Clinical Lymphoma, Myeloma & Leukemia最新文献

{"title":"Real-World Outcomes in First-Line Venetoclax-Based Therapy in Patients With AML Ineligible for Intensive Chemotherapy: A Single Center Study","authors":"Cheryl H. Chang,&nbsp;Allison O. Taylor,&nbsp;Nia M. Mitchell,&nbsp;Susan C. Locke,&nbsp;Jesse D. Troy,&nbsp;Rebecca P. Bystrom,&nbsp;Harry P. Erba,&nbsp;Sanghee Hong,&nbsp;Chenyu Lin,&nbsp;Thomas W. LeBlanc","doi":"10.1016/j.clml.2026.07.018","DOIUrl":"10.1016/j.clml.2026.07.018","url":null,"abstract":"<div><h3>Background</h3><div>VIALE-A established azacitidine and venetoclax as first-line therapy for patients with acute myeloid leukemia (AML) ineligible for intensive chemotherapy. However, real-world use of venetoclax often differs from clinical trial protocols.</div></div><div><h3>Patients and Methods</h3><div>We conducted a single-center retrospective study of 160 AML patients treated with first-line venetoclax-based therapy to investigate how cycle 1 venetoclax exposure, characterized by treatment duration and dose (adjusted for CYP3A inhibitor use), is associated with treatment outcomes.</div></div><div><h3>Results</h3><div>The composite complete response (CRc) rate was 55% overall, and 66% among patients with an evaluable bone marrow biopsy, with a median time to CRc of 41.5 days. Patients receiving 21 ± 3 days of venetoclax in cycle 1 demonstrated higher CRc rates and shorter time to CRc compared with those receiving the standard 28 days, while greater venetoclax dose or exposure in cycle 1 was not associated with improved outcomes. Hematologic adverse events requiring treatment modification were significantly associated with the achievement of CRc (<em>P</em> &lt; .001). Cycle 1 venetoclax exposure did not correlate with subsequent treatment duration.</div></div><div><h3>Conclusion</h3><div>These findings suggest that increased early venetoclax exposure was not associated with improved clinical outcomes in this real-world cohort; however, prospective studies are needed to validate these observations and inform optimization of venetoclax dosing strategies in real-world practice.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 10","pages":"Pages 661-669"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788938","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":"Sequential TKI Treatment in Patients With Chronic Phase Chronic Myeloid Leukemia Resistant to Frontline Nilotinib or Dasatinib Therapy. A Real-Life Survey From the Italian Campus CML Network","authors":"Gabriele Gugliotta,&nbsp;Mario Annunziata,&nbsp;Isabella Capodanno,&nbsp;Davide Rapezzi,&nbsp;Immacolata Attolico,&nbsp;Marianna Caramella,&nbsp;Iolanda D. Vincelli,&nbsp;Antonella R. Rossi,&nbsp;Mario Tiribelli,&nbsp;Alessandra Malato,&nbsp;Michele Cimminiello,&nbsp;Vincenzo Accurso,&nbsp;Massimiliano Bonifacio,&nbsp;Sara Galimberti,&nbsp;Giuseppina Loglisci,&nbsp;Elisabetta Abruzzese,&nbsp;Monica Bocchia,&nbsp;Antonella Gozzini,&nbsp;Micaela Bergamaschi,&nbsp;Maria C. Miggiano,&nbsp;Fabio Stagno","doi":"10.1016/j.clml.2026.07.011","DOIUrl":"10.1016/j.clml.2026.07.011","url":null,"abstract":"<div><h3>Background</h3><div>Limited information is available on the management and outcome of chronic myeloid leukemia (CML) patients who are resistant to first-line treatment with a second-generation tyrosine kinase inhibitor (2G-TKI).</div></div><div><h3>Patients and Methods</h3><div>We conducted a multicenter, real-world, retrospective analysis on 69 chronic phase (CP) CML patients who switched to second-line treatment in case of failure (according to the European LeukemiaNet 2020 recommendations) after first-line nilotinib or dasatinib.</div></div><div><h3>Results</h3><div>The median time to switch to second-line therapy was 15 months, and ponatinib was the most frequently used TKI (68%). As best molecular response (MR), 78% of patients achieved a BCR::ABL1^IS transcript level &lt;1%. The estimated 3-year cumulative incidence of MR3 was 69.4% (95% CI, 53.2%-84.2%). Thirty percent of patients, after a median time of 9 months from the start of second-line treatment, received a third-line treatment, mainly because of resistance (81%). As the best MR to third-line TKI, 50% of patients obtained a BCR::ABL1^IS transcript level &lt;1%. Overall, 9% of patients proceeded to stem-cell transplantation. Progression to blast phase occurred in 7% of patients, and all of them died. An additional patient died because of heart failure. The estimated 5-year progression-free survival and overall survival were 87% (95% CI, 67.1%-95.2%) and 83% (95% CI, 61.7%-93%), respectively. The MR at the last contact was ≥MR4 in 30% and MR3 in 22% of patients.</div></div><div><h3>Conclusion</h3><div>Our analysis highlights that sequential treatment in patients with CP-CML resistant to frontline 2G-TKIs therapy is feasible and can be effective in a relevant proportion of patients.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 10","pages":"Pages e1211-e1217"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788946","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 | Predictive Markers for Ruxolitinib in Myelofibrosis","authors":"Francesca Palandri,&nbsp;Filippo Branzanti","doi":"10.1016/j.clml.2026.07.012","DOIUrl":"10.1016/j.clml.2026.07.012","url":null,"abstract":"<div><div>Myelofibrosis (MF) is a biologically heterogeneous myeloproliferative neoplasm characterized by constitutive activation of the JAK–STAT pathway, progressive marrow fibrosis, cytopenias, splenomegaly, and systemic inflammation. Ruxolitinib, a <em>JAK1</em>/<em>JAK2</em> inhibitor, remains the standard frontline therapy for intermediate- and high-risk MF, providing significant improvements in splenomegaly, constitutional symptoms, and survival. However, responses are highly variable, and a substantial proportion of patients experience suboptimal benefit, early discontinuation, or disease progression, underscoring the need for reliable predictors of treatment outcome. This review summarizes current evidence on clinical, molecular, cytogenetic, and dynamic predictors of ruxolitinib response in MF. Clinical variables, including cytopenic phenotype, peripheral blasts, baseline spleen size, symptom burden, prognostic risk category, timing of treatment initiation, and dose intensity, consistently influence treatment efficacy and durability. Notably, inadequate dose intensity emerges as the most relevant modifiable determinant of response. Molecular profiling further refines risk stratification: high-molecular-risk mutations, increased mutational burden, RAS/CBL pathway alterations, and adverse cytogenetics are associated with inferior outcomes, while driver mutation status alone has limited predictive value. The emergence of dynamic prognostic models such as RR6, iRR6, and STR-PM has enabled the integration of early treatment-related variables, including spleen response, transfusion dependence, and dose intensity, to identify patients at higher risk of treatment failure. These tools represent a shift from static baseline prognostication toward adaptive, response-oriented management. Emerging approaches integrating multi-omics profiling, circulating biomarkers, and artificial intelligence are warranted to further improve individualized decision-making among the expanding JAK inhibitor-based strategies in MF.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 10","pages":"Pages e1147-e1159"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721509","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":"Immunoglobulin D-Associated AL Amyloidosis: Clinical Features and Outcomes","authors":"Sarika D. Gurnani,&nbsp;Andrew Staron,&nbsp;Lisa M. Mendelson,&nbsp;Natasha J. Burke,&nbsp;Vaishali Sanchorawala","doi":"10.1016/j.clml.2026.07.013","DOIUrl":"10.1016/j.clml.2026.07.013","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>When serum or urine immunofixation electrophoresis (IFE) demonstrates a light chain-only monoclonal protein, clinicians should consider the possibility of an underlying IgD monoclonal gammopathy.</div></span></li><li><span>•</span><span><div>Although patients with IgD-associated AL amyloidosis can achieve deep hematologic responses with plasma cell–directed therapies, organ recovery often remains limited.</div></span></li></ul></div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 10","pages":"Pages 706-710"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757877","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| Mediastinal Gray-zone Lymphoma: Novel Biologic Insights and Updates on How Best to Approach This Rare Entity","authors":"Gonca Ozcan,&nbsp;Joseph L. Roswarski,&nbsp;Kieron Dunleavy","doi":"10.1016/j.clml.2026.07.005","DOIUrl":"10.1016/j.clml.2026.07.005","url":null,"abstract":"<div><div>Mediastinal gray zone lymphoma (MGZL) is a very rare aggressive B-cell non-Hodgkin lymphoma characterized by clinical, pathologic, and molecular features that overlap between nodular sclerosis Hodgkin lymphoma (NSHL) and primary mediastinal B-cell lymphoma (PMBL). While these are clinically related lymphomas, recent molecular profiling studies demonstrated similarities between these 3 entities, including alterations in the nuclear factor-κB pathway, JAK2/STAT signaling, copy number alterations in 9p24.1, and immune evasion. In the most recent WHO-5 and ICC classifications, the definition of GZL was restricted to mediastinal GZL (MGZL), which remains as a separate entity between NSHL and PMBL; however, non-mediastinal GZL was classified under diffuse large B-cell lymphoma, not otherwise specified (DLBCL-NOS). Given the rarity of the disease, evolving definition, and diagnostic challenges, few prospective studies have been undertaken to evaluate treatment outcomes. Response rates and survival with frontline chemotherapy are inferior compared to PMBL, and retrospective studies suggest superiority of dose-intensive regimens compared to R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) in MGZL. Despite recent therapeutic advancements in PMBL and classical Hodgkin lymphoma (cHL), most clinical trials have excluded patients with MGZL, leading to uncertainty regarding the best therapeutic strategy in both the frontline and relapsed/refractory settings.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 10","pages":"Pages 633-639"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"KMT2A-Partial Tandem Duplication Associates With Leukemia Transformation in Myelodysplastic Syndrome","authors":"Zhao-Yu Li,&nbsp;Dai-Hong Xie,&nbsp;Wen-Min Chen,&nbsp;Xu Wang,&nbsp;Ling-Di Li,&nbsp;Yue Hao,&nbsp;Jin-Ying Li,&nbsp;Xiao-Su Zhao,&nbsp;Hao Jiang,&nbsp;Qian Jiang,&nbsp;Xiao-Jun Huang,&nbsp;Ya-Zhen Qin","doi":"10.1016/j.clml.2026.07.008","DOIUrl":"10.1016/j.clml.2026.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Partial tandem duplication of <em>KMT2A</em> (<em>KMT2A</em>-PTD) is observed not only in acute myeloid leukemia (AML) but also in myelodysplastic syndrome (MDS), while the prognostic value of <em>KMT2A</em>-PTD in MDS needs to be clarified and the optimal therapies for these patients remains unclear.</div></div><div><h3>Methods</h3><div>In this study, we analyzed 137 MDS patients with <em>KMT2A</em>-PTD from our hospital (PKUPH cohort) and incorporated 2493 MDS patients from the International Working Group for Prognosis in MDS (IWG-PM) cohort, among whom 65 patients had <em>KMT2A</em>-PTD.</div></div><div><h3>Results</h3><div>MDS patients with <em>KMT2A</em>-PTD in IWG-PM cohort had significantly higher blast percentage and IPSS-R score than those without <em>KMT2A</em>-PTD. The 3-year cumulative incidence of leukemia transformation in MDS patients with <em>KMT2A</em>-PTD from both PKUPH and IWG-PM cohort was significantly higher than that in MDS patients without <em>KMT2A</em>-PTD (49.8% [95% CI, 38.6%-61.1%] vs. 19.3% [95% CI, 17.5%-21.2%], <em>P</em> &lt; .001; 58.3% [95% CI, 43.1%-73.5%] vs. 19.3% [95% CI, 17.5%-21.2%], <em>P</em> &lt; .001), respectively. Multivariate analysis in the IWG-PM cohort showed that <em>KMT2A</em>-PTD was an independent poor predictor for leukemia transformation (<em>P</em> &lt; .001). None of co-occurring gene mutations significantly influenced the risk of leukemia transformation in MDS patients with <em>KMT2A</em>-PTD. A landmark analysis in PKUPH cohort suggested that allogenic hematopoietic stem cell transplantation (allo-HSCT) significantly reduced the cumulative incidence of leukemia transformation (<em>P</em> &lt; .001) and the cumulative incidence of relapse (17.6% [95% CI, 5.1%-28.7%] vs. 100% [95% CI, 51.0%-100%], <em>P</em> &lt; .001), respectively.</div></div><div><h3>Conclusion</h3><div><em>KMT2A</em>-PTD may identify a distinct MDS subgroup characterized by a high risk of leukemia transformation, and allo-HSCT could improve outcomes of MDS patients with <em>KMT2A</em>-PTD.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 10","pages":"Pages 689-697"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711477","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| Individualizing Treatment Selection in Myelofibrosis","authors":"Anthony M. Hunter MD,&nbsp;Prithviraj Bose MD","doi":"10.1016/j.clml.2026.07.010","DOIUrl":"10.1016/j.clml.2026.07.010","url":null,"abstract":"<div><div>Myelofibrosis is an advanced myeloproliferative neoplasm that is biologically driven by constitutively active JAK-STAT signaling. Resultant effects on hematopoiesis and inflammatory cytokine signaling give rise to an array of clinical manifestations that include proliferative features, splenomegaly, constitutional symptoms, cytopenias, propensity towards leukemic transformation, and risk of thrombosis, with patients exhibiting a high degree of variability in regard to clinical course. This necessitates an individualized treatment approach that accounts for a variety of clinical and therapy-specific factors. JAK inhibitors have emerged as the cornerstone of therapy. With 4 agents now approved in the class, selecting the appropriate agent is of critical importance. In this review we discuss key variables that should be considered in the creation of a therapeutic plan for patients with myelofibrosis. We will review pharmacologic differences between available JAK inhibitors, discuss the patient factors that drive therapy decisions in myelofibrosis, and highlight emerging therapies in the field.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 10","pages":"Pages 640-648"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758299","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":"Real-World Delivery, Dose Adaptation, and Molecular Monitoring of Gilteritinib, Venetoclax, and Azacitidine in Relapsed or Refractory FLT3-Mutated Acute Myeloid Leukemia","authors":"Meiling Chen,&nbsp;Yuanzhong Chen,&nbsp;Shaoyuan Wang,&nbsp;Feng’e Yang,&nbsp;Jing Zheng,&nbsp;Danhui Fu,&nbsp;Jia Lin,&nbsp;Xiaofan Li,&nbsp;Nainong Li","doi":"10.1016/j.clml.2026.07.015","DOIUrl":"10.1016/j.clml.2026.07.015","url":null,"abstract":"<div><h3>Background</h3><div>Gilteritinib (GIL)-based venetoclax regimens are active in relapsed or refractory (R/R) fms-like tyrosine kinase 3 (<em>FLT3</em>)-mutated acute myeloid leukemia (AML), but real-world delivery after prior targeted therapy remains challenging.</div></div><div><h3>Patients and Methods</h3><div>Adults with <em>FLT3</em>-mutated AML treated with GIL-based therapy from May 2021 to May 2025 were retrospectively reviewed. The analysis focused on patients with active R/R disease who received GIL, venetoclax (VEN), and azacitidine (AZA); patients who received single-agent GIL as post-allogeneic hematopoietic stem cell transplantation (allo-HSCT) maintenance without active leukemia were not the subject of this study and were excluded. The primary endpoint was modified composite remission (mCRc) within 2 cycles.</div></div><div><h3>Results</h3><div>Thirty-eight patients received GIL/VEN/AZA for active R/R disease. Prior <em>FLT3</em>-inhibitor and VEN exposure were present in 63.2% and 28.9%. Early day 14-21 marrow clearance/aplasia occurred in 63.2%, and VEN shortening/interruption in 78.9%. mCRc occurred in 60.5% (95% confidence interval [CI], 43.4-76.0). Among evaluable responders, multiparameter flow-cytometry measurable residual disease (MRD) negativity and <em>FLT3</em> molecular MRD negativity occurred in 66.7% and 72.2%. Median overall survival was 11.2 months. Prior <em>FLT3</em>-inhibitor exposure was not associated with inferior outcome, whereas RAS/mitogen-activated protein kinase (RAS/MAPK)-pathway co-mutation was associated with lower mCRc and shorter survival. Grade 3 or higher infection occurred in 47.4%, and 60-day mortality was 5.3%. Paired failure profiling showed <em>FLT3</em>-persistent and <em>FLT3</em>-loss patterns.</div></div><div><h3>Conclusion</h3><div>GIL/VEN/AZA was feasible in selected heavily pretreated R/R <em>FLT3</em>-mutated AML with early marrow-guided dose adaptation. Molecular context and repeat profiling may guide subsequent therapy.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 10","pages":"Pages e1218-e1228.e3"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788995","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":"Hospital at Home for BCMA-Directed Bispecific Antibodies in Multiple Myeloma: A Multicenter Real-World Feasibility and Safety Study","authors":"Jeremie Zerbit,&nbsp;Marguerite Vignon,&nbsp;Guillemette Fouquet,&nbsp;Marion Detroit,&nbsp;Sylvain Choquet,&nbsp;Laurent Garderet,&nbsp;Olivier Hermine,&nbsp;Clarisse Cazelles,&nbsp;Laurent Frenzel,&nbsp;Mohamad Mohty,&nbsp;Zoe Van De Wyngaert,&nbsp;Stephanie Harel,&nbsp;Ramy Rahme,&nbsp;Mathis Collier,&nbsp;Frederique Moufle,&nbsp;Clement Leclaire,&nbsp;Didier Bouscary,&nbsp;Philippe Moreau,&nbsp;Romain Winer","doi":"10.1016/j.clml.2026.07.017","DOIUrl":"10.1016/j.clml.2026.07.017","url":null,"abstract":"<div><h3>Purpose</h3><div>BCMA-directed bispecific antibodies (BsAbs) have improved outcomes in relapsed/refractory multiple myeloma (rrMM), but early toxicities often require close hospital monitoring. We evaluated the feasibility and safety of BsAb administration through a Hospital at Home (HaH) model.</div></div><div><h3>Patients and Methods</h3><div>We conducted a retrospective multicenter real-world study including consecutive triple-class or penta-refractory rrMM patients treated with teclistamab or elranatamab between July 2022 and January 2024. Outcomes of patients receiving at least one HaH administration were descriptively evaluated alongside those of patients managed exclusively in conventional hospital settings. Safety and survival outcomes were assessed using a 68-day landmark analysis corresponding to the median time to HaH transition.</div></div><div><h3>Results</h3><div>Among 201 patients, 46 received HaH administration and 155 were managed exclusively in hospital. Baseline characteristics were broadly comparable, with differences consistent with clinical selection for HaH, notably performance status. After the landmark, no grade ≥ 3 infection was observed in the HaH group, whereas severe infectious events continued to accumulate in the No HaH group. Rates of post-landmark bacterial, respiratory, opportunistic, and fungal infections were broadly similar across care pathways. Overall survival, progression-free survival, and time to treatment failure did not suggest inferior outcomes in the HaH group.</div></div><div><h3>Conclusion</h3><div>In selected rrMM patients, HaH administration of BsAb therapy was feasible and was not associated with inferior survival outcomes. The lower observed rate of severe infections supports further evaluation of this model, while accounting for clinical selection and supportive-care differences.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 10","pages":"Pages e1178-e1186"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Search of Long-Term Disease Control: CAR T-Cell Therapy With Axicabtagene Ciloleucel or Allogeneic Hematopoietic Cell Transplantation Against Relapsed/Refractory Large B-Cell Lymphoma","authors":"Markus Maulhardt,&nbsp;Lina J. Kolloch,&nbsp;Gina Westhofen,&nbsp;Enver Aydilek,&nbsp;Margarete E. Laage,&nbsp;Christian Plate,&nbsp;Judith Büntzel,&nbsp;Alexander C. Angleitner,&nbsp;Kristian Thomson,&nbsp;Wolfram Jung,&nbsp;Justin Hasenkamp,&nbsp;Evgenii Shumilov,&nbsp;Gerald G. Wulf","doi":"10.1016/j.clml.2026.08.002","DOIUrl":"10.1016/j.clml.2026.08.002","url":null,"abstract":"<div><h3>Background</h3><div>CD19-directed chimeric antigen receptor (CAR) T-cell therapy has become the preferred cellular immunotherapy for relapsed/refractory (r/r) large B-cell lymphoma (LBCL), whereas allogeneic hematopoietic cell transplantation (allo-HCT) remains a potential salvage option. Comparative real-world data between both approaches are limited.</div></div><div><h3>Patients and Methods</h3><div>We conducted a retrospective single-center real-world analysis comparing outcomes of allo-HCT and CD19-directed CAR T-cell therapy with axicabtagene ciloleucel (axi-cel). A total of 187 patients with r/r large B-cell lymphoma (r/r LBCL) were included. Primary endpoints were progression-free survival (PFS) and overall survival (OS). Secondary endpoints included relapse incidence (RI), non-relapse mortality (NRM), and treatment-related toxicities. Propensity score matching (PSM) was performed to adjust for baseline differences.</div></div><div><h3>Results</h3><div>Response rates and relapse incidence were comparable between groups. However, NRM was significantly higher after allo-HCT (12% vs. 36%; <em>P</em> = &lt; .001), mainly driven by infections and graft-versus-host disease. Consequently, axi-cel was associated with superior survival, with 12-month PFS of 50.1% versus 33.8% and OS of 60.5% versus 43.2% (both <em>P</em> &lt; .05). These findings were confirmed in subgroup analyses (≥ 3rd line) and propensity score–matched cohorts. Multivariable analyses identified primary refractoriness and poor performance status as adverse prognostic factors, while treatment modality mainly impacted NRM rather than relapse risk.</div></div><div><h3>Conclusion</h3><div>In conclusion, axi-cel provided superior PFS and OS to patients with r/r LBCL compared with allo-HCT, primarily due to lower treatment-related mortality and improved disease control in patients with chemorefractory disease prior to cellular therapy.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"26 10","pages":"Pages 670-688.e2"},"PeriodicalIF":4.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}