Leukemia & Lymphoma最新文献

To assess the impact of imatinib compared to 2 G-TKIs on hemoglobin (Hb) in the long-lasting frontline treatment, 242 patients with chronic myeloid leukemia (CML) from 2 Centers still receiving frontline TKI after 5 years [186 (76.8%) imatinib and 56 (23.2%) 2 G-TKIs] were evaluated. Baseline rate of patients with mild/moderate anemia (Hb < 11 g/dl) was lower in those treated with imatinib (18.2% vs 35.7% with 2 G-TKIs, p = 0.006), while at the 60^th month became significantly higher in those treated with imatinib (15.6% vs 3.6% with 2 G-TKI, p = 0.018). Event-free and Overall Survival beyond the 60^th month in patients receiving imatinib with anemia at that time-point were significantly shorter than in patients without anemia (p < 0.001 and p = 0.002, respectively). Long-lasting treatment with imatinib caused late anemia in about 15% of patients at the 60^th month. This event, which seems very rare with 2 G-TKIs, affected survival and should be recognized in the long-term management of CML patients.

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been a cornerstone in the treatment of adult acute lymphoblastic leukemia (ALL). Its indications have evolved with the adoption of pediatric-inspired protocols, refined risk stratification based on minimal residual disease (MRD), the identification of high-risk genetic subtypes, and the emergence of novel immunotherapies. Agents such as blinatumomab and inotuzumab ozogamicin can induce deep remissions and increasingly challenge traditional transplant algorithms. Chimeric antigen receptor T cell (CAR T-cell) therapies further reshape post-relapse strategies, while advances in conditioning regimens and donor selection have broadened allo-HSCT applicability. Current evidence supports allo-HSCT in patients with high-risk features or persistent MRD, though its benefit is increasingly debated in MRD-negative responders. This review synthesizes evolving data on indications, timing, modalities, and outcomes of allo-HSCT in adult ALL and highlights the need for personalized, MRD and genomics-guided approaches to optimize cure while minimizing transplant-related risks in the immunotherapy era.

We aimed to analyze survival outcomes and failure patterns in stage I/II extranodal NK/T-cell lymphoma (ENKTCL) treated with involved site radiotherapy (ISRT) combined with asparaginase-containing chemotherapy regimens. Kaplan-Meier method was performed to calculate overall survival (OS) and progression-free survival (PFS). Univariate and multivariate Cox proportional hazards models were employed to identify independent prognostic factors for OS and PFS. The 2-year, 5-year OS and 2-year, 5-year PFS were 90.6%, 87.5% and 88.3%, 82.2%, respectively. Univariate and multivariate analyses identified primary tumor location, Lugano stage, and radiotherapy doses as prognostic factors for PFS. A total of 27 patients developed recurrence, 3 patients (1.8%) developed in-field recurrence, 3(1.8%) patients developed concurrent in-field and out-of-field recurrence and 21 (12.3%) patients developed out-of-field recurrence. The 5-year local recurrence-free rate of 96.5%. Patients with stage I/II ENKTCL treated with ISRT combined with asparaginase-containing chemotherapy regimens exhibit favorable prognoses.

Hairy cell leukemia (HCL) is an indolent B-cell malignancy characterized by distinctive morphologic features (hairy cytoplasmatic protrusions'hairy cells', HCs), cytopenia, and splenomegaly. Classical HCL is characterized by the BRAF^V600E mutation. Splenic B-Cell Lymphoma with Prominent Nucleoli (SBLPN) - previously known as HCL variant - lacks the BRAF^V600E mutation and shows a more aggressive clinical course. Current treatment approaches achieve remission rates above 95%, but high relapse rates highlight the necessity for tailored strategies. The unique dissemination profile of HCs into bone marrow, spleen, and blood, and their unusually low abundance in lymph nodes, indicates that HCs must have a particular interaction capacity with accessory cells and matrix proteins. However, the micro environmental interactions of HCs are incompletely understood. This review highlights the interaction between HCs and the tumor microenvironment, including T-cell dysfunction and hematopoietic inhibition due to cytokine production and bone marrow fibrosis, playing a crucial role in disease progression.

Multiple myeloma (MM) the second most frequent hematological malignancy is typically preceded by asymptomatic precursor stages. Genetic alterations alone do not fully explain disease progression, as many are already present in pre-malignant stages, highlighting the critical role of the bone marrow microenvironment (BMME) in supporting malignant transformation, disease progression, and therapy resistance. BMME provide survival cues, mediate adhesion-dependent drug resistance, and orchestrate cytokine networks that protect MM cells from therapeutic stress. Despite the advances made in the past two decades, MM is, in most cases, still an incurable disease. The rising use of T cell redirecting therapy (CAR-T cells and bispecific antibodies) has increased awareness on the importance of the immune microenvironment. In this paper we will review the role of the different components of the BMME putting them in the context of novel therapy, with a special focus on T-cell redirecting therapies, with a glance at future perspectives and developments.

This retrospective study analyzed EHR data from 2,736 adult MDS patients (IPSS-R risk >1.5), newly diagnosed between January 2011 and January 2021, evaluating characteristics, treatment patterns, and outcomes across IPSS-R categories within the US community oncology setting. Overall, 61.7% initiated 1 L treatment, with higher initiation in higher-risk (IPSS-R > 3) versus low-risk (IPSS-R ≤ 3) patients (74.2% vs. 35.5%). Monotherapy HMA predominated as 1 L therapy, used by 93.4% overall and 95.2% of higher-risk patients. Most discontinued 1 L, with few advancing to 2 L, indicating limited options beyond conventional treatments. Median OS was 22.5 versus 67.2 months for higher- versus low-risk patients, underscoring IPSS-R's prognostic value and poor survival in higher-risk profiles. Allogenic hematopoietic stem cell transplant utilization was low (∼10%) among a subset of higher-risk patients, reflecting eligibility and donor availability constraints. This study highlights real-world MDS treatment patterns and outcomes, emphasizing the need for novel therapies, especially for higher-risk MDS.