Blood Neoplasia最新文献

{"title":"JAK1/2 inhibitor ruxolitinib for the treatment of systemic chronic active Epstein-Barr virus disease: a phase 2 study","authors":"Yu Uemura ,&nbsp;Masahide Yamamoto ,&nbsp;Masataka Ishimura ,&nbsp;Hirokazu Kanegane ,&nbsp;Akihisa Sawada ,&nbsp;Akihiro Hirakawa ,&nbsp;Ken-Ichi Imadome ,&nbsp;Mayumi Yoshimori ,&nbsp;Masashi Nagata ,&nbsp;Kouhei Yamamoto ,&nbsp;Norio Shimizu ,&nbsp;Ryuji Koike ,&nbsp;Ayako Arai","doi":"10.1016/j.bneo.2024.100053","DOIUrl":"10.1016/j.bneo.2024.100053","url":null,"abstract":"<div><h3>Abstract</h3><div>Systemic chronic active Epstein-Barr virus disease (sCAEBV) is a rare intractable EBV-positive T-cell or natural killer (NK)-cell lymphoid neoplasm with systemic inflammation. The only curative treatment is allogeneic hematopoietic stem cell transplantation (allo-HSCT). Disease activity defined by multiple inflammatory symptoms is associated with poor survival. In sCAEBV, signal transducer and activator of transcription 3 (STAT3) is constitutively activated in EBV-infected T and NK cells and promotes their activation and survival. Ruxolitinib, a Janus kinase 1/2 inhibitor, suppresses the STAT3 activation in vitro, suggesting its clinical potential. We conducted a phase 2, multicenter, open-label study to investigate the effects of ruxolitinib on disease activity of sCAEBV. Complete response (CR) and partial response were defined as complete and partial resolution of disease activity, respectively. Nine patients received ruxolitinib, and 7 patients completed the study. The primary end point, CR rate (%) 56 days after the administration or at early termination as defined in the protocol, was 22.2% (2/9). No patient showed hematopoietic toxicity nor disease progression. Notably, 71.4% (5/7) of patients who completed the study were treated at our outpatient clinic. One patient developed a severe adverse event of oral bleeding due to lesion shrinkage during the treatment, and ruxolitinib was discontinued. EBV-DNA levels in whole blood did not change significantly whether the treatment was effective or not. After ruxolitinib treatment, 7 patients received allo-HSCT, and 5 of them achieved CR with undetectable EBV-DNA levels in whole blood. Ruxolitinib is a potent treatment drug that may improve allo-HSCT outcomes by suppressing disease activity of sCAEBV. The trial was registered at University hospital Medical Information Network (UMIN), numbered UMIN000035121.</div></div>","PeriodicalId":100189,"journal":{"name":"Blood Neoplasia","volume":"2 1","pages":"Article 100053"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149222","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}

{"title":"Real-world characteristics, treatment patterns, and outcomes of patients with 2 or more LOTs for CLL/SLL in the United States","authors":"Matthew S. Davids ,&nbsp;Jacob Ambrose ,&nbsp;Enrico de Nigris ,&nbsp;Jennifer Prescott ,&nbsp;Siyang Leng ,&nbsp;Mohammed Z. H. Farooqui ,&nbsp;Shravanthi R. Gandra ,&nbsp;Christina M. Zettler ,&nbsp;Laura L. Fernandes ,&nbsp;Ching Kun Wang ,&nbsp;Mazyar Shadman","doi":"10.1016/j.bneo.2024.100047","DOIUrl":"10.1016/j.bneo.2024.100047","url":null,"abstract":"<div><h3>Abstract</h3><div>The development of targeted agents for chronic lymphocytic leukemia (CLL) has transformed the treatment paradigm for patients with CLL. Because of this evolving treatment landscape, contemporaneous evidence was needed related to US treatment patterns and outcomes among patients treated in the real-world. Using COTA’s electronic health records–based database, we examined characteristics, treatment patterns, and outcomes of patients receiving ≥2 lines of therapy (LOTs). A total of 1283 adult patients with CLL were identified who initiated second LOT (2L) between 1 January 2014 and 30 June 2022. Of those patients, 542 (42.2%) later received third-line (3L) therapy, of whom 228 (42.1%) went on to receive fourth-line (4L) therapy. Overall, &gt;18% of patients died after 2L initiation and before 3L initiation, and more than a quarter died before 4L initiation. Most patients were White (77.7%), male (60.6%), aged ≥65 years (68.8%), and treated in a community practice setting (87.8%). From 2014 to 2023, the use of chemoimmunotherapy in any ≥2L LOT decreased, whereas use of Bruton tyrosine kinase inhibitor and B-cell lymphoma 2 inhibitor therapy increased. Across endpoints, median times to event(s) were generally shorter with each subsequent LOT received, both in the overall population and among patients receiving a given therapy in different LOTs. With a median follow-up time from 2L initiation of 38.0 months, median real-world time to next treatment, progression-free survival, and overall survival was 31.9, 33.8, and 80.1 months, respectively. Despite great advancements in CLL treatments since 2014, unmet need persists for patients receiving late LOT.</div></div>","PeriodicalId":100189,"journal":{"name":"Blood Neoplasia","volume":"2 1","pages":"Article 100047"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149223","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}

{"title":"Loss of p53 impairs death receptor expression and confers resistance to CD19 CAR T-cell therapy in BCP-ALL","authors":"Willem P. J. Cox ∗ ,&nbsp;Noël M. M. Dautzenberg ∗ ,&nbsp;Linde Dekker ,&nbsp;Tesa Klenovsek ,&nbsp;Annelisa M. Cornel ,&nbsp;Marliek van Hoesel ,&nbsp;Dorette S. van Ingen Schenau ,&nbsp;Reno S. Bladergroen ,&nbsp;Roland P. Kuiper ,&nbsp;Laurens T. van der Meer ,&nbsp;Friso G. Calkoen † ,&nbsp;Stefan Nierkens † ,&nbsp;Frank N. van Leeuwen †","doi":"10.1016/j.bneo.2024.100060","DOIUrl":"10.1016/j.bneo.2024.100060","url":null,"abstract":"<div><h3>Abstract</h3><div>Loss of p53 function predicts a dismal outcome in relapsed B-cell precursor acute lymphoblastic leukemia (BCP-ALL). Chimeric antigen receptor T-cell (CAR T) therapy was recently approved to salvage relapsed/refractory BCP-ALL. We observed a significantly worse overall survival after CD19-targeting CAR T therapy in children with <em>TP53</em>-mutated (<em>TP53</em>^Mut) compared with <em>TP53</em>–wild-type (<em>TP53</em>^WT) BCP-ALL. To investigate the effect of p53 loss on CAR T therapy response, we modeled <em>TP53</em> mutations in 2 BCP-ALL cell lines and observed resistance to CAR T upon p53 loss. Moreover, expression analysis in cell lines and xenografts demonstrated that loss of p53 abrogates the expression of the death receptors Fas and death receptor 5 (DR5), both implicated in CAR T cytotoxicity. Conversely, ectopic expression of Fas improved CAR T cytotoxicity. Furthermore, p53 stabilization induced expression of both Fas and DR5, accompanied by increased CAR T–mediated killing. Although these findings provide mechanistic insight into why CAR T therapy fails against <em>TP53</em>^Mut BCP-ALL, they may also provide opportunities to enhance the efficacy of CAR T treatment both in patients with <em>TP53</em>^Mut and <em>TP53</em>^WT BCP-ALL. Furthermore, these data underscore the need for alternative curative therapies for this very high-risk patient group.</div></div>","PeriodicalId":100189,"journal":{"name":"Blood Neoplasia","volume":"2 1","pages":"Article 100060"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150203","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}

{"title":"Population differences in the associations between chromosomal abnormalities and overall survival of multiple myeloma","authors":"Bei Wang ,&nbsp;Benjamin A. Derman ,&nbsp;Madina Sukhanova ,&nbsp;Daniel Appelbaum ,&nbsp;John Cursio ,&nbsp;Wei Zhang ,&nbsp;Andrzej Jakubowiak ,&nbsp;Brian C.-H. Chiu","doi":"10.1016/j.bneo.2024.100065","DOIUrl":"10.1016/j.bneo.2024.100065","url":null,"abstract":"<div><h3>Abstract</h3><div>Cytogenetic abnormalities influence the prognosis of multiple myeloma (MM). How these abnormalities associate with overall survival (OS) in European Americans (EAs) and African Americans (AAs) remains unclear. We collected data on fluorescence in situ hybridization targeting 17 cytogenetic abnormalities from 181 patients newly diagnosed with MM between 2010 and 2019. Vital status was ascertained using the National Death Index. Baseline clinical data were retrieved from electronic medical records. Established high-risk cytogenetic abnormalities (HRCAs) include t(4;14), t(14;16), t(14;20), del 17p, and gain/amplification of 1q. In each population, we evaluated the associations between cytogenetic abnormalities and OS. Among 55 AAs and 126 EAs, 65 deaths occurred (median follow-up: 5.8 years). The distribution of the abnormalities was similar between EAs and AAs. High-risk MM, characterized by HRCAs, was associated with worse OS in EAs (hazard ratio [HR], 2.6; 95% confidence interval [CI], 1.3-5.5), but not AAs. Del 13q was associated with worse OS in both populations. Gain/amplification of 1q was associated with poorer OS in EAs (HR, 3.44; 95% CI, 1.3-9.3) but not AAs, whereas t(4;14) was associated with poorer OS in AAs (HR, 14.51; 95% CI, 2.3-92.3) but not EAs. These associations remained after controlling for prognostic factors or other HRCAs, highlighting the potential of population heterogeneity in the prognostic significance of cytogenetic abnormalities.</div></div>","PeriodicalId":100189,"journal":{"name":"Blood Neoplasia","volume":"2 1","pages":"Article 100065"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150204","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}

{"title":"Addition of navitoclax to ruxolitinib for patients with myelofibrosis with progression or suboptimal response","authors":"Naveen Pemmaraju ,&nbsp;Tim C.P. Somervaille ,&nbsp;Francesca Palandri ,&nbsp;Claire Harrison ,&nbsp;Rami S. Komrokji ,&nbsp;Andrew Perkins ,&nbsp;Rosa M. Ayala Diaz ,&nbsp;David Lavie ,&nbsp;Akihiro Tomita ,&nbsp;Yang Feng ,&nbsp;Qin Qin ,&nbsp;Jason Harb ,&nbsp;Akshanth R. Polepally ,&nbsp;Jalaja Potluri ,&nbsp;Jacqueline S. Garcia","doi":"10.1016/j.bneo.2024.100056","DOIUrl":"10.1016/j.bneo.2024.100056","url":null,"abstract":"<div><h3>Abstract</h3><div>Navitoclax (oral B-cell lymphoma-2 family protein inhibitor induces apoptosis of malignant cells in myelofibrosis (MF). We present pooled cohort 1 results from the phase 2 REFINE trial, which evaluated navitoclax plus ruxolitinib (NAV+RUX) for patients with relapsed/refractory MF with suboptimal response to RUX (≥10 mg twice daily stable dose for ≥12 weeks [cohort 1a] or ≥24 weeks [cohort 1b]). Cohort 1a received add-on NAV 50 mg/d, with escalation to ≤300 mg if platelet count was ≥75 × 10⁹/L. Cohort 1b received NAV 100 or 200 mg/d if platelet count was ≤150 or &gt;150 × 10⁹/L, respectively. The primary end point was spleen volume reduction of ≥35% (SVR₃₅) at week 24. Secondary end points included ≥50% total symptoms score (TSS₅₀) reduction at week 24, bone marrow fibrosis (BMF) grade changes, anemia response, and safety. In total, 125 patients received ≥1 dose of NAV+RUX. With median follow-up of 21 months, SVR₃₅ rate was 23% at week 24 and 39% at any time on study (median duration: 11 months). TSS₅₀ rate was 24% at week 24 and 46% at any time on study. BMF improved by ≥1 grade, any time on study, in 39% of patients. Anemia responses were achieved in 23% of patients. Median overall and progression-free survival were 52.3 and 22.1 months, respectively. No new safety signals were observed. The most common adverse event was thrombocytopenia without clinically significant bleeding. NAV+RUX was tolerable and demonstrated early improvement in disease modification parameters in this difficult-to-treat population. This trial was registered at <span><span>www.ClinicalTrials.gov</span><svg><path></path></svg></span> as #<span><span>NCT03222609</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":100189,"journal":{"name":"Blood Neoplasia","volume":"2 1","pages":"Article 100056"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149221","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}

{"title":"Pralatrexate injection combined with oral leucovorin for mucositis management in PTCL/CTCL treatment: a multicenter phase 2 trial","authors":"Swaminathan P. Iyer ,&nbsp;Shaker Dakhil ,&nbsp;Michi M. Shinohara ,&nbsp;Jasmine Zain ,&nbsp;Mark Acosta ,&nbsp;Francine Foss","doi":"10.1016/j.bneo.2024.100055","DOIUrl":"10.1016/j.bneo.2024.100055","url":null,"abstract":"<div><h3>Abstract</h3><div>Pralatrexate (Folotyn) is an antifolate indicated for the treatment of relapsed/refractory peripheral T-cell lymphoma (PTCL), and although durable clinical benefit has been demonstrated, oral and gastrointestinal mucositis and/or skin reactions are frequent toxicity complications associated with pralatrexate treatment. Leucovorin (d,l-folinic acid) administration has been used as a standard rescue for patients receiving high-dose methotrexate therapy and has recently been studied in patients with PTCL and cutaneous T-cell lymphoma receiving pralatrexate. We describe results from a multicenter, phase 2, single-arm, open-label trial, conducted with the primary objective of evaluating the effect of leucovorin in preventing or reducing the incidence of grade 2 or higher oral mucositis associated with pralatrexate treatment in cycle 1. Patients were administered pralatrexate, 30 mg/m² as an IV push, once weekly for 6 weeks in each cycle, followed by a week of rest (no treatment). Leucovorin 25 mg tablets were administered 3 times daily for 2 days (a total of 6 doses [150 mg cumulative weekly dose]), initiated 24 hours (±2 hours) after each pralatrexate dose. The evaluable population included 34 patients, with a mean age of 63.7 years and 60% males, of whom 2 (5.9%) developed grade 2 oral mucositis during the study period (<em>P</em> &lt; .0001) and there were no reports of grade 3 or higher oral mucositis. Dose modifications, including omissions, delays, or reductions, due to oral mucositis were limited to 1 patient. Coadministration of leucovorin resulted in a significant reduction in mucositis and can be considered a prophylactic therapy in patients receiving pralatrexate treatment. This trial was registered at <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span> as #<span><span>NCT02106650</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":100189,"journal":{"name":"Blood Neoplasia","volume":"2 1","pages":"Article 100055"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149225","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}

{"title":"Low platelet counts and low CD4/CD8 ratios at apheresis increase the risk of CAR T-cell manufacturing failure in myeloma","authors":"Tomoyasu Jo ∗ ,&nbsp;Kyoko Yoshihara ∗ ,&nbsp;Masaki Ri ,&nbsp;Nobuhiro Tsukada ,&nbsp;Naoya Mimura ,&nbsp;Keiko Fujii ,&nbsp;Kentaro Fukushima ,&nbsp;Shin-Ichiro Fujiwara ,&nbsp;Yuji Shimura ,&nbsp;Kyoko Haraguchi ,&nbsp;Koji Kato ,&nbsp;Atsushi Satake ,&nbsp;Akiyo Yoshida ,&nbsp;Rikio Suzuki ,&nbsp;Junko Ikemoto ,&nbsp;Keita Iwaki ,&nbsp;Wataru Takeda ,&nbsp;Noboru Yonetani ,&nbsp;Ryuji Tanosaki ,&nbsp;Minami Yamada-Fujiwara ,&nbsp;Yasuyuki Arai","doi":"10.1016/j.bneo.2024.100051","DOIUrl":"10.1016/j.bneo.2024.100051","url":null,"abstract":"<div><h3>Abstract</h3><div>Chimeric antigen receptor (CAR) T-cell (CAR-T) therapy has significantly improved management of relapsed or refractory multiple myeloma. However, manufacturing failure due to poor cell growth necessitates revision of treatment strategies that negatively impact patients. To identify risk factors for CAR-T manufacturing failure in patients with myeloma, a nationwide cohort study was performed, analyzing patients who underwent apheresis for idecabtagene vicleucel in Japan. Of 154 patients analyzed, 13 cases (8.4%) experienced manufacturing failure. We compared clinical factors between patients with manufacturing failure (failed group) and those who met specifications (successful group). Patients in the failed group had a higher prevalence of deletion 17p at diagnosis (38.5% vs 14.9%), were more likely to have been treated with alkylating agents within 6 months before apheresis (53.8% vs 23.4%), and had undergone more chemotherapy lines before apheresis (median, 6 vs 5). Additionally, patients with manufacturing failure exhibited significantly lower hemoglobin levels (8.6 vs 10.0 g/dL), platelet counts (5.9 × 10⁴/μL vs 13.8 × 10⁴/μL), and CD4/CD8 ratios (0.169 vs 0.474) than patient with successful manufacturing. Multivariate analysis revealed that low platelet counts (odds ratio [OR], 0.130 for every increase of 10⁵/μL; <em>P</em> = .041), or low CD4/CD8 ratios (OR, 0.100 for each doubling; <em>P</em> = .003) at apheresis increased the risk of manufacturing failure. Alkylating agents within 6 months before apheresis were associated with decreased platelet counts and CD4/CD8 ratios. Manufacturing failure remains an obstacle to CAR-T therapy for patients with myeloma. Avoiding risk factors, such as alkylating agents, and adopting risk-adapted strategies may optimize CAR-T therapy for patients with myeloma.</div></div>","PeriodicalId":100189,"journal":{"name":"Blood Neoplasia","volume":"2 1","pages":"Article 100051"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150202","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}

{"title":"Pathogenic germ line variants in a prospective multicenter cohort of patients with multiple myeloma","authors":"Julia Erin Wiedmeier-Nutor ,&nbsp;Michael A. Golafshar ,&nbsp;Katie L. Kunze ,&nbsp;Edward D. Esplin ,&nbsp;Robert L. Nussbaum ,&nbsp;Erik Jessen ,&nbsp;Brandie Heald ,&nbsp;A. Keith Stewart ,&nbsp;N. Jewel Samadder ,&nbsp;P. Leif Bergsagel ,&nbsp;Rafael Fonseca","doi":"10.1016/j.bneo.2024.100045","DOIUrl":"10.1016/j.bneo.2024.100045","url":null,"abstract":"","PeriodicalId":100189,"journal":{"name":"Blood Neoplasia","volume":"2 1","pages":"Article 100045"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150206","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}

{"title":"Cerebrospinal fluid attenuates the efficacy of methotrexate against acute lymphoblastic leukemia cells","authors":"Jongseok Kang ∗ ,&nbsp;Jason Ostergaard ∗ ,&nbsp;Xiaohong Wang ,&nbsp;Peter M. Gordon","doi":"10.1016/j.bneo.2024.100057","DOIUrl":"10.1016/j.bneo.2024.100057","url":null,"abstract":"<div><h3>Abstract</h3><div>Treatment and prophylaxis of the central nervous system (CNS) is a standard component of acute lymphoblastic leukemia (ALL) therapy. However, CNS-directed therapies are a significant cause of morbidity, and CNS relapse remains a cause of treatment failure. CNS-directed ALL therapies must target leukemia cells within cerebrospinal fluid (CSF), a fluid that is compositionally distinct from plasma and has been shown to affect leukemia biology. Herein, we demonstrate that human CSF attenuates the potency and efficacy of antifolate drugs including methotrexate, the primary CNS-directed chemotherapeutic for &gt;6 decades. Importantly, this effect of CSF on leukemia methotrexate sensitivity was reversible. Additional mechanistic studies support that diminished proliferation and activation of the integrated stress response in leukemia cells in the CSF may contribute to this resistance. Our findings suggest potential strategies to enhance methotrexate efficacy in CNS-directed ALL therapy and highlight the need to critically reassess even established standards of care.</div></div>","PeriodicalId":100189,"journal":{"name":"Blood Neoplasia","volume":"2 1","pages":"Article 100057"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143149224","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}

{"title":"Diagnostic genomic analysis is prognostic in AYA patients with ALL treated on an MRD-stratified pediatric protocol","authors":"David T. Yeung ∗ ,&nbsp;Laura N. Eadie ∗ ,&nbsp;Jacqueline Rehn ,&nbsp;Susan L. Heatley ,&nbsp;Barbara J. McClure ,&nbsp;Elyse C. Page ,&nbsp;Caitlin E. Schutz ,&nbsp;Michael P. Osborn ,&nbsp;Toby Trahair ,&nbsp;Rosemary Sutton ,&nbsp;Michelle J. Henderson ,&nbsp;John Kwan ,&nbsp;Sally Mapp ,&nbsp;Luciano Dalla-Pozza ,&nbsp;Kenneth Bradstock ,&nbsp;Matthew Greenwood † ,&nbsp;Deborah L. White †","doi":"10.1016/j.bneo.2024.100041","DOIUrl":"10.1016/j.bneo.2024.100041","url":null,"abstract":"<div><h3>Abstract</h3><div>Next-generation sequencing has enabled classification of multiple new recurrent genomic drivers of acute lymphoblastic leukemia (ALL). We aimed to describe the genomic drivers of ALL in an adolescent and young adult (AYA) cohort (ALL06; target age, 15-39 years; recruited age, 16.6-39 years), treated uniformly on a pediatric-inspired protocol (the Australasian Leukaemia and Lymphoma Group ALL06 study). ALL06 assessed the safety and efficacy of adapting a pediatric chemotherapy protocol in older patients. Genomic risk classification of enrolled B-ALL and T-ALL patients was based on multiple assays: messenger RNA sequencing, multiplex ligation-dependent probe amplification, immunophenotyping, and cytogenetics. Using this approach, 36 of 40 (90%) patients with B-ALL and 13 of 17 (76.5%) patients with T-ALL were classified according to genomic risk. A strong correlation existed between adverse genomic risk and minimal residual disease (MRD) at the end of consolidation, translating to inferior overall and relapse free survival. Patients with adverse risk genomics who achieved negative MRD status had improved responses compared with those with persistent MRD. Patients with standard-risk genomics had excellent responses regardless of MRD status. This is the first report of the impact of genomics in an individual cohort of AYA patients treated on a single protocol. These data argue strongly for incorporation of a genomic risk classification into future ALL treatment paradigms at the time of diagnosis, and also for the rigorous assessment of risk assignments in a group of patients who are not children and not older adults. This trial was registered at <span><span>https://anzctr.org.au/</span><svg><path></path></svg></span> as #ACTRN12611000814976.</div></div>","PeriodicalId":100189,"journal":{"name":"Blood Neoplasia","volume":"2 1","pages":"Article 100041"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143150207","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}