Clinical Lymphoma, Myeloma & Leukemia最新文献

{"title":"Outcomes of Newly Diagnosed Multiple Myeloma Patients Requiring Dialysis.","authors":"Despina Fotiou, Foteini Theodorakakou, Eirini Solia, Vasiliki Spiliopoulou, Ioannis Ntanasis-Stathopoulos, Panagiotis Malandrakis, Erasmia Psimenou, Nikolaos Kanellias, Maria Roussou, Magdalini Migkou, Evangelos Eleutherakis-Papaiakovou, Angeliki Andrikopoulou, Stavroula Giannouli, Maria Gavriatopoulou, Evangelos Terpos, Efstathios Kastritis, Meletios A Dimopoulos","doi":"10.1016/j.clml.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.clml.2025.03.003","url":null,"abstract":"<p><strong>Introduction: </strong>Renal impairment (RI) is a common complication in newly diagnosed multiple myeloma (NDMM), with 1-5% of patients presenting with severe RI requiring dialysis, which is associated with significant morbidity and early mortality. Limited real-world data exist on outcomes for these patients.</p><p><strong>Aim/methods: </strong>We assessed renal response patterns and outcome determinants in 73 consecutive NDMM patients requiring dialysis, treated in a single centre (2010 to 2023).</p><p><strong>Results: </strong>Median age was 69 years; 52% had high-risk cytogenetics. All patients received bortezomib-based induction therapy (19% doublets, 71% triplets, 10% quadruplets; 12% anti-CD38 antibodies). Median follow-up was 37.2 months. Dialysis independence was achieved by 31 patients (42.5%) after a median of 52 days (range 3-247). Dialysis independence was associated with improved survival (median 36 vs. 13.3 months, P = .085) and lower early mortality (3.2% vs. 14.3%, P = .15). Factors associated with independence from dialysis were younger age) OR 0.92, P = .003), hypercalcemia (OR 1.43, P = .013) and hematologic response (≥ PR) at 1 month (OR 3.7, P = .015). In multivariate analysis, younger age (P = .012, OR 0.93) and hematologic response (≥ PR) at 1 month (P = .014, OR 4.94) were independent predictors of dialysis independence. Depth of hematologic response (≥ VGPR) significantly impacted renal recovery (OR 4.0, P = .020). High-risk cytogenetics independently predicted poor outcomes (HR 3.67, P = .003).</p><p><strong>Conclusion: </strong>Dialysis independence is achievable in 42.5% of NDMM patients without special filters in the era of bortezomib-based regimens, with significant impact on outcome. Outcomes remain poor overall for patients who are dialysis-dependent at diagnosis and further evaluation of quadruplet regimens with anti-CD38 antibodies is needed.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy Trends in Acute Myeloid Leukemia: 2004 to 2020.","authors":"Aditya Ravindra, Bradley Loeffler, Luna Acharya, Avantika Pyakuryal, Vijaya Raj Bhatt, Prajwal Dhakal","doi":"10.1016/j.clml.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.014","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy is crucial for treating acute myeloid leukemia (AML), as it improves survival and quality of life. However, prior studies have shown that many eligible patients in the United States do not receive chemotherapy due to demographic and socioeconomic disparities.</p><p><strong>Patients and methods: </strong>We utilized the National Cancer Database to analyze chemotherapy utilization in 82,755 patients with AML from 2004 to 2020. We examined trends in 2 time periods, 2004 to 2010 and 2011 to 2019, with a separate analysis for 2020 to evaluate the impact of the COVID pandemic on chemotherapy use.</p><p><strong>Results: </strong>Among all patients with AML, 57.1% received multiagent chemotherapy, 20.5% received single-agent chemotherapy, and 22.4% received no chemotherapy. Chemotherapy use rose from 72.9% in 2004 to 81.3% in 2019, then slightly declined to 80.6% in 2020. The odds of receiving chemotherapy increased significantly in 2011 to 2019 compared to 2004 to 2010 based on age (P = .02), race (P < .01), and AML subtype (P = .03). Patients aged 18 to 40 consistently had higher chemotherapy utilization rates, with treatment odds rising across all age groups. While Black patients were less likely than White patients to receive chemotherapy from 2004 to 2010, their odds improved significantly in 2011 to 2019. Despite increased chemotherapy use across all AML subtypes, therapy-related AML consistently showed the lowest odds of treatment. Lower-income patients, those with more co-morbidities, and female patients had reduced chances of receiving chemotherapy, and these inequities remained largely consistent over time.</p><p><strong>Conclusion: </strong>This large database study highlights improved but persistent disparities based on demographic and socioeconomic status, calling for innovative measures to expand chemotherapy use.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SOHO State of the Art Updates and Next Questions | Latest Advances in the Management of Primary Mediastinal B-Cell Lymphoma.","authors":"Coen J Lap, Kieron Dunleavy","doi":"10.1016/j.clml.2025.02.013","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.013","url":null,"abstract":"<p><p>Primary mediastinal B-cell lymphoma (PMBCL) is recognized as a distinct clinicopathologic entity that predominantly affects adolescents and young adults (AYA) and is more common in females. Although PMBCL was previously considered to be a subtype of diffuse large B-cell lymphoma, the clinical, histological, and biological characteristics overlap significantly with those of nodular-sclerosing Hodgkin lymphoma (NS-HL). Over recent years, the shared biology of these 2 entities has been highlighted in several studies, and mediastinal gray zone lymphoma, with features intermediate between PMBCL and NS-HL, has been recognized as a unique molecular entity. Although there is a lack of consensus about the optimal therapeutic strategy for patients with newly diagnosed PMCBL, highly curative treatment regimens that obviate the need for mediastinal radiation therapy (RT) are favored by most. Recently, the results from IELSG-37 were presented and demonstrated that patients with a negative PET/CT scan at the completion of treatment do not require consolidative RT. Progress in understanding the biology of PMBCL and its close relationship to NS-HL have helped pave the way for the investigation of novel strategies, including immune checkpoint inhibitors (ICI), CD30-targeting agents and adoptive T-cell approaches. Currently, a clinic trial is ongoing that is evaluating the role of nivolumab with chemo-immunotherapy for the frontline treatment of PMBCL, after ICI have shown robust responses in patients with relapsed and refractory (R/R) PMBCL. In the R/R setting, studies with anti-CD19 CAR-T-cell therapies and treatments with bispecific antibodies have shown good activity.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrowing of the Racial Disparities Gap in Survival of Patients With Mycosis Fungoides: A Longitudinal Analysis of the SEER Database.","authors":"Britney Le, Noha Soror, Hamid D Ismail, Mohammed Baker, Salman Abu Shetayyah, Catherine G Chung, Basem M William","doi":"10.1016/j.clml.2025.02.012","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.012","url":null,"abstract":"<p><strong>Background: </strong>Mycosis fungoides (MF) is the commonest subtype of cutaneous T-cell lymphoma. In the United States, prior studies reported that African Americans (AA) with MF had poor outcomes. Data characterizing differences in racial disparity outcomes over time are limited.</p><p><strong>Patients and methods: </strong>We collected data from the United States Surveillance, Epidemiology, and End Results (SEER) database to investigate the survival patterns of patients with MF from 1988 to 2011. Cases were divided into 3 cohorts based on the year of diagnosis. Univariable and multivariable analysis were conducted to assess for factors associated with overall survival (OS).</p><p><strong>Results: </strong>2896 cases of MF were detected, with a median follow-up duration of 60 months. The disparity in survival between the years 1988-1995 and 2004-2011 was significant (P = .05). The parameter estimates of the Cox proportional hazards model for the 1988-1995 period (using the 2004-2011 period as a reference) was also significant (P = .024). Patients diagnosed between 1988 and 1995 were 1.4 times more likely to die from the disease than those diagnosed between 2004 and 2011. The survival gap between AA and white patients narrowed in 1996-2003 and 2004-2011 in comparison to 1988-1995. This indicates improvements in the survival of AA patients over time. Conversely, the survival rates of white patients remained relatively stable over time.</p><p><strong>Conclusions: </strong>Our study demonstrates that AA with MF have reduced survival. Despite the persistent pattern of lower survival across all periods, the gap in survival between white and AA seems to be narrowing over time.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Predicting Spontaneous Regression in Other Iatrogenic Immunodeficiency-Associated Lymphoproliferative Diseases.","authors":"Kosuke Takayama, Yuki Nakajima, Takuya Miyazaki, Kenji Matsumoto, Haruka Yamanokawa, Yuki Yamada, Kohei Shinmura, Yuto Hibino, Mayoko Shirafuta, Jun Nukui, Marika Tanaka, Haruka Teshigawara, Yoshimi Ishii, Maki Hagihara, Shin Fujisawa, Hideaki Nakajima","doi":"10.1016/j.clml.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.008","url":null,"abstract":"<p><strong>Background: </strong>Other iatrogenic immunodeficiency-associated lymphoproliferative diseases (OIIA-LPDs) occur in patients taking immunosuppressive drugs (ISDs) for autoimmune diseases, such as rheumatoid arthritis and have been suggested to be associated with Epstein-Barr virus (EBV) infection. Although some patients regress spontaneously upon discontinuation of ISDs, factors predicting spontaneous regression (SR) remain controversial. Therefore, we conducted a retrospective observational study of the clinical characteristics and factors associated with treatment response, prognosis, and SR in patients diagnosed with OIIA-LPD.</p><p><strong>Patients and methods: </strong>We analyzed 82 patients at two institutions between 2002 and 2022, 41 (50%) of whom had SR after discontinuation of ISDs, with a 5-year overall survival (OS) rate of 86.3% and a median follow-up of 48 months (range, 9-201 months).</p><p><strong>Results: </strong>The 5-year survival rates of the SR and non-SR groups were 96.9% and 77.2%, respectively. This value was significantly higher in the SR group (P = .001). The 5-year progression-free survival (PFS) rate for all patients was 60.1%, whereas the PFS rate for patients in the non-SR group who required chemotherapy was 54.4%. In univariate analysis, localized stage, good performance status, positive EBV-encoded RNA in situ hybridization (EBER-ISH) results, low C-reactive protein level, and low soluble interleukin-2 receptor (sIL-2R) level were associated with SR. Multivariate analysis revealed that EBER-ISH positivity and low sIL-2R levels were associated with SR (P = .016 and .012, respectively).</p><p><strong>Conclusion: </strong>The OS was significantly longer in the SR group than in the non-SR group. EBER-ISH and sIL-2R levels are predictors of SR.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematological Response to Frontline Treatment in Lower Risk Myelodysplastic Syndromes (LRMDS) is Associated With Better Overall Survival.","authors":"Rami S Komrokji, Muhammad Ammad-Ud-Din, Najla H Al Ali, Zhuoer Xie, Onyee Chan, Andrew T Kuykendall, Seongseok Yun, Alison R Walker, Jeffrey Lancet, Eric Padron, David A Sallman","doi":"10.1016/j.clml.2025.02.010","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.010","url":null,"abstract":"","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melphalan 140 mg/m² is Safe and Effective for Frail and Older Multiple Myeloma Patients With Comparable Rates of Minimal Residual Disease Negativity.","authors":"Jeries Kort, Nikolas Naleid, Frank Oley, James Ignatz-Hoover, Seunghee Margevicius, Pingfu Fu, Ehsan Malek, Brenda Cooper","doi":"10.1016/j.clml.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.004","url":null,"abstract":"<p><strong>Background: </strong>Despite therapeutic advances, multiple myeloma (MM) remains challenging to treat effectively. High-dose melphalan (Mel200) with autologous stem cell transplantation (ASCT) is the standard treatment for transplant-eligible patients. Reduced-dose melphalan (Mel140) is an alternative for older or frail patients, yet its efficacy data remain unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed 233 MM patients undergoing first ASCT between 2014 and 2022, comparing outcomes between Mel140 (n = 82) and Mel200 (n = 151). We assessed patient demographics, disease characteristics, progression-free survival (PFS), and overall survival (OS). In an exploratory subset analysis achievement of MRD from bone marrow samples after ASCT was compared between the 2 groups.</p><p><strong>Results: </strong>As expected, patients who received Mel 140 were significantly older with a higher KPS. Median follow-up was 47.7 months. Both groups had similar rates of readmissions and infections within the first 100 days after transplant despite Mel140 group being older with more comorbidities. No significant difference in PFS or OS was observed between Mel140 and Mel200 groups (P > .05). MRD negativity rates at sensitivity levels of 10^-5 and 10^-6 were comparable (64% vs. 60%, P = .7). Patients achieving sustained MRD negativity demonstrated improved PFS regardless of melphalan dose.</p><p><strong>Conclusion: </strong>Our findings suggest equivalent efficacy and safety profiles between Mel140 and Mel200, supporting Mel140 as a viable option for older or frail MM patients. In a subset analysis equivalent rates of MRD were achieved between the groups and remained a highly significant predictor of PFS, highlighting its relevance regardless of dosing strategies.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma Cytokine and Chemokine Profiles Predict Efficacy and Toxicity of Anti-CD19 CAR-T Cell Therapy in Large B-Cell Lymphoma.","authors":"Fanyuan Zeng, Hanwen Zhang, Shuhua Wang, Tenzin Passang, Yiwen Li, Christopher R Funk, Sarah Wyman, Colin B O'Leary, Aseala I Abousaud, Yuan Liu, Manali Rupji, Kavita M Dhodapkar, Edmund K Waller, Jean L Koff","doi":"10.1016/j.clml.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.009","url":null,"abstract":"<p><strong>Background: </strong>Anti-CD19 chimeric antigen receptor T-cell (CAR-T) therapy has emerged as a promising treatment for large B-cell lymphoma (LBCL); however, durable complete responses are achieved in only 30% to 40% of patients. Additionally, CAR-T therapy is frequently associated with significant toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS).</p><p><strong>Patients and methods: </strong>We explored the translational potential of cytokines and chemokines as predictive biomarkers for CAR-T outcomes by analyzing 47 plasma cytokines/chemokines in serial blood samples from 24 LBCL patients undergoing CAR-T therapy. Blood samples were collected at multiple times: prelymphodepletion, day of CAR-T infusion (Day 0), and post-infusion. We investigated the association between cytokine levels and key clinical outcomes using machine learning models, including treatment response at 3 months, CRS, and ICANS.</p><p><strong>Results: </strong>Higher day 0 IL-7, day 7 IL-21, and day 0 CCL8 levels correlated with improved remission rates. Conversely, elevated CRS risk was linked to higher day 0 CCL17 and day 3 CCL13, IL-6, and IFN-γ levels. ICANS development was associated with increased day 0 TGF-β1, and day 3 IL-5 and IL-7 levels, while lower day 0 CCL19 and day 3 VIP levels were inversely related to ICANS risk. Additionally, patients who received higher-intensity lymphodepletion had elevated day 0 CCL2 and IL-15 levels.</p><p><strong>Conclusion: </strong>These findings highlight the role of plasma cytokines and chemokines as biomarkers for predicting both the therapeutic efficacy and toxicity of CART, with the potential to guide more personalized, safer, and effective immunotherapies for B cell lymphoma.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related Quality of Life in Patients With Relapsed/Refractory Multiple Myeloma Treated With Carfilzomib, Dexamethasone, and Daratumumab Versus Carfilzomib and Dexamethasone: An Analysis of Patient-Reported Outcomes From the Phase 3 CANDOR Trial.","authors":"Katja Weisel, Maria-Victoria Mateos, Ola Landgren, Xavier Leleu, Hang Quach, Lee Bennett, Mihaela Talpes, Istvan Majer, Sachin Patel, Saad Z Usmani","doi":"10.1016/j.clml.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.005","url":null,"abstract":"<p><strong>Background: </strong>In the phase 3 CANDOR trial (NCT03158688), daratumumab added to carfilzomib and dexamethasone (KdD) significantly prolonged progression-free survival relative to carfilzomib and dexamethasone (Kd) alone in previously treated patients with relapsed/refractory multiple myeloma (RRMM).</p><p><strong>Materials and methods: </strong>We present a post hoc analysis of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-item module (EORTC QLQ-C30) and EORTC QLQ Myeloma 20-item module (EORTC QLQ-MY20) patient-reported outcome (PRO) measures from the CANDOR trial.</p><p><strong>Results: </strong>Median (range) duration of observation for PROs was 18.4 (0.9-50.0) months (KdD) and 10.3 (0.9-48.4) months (Kd). PRO compliance rates were high and similar between arms. Mean scores on the EORTC QLQ-C30 global health status (GHS)/quality-of-life (QOL) scale were numerically higher in the KdD than in the Kd arm and were generally sustained or trended toward improvement from baseline. Other EORTC QLQ-C30, EORTC QLQ-MY20, and EQ-5D visual analog scale (VAS) scores were generally similar between treatment arms and were stable over time, with some numerical trends favoring KdD. Risks of deterioration were similar for most scales; hazard ratios suggested improvement for KdD for EORTC QLQ-C30 social functioning, EORTC QLQ-MY20 disease symptoms, and EQ-5D VAS. Results were consistent for lenalidomide-exposed and lenalidomide-refractory subgroups. EORTC QLQ-C30 GHS/QOL scores trended toward improvement at some time points, and other scores remained generally stable when daratumumab was added to carfilzomib and dexamethasone.</p><p><strong>Conclusion: </strong>These results support the benefits of KdD for the RRMM population, including lenalidomide-exposed and lenalidomide-refractory patients.</p><p><strong>Clinical trial registration: </strong>NCT03158688.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SOHO State of the Art Updates and Next Questions | Challenging Scenarios in the Management of Myeloproliferative Neoplasms.","authors":"Joseph Cannova, Shiv Shah, Anand A Patel","doi":"10.1016/j.clml.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.003","url":null,"abstract":"<p><p>Philadelphia-chromosome negative (Ph-neg) myeloproliferative neoplasms (MPNs) carry a variable rate of progression to the fibrotic stage of disease and/or the accelerated/blast-phase (AP/BP) of disease. Many of the challenging management scenarios that arise in the treatment of MPNs occur in those with higher-risk myelofibrosis (MF) or MPN-AP/BP. In this review we will focus upon 3 challenging clinical scenarios pertinent to the management of high-risk MPNs. We discuss how to incorporate molecular data into decision making around allogeneic hematopoietic stem cell transplantation in MF, strategies to address splenomegaly in patients with MF with inadequate response to an initial JAK inhibitor, and what sort of treatment approaches can be employed in the management of MPN-AP/BP.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}