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Diagnostic and prognostic relevance of RAF1 gene in acute myeloid leukemia 急性髓系白血病中RAF1基因的诊断和预后相关性
IF 0.7 Q4 HEMATOLOGY Pub Date : 2025-01-01 Epub Date: 2025-07-10 DOI: 10.1016/j.lrr.2025.100528
Seyedeh Kosar Rahimpour , Yasin Mirazimi , Seyedeh Zahra Shahrokhi , Mohammad Sayyadi , Maryam Kargar , Mohammad Rafiee
Acute Myeloid Leukemia (AML) demands precise diagnostic and prognostic tools for accurate detection and personalized-treatment strategies. Using Real-Time PCR, we investigated the RAF1, miR-146 b-3p, and Circ-RPL15 network expression in AML. Because RAF1 is a crucial gene involved in various ways, it is considered a potential biomarker for prognosis and diagnosis. While no significant correlation was found within the network, RAF1 expression showed a marked difference between groups. ROC curve analysis for RAF1 demonstrated promising diagnostic performance, and our bioinformatics investigations supported its strong prognostic potential. Identifying such biomarkers can aid in developing better management based on patients' characteristics.
急性髓性白血病(AML)需要精确的诊断和预后工具来准确检测和个性化治疗策略。使用Real-Time PCR,我们研究了RAF1、miR-146 b-3p和Circ-RPL15网络在AML中的表达。由于RAF1是一个以多种方式参与的关键基因,因此被认为是预后和诊断的潜在生物标志物。虽然网络内部没有发现明显的相关性,但RAF1的表达在组间有显著差异。RAF1的ROC曲线分析显示了有希望的诊断性能,我们的生物信息学调查支持其强大的预后潜力。识别这些生物标记物有助于根据患者特征制定更好的管理方法。
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引用次数: 0
Trans-differentiation of plasma cell neoplasm to acute myeloid leukemia with monocytic features: Case report of divergent phenotype with identical genotype 浆细胞肿瘤向具有单核细胞特征的急性髓系白血病的反分化:基因型相同但表型不同的病例报告
IF 0.7 Q4 HEMATOLOGY Pub Date : 2025-01-01 Epub Date: 2025-02-17 DOI: 10.1016/j.lrr.2025.100504
Saja Asakrah , Kristin K. Deeb , Nikolaos Papadantonakis , George Deeb
Myeloid malignancies following treatment for plasma cell neoplasms (PCN) are infrequent but is a serious complication, often exhibiting complex karyotype and TP53 mutations. Plasma cell myeloma lineage switch to a myeloid malignancy with evident clonal relatedness is seldomly reported. Here, we report a unique case of acute myeloid leukemia with monocytic differentiation that shares clonal features with an antecedent plasma cell myeloma with t(4;14)(FGFR3::IGH). This phenomenon differs from therapy-related myeloid neoplasm arising from an unrelated clone and underscores the need to elucidate the role of mutations in pathways such as MAPK (e.g., BRAF and KRAS) into lineage plasticity.
浆细胞肿瘤(PCN)治疗后出现髓系恶性肿瘤并不常见,但却是一种严重的并发症,通常表现为复杂的核型和TP53突变。浆细胞骨髓瘤谱系转换为髓系恶性肿瘤与明显的克隆相关性很少报道。在这里,我们报告了一例独特的单核细胞分化急性髓性白血病,其克隆特征与先前的t(4;14)浆细胞骨髓瘤(FGFR3::IGH)相同。这种现象不同于由不相关克隆引起的治疗相关髓系肿瘤,强调了阐明MAPK(例如BRAF和KRAS)等通路突变在谱系可塑性中的作用的必要性。
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引用次数: 0
Proteasome inhibitors prevent tumor cell proliferation in HHV-8-unrelated PEL-like lymphoma 蛋白酶体抑制剂阻止hhv -8无关的pel样淋巴瘤的肿瘤细胞增殖。
IF 0.7 Q4 HEMATOLOGY Pub Date : 2025-01-01 Epub Date: 2024-12-19 DOI: 10.1016/j.lrr.2024.100497
Kiyotaka Kawauchi , Toshie Ogasawara
Primary effusion lymphoma (PEL)-like lymphoma is a rare variant of PEL that exhibits diverse clinical behaviors, ranging from mild to aggressive disease courses. The clinicopathological features and effective treatments for this type of lymphoma have not been well defined. We found that proteasome inhibitors were effective in inhibiting the growth and survival of OGU1 cells, which were derived from a patient with aggressive PEL-like lymphoma, highlighting the critical role of proteasome activity in the proliferation of PEL-like lymphoma cells. This suggests that proteasome inhibitors, such as bortezomib, could be promising therapeutic options for patients who respond poorly to conventional chemotherapy.
原发性积液性淋巴瘤(PEL)样淋巴瘤是一种罕见的PEL变体,其临床表现多样,从轻度到侵袭性病程不等。该类型淋巴瘤的临床病理特征和有效治疗尚未明确。我们发现蛋白酶体抑制剂可以有效抑制OGU1细胞的生长和存活,OGU1细胞来源于侵袭性pel样淋巴瘤患者,这突出了蛋白酶体活性在pel样淋巴瘤细胞增殖中的关键作用。这表明蛋白酶体抑制剂,如硼替佐米,可能是对传统化疗反应不良的患者的有希望的治疗选择。
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引用次数: 0
Impact of non-coding RNAs on resistance to imatinib in chronic myelogenous leukemia 非编码rna对慢性粒细胞白血病伊马替尼耐药的影响
IF 0.7 Q4 HEMATOLOGY Pub Date : 2025-01-01 Epub Date: 2025-07-10 DOI: 10.1016/j.lrr.2025.100529
Fatemeh Ensafi Talemi , Soudeh Ghafouri-Fard
Imatinib is approved as the first-line treatment for newly diagnosed chronic myelogenous leukemia (CML). In spite of profound response in the majority of patients, resistance occurs in a subgroup of CML cases. Recently, it has been demonstrated that different classes of non-coding RNAs can modulate response to this tyrosine kinase inhibitor. Recognition of the role of these transcripts in this process not only expands our knowledge about the molecular mechanisms of imatinib resistance, but also provides novel strategies for combating this phenotype. The current review summarizes the role of non-coding RNAs in this process and suggests novel candidates for further studies in this field to enhance therapeutic response to imatinib.
伊马替尼被批准为新诊断的慢性粒细胞白血病(CML)的一线治疗药物。尽管在大多数患者中有深刻的反应,但耐药性发生在CML病例的一个亚组中。最近,已经证明不同种类的非编码rna可以调节对这种酪氨酸激酶抑制剂的反应。认识到这些转录本在这一过程中的作用不仅扩大了我们对伊马替尼耐药分子机制的认识,而且为对抗这种表型提供了新的策略。本文总结了非编码rna在这一过程中的作用,并提出了该领域进一步研究的新候选物,以提高对伊马替尼的治疗反应。
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引用次数: 0
Pediatric-inspired (R3) vs. Adult salvage (FA) chemotherapy in relapsed adolescents and young adults (AYA) acute lymphoblastic leukemia (ALL): A comparative outcome analysis 儿科启发(R3)与成人挽救(FA)化疗治疗复发的青少年和年轻人(AYA)急性淋巴细胞白血病(ALL):一项比较结果分析
IF 0.9 Q4 HEMATOLOGY Pub Date : 2025-01-01 Epub Date: 2025-10-03 DOI: 10.1016/j.lrr.2025.100548
Chokri Ben Lamine , Mohammed Alshehri , Lara Samhan , Maha Abdullah Hassan , Tusneem Ahmed M. Elhassan , Riad Elfakih , Feras Abdulaziz Alfraih , Syed Osman Ahmed , Amr Hanbali

Background

Relapsed acute lymphoblastic leukemia (ALL) in adolescents and young adults (AYA) remains a high-risk scenario with limited evidence guiding optimal salvage regimens. Pediatric-inspired protocols have improved frontline outcomes in AYA-ALL, yet their applicability in relapse remains undefined.

Objective

To compare the clinical efficacy and toxicity of the pediatric-based UKALL R3 protocol versus the adult salvage fludarabine/cytarabine (FA) regimen in relapsed Philadelphia-negative AYA-ALL.

Methods

A retrospective cohort study was conducted at a single tertiary care center including 77 patients aged 14–40 years with relapsed AYA-ALL. Seventeen patients received the R3 regimen and sixty received the FA protocol. Primary endpoints included complete remission (CR) rate and overall survival (OS). Secondary endpoints assessed minimal residual disease (MRD) response, transplantation rates, and treatment-related toxicities.

Results

Baseline characteristics were comparable, though the FA cohort had older patients and higher-risk cytogenetics. CR rates were 60 % in R3 versus 76.3 % in FA (p=0.1). Median follow-up of 4 years showed numerically superior OS with R3 (53 % vs. 30.8 %, p=0.8). Toxicities varied: febrile neutropenia and hepatotoxicity were more frequent with FA, while mucositis and peripheral neuropathy predominated in R3. Infection-related deaths occurred less often in R3 (12.5 % vs. 25 %).

Conclusion

The pediatric-inspired R3 and adult-based FA regimens yielded similar survival and remission rates in relapsed AYA-ALL. Distinct toxicity profiles suggest that treatment selection should be individualized. Larger, prospective studies are warranted to validate the role of pediatric salvage protocols in this challenging population.
背景:青少年和青壮年(AYA)复发性急性淋巴细胞白血病(ALL)仍然是一个高风险的情况,指导最佳抢救方案的证据有限。儿科方案改善了AYA-ALL的一线预后,但其在复发中的适用性仍不明确。目的比较以儿科为基础的UKALL R3方案与成人补救性氟达拉滨/阿糖胞苷(FA)方案治疗复发性philadelphia -阴性AYA-ALL的临床疗效和毒性。方法在某三级医疗中心对77例14-40岁复发AYA-ALL患者进行回顾性队列研究。17名患者接受R3方案,60名患者接受FA方案。主要终点包括完全缓解(CR)率和总生存(OS)。次要终点评估最小残留病(MRD)反应、移植率和治疗相关毒性。结果:尽管FA队列患者年龄较大,细胞遗传学风险较高,但基线特征具有可比性。R3组的CR率为60%,FA组为76.3% (p=0.1)。中位随访4年显示R3的OS在数值上优于R3 (53% vs. 30.8%, p=0.8)。毒性各不相同:热性中性粒细胞减少症和肝毒性在FA中更为常见,而粘膜炎和周围神经病变在R3中占主导地位。R3组感染相关死亡较少(12.5% vs. 25%)。结论儿科启发的R3和成人为基础的FA方案在复发的AYA-ALL中具有相似的生存率和缓解率。不同的毒性特征表明治疗选择应个体化。需要更大规模的前瞻性研究来验证儿科抢救方案在这一具有挑战性的人群中的作用。
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引用次数: 0
First reported TRIB1 copy number loss in myelodysplastic syndrome (MDS) revealed by single nucleotide polymorphism array (SNP-array) with patient-matched control 首次报道的TRIB1拷贝数丢失在骨髓增生异常综合征(MDS)中发现,单核苷酸多态性阵列(SNP-array)与患者匹配的对照
IF 0.9 Q4 HEMATOLOGY Pub Date : 2025-01-01 Epub Date: 2025-09-01 DOI: 10.1016/j.lrr.2025.100542
Kun Chi , Lili Song
A 30-year-old woman with MDS with low blasts (MDS-LB) presented a somatic 67-kb copy number loss at 8q24.13 involving TRIB1, detected by single nucleotide polymorphism (SNP) array. Bone marrow analysis showed no mutations in common MDS genes (TP53, ASXL1, TET2, RUNX1) or karyotypic abnormalities (46, XX). Using oral epithelial DNA as a patient-matched control, SNP-array identified four hereditary uniparental disomies (UPDs) and a somatic TRIB1-containing deletion at 8q24.13. This deletion likely caused TRIB1 haploinsufficiency, reducing control over dysplastic clones and driving progression to MDS with increased blasts 2 (MDS-IB2) over three years. This first report of TRIB1 copy number loss in myeloid disorders highlights the value of SNP-array with patient-matched controls in distinguishing somatic variants, expanding MDS’s genetic profile and underscoring TRIB1’s context-dependent roles in oncogenesis.
1例30岁女性MDS伴低原细胞(MDS- lb),通过单核苷酸多态性(SNP)阵列检测到涉及TRIB1的8q24.13位点存在67kb的体细胞拷贝数缺失。骨髓分析显示常见MDS基因(TP53、ASXL1、TET2、RUNX1)未发生突变或核型异常(46,XX)。使用口腔上皮DNA作为患者匹配的对照,SNP-array鉴定出4个遗传性单代二体(upd)和8q24.13处含有trib1的体细胞缺失。这种缺失可能导致TRIB1单倍体功能不全,减少对发育不良克隆的控制,并在三年内导致MDS的进展,并增加MDS- ib2。这篇关于骨髓疾病中TRIB1拷贝数丢失的第一篇报道强调了snp阵列与患者匹配对照在区分体细胞变异、扩展MDS的遗传谱和强调TRIB1在肿瘤发生中的环境依赖性作用方面的价值。
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引用次数: 0
Comprehensive analysis of Atypical chronic myeloid leukemia (aCML): Epidemiology, clinical features, and survival outcomes based on SEER database insights 非典型慢性髓性白血病(aCML)的综合分析:基于SEER数据库见解的流行病学,临床特征和生存结果
IF 0.7 Q4 HEMATOLOGY Pub Date : 2025-01-01 Epub Date: 2025-02-17 DOI: 10.1016/j.lrr.2025.100505
Zhaoyang Hong , Fan Wang

Background

Atypical Chronic Myeloid Leukemia (aCML) is a rare and aggressive myelodysplastic syndrome/myeloproliferative neoplasm. This study aimed to provide a comprehensive understanding of the epidemiology, clinical characteristics, and survival outcomes of aCML patients.

Methods

The study utilized data from the Surveillance, Epidemiology, and End Results (SEER) database from 2001 to 2020. The age-adjusted incidence rate (AIR) of aCML was calculated, and survival outcomes were analyzed using the Kaplan-Meier method and accelerated failure time (AFT) regression analysis.

Results

The AIR of aCML was found to be 0.024 per 100,000 person-years, with the highest rate observed in 2020. The incidence of aCML increased with age and was higher in males. The study cohort predominantly consisted of elderly White individuals, with an average age at diagnosis of 68.2 ± 15.3 years. The median overall survival (OS) and disease-specific survival (DSS) were 1.4 years and 1.7 years, respectively. Older age was independently associated with worse survival outcomes. Notably, treatment delay and chemotherapy did not significantly impact OS or DSS.

Conclusions

This study provides comprehensive insights into the epidemiology, clinical characteristics, and survival outcomes of aCML, highlighting its rarity, aggressive nature, and poor prognosis. Further research is needed to validate these findings and explore novel therapeutic strategies for improving outcomes in this challenging hematologic malignancy.
背景:典型慢性髓系白血病(aCML)是一种罕见的侵袭性骨髓增生异常综合征/骨髓增生性肿瘤。本研究旨在全面了解aCML患者的流行病学、临床特征和生存结局。方法本研究利用2001年至2020年监测、流行病学和最终结果(SEER)数据库的数据。计算aCML的年龄调整发生率(AIR),并采用Kaplan-Meier法和加速失效时间(AFT)回归分析生存结局。结果aCML的AIR为0.024 / 10万人-年,以2020年发生率最高。aCML的发病率随着年龄的增长而增加,男性发病率较高。研究队列主要由老年白人个体组成,平均诊断年龄为68.2±15.3岁。中位总生存期(OS)和疾病特异性生存期(DSS)分别为1.4年和1.7年。年龄越大与生存结果越差独立相关。值得注意的是,治疗延迟和化疗对OS或DSS没有显著影响。结论本研究对aCML的流行病学、临床特征和生存结果提供了全面的见解,突出了其罕见性、侵袭性和预后差。需要进一步的研究来验证这些发现,并探索新的治疗策略来改善这种具有挑战性的血液恶性肿瘤的预后。
{"title":"Comprehensive analysis of Atypical chronic myeloid leukemia (aCML): Epidemiology, clinical features, and survival outcomes based on SEER database insights","authors":"Zhaoyang Hong ,&nbsp;Fan Wang","doi":"10.1016/j.lrr.2025.100505","DOIUrl":"10.1016/j.lrr.2025.100505","url":null,"abstract":"<div><h3>Background</h3><div>Atypical Chronic Myeloid Leukemia (aCML) is a rare and aggressive myelodysplastic syndrome/myeloproliferative neoplasm. This study aimed to provide a comprehensive understanding of the epidemiology, clinical characteristics, and survival outcomes of aCML patients.</div></div><div><h3>Methods</h3><div>The study utilized data from the Surveillance, Epidemiology, and End Results (SEER) database from 2001 to 2020. The age-adjusted incidence rate (AIR) of aCML was calculated, and survival outcomes were analyzed using the Kaplan-Meier method and accelerated failure time (AFT) regression analysis.</div></div><div><h3>Results</h3><div>The AIR of aCML was found to be 0.024 per 100,000 person-years, with the highest rate observed in 2020. The incidence of aCML increased with age and was higher in males. The study cohort predominantly consisted of elderly White individuals, with an average age at diagnosis of 68.2 ± 15.3 years. The median overall survival (OS) and disease-specific survival (DSS) were 1.4 years and 1.7 years, respectively. Older age was independently associated with worse survival outcomes. Notably, treatment delay and chemotherapy did not significantly impact OS or DSS.</div></div><div><h3>Conclusions</h3><div>This study provides comprehensive insights into the epidemiology, clinical characteristics, and survival outcomes of aCML, highlighting its rarity, aggressive nature, and poor prognosis. Further research is needed to validate these findings and explore novel therapeutic strategies for improving outcomes in this challenging hematologic malignancy.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100505"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tyrosine kinase inhibitors modulate the expression of peroxiredoxins 1 and 2 in chronic myeloid leukemia cells 酪氨酸激酶抑制剂调节慢性髓性白血病细胞中过氧化物还毒素1和2的表达
IF 0.7 Q4 HEMATOLOGY Pub Date : 2025-01-01 Epub Date: 2025-03-18 DOI: 10.1016/j.lrr.2025.100508
Hiroshi Kazama , Yan-Hua Wang , Junji Tanaka
Chronic myeloid leukemia (CML) is characterized by the presence of the BCR::ABL1 fusion protein with active tyrosine kinase activity. The BCR::ABL1 fusion protein induces the production of reactive oxygen species (ROS). DNA damage caused by ROS is involved in the mechanism of CML progression. Antioxidant systems include peroxiredoxins (PRDXs), which play various roles in hematological malignancies. Although tyrosine kinase inhibitors (TKIs) are known to affect ROS production, their effects on the expression of the antioxidants PRDX1 and PRDX2 remain unclear; thus, we aimed to evaluate the effects of TKIs on the expression of these PRDXs and ROS levels in CML cells. We found that TKIs, such as imatinib, nilotinib, and dasatinib, increased the gene expression of PRDX2 in K562 cells; however, only dasatinib increased the cytoplasmic protein expression of PRDX2. Additionally, while TKIs reduced the gene expression of PRDX1 in contrast to that of PRDX2, dasatinib increased the cytoplasmic protein expression of PRDX1. This discrepancy was linked to post-translational regulation through SUMOylation in cooperation with dasatinib. Our results suggest that the antioxidants PRDX1 and PRDX2 could serve as potential targets for TKIs in the treatment of CML.
慢性髓性白血病(CML)的特点是存在具有活跃酪氨酸激酶活性的BCR::ABL1融合蛋白。BCR::ABL1融合蛋白诱导活性氧(ROS)的产生。由ROS引起的DNA损伤参与了CML进展的机制。抗氧化系统包括在血液系统恶性肿瘤中发挥多种作用的过氧化物还毒素(PRDXs)。虽然已知酪氨酸激酶抑制剂(TKIs)会影响ROS的产生,但它们对抗氧化剂PRDX1和PRDX2表达的影响尚不清楚;因此,我们旨在评估TKIs对CML细胞中这些PRDXs表达和ROS水平的影响。我们发现TKIs,如伊马替尼、尼罗替尼和达沙替尼,增加了K562细胞中PRDX2的基因表达;然而,只有达沙替尼增加了PRDX2的细胞质蛋白表达。此外,与PRDX2相比,TKIs降低了PRDX1的基因表达,而达沙替尼增加了PRDX1的细胞质蛋白表达。这种差异与通过SUMOylation与达沙替尼合作进行的翻译后调节有关。我们的研究结果表明,抗氧化剂PRDX1和PRDX2可能是TKIs治疗CML的潜在靶点。
{"title":"Tyrosine kinase inhibitors modulate the expression of peroxiredoxins 1 and 2 in chronic myeloid leukemia cells","authors":"Hiroshi Kazama ,&nbsp;Yan-Hua Wang ,&nbsp;Junji Tanaka","doi":"10.1016/j.lrr.2025.100508","DOIUrl":"10.1016/j.lrr.2025.100508","url":null,"abstract":"<div><div>Chronic myeloid leukemia (CML) is characterized by the presence of the BCR::ABL1 fusion protein with active tyrosine kinase activity. The BCR::ABL1 fusion protein induces the production of reactive oxygen species (ROS). DNA damage caused by ROS is involved in the mechanism of CML progression. Antioxidant systems include peroxiredoxins (PRDXs), which play various roles in hematological malignancies. Although tyrosine kinase inhibitors (TKIs) are known to affect ROS production, their effects on the expression of the antioxidants PRDX1 and PRDX2 remain unclear; thus, we aimed to evaluate the effects of TKIs on the expression of these PRDXs and ROS levels in CML cells. We found that TKIs, such as imatinib, nilotinib, and dasatinib, increased the gene expression of <em>PRDX2</em> in K562 cells; however, only dasatinib increased the cytoplasmic protein expression of PRDX2. Additionally, while TKIs reduced the gene expression of <em>PRDX1</em> in contrast to that of <em>PRDX2</em>, dasatinib increased the cytoplasmic protein expression of PRDX1. This discrepancy was linked to post-translational regulation through SUMOylation in cooperation with dasatinib. Our results suggest that the antioxidants PRDX1 and PRDX2 could serve as potential targets for TKIs in the treatment of CML.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"23 ","pages":"Article 100508"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of Philadelphia chromosome-positive B-cell acute lymphoblastic leukemia in a Jehovah’s Witness using chemotherapy free regimen: A case report and review of literature
IF 0.7 Q4 HEMATOLOGY Pub Date : 2025-01-01 Epub Date: 2025-06-01 DOI: 10.1016/j.lrr.2025.100517
Muhammad Hassan Raza , Eiraj Khan , Alexis M Desjarlais , Salman Fazal

Introduction and Importance

Treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia (pH-positive ALL) in Jehovah’s Witness (JW) using chemotherapy agents, opens an ethically and morally challenging paradigm instead of their religious practices.

Case Presentation

We present a case of pH-positive B cell ALL in a Jehovah's Witness patient who refused the transfusion of blood as a part of their treatment regimen. We intended to treat this patient using a new “chemotherapy-free” approach and achieved Minimal Residual Disease (MRD) negative state with durable outcomes for the next three years.

Clinical Discussion

With “chemotherapy-free” regimen, we achieved complete molecular remission without any significant side effects in our patient.

Conclusion

Chemo-free approach is a promising opportunity to treat Jehovah’s witnesses with pH-positive B cell ALL as the haemoglobin and platelets remained above transfusion thresholds. However, further research is required to fully understand and implement this approach. Future clinical trials should consider including this unique patient population to better understand their needs and improve outcomes.
在耶和华见证会(JW)中使用化疗药物治疗费城染色体阳性急性淋巴细胞白血病(ph阳性ALL),打开了一个伦理和道德上具有挑战性的范式,而不是他们的宗教实践。​我们打算使用一种新的“无化疗”方法治疗该患者,并在未来三年内达到最小残留病(MRD)阴性状态。通过“无化疗”方案,我们在患者身上实现了完全的分子缓解,没有任何明显的副作用。结论无化疗方法是治疗ph值阳性B细胞ALL的一个很好的机会,因为血红蛋白和血小板仍高于输血阈值。然而,要充分理解和实施这种方法,还需要进一步的研究。未来的临床试验应考虑纳入这一独特的患者群体,以更好地了解他们的需求并改善结果。
{"title":"Management of Philadelphia chromosome-positive B-cell acute lymphoblastic leukemia in a Jehovah’s Witness using chemotherapy free regimen: A case report and review of literature","authors":"Muhammad Hassan Raza ,&nbsp;Eiraj Khan ,&nbsp;Alexis M Desjarlais ,&nbsp;Salman Fazal","doi":"10.1016/j.lrr.2025.100517","DOIUrl":"10.1016/j.lrr.2025.100517","url":null,"abstract":"<div><h3>Introduction and Importance</h3><div>Treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia (pH-positive ALL) in Jehovah’s Witness (JW) using chemotherapy agents, opens an ethically and morally challenging paradigm instead of their religious practices.</div></div><div><h3>Case Presentation</h3><div>We present a case of pH-positive B cell ALL in a Jehovah's Witness patient who refused the transfusion of blood as a part of their treatment regimen. We intended to treat this patient using a new “chemotherapy-free” approach and achieved Minimal Residual Disease (MRD) negative state with durable outcomes for the next three years.</div></div><div><h3>Clinical Discussion</h3><div>With “chemotherapy-free” regimen, we achieved complete molecular remission without any significant side effects in our patient.</div></div><div><h3>Conclusion</h3><div>Chemo-free approach is a promising opportunity to treat Jehovah’s witnesses with pH-positive B cell ALL as the haemoglobin and platelets remained above transfusion thresholds. However, further research is required to fully understand and implement this approach. Future clinical trials should consider including this unique patient population to better understand their needs and improve outcomes.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"24 ","pages":"Article 100517"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diagnostic and taxonomic challenges in chronic myelomonocytic leukemia with lymph node involvement: A case report and mini-review 慢性髓细胞白血病伴淋巴结累及的诊断和分类学挑战:一例报告和小型回顾
IF 0.7 Q4 HEMATOLOGY Pub Date : 2025-01-01 Epub Date: 2025-06-14 DOI: 10.1016/j.lrr.2025.100520
Bhaumik Shah , Mitra Abdollahi-Neisani , Pegah Taheri , Asya Varshavsky , Reza Nejati , Nicholas Mackrides
The WHO and ICC classifications lack standardized terminology to define the disease phase of chronic myeloproliferative neoplasms in extramedullary sites, particularly lymph nodes, when infiltrates resemble extramedullary hematopoiesis (EH). We report a lymph node case of extramedullary chronic myelomonocytic leukemia (CMML) in blast phase mimicking EH. Comprehensive genomic profiling, using chromosomal microarray and NGS-based sequencing, identified copy neutral loss of heterozygosity (cn-LOH), previously unreported in extramedullary CMML. We discuss challenges in determining the CMML disease phase in lymph nodes and review the literature to underscore the need for consensus terminology for cases not meeting myeloid sarcoma criteria.
WHO和ICC分类缺乏标准化术语来定义髓外部位慢性骨髓增生性肿瘤的疾病阶段,特别是淋巴结,当浸润类似髓外造血(EH)时。我们报告一例髓外慢性髓单核细胞白血病(CMML)在模拟EH的母细胞期淋巴结病例。综合基因组分析,使用染色体微阵列和基于ngs的测序,鉴定了拷贝中性杂合性缺失(cn-LOH),以前未在髓外CMML中报道。我们讨论了确定淋巴结CMML疾病分期的挑战,并回顾了文献,以强调不符合髓系肉瘤标准的病例需要一致的术语。
{"title":"Diagnostic and taxonomic challenges in chronic myelomonocytic leukemia with lymph node involvement: A case report and mini-review","authors":"Bhaumik Shah ,&nbsp;Mitra Abdollahi-Neisani ,&nbsp;Pegah Taheri ,&nbsp;Asya Varshavsky ,&nbsp;Reza Nejati ,&nbsp;Nicholas Mackrides","doi":"10.1016/j.lrr.2025.100520","DOIUrl":"10.1016/j.lrr.2025.100520","url":null,"abstract":"<div><div>The WHO and ICC classifications lack standardized terminology to define the disease phase of chronic myeloproliferative neoplasms in extramedullary sites, particularly lymph nodes, when infiltrates resemble extramedullary hematopoiesis (EH). We report a lymph node case of extramedullary chronic myelomonocytic leukemia (CMML) in blast phase mimicking EH. Comprehensive genomic profiling, using chromosomal microarray and NGS-based sequencing, identified copy neutral loss of heterozygosity (cn-LOH), previously unreported in extramedullary CMML. We discuss challenges in determining the CMML disease phase in lymph nodes and review the literature to underscore the need for consensus terminology for cases not meeting myeloid sarcoma criteria.</div></div>","PeriodicalId":38435,"journal":{"name":"Leukemia Research Reports","volume":"24 ","pages":"Article 100520"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 Research Reports
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