Gaskova, Irina Kalinina, Kirill Voronin, Yulia Rumiantseva, Alexander Karachunskii, Michael Maschan, Alexey Maschan, Galina Novichkova, Yulia Olshanskaya, Deepa Bhojwani, Gordana Raca, Elena Zerkalenkova","doi":"10.1080/10428194.2024.2376166","DOIUrl":"https://doi.org/10.1080/10428194.2024.2376166","url":null,"abstract":"<p><p>In children, therapy-related hematologic neoplasms (t-HN) are uncommon. Many are driven by genetic events independent of clonal hematopoiesis. We sought to understand the clinical and genetic factors of pediatric t-HN in a large independent cohort. Fifty-six t-HN were retrospectively identified. Chromosome microarray, next-generation and/or RNA sequencing were performed. Patients had primary hematologic, solid, or central nervous system tumors. t-HN included myeloid (t-MN) and lymphoblastic (t-ALL) phenotypes. Approximately half of the cases harbored <i>KMTA2A</i> rearrangement (<i>KMT2A</i>r). Among t-HN without <i>KMT2A</i>r, genetic drivers were heterogeneous, including diverse fusions or aneuploidy. Approximately 18% harbored 17p deletions and/or <i>TP53</i> mutations. EFS/OS was not associated with t-HN lineage or <i>KMT2A</i>r, but HSCT was associated with improved EFS and OS. We detail one of the largest cohorts to date of pediatric t-HN, confirming frequent <i>KMT2A</i>r and t-ALL.</p>","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907005","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}
Previous studies have demonstrated that a low skeletal muscle mass (SMM) is an adverse factor for overall survival (OS) in diffuse large B-cell lymphoma (DLBCL). However, its association with the treatment response has not been extensively investigated. This study aimed to determine the association between low skeletal muscle mass (SMM) and treatment response in DLBCL patients. We conducted a retrospective cohort study of 123 patients with DLBCL, in whom SMM was assessed using computed tomography before chemotherapy administration. The demographic characteristics of the patients with low SMM and those with normal SMM were not statistically different. However, there were notable differences in weight and BMI; patients with low SMM had a lower mean weight (59.2 vs 63, p = 0.002) and a higher proportion of patients with normal BMI (61.5% vs. 21.1%, p < 0.001). In addition, patients with low SMM were more likely to receive R-CHOP-like treatment (21.2% vs. 7%, p = 0.022) and experienced more delays in administration (42.9% vs. 33.3%, p = 0.452). Low SMM was not associated with failure to achieve CR (HR 1.9; 95% CI [0.9-4.1] p = 0.84), but it was reported to risk OS in univariate analysis (HR 2.1; 95% CI [1.03-4.2], p = 0.041). An interesting result was the interaction of low SMM with hypertension as a risk factor for not achieving CR (HR 2.7; 95% CI [1.1-6.5] p = 0.034) or OS (HR 7.9; 95% CI [3.4-18.8] p < 0.001). Low SMM was not a risk factor for achieving CR in patients with DLBCL and seemed to play a role in OS.
以往的研究表明,骨骼肌质量(SMM)过低是影响弥漫大B细胞淋巴瘤(DLBCL)患者总生存期(OS)的不利因素。然而,其与治疗反应的关系尚未得到广泛研究。本研究旨在确定低骨骼肌质量(SMM)与弥漫性大B细胞淋巴瘤患者治疗反应之间的关系。我们对123名DLBCL患者进行了回顾性队列研究,在化疗前使用计算机断层扫描评估了他们的骨骼肌质量。低SMM患者和正常SMM患者的人口统计学特征没有统计学差异。然而,体重和体重指数有显著差异;低SMM患者的平均体重较低(59.2 vs. 63,p = 0.002),体重指数正常的患者比例较高(61.5% vs. 21.1%,p = 0.022),且用药延迟时间较长(42.9% vs. 33.3%,p = 0.452)。低 SMM 与未能达到 CR 无关(HR 1.9;95% CI [0.9-4.1],p = 0.84),但据报道,在单变量分析中,低 SMM 会给 OS 带来风险(HR 2.1;95% CI [1.03-4.2],p = 0.041)。一个有趣的结果是,低 SMM 与高血压的交互作用是未达到 CR(HR 2.7;95% CI [1.1-6.5],p = 0.034)或 OS(HR 7.9;95% CI [3.4-18.8],p = 0.034)的风险因素。
{"title":"Association between skeletal muscle mass and treatment response in patients with diffuse large B-cell lymphoma.","authors":"Junice Teresita Sosa-Romero, Lilia Castillo-Martínez, Jesús Alejandro Gabutti-Thomas, Gladys Patricia Agreda-Vásquez","doi":"10.1080/10428194.2024.2386591","DOIUrl":"10.1080/10428194.2024.2386591","url":null,"abstract":"<p><p>Previous studies have demonstrated that a low skeletal muscle mass (SMM) is an adverse factor for overall survival (OS) in diffuse large B-cell lymphoma (DLBCL). However, its association with the treatment response has not been extensively investigated. This study aimed to determine the association between low skeletal muscle mass (SMM) and treatment response in DLBCL patients. We conducted a retrospective cohort study of 123 patients with DLBCL, in whom SMM was assessed using computed tomography before chemotherapy administration. The demographic characteristics of the patients with low SMM and those with normal SMM were not statistically different. However, there were notable differences in weight and BMI; patients with low SMM had a lower mean weight (59.2 vs 63, <i>p</i> = 0.002) and a higher proportion of patients with normal BMI (61.5% vs. 21.1%, <i>p</i> < 0.001). In addition, patients with low SMM were more likely to receive R-CHOP-like treatment (21.2% vs. 7%, <i>p</i> = 0.022) and experienced more delays in administration (42.9% vs. 33.3%, <i>p</i> = 0.452). Low SMM was not associated with failure to achieve CR (HR 1.9; 95% CI [0.9-4.1] <i>p</i> = 0.84), but it was reported to risk OS in univariate analysis (HR 2.1; 95% CI [1.03-4.2], <i>p</i> = 0.041). An interesting result was the interaction of low SMM with hypertension as a risk factor for not achieving CR (HR 2.7; 95% CI [1.1-6.5] <i>p</i> = 0.034) or OS (HR 7.9; 95% CI [3.4-18.8] <i>p</i> < 0.001). Low SMM was not a risk factor for achieving CR in patients with DLBCL and seemed to play a role in OS.</p>","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875268","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}
Pub Date : 2024-08-01Epub Date: 2024-04-27DOI: 10.1080/10428194.2024.2338849
Jingbo Yu, James Nelson, Taylor Marlin, Evan Braunstein, Michelle Jerry
Myeloproliferative neoplasms (MPNs) are associated with substantial healthcare resource use and productivity loss. This retrospective cohort analysis used disability leave and medical claims data to measure direct and indirect healthcare costs associated with MPNs. The analysis included 173 patients with myelofibrosis (MF), 4477 with polycythemia vera (PV), 6061 with essential thrombocythemia (ET), and matched controls (n = 519, n = 13,431, and n = 18,183, respectively). Total healthcare costs were significantly higher for cases versus controls in each cohort (mean cost difference: MF, $67,456; PV, $10,970; ET, $22,279). Cases were more likely than controls to take disability leave and incurred higher disability-related costs. Among subgroups with thrombotic events, direct and indirect costs were higher for cases versus controls. Thrombotic events substantially increased direct costs and disability leave for patients with PV or ET compared with the full PV or ET cohorts. These findings demonstrate increased economic burden for patients with MPNs.
{"title":"Direct and indirect costs for patients with myeloproliferative neoplasms.","authors":"Jingbo Yu, James Nelson, Taylor Marlin, Evan Braunstein, Michelle Jerry","doi":"10.1080/10428194.2024.2338849","DOIUrl":"10.1080/10428194.2024.2338849","url":null,"abstract":"<p><p>Myeloproliferative neoplasms (MPNs) are associated with substantial healthcare resource use and productivity loss. This retrospective cohort analysis used disability leave and medical claims data to measure direct and indirect healthcare costs associated with MPNs. The analysis included 173 patients with myelofibrosis (MF), 4477 with polycythemia vera (PV), 6061 with essential thrombocythemia (ET), and matched controls (<i>n</i> = 519, <i>n</i> = 13,431, and <i>n</i> = 18,183, respectively). Total healthcare costs were significantly higher for cases versus controls in each cohort (mean cost difference: MF, $67,456; PV, $10,970; ET, $22,279). Cases were more likely than controls to take disability leave and incurred higher disability-related costs. Among subgroups with thrombotic events, direct and indirect costs were higher for cases versus controls. Thrombotic events substantially increased direct costs and disability leave for patients with PV or ET compared with the full PV or ET cohorts. These findings demonstrate increased economic burden for patients with MPNs.</p>","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858450","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}
Pub Date : 2024-08-01Epub Date: 2024-05-14DOI: 10.1080/10428194.2024.2343778
Seena Cherian, Lisa Modelevsky, Anne S Reiner, Christian Grommes
{"title":"Treatment of methotrexate-refractory primary central nervous system lymphoma (PCNSL) at Memorial Sloan Kettering Cancer Center.","authors":"Seena Cherian, Lisa Modelevsky, Anne S Reiner, Christian Grommes","doi":"10.1080/10428194.2024.2343778","DOIUrl":"10.1080/10428194.2024.2343778","url":null,"abstract":"","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922611","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}
To evaluate the effects of gene mutations on Bruton tyrosine kinase inhibitor, zanubrutinib's effectiveness in patients with diffuse large B-cell lymphoma (DLBCL), we examined pooled data from four single-arm studies (BGB-3111-AU-003 [NCT02343120], BGB-3111-207 [NCT03145064], BGB-3111_GA101_Study_001 [NCT02569476], BGB-3111-213 [NCT03520920]; n = 121). Objective response rate (ORR) was higher, though not statistically significant, in patients with activated B-cell-like (ABC)- and unclassified DLBCL (42.9% [21/49]) versus those with germinal-center B-cell-like DLBCL (14.3% [1/7]; p = 0.15). Patients with CD79B mutations had better ORR (60%) versus patients with wild-type alleles (25.9%, p < 0.01). Higher TCL1A expression correlated with better zanubrutinib response (p = 0.03), longer progression-free survival (p = 0.01), and longer overall survival (p = 0.12). TCL1A expression was higher in ABC-DLBCL (p < 0.001) and MYD88/CD79B-mutated subtypes (p < 0.0001). Eighteen patients with high MYC/BCL-2 expression responded better to zanubrutinib (ORR = 61 vs. 29%, p = 0.02). Our results support assessing CD79B mutations, co-expressor DLBCL, and TCL1A expression status to identify patients with DLBCL who will benefit from zanubrutinib.
{"title":"Zanubrutinib is effective in non-germinal-center B-cell-like diffuse large B-cell lymphoma with mutated <i>CD79B</i>, high <i>TCL1A</i> expression, or over- expressed MYC/BCL-2.","authors":"Yang Liu, Xiaopeng Ma, Xikun Wu, Xinfeng Hou, Wei Jin, Lina Fu, Xiaolei Xun, Yiling Yu, Zhirong Shen","doi":"10.1080/10428194.2024.2343779","DOIUrl":"10.1080/10428194.2024.2343779","url":null,"abstract":"<p><p>To evaluate the effects of gene mutations on Bruton tyrosine kinase inhibitor, zanubrutinib's effectiveness in patients with diffuse large B-cell lymphoma (DLBCL), we examined pooled data from four single-arm studies (BGB-3111-AU-003 [NCT02343120], BGB-3111-207 [NCT03145064], BGB-3111_GA101_Study_001 [NCT02569476], BGB-3111-213 [NCT03520920]; <i>n</i> = 121). Objective response rate (ORR) was higher, though not statistically significant, in patients with activated B-cell-like (ABC)- and unclassified DLBCL (42.9% [21/49]) versus those with germinal-center B-cell-like DLBCL (14.3% [1/7]; <i>p</i> = 0.15). Patients with <i>CD79B</i> mutations had better ORR (60%) versus patients with wild-type alleles (25.9%, <i>p</i> < 0.01). Higher <i>TCL1A</i> expression correlated with better zanubrutinib response (<i>p</i> = 0.03), longer progression-free survival (<i>p</i> = 0.01), and longer overall survival (<i>p</i> = 0.12). <i>TCL1A</i> expression was higher in ABC-DLBCL (<i>p</i> < 0.001) and <i>MYD88</i>/<i>CD79B</i>-mutated subtypes (<i>p</i> < 0.0001). Eighteen patients with high MYC/BCL-2 expression responded better to zanubrutinib (ORR = 61 <i>vs.</i> 29%, <i>p</i> = 0.02). Our results support assessing <i>CD79B</i> mutations, co-expressor DLBCL, and <i>TCL1A</i> expression status to identify patients with DLBCL who will benefit from zanubrutinib.</p>","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076200","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}
Pub Date : 2024-08-01DOI: 10.1080/10428194.2024.2381647
Charalampos Charalampous, Kimberley Doucette, Aimee Chappell, David H Vesole
{"title":"Venetoclax-based induction therapy for primary plasma cell leukemia with high BCL-2 expression.","authors":"Charalampos Charalampous, Kimberley Doucette, Aimee Chappell, David H Vesole","doi":"10.1080/10428194.2024.2381647","DOIUrl":"https://doi.org/10.1080/10428194.2024.2381647","url":null,"abstract":"","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875269","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}
Pub Date : 2024-08-01Epub Date: 2024-03-27DOI: 10.1080/10428194.2024.2333451
Jorge Cortes, Brian A Jonas, Gary Schiller, Alice Mims, Gail J Roboz, Andrew H Wei, Pau Montesinos, P Brent Ferrell, Karen Wl Yee, Pierre Fenaux, Anthony Schwarer, Justin M Watts
Olutasidenib, a potent, selective, oral, mutant isocitrate dehydrogenase 1 (mIDH1) inhibitor, is FDA-approved for relapsed/refractory (R/R) acute myeloid leukemia (AML). Here we report efficacy and safety of olutasidenib in 18 patients with mIDH1 AML who were relapsed (10), refractory (6) or had complete remission with incomplete hematologic recovery (CRi; 2) to a venetoclax combination. Of the 16 patients who were R/R, 4 (25%) achieved complete remission (CR), one (6.3%) achieved CR with partial hematologic recovery (CRh), and 7 (43.8%) achieved a composite complete remission (CRc). Median time to CRc was 1.9 months (range 1-2.8). As of data cutoff (18 June 2021), median duration of CRc was not reached (range, 1.2-NR, ongoing at 30.4+ months). Both patients with CRi at study entry achieved a CR. Safety was consistent with the overall profile of olutasidenib. Olutasidenib offers a valuable treatment option for patients with mIDH1 AML previously treated with venetoclax.
{"title":"Olutasidenib in post-venetoclax patients with mutant isocitrate dehydrogenase 1 (m<i>IDH1</i>) acute myeloid leukemia (AML).","authors":"Jorge Cortes, Brian A Jonas, Gary Schiller, Alice Mims, Gail J Roboz, Andrew H Wei, Pau Montesinos, P Brent Ferrell, Karen Wl Yee, Pierre Fenaux, Anthony Schwarer, Justin M Watts","doi":"10.1080/10428194.2024.2333451","DOIUrl":"10.1080/10428194.2024.2333451","url":null,"abstract":"<p><p>Olutasidenib, a potent, selective, oral, mutant isocitrate dehydrogenase 1 (mIDH1) inhibitor, is FDA-approved for relapsed/refractory (R/R) acute myeloid leukemia (AML). Here we report efficacy and safety of olutasidenib in 18 patients with m<i>IDH1</i> AML who were relapsed (10), refractory (6) or had complete remission with incomplete hematologic recovery (CRi; 2) to a venetoclax combination. Of the 16 patients who were R/R, 4 (25%) achieved complete remission (CR), one (6.3%) achieved CR with partial hematologic recovery (CRh), and 7 (43.8%) achieved a composite complete remission (CRc). Median time to CRc was 1.9 months (range 1-2.8). As of data cutoff (18 June 2021), median duration of CRc was not reached (range, 1.2-NR, ongoing at 30.4+ months). Both patients with CRi at study entry achieved a CR. Safety was consistent with the overall profile of olutasidenib. Olutasidenib offers a valuable treatment option for patients with m<i>IDH1</i> AML previously treated with venetoclax.</p>","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140306107","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}
Pub Date : 2024-07-31DOI: 10.1080/10428194.2024.2385501
Eli Zolotov, Maciej Kabat, Harsh Parmar, Palka Anand, Joshua Zenreich, Adolfo Aleman, Pooja Phull, Kimberly Doucette, David H Vesole, David S Siegel, Noa Biran
Patients with high-risk multiple-myeloma (HRMM) and ultra-high-risk multiple-myeloma (UHRMM) show rapid disease progression and shorter survival compared to those with standard-risk multiple-myeloma (SRMM). Lenalidomide maintenance after autologous stem cell transplant (ASCT) has shown inferior outcomes in this subgroup compared to SRMM, and there is an unmet need for improved post-ASCT therapy. This retrospective study, from September 2016 to March 2023, assesses elotuzumab combined with lenalidomide or pomalidomide and dexamethasone (ERd or EPd) as consolidation therapy post-ASCT for HRMM and UHRMM patients. HRMM (1 cytogenetic abnormality) and UHRMM (≥2 cytogenetic abnormalities) were defined using IMWG and mSMART criteria. Among 75 patients (median age: 64 years), 59 received ERd and 16 EPd. Median progression-free survival was 29.3 months for all patients, 32.7 months for HRMM, and 21.9 months for UHRMM. Elotuzumab plus an IMiD consolidation therapy post-ASCT demonstrated promising efficacy compared to other studies, with a fixed duration and reduced lenalidomide-related toxicity.
{"title":"Post-ASCT consolidation with elotuzumab, lenalidomide, and dexamethasone or elotuzumab, pomalidomide, and dexamethasone in high-risk and ultra-high-risk multiple myeloma: a retrospective single-center study.","authors":"Eli Zolotov, Maciej Kabat, Harsh Parmar, Palka Anand, Joshua Zenreich, Adolfo Aleman, Pooja Phull, Kimberly Doucette, David H Vesole, David S Siegel, Noa Biran","doi":"10.1080/10428194.2024.2385501","DOIUrl":"https://doi.org/10.1080/10428194.2024.2385501","url":null,"abstract":"<p><p>Patients with high-risk multiple-myeloma (HRMM) and ultra-high-risk multiple-myeloma (UHRMM) show rapid disease progression and shorter survival compared to those with standard-risk multiple-myeloma (SRMM). Lenalidomide maintenance after autologous stem cell transplant (ASCT) has shown inferior outcomes in this subgroup compared to SRMM, and there is an unmet need for improved post-ASCT therapy. This retrospective study, from September 2016 to March 2023, assesses elotuzumab combined with lenalidomide or pomalidomide and dexamethasone (ERd or EPd) as consolidation therapy post-ASCT for HRMM and UHRMM patients. HRMM (1 cytogenetic abnormality) and UHRMM (≥2 cytogenetic abnormalities) were defined using IMWG and mSMART criteria. Among 75 patients (median age: 64 years), 59 received ERd and 16 EPd. Median progression-free survival was 29.3 months for all patients, 32.7 months for HRMM, and 21.9 months for UHRMM. Elotuzumab plus an IMiD consolidation therapy post-ASCT demonstrated promising efficacy compared to other studies, with a fixed duration and reduced lenalidomide-related toxicity.</p>","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855864","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}
Pub Date : 2024-07-31DOI: 10.1080/10428194.2024.2371500
Yixuan Li, Qi Sheng, Jiayao Li, Wenyu Liu, Li Ma, Lei Han, Juan He, Ting Zhao, Yuning Chu
Findings regarding the relationship between sarcopenia and lymphoma have been inconsistent across studies. This study investigated the association between sarcopenia and lymphoma. We systematically searched the Embase, Science Direct, Cochrane Library, and PubMed databases from inception to 31 March 2024 to identify relevant studies. Two researchers independently extracted and evaluated studies that met inclusion and exclusion criteria. Twenty-six studies with 3659 participants were included. Sarcopenic lymphoma patients had poor overall survival (OS) (HR = 1.88; 95% CI: 1.47-2.41; p < 0.001). The heterogeneity was high (I2=80%). However, the result of the Egger test indicated a significant publication bias (p < 0.001). After employing the trim and fill method to adjust for this bias, the HR of OS became non-significant (p > 0.05). The progression-free survival (PFS) was worse in sarcopenic patients (HR = 1.77; 95% CI: 1.37-2.29; p < 0.001; I2=70%). There was no significant publication bias (p > 0.05). In the subgroup analyses, sarcopenia was a negative predictor of OS in lymphoma patients who undergo hematopoietic cell transplantation (HCT) (HR = 1.61;95% CI: 1.19-2.18; I2=30%). Male lymphoma patients with sarcopenia had a significantly worse OS (HR = 2.29; 95% CI:1.24-4.24; p = 0.009). Among patients with primary central nervous system lymphoma (PCNSL), those with sarcopenia defined by temporal muscle thickness (TMT) exhibited significantly worse OS (HR = 2.20; 95% CI:1.04-4.65; p = 0.039; I2=68%). Sarcopenia is associated with worse PFS in lymphoma patients. Subgroup analyses indicate that sarcopenia is a negative predictor of OS after HCT, and male lymphoma patients who suffer from sarcopenia have higher mortality. Sarcopenia defined by TMT is also a negative predictor of OS for patients with PCNSL.
{"title":"Sarcopenia is a prognostic factor in lymphoma patients: a systematic review and meta-analysis.","authors":"Yixuan Li, Qi Sheng, Jiayao Li, Wenyu Liu, Li Ma, Lei Han, Juan He, Ting Zhao, Yuning Chu","doi":"10.1080/10428194.2024.2371500","DOIUrl":"https://doi.org/10.1080/10428194.2024.2371500","url":null,"abstract":"<p><p>Findings regarding the relationship between sarcopenia and lymphoma have been inconsistent across studies. This study investigated the association between sarcopenia and lymphoma. We systematically searched the Embase, Science Direct, Cochrane Library, and PubMed databases from inception to 31 March 2024 to identify relevant studies. Two researchers independently extracted and evaluated studies that met inclusion and exclusion criteria. Twenty-six studies with 3659 participants were included. Sarcopenic lymphoma patients had poor overall survival (OS) (HR = 1.88; 95% CI: 1.47-2.41; <i>p</i> < 0.001). The heterogeneity was high (I<sup>2</sup>=80%). However, the result of the Egger test indicated a significant publication bias (<i>p</i> < 0.001). After employing the trim and fill method to adjust for this bias, the HR of OS became non-significant (<i>p</i> > 0.05). The progression-free survival (PFS) was worse in sarcopenic patients (HR = 1.77; 95% CI: 1.37-2.29; <i>p</i> < 0.001; I<sup>2</sup>=70%). There was no significant publication bias (<i>p</i> > 0.05). In the subgroup analyses, sarcopenia was a negative predictor of OS in lymphoma patients who undergo hematopoietic cell transplantation (HCT) (HR = 1.61;95% CI: 1.19-2.18; I<sup>2</sup>=30%). Male lymphoma patients with sarcopenia had a significantly worse OS (HR = 2.29; 95% CI:1.24-4.24; <i>p</i> = 0.009). Among patients with primary central nervous system lymphoma (PCNSL), those with sarcopenia defined by temporal muscle thickness (TMT) exhibited significantly worse OS (HR = 2.20; 95% CI:1.04-4.65; <i>p</i> = 0.039; I<sup>2</sup>=68%). Sarcopenia is associated with worse PFS in lymphoma patients. Subgroup analyses indicate that sarcopenia is a negative predictor of OS after HCT, and male lymphoma patients who suffer from sarcopenia have higher mortality. Sarcopenia defined by TMT is also a negative predictor of OS for patients with PCNSL.</p>","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860194","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}