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Sexually transmitted infections in the context of haematological malignancies. 血液恶性肿瘤中的性传播感染。
IF 15.4 1区 医学 Q1 HEMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.1016/S2352-3026(24)00210-2
Tamim Alsuliman, Paolo Musiu, Nicolas Stocker, Lana Desnica, Jean El-Cheikh, Simona Sestili, Micha Srour, Zora Marjanovic, Ali Alrstom

Sexually transmitted infections (STIs) are a difficult health challenge for immunocompromised patients. Patients treated for several haematological malignancies have further compromised immune systems. Furthermore, many chemotherapies, alone or associated with haematopoietic stem-cell transplantation, make the body's natural barriers extremely fragile. STIs can negatively impact both patient morbidity and mortality. In this Series paper, we discuss Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, human immunodeficiency virus, herpes simplex virus, human papilloma virus, and hepatitis B virus, as we found them to be associated with increased risks for haematological malignancy treatments, either by incidence or by severity. Protective measures and vaccines for patients with haematological malignancies are also discussed. Large, well conducted studies should be encouraged, with the aim to systematically analyse the impacts of STIs in patients with haematological malignancies, especially given the difficulties that antimicrobial resistance can confer to patient management.

对于免疫力低下的患者来说,性传播感染(STI)是一项棘手的健康挑战。接受多种血液恶性肿瘤治疗的患者的免疫系统会进一步受损。此外,许多化疗药物,无论是单独使用还是与造血干细胞移植联合使用,都会使人体的天然屏障变得极其脆弱。性传播感染会对患者的发病率和死亡率产生负面影响。在本系列论文中,我们将讨论沙眼衣原体、淋病奈瑟菌、梅毒、人类免疫缺陷病毒、单纯疱疹病毒、人类乳头瘤病毒和乙型肝炎病毒,因为我们发现这些病毒与血液恶性肿瘤治疗风险的增加有关,无论是发病率还是严重程度。我们还讨论了血液恶性肿瘤患者的保护措施和疫苗。应鼓励开展大规模的研究,以便系统分析性传播感染对血液恶性肿瘤患者的影响,尤其是考虑到抗菌素耐药性会给患者管理带来困难。
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引用次数: 0
Association and small risk from low-dose radiation exposure. 低剂量辐照的关联性和小风险。
IF 15.4 1区 医学 Q1 HEMATOLOGY Pub Date : 2024-10-01 DOI: 10.1016/S2352-3026(24)00284-9
Won Jin Lee
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引用次数: 0
The Lancet Haematology at 10. 柳叶刀血液学》第 10 期。
IF 15.4 1区 医学 Q1 HEMATOLOGY Pub Date : 2024-10-01 DOI: 10.1016/S2352-3026(24)00289-8
Lan-Lan Smith, Yaiza Del Pozo Martín, Emma Cookson
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引用次数: 0
Lines of the haematology community. 血液病学界的路线。
IF 15.4 1区 医学 Q1 HEMATOLOGY Pub Date : 2024-10-01 DOI: 10.1016/S2352-3026(24)00287-4
Jacqueline Del Castillo
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引用次数: 0
Lines of the haematology community. 血液病学界的路线。
IF 15.4 1区 医学 Q1 HEMATOLOGY Pub Date : 2024-10-01 DOI: 10.1016/S2352-3026(24)00287-4
Jacqueline Del Castillo
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引用次数: 0
Let's talk about sex and haematopoietic stem-cell transplantation. 让我们来谈谈性与造血干细胞移植。
IF 15.4 1区 医学 Q1 HEMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.1016/S2352-3026(24)00270-9
Andrea Linke, Jacqueline Del Castillo, Kirsti Scheffel, Peter Feenstra, Riikka-Leena Manninen
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引用次数: 0
Sexual health-related psychological and emotional life after allogeneic haematopoietic stem-cell transplantation. 异体造血干细胞移植后与性健康相关的心理和情感生活。
IF 15.4 1区 医学 Q1 HEMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.1016/S2352-3026(24)00209-6
Tamim Alsuliman, Lugien Alasadi, Alice Polomeni, Antoine Capes, Zinaida Peric, Andrea Linke, Hélène Schoemans, Florent Malard, Yves Chalandon, Mohamad Mohty

Sexual health is important for the quality of life of patients who have received haematopoietic stem-cell transplantation (HSCT). Sexual dysfunction and couple dissatisfaction can seriously affect a patient's recovery and treatment process. However, this aspect of post-transplantation recovery is still usually neglected in clinical practice. In this Series paper, we aim to elucidate the emotional and psychosocial factors affecting the sexual function in these patients, with a special focus on the partner's role and the psychological consequences of some adverse effects of HSCT. Moreover, we provide an overview of the management approaches and assessment tools of psychological issues associated with sexual dysfunction reported in the literature. These tools can help clinicians in this field to plan essential lifestyle and clinical interventions to help their patients. In conclusion, screening for psychological issues is indispensable when approaching sexual dysfunction in patients with HSCT. Health-care teams in transplantation units should be trained to discuss this aspect of recovery and provide the required treatment and follow-up plan.

性健康对接受造血干细胞移植(HSCT)患者的生活质量非常重要。性功能障碍和夫妻不满意会严重影响患者的康复和治疗过程。然而,在临床实践中,移植后康复的这一问题通常仍被忽视。在这篇系列论文中,我们旨在阐明影响这些患者性功能的情感和社会心理因素,特别关注造血干细胞移植后伴侣的角色和一些不良反应的心理后果。此外,我们还概述了文献中报道的与性功能障碍相关的心理问题的处理方法和评估工具。这些工具可帮助该领域的临床医生规划必要的生活方式和临床干预措施,以帮助他们的患者。总之,在处理造血干细胞移植患者的性功能障碍时,心理问题筛查是必不可少的。移植单位的医疗团队应接受培训,以讨论康复的这一方面,并提供所需的治疗和后续计划。
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引用次数: 0
Anti-BCMA/GPRC5D bispecific CAR T cells in patients with relapsed or refractory multiple myeloma: a single-arm, single-centre, phase 1 trial. 抗BCMA/GPRC5D双特异性CAR T细胞治疗复发性或难治性多发性骨髓瘤患者:单臂、单中心、1期试验。
IF 15.4 1区 医学 Q1 HEMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-23 DOI: 10.1016/S2352-3026(24)00176-5
Dian Zhou, Qian Sun, Jieyun Xia, Weiying Gu, Jun Qian, Wanchuan Zhuang, Zhiling Yan, Hai Cheng, Wei Chen, Feng Zhu, Kunming Qi, Depeng Li, Wei Sang, Lili Zhu, Sha Ma, Hujun Li, Huanxin Zhang, Tingting Qiu, Dongmei Yan, Yanlei Zhang, Shuixiu Peng, Alex H Chang, Kailin Xu, Zhenyu Li
<p><strong>Background: </strong>Some challenges still exist with single-target B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell therapies due to variable or negative BCMA expression, although they have yielded remarkable efficacy in relapsed or refractory multiple myeloma. We developed anti-BCMA/GPRC5D bispecific CARs to mitigate the limitations and potentiate the functions of CAR T cells.</p><p><strong>Methods: </strong>This single-arm, phase 1 trial was conducted at the Affiliated Hospital of Xuzhou Medical University (Xuzhou, China). The trial enrolled patients aged 18-75 years with relapsed or refractory multiple myeloma and an Eastern Cooperative Oncology Group performance status of 0-3. Anti-BCMA/GPRC5D bispecific CAR T cells were administered at 0·5 × 10<sup>6</sup>, 1·0 × 10<sup>6</sup>, 2·0 × 10<sup>6</sup>, and 4·0 × 10<sup>6</sup> CAR T cells per kg in the dose-escalation phase, with additional patients included at the dose selected for the dose-expansion phase. The primary endpoint was safety, which included dose-limiting toxicity and maximum tolerated dose. Activity was also evaluated as a secondary endpoint. The maximum tolerated dose was chosen for the dose-expansion phase. Safety and activity analyses were done in all patients who received anti-BCMA/GPRC5D bispecific CAR T cells as defined in the protocol. This trial is registered with ClinicalTrials.gov (NCT05509530) and is complete.</p><p><strong>Findings: </strong>Between Sept 1, 2022, and Nov 3, 2023, 24 patients were enrolled and underwent apheresis. Three patients were excluded after apheresis (two patients discontinued due to rapid disease progression and one patient was withdrawn because of failed manufacture of CAR T cells), so 21 patients were infused with anti-BCMA/GPRC5D bispecific CAR T cells. Median follow-up was 5·8 months (IQR 5·2-6·7). Median age was 62 years (IQR 56-67). Eight (38%) patients were male, and 13 (62%) female. All patients were Chinese. At the 4·0 × 10<sup>6</sup> CAR T cells per kg dose, two patients had dose-limiting toxicities, of whom one died of subarachnoid haemorrhage (which was not considered to be related to the study treatment). The maximum tolerated dose was identified as 2·0 × 10<sup>6</sup> CAR T cells per kg. The most common grade 3 or worse adverse events were haematological toxicities in 19 (90%) patients (except lymphopenia). 15 (71%) patients had cytokine release syndrome, of which all cases were grade 1 or 2. One case of grade 1 immune effector cell-associated neurotoxicity syndrome (ICANS) was observed in a patient who received 4·0 × 10<sup>6</sup> CAR T cells per kg. No ICANS or grade 3 or worse organ toxicities were observed in patients who received 0·5-2·0 × 10<sup>6</sup> CAR T cells per kg. The overall response rate was 86% (18 of 21 patients), with 13 (62%) patients having a complete response or better, and 17 (81%) patients having measurable residual disease negativity. Of the 12 patients who received
背景:尽管单靶点B细胞成熟抗原(BCMA)嵌合抗原受体(CAR)T细胞疗法在复发或难治性多发性骨髓瘤中取得了显著疗效,但由于BCMA表达可变或阴性,该疗法仍面临一些挑战。我们开发了抗BCMA/GPRC5D双特异性CAR,以缓解CAR T细胞的局限性并增强其功能:这项单臂一期试验在徐州医科大学附属医院(中国徐州)进行。该试验招募了年龄在18-75岁之间、患有复发性或难治性多发性骨髓瘤且东部合作肿瘤学组表现状态为0-3的患者。在剂量递增阶段,抗BCMA/GPRC5D双特异性CAR T细胞的给药剂量分别为每千克0-5×106、1-0×106、2-0×106和4-0×106个CAR T细胞,并在剂量扩展阶段按选定的剂量纳入更多患者。主要终点是安全性,包括剂量限制毒性和最大耐受剂量。活性也作为次要终点进行评估。剂量扩展阶段选择的是最大耐受剂量。所有接受抗BCMA/GPRC5D双特异性CAR T细胞治疗的患者都按照方案规定进行了安全性和活性分析。该试验已在ClinicalTrials.gov(NCT05509530)上注册,并已完成:2022年9月1日至2023年11月3日期间,24名患者入组并接受了血液净化。3名患者在血液净化后被排除(2名患者因疾病快速进展而中止治疗,1名患者因CAR T细胞制造失败而退出治疗),因此21名患者输注了抗BCMA/GPRC5D双特异性CAR T细胞。中位随访时间为 5-8 个月(IQR 5-2-6-7)。中位年龄为 62 岁(IQR 56-67)。8例(38%)患者为男性,13例(62%)患者为女性。所有患者均为中国人。在每公斤4-0×106个CAR T细胞的剂量下,两名患者出现了剂量限制性毒性反应,其中一人死于蛛网膜下腔出血(认为与研究治疗无关)。最大耐受剂量被确定为每公斤 2-0 × 106 个 CAR T 细胞。最常见的3级或更严重不良事件是19名(90%)患者出现血液学毒性反应(淋巴细胞减少除外)。15例(71%)患者出现细胞因子释放综合征,其中所有病例均为1级或2级。在一名接受每公斤 4-0 × 106 个 CAR T 细胞治疗的患者身上观察到了 1 级免疫效应细胞相关神经毒性综合征(ICANS)。每公斤接受0-5-2-0×106个CAR T细胞治疗的患者未观察到ICANS或3级或更严重的器官毒性。总体反应率为86%(21例患者中有18例),其中13例(62%)患者获得完全反应或更好的反应,17例(81%)患者的可测量残留疾病呈阴性。12名患者接受了每公斤2-0 × 106个CAR T细胞治疗(3名患者在剂量递增阶段,另外9名患者在剂量扩大阶段),总反应率为92%(12名患者中的11名),其中9名患者(75%)获得了完全反应或更好的反应:抗BCMA/GPRC5D双特异性CAR T细胞在复发或难治性多发性骨髓瘤患者中显示出良好的安全性和令人鼓舞的活性:国家自然科学基金:摘要中文译文见补充材料部分。
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引用次数: 0
Sexual health and emotional wellbeing of adolescent and young adult survivors of haematological malignancies. 青少年和年轻成人血液恶性肿瘤幸存者的性健康和情绪健康。
IF 15.4 1区 医学 Q1 HEMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.1016/S2352-3026(24)00244-8
Tamim Alsuliman, Reyes María Martín Rojas, Ahmad Ali Basha, Paolo Musiu, Léonardo Magro, Anna Maria Testi, Mohamad Mohty
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引用次数: 0
Sexual health and emotional wellbeing of patients with haematological malignancies: general review. 血液恶性肿瘤患者的性健康和情感健康:综述。
IF 15.4 1区 医学 Q1 HEMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-20 DOI: 10.1016/S2352-3026(24)00208-4
Tamim Alsuliman, Reyes María Martín Rojas, Nour Moukalled, Eolia Brissot, Laurence Quarez-Blaise, Zora Marjanovic, Didier Blaise, Danielle Murphy, Melissa Logue, Bipin N Savani, Mohamad Mohty

Sexual health is an important aspect of a person's life. Many patients and haematologists believe that intimacy and sexuality issues are substantial during cancer treatment. The haematological cancer disease, diagnosis, shock of the announcement, treatment, and follow-up appointments, can all have negative effects on the quality of life of patients, their partners, other family members, and friends. Addressing the intimate aspects of patients' lives not only enhances their wellbeing but also contributes to the quality of their survivorship. Progress has been made in the management of sexual life-related complications; however, novel strategies in coordination with a multidisciplinary team need to be implemented. New and comprehensive approaches must be developed on a multidisciplinary scale. In this Series paper, we discuss the factors affecting the sexual life of patients with haematological malignancies, different methods to assess sexual function, as well as management approaches of sexual wellbeing among patients with haematological cancers.

性健康是一个人生活的重要方面。许多患者和血液病专家认为,在癌症治疗期间,亲密关系和性生活问题非常重要。血液肿瘤疾病、诊断、宣布的震惊、治疗和复诊都会对患者、其伴侣、其他家庭成员和朋友的生活质量产生负面影响。解决患者生活中的私密问题不仅能提高他们的幸福感,还有助于提高他们的生存质量。在处理与性生活有关的并发症方面已经取得了进展,但还需要与多学科团队协调实施新的策略。必须在多学科范围内开发新的综合方法。在这篇系列论文中,我们将讨论影响血液恶性肿瘤患者性生活的因素、评估性功能的不同方法以及血液肿瘤患者性健康的管理方法。
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引用次数: 0
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Lancet Haematology
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