Annals of Hematology最新文献

Multiple Myeloma (MM) is the second most frequent hematologic malignancy in adults in the Western world. The bone marrow microenvironment plays a critical role in MM progression by supporting malignant plasma cell (PC) survival, immune evasion, and proliferation. Among immune checkpoints, TIGIT has recently emerged as a relevant immunoregulatory molecule, capable of dampening cytotoxic responses and enhancing immune suppression. We investigated the expression of TIGIT in the bone marrow of newly diagnosed MM patients and its correlation with disease characteristics and microenvironmental features. We enrolled 25 consecutive patients with newly diagnosed MM. Bone marrow samples were collected for cytomorphology, cytogenetics (FISH), and immunohistochemistry using the Cytomatrix system. TIGIT expression was analyzed in bone marrow-infiltrating immune cells. Histological evaluation and confocal microscopy assessed immune cell localization, neutrophil extracellular trap (NET) formation, and proinflammatory cytokine expression. Clinical parameters, staging (ISS, R-ISS, R2-ISS), cytogenetic risk, and laboratory values were correlated with TIGIT status. TIGIT was expressed in 86% (19/22) of evaluable samples. TIGIT-positive patients had a significantly higher frequency of advanced R-ISS stages (p = 0.01), high-risk cytogenetics (100%), and elevated LDH (> 220 mU/ml, 100% TIGIT+). Among patients with PC% >60% or FLC ratio > 100, 92% were TIGIT+. Morphological differences were evident between groups: TIGIT-negative PCs were larger and altered, while TIGIT-positive PCs showed polarized nuclei and proximity to neutrophils. TIGIT-positive samples displayed increased neutrophils undergoing NETosis, as confirmed by neutrophil elastase and Ly6b co-expression (p = 0.0067). Elevated IL-6 (p = 0.0003) and IL-8 (p = 0.004) in TIGIT-positive samples suggest a proinflammatory microenvironment promoting neutrophil recruitment and NETosis. TIGIT expression in the bone marrow of MM patients is associated with more aggressive disease features and an inflammatory microenvironment enriched with NET-forming neutrophils. These findings support TIGIT as a potential biomarker of disease severity and a therapeutic target in MM.

Burkitt lymphoma (BL) is a B-cell malignancy with a rapid doubling time, originating in follicular germinal centers. We aimed to explore the characteristics and prognosis of childhood Burkitt leukemia. A total of 124 children with Burkitt leukemia enrolled during the 6-year period of China Net Childhood Lymphoma- mature B-cell lymphoma 2017 regimen (CNCL-B-NHL-2017) were assessed. The median age at onset was 7 years (1–15 years), with a male-to-female ratio of 4.17:1. Of the total, 50.8% children were aged 5–10 years. Children with Burkitt leukemia were more likely to have tumor lysis syndrome, renal insufficiency, lactate dehydrogenase (LDH) > 4 times, multiple organ involvement, and central nervous system infiltration at diagnosis, whereas those with large tumor mass were rare. Eleven children had pure Burkitt leukemia (8.9%), with no significant differences in relapse, progression, white blood cell counts at initial diagnosis, LDH levels, CNS infiltration, and rates of tumor lysis syndrome before treatment compared to those of children with tumor masses. (P > 0.05). The median follow-up time for the entire group was 32.85 months (0.4–70.7), with 3-year overall survival and event-free survival rates of 87.1% and 81.5%, respectively. Thirteen (10%) children progressed or relapsed during treatment, of which nine received chimeric antigen receptor T-cell therapy, with only three fatalities. The analysis identified residual disease at midterm evaluation (P = 0.024) and LDH elevation ≥ 2000 U/L (P = 0.014) as independent prognostic factors affecting survival. The CNCL-B-NHL-2017 protocol demonstrated significant efficacy in treating children with Burkitt leukemia.

Chronic graft-versus-host disease (cGVHD), presented as an autoimmune-like syndrome, is an important late complication and has become the leading cause of non-recurrent death after allogeneic hematopoietic stem cell transplantation (allo-HSCT). A cohort of 52 cGVHD patients were analyzed for the presence of Tph cells, circulating follicular helper T (cTfh) cells and B cells in peripheral blood mononuclear cells (PBMCs). We found decreased frequency of cTfh cells, but increased frequency of Tph cells in post-transplant patients compared to healthy controls (HCs). Higher percentage and absolute number of CCR2⁺Tph cells were observed in cGVHD patients. The percentage and absolute number of Tph cells decreased significantly with anti-cGVHD therapy. The percentage of Naive B cells, Breg cells and pre-GC B cells was negatively associated with Tph cells. The absolute number of plasma cells was positively associated with the absolute number of Tph cells. The percentage and absolute number of post-GC B cells were both positively associated with Tph cells expression. Collectively, our results showed that Tph cells are involved in the development of cGVHD and correlate with the severity of the disease.

This study aims to map the current research trends, application areas, and thematic clusters of artificial intelligence (AI) technologies in hematology. A literature search was conducted in the Web of Science on June 1, 2025, covering the years 1980–2025. A total of 376 original research articles were analyzed using bibliometric techniques, including trend keyword and factor analyses, via the bibliometrix package in R Studio. The USA (n = 111), China (79), the United Kingdom (22), and Germany (21) were the most productive countries, with Harvard University as the leading institution. Keywords revealed research concentration in thrombosis, venous thromboembolism, risk assessment, hematopoietic stem cell transplantation, atrial fibrillation, anticoagulants, morphological analysis, blood management, sepsis, and acute myeloid leukemia. Recent years have shown rising interest in transcriptome, prediction modeling, hematopoietic stem cell transplantation, blood management, thrombosis, venous thromboembolism cancer and COVID-19 related complications. Factor analysis grouped the literature into five clusters: AI and core hematologic diseases, clinical quality improvement, risk prediction using health data, intensive care, and cardiovascular applications. AI demonstrates substantial contributions to diagnostic accuracy, prognostication, and personalized care in hematology. The findings highlight AI’s growing potential in enhancing clinical decision-making and improving patient outcomes through data-driven and genomics-based innovations.

Diffuse large B-cell lymphoma (DLBCL) patients with co-expression of MYC (≥ 40%) and BCL2 (≥ 50%), classified as double-expressor DLBCL (DE-DLBCL), consistently exhibit poor prognosis with traditional first-line therapies. In order to address the unmet therapeutic needs in this high-risk population, this real-world study retrospectively reviewd 46 newly diagnosed DE-DLBCL patients from two centers to evaluate the efficacy and safety of zanubrutinib-based regimens. Key outcomes included complete response rate (CRR), objective response rates (ORR), progression-free survival (PFS), overall survival (OS) and adverse events. Univariate analysis was conducted to evaluate the impact of various prognostic factors on complete response. The median age was 57.8 years (range:20–81), with 45.65% of patients over 60 years old and 17.39% over 75 years old. Advanced-stage (III/IV) disease was present in 60.87% of patients at diagnosis, 78.26% had a non-germinal center B-cell (non-GCB) subtype, and 41.3% exhibited an International Prognostic Index score ≥ 3. The best CRR was 73.90% (95% CI, 58.90%-85.70%), and the best ORR was 95.70% (95% CI, 85.20%-99.50%). At a median follow-up of 15.7 months, the 3-year PFS and OS was 86.27% (95% CI, 75.37%-98.75%) and 89.79% (95% CI, 78.40%-100%) respectively. Multivariate analysis revealed that zanubrutinib-based chemotherapy regimen significantly improved CRR. Significant differences in PFS were observed across age, bulky disease, IPI score, and extranodal involvement stratification. Adverse events were mainly hematologic toxicities and fatigue. These findings suggest that zanubrutinib may serve as an effective component of first-line therapy for this population, with favorable tolerability.

NUP98 fusions are molecularly rare in T-cell acute lymphoblastic leukemia (T-ALL), with limited data available regarding treatment response and clinical outcomes. Here, we report a case of T-ALL harboring a NUP98::ADD3 fusion (involving NUP98 exon 13 and ADD3 exon 13), representing only the second documented instance of this genetic rearrangement in T-ALL. Notably, the patient demonstrated refractoriness to venetoclax-based chemotherapy. To our knowledge, this is the first report of a T-ALL case with the NUP98::ADD3 fusion exhibiting resistance to venetoclax-containing regimens.

Recent advances in multiple myeloma (MM) treatment, including bispecific antibodies (BsAbs), have improved outcomes. Elranatamab, a BsAb targeting B-cell maturation antigen and CD3, has shown efficacy in relapsed/refractory MM (RRMM). However, its use in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) is not well documented, as clinical trials often exclude this population. We report a 72-year-old woman with RRMM and ESRD on HD who was successfully treated with elranatamab after multiple prior therapies. She achieved a stringent complete response with undetectable minimal residual disease. Adverse events included grade 1 cytokine release syndrome, mild hypotension, and acute cholangitis, all resolved with appropriate management. Our literature review suggests BsAbs can be effective and generally well-tolerated in RRMM patients with ESRD on HD, although infection risk warrants caution. This report highlights elranatamab as a promising option for this vulnerable population. While initial responses and safety appear favourable, further studies are required to establish long-term outcomes.