Clinical Lymphoma, Myeloma & Leukemia最新文献

{"title":"Efficacy and Safety of Total Body Irradiation Versus Chemotherapy Conditioning for Hematopoietic Stem Cell Transplant in Adult Acute Lymphoblastic Leukemia: A Systematic Review and Meta-Analysis","authors":"Hasaan Ans ,&nbsp;Haiqah Amjad ,&nbsp;Sara Nazir ,&nbsp;Sara Sajjad Cheema ,&nbsp;Dhruv Mistry ,&nbsp;Tazeen Fatima ,&nbsp;Ahmed Yar Khan ,&nbsp;Muhammad Usama Imtiaz ,&nbsp;Fasih Mand Khan ,&nbsp;Saif Khalid ,&nbsp;Mohammad Ebad Ur Rehman ,&nbsp;Muhammad Salman Faisal","doi":"10.1016/j.clml.2024.12.007","DOIUrl":"10.1016/j.clml.2024.12.007","url":null,"abstract":"<div><div>Hematopoietic stem cell transplantation (HSCT) is a potentially curative option for adults with acute lymphoblastic leukemia (ALL) who have achieved remission. This systematic review and meta-analysis compare the efficacy of total body irradiation (TBI) versus chemotherapy (CHT) based regimens for conditioning in adult ALL patients being prepared for HSCT. A comprehensive literature search was conducted in MEDLINE, Embase, the Cochrane Library, and relevant trial registries from their inception to August 2024. The inclusion criteria encompassed all randomized controlled trials (RCTs) and cohort studies that compared TBI with CHT as conditioning regimens prior to HSCT in adult patients with ALL. The primary outcomes assessed were overall survival (OS) and event-free survival (EFS). All statistical analyses were carried out using RevMan version 5.4, using a random-effects model. This meta-analysis includes 20 cohort studies and one RCT. The relative risk (RR) for OS was 1.37 (95% CI: 1.20-1.57), while the RR for EFS was 1.28 (95% CI: 1.15-1.43), highlighting the superior efficacy of TBI-based regimens in this patient population. TBI was also superior in terms of relapse rate (RR 0.71). The 2 regimens were comparable in terms of nonrelapse mortality, acute graft-versus-host disease (GVHD), and chronic GVHD. When used for conditioning prior to HSCT, TBI-based conditioning regimens demonstrate superior OS, EFS, and relapse outcomes compared to CHT-based regimens.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 4","pages":"Pages e232-e242"},"PeriodicalIF":2.7,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001181","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":"Clinical Outcomes of Patients With Newly Diagnosed Acute Myeloid Leukemia Receiving Treatment in a Safety-Net Hospital System","authors":"Jason Lu ,&nbsp;Preeya Bhakta ,&nbsp;Hyunsoo Hwang ,&nbsp;Curtis Lachowiez ,&nbsp;Effrosyni Apostolidou","doi":"10.1016/j.clml.2024.12.009","DOIUrl":"10.1016/j.clml.2024.12.009","url":null,"abstract":"<div><h3>Background</h3><div>'Standard of care’ therapies for adult acute myeloid leukemia (AML) have yielded 5-year overall survival (OS) rates of 30%-45 %. Risk stratification and novel targeted therapies have improved 5-year OS rates to &gt;75 % for certain groups in specialized centers.</div></div><div><h3>Patients and Methods</h3><div>This is a retrospective cohort analysis of outcomes in patients ≥18 years with newly diagnosed AML treated between 2005 and 2019 in the Harris Health County, Safety-Net Hospital System in Houston, TX.</div></div><div><h3>Results</h3><div>192 patients were identified. Median age was 52 years, 52 % were male and 57 % identified as Hispanic. Most patients were uninsured or indigent, receiving care under the county's financial assistance programs (62 %). Of the 184 response-assessable patients, 139 achieved composite complete remission (CRc) (76 %). 182 patients had indications for HCT and only 25 patients received HCT (14 %), with main reasons including noncitizenship status and financial/insurance constraints. The 5-year OS rate in the entire cohort was 30 % (35 % in patients &lt;60 years and 16 % if ≥60 years), with 92 % of deaths attributed to AML-related complications. Early death (&lt;4 weeks) rate was 2 %. Secondary, adverse-risk AML, and uninsured status all portended significantly worse OS rates, per multivariate analysis. Patients with indications for HCT who received this modality fared significantly better than those who did not receive it (5-year OS 54 % vs. 21 %).</div></div><div><h3>Conclusions</h3><div>Optimizing AML remission induction regimens, reducing medication costs, ensuring timely administration of AML directed therapies, enhancing equity and diversity in clinical trials, and addressing socioeconomic factors may improve leukemia care for underserved patients.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 5","pages":"Pages 349-356"},"PeriodicalIF":2.7,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969631","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":"A Journey Through the Golden Era of Myeloma Treatment: From Bench to Bedside","authors":"Sundar Jagannath","doi":"10.1016/j.clml.2024.12.003","DOIUrl":"10.1016/j.clml.2024.12.003","url":null,"abstract":"","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 5","pages":"Pages 316-318"},"PeriodicalIF":2.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001171","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 Effectiveness of Chemoimmunotherapy and Novel Therapies for Patients With Relapsed/Refractory Aggressive Large B-Cell Lymphoma","authors":"Loretta J. Nastoupil ,&nbsp;Clark R. Andersen ,&nbsp;Amy Ayers ,&nbsp;Yucai Wang ,&nbsp;Thomas M. Habermann ,&nbsp;Dai Chihara ,&nbsp;Brad S. Kahl ,&nbsp;Brian K. Link ,&nbsp;Jean L. Koff ,&nbsp;Jonathon B. Cohen ,&nbsp;Peter Martin ,&nbsp;Izidore S. Lossos ,&nbsp;Michele Stanchina ,&nbsp;Sara Haddadi ,&nbsp;Carla Casulo ,&nbsp;Sabarish Ayyappan ,&nbsp;Ruitao Lin ,&nbsp;Ziyi Li ,&nbsp;Melissa A. Larson ,&nbsp;Matthew J. Maurer ,&nbsp;Christopher R. Flowers","doi":"10.1016/j.clml.2024.11.014","DOIUrl":"10.1016/j.clml.2024.11.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical trials provide meaningful data regarding the safety and efficacy of novel therapies but there is often a lag between the time of new drug approval and information on posttreatment clinical outcomes in real-world practice. This study evaluated clinical outcomes in a large real-world population of patients with relapsed and/or refractory large B-cell lymphoma (r/r LBCL) treated with chemoimmunotherapy or novel therapies in second or later lines of therapy (2L+).</div></div><div><h3>Materials and Methods</h3><div>Data from the Lymphoma Epidemiology of Outcomes (LEO) Consortium of Real-World Evidence (CReWE) cohort (1/1/2015–2/15/2023) were analyzed. Patients’ demographic and clinical characteristics were described and response rates, duration of response, progression-free survival, and overall survival were evaluated. Multivariable Cox proportional hazards regression models were used to assess associations between patient clinical characteristics and outcomes.</div></div><div><h3>Results</h3><div>The 2L+ cohort included patients treated with chemoimmunotherapy (N = 593), lenalidomide-based therapy (n = 60), polatuzumab vedotin-based therapy (N = 116), tafasitamab-based therapy (N = 55), and loncastuximab tesirine (N = 42). Most patients who received prior chimeric antigen receptor T-cell therapy (CAR-T) were refractory to the treatment. Across all patients, overall response rates were &lt;50%, with one-quarter achieving complete response and median duration of response and overall survival were short (&lt;6 and &lt;10 months, respectively) among patients treated with chemoimmunotherapy or novel therapies. The prognosis was worse for patients who had previously received CAR-T. Primary refractory status, high-risk disease, and failing 3 or more lines of therapy were significantly associated with worse outcomes.</div></div><div><h3>Conclusion</h3><div>Patients with r/r LBCL have unfavorable outcomes and need more effective treatment alternatives.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 4","pages":"Pages e183-e199.e8"},"PeriodicalIF":2.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448337","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":"Expert Opinion on Multiple Myeloma Treatment in Brazil in the Bispecific Antibody Era","authors":"Vania Hungria ,&nbsp;Jorge Vaz Pinto Neto MD, PhD ,&nbsp;Pedro Manoel Marques Garibaldi ,&nbsp;Angela Marie Jansen ,&nbsp;Roberto Jose Pessoa de Magalhães Filho ,&nbsp;Fernando Vieira Pericole ,&nbsp;Gayatri Sanku ,&nbsp;Angelo Maiolino","doi":"10.1016/j.clml.2024.12.001","DOIUrl":"10.1016/j.clml.2024.12.001","url":null,"abstract":"<div><div>Multiple myeloma treatment has evolved rapidly with the development of novel targeted therapies. The paper outlines multiple myeloma epidemiology, current treatments, and recent advances, highlighting the role of bispecific antibodies. Brazilian authorities have approved 3 bispecific antibodies (teclistamab, elranatamab, and talquetamab) for relapsed/refractory multiple myeloma patients who have received at least three prior therapies. These therapies have shown promising efficacy in clinical trials, with 61%-74% overall response rates. However, access to these treatments varies significantly between Brazil's private and public healthcare systems. A panel of 6 Brazilian experts in multiple myeloma and bispecific antibody therapy convened for a three-day virtual conference organized and moderated by Americas Health Foundation. They addressed key questions regarding bispecific antibody therapy in multiple myeloma and developed consensus recommendations. While bispecific antibodies offer new hope for multiple myeloma patients, challenges remain in ensuring equitable access to these therapies. The paper discusses the sequencing of bispecific antibodies with other treatments, the management of adverse events, and the need for real-world data. It also highlights the disparities in multiple myeloma treatment between Brazil's public and private healthcare systems, emphasizing the need for targeted efforts to bridge this gap and improve outcomes for all multiple myeloma patients.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 4","pages":"Pages e200-e209"},"PeriodicalIF":2.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982969","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":"Is Bone Marrow Trephine Biopsy Necessary in Multiple Myeloma Patients at Diagnosis?","authors":"Ana Gea ,&nbsp;Tatiana Fernández ,&nbsp;Sara Fernández-Luis ,&nbsp;Juan J. Domínguez-García ,&nbsp;Irene Francés ,&nbsp;Ana Tobalina ,&nbsp;Rodrigo Cantera ,&nbsp;Julia Bannatyne ,&nbsp;Irene Gorostidi ,&nbsp;María Oviedo ,&nbsp;Juan M. Cerezo ,&nbsp;Raquel García ,&nbsp;Andrés Insunza ,&nbsp;Carmen Montes-Gaisán ,&nbsp;Aránzazu Bermúdez ,&nbsp;Santiago Montes-Moreno ,&nbsp;Montserrat Briz ,&nbsp;Enrique M. Ocio","doi":"10.1016/j.clml.2024.12.004","DOIUrl":"10.1016/j.clml.2024.12.004","url":null,"abstract":"<div><div>Multiple myeloma (MM) diagnosis requires ≥10% plasma cell (PC) infiltration in the bone marrow (BM), detected by bone marrow aspiration (BMA) or biopsy (BMB). We evaluated the concordance of these 2 techniques in 189 patients. In 43 cases (23%), the techniques were discordant, 10 due to poor sample quality. In the remaining 33 patients, BMB diagnosed MM, while BMA detected &lt; 10% PC, being symptomatic in 16 patients and smouldering (SMM) in 17. Without an initial BMB, 11% would have been misdiagnosed; and 12% of symptomatic patients would require a second BMA or BMB for strict diagnosis according to current criteria.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 4","pages":"Pages e210-e213"},"PeriodicalIF":2.7,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909381","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 Treatment Patterns and Clinical Outcomes in Patients With Multiple Myeloma Previously Treated With Lenalidomide and an Anti-CD38 Monoclonal Antibody","authors":"Karthik Ramasamy ,&nbsp;Ravi Vij ,&nbsp;David Kuter ,&nbsp;David Cella ,&nbsp;Brian G.M. Durie ,&nbsp;Rafat Abonour ,&nbsp;Robert M. Rifkin ,&nbsp;Sikander Ailawadhi ,&nbsp;Hans C. Lee ,&nbsp;Andrew J. Cowan ,&nbsp;Carrie Ho ,&nbsp;Sujith Dhanasiri ,&nbsp;Susan Fish ,&nbsp;Edward Yu ,&nbsp;Amol D. Dhamane ,&nbsp;Jiaqi Fang ,&nbsp;Thomas S. Marshall ,&nbsp;Amir Samuel ,&nbsp;Liang Liu ,&nbsp;Jessica Katz ,&nbsp;Sundar Jagannath","doi":"10.1016/j.clml.2024.12.002","DOIUrl":"10.1016/j.clml.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>This analysis explored real-world characteristics, treatment patterns and clinical outcomes in patients with relapsed or refractory multiple myeloma (RRMM) previously treated with lenalidomide and an anti-CD38 monoclonal antibody (mAb) and requiring subsequent treatment.</div></div><div><h3>Materials and Methods</h3><div>The PREAMBLE and Connect MM prospective registries of patients with multiple myeloma (MM), and the US nationwide Flatiron Health electronic health record-derived de-identified database were analysed. MM-specific treatment patterns (prior/index therapies) and outcomes (progression-free survival [PFS]/overall survival [OS]) were assessed.</div></div><div><h3>Results</h3><div>This analysis included: PREAMBLE n = 215; Connect MM n = 232; Flatiron Health n = 845. Median age at index was 69.0 years, median 3 prior lines of therapy; &gt; 50% male. The most common index regimens accounted &lt; 15% of treatments (most common PREAMBLE, Connect MM: carfilzomib±dexamethasone; Flatiron Health: pomalidomide+daratumumab+dexamethasone); most patients received classes that they had previously; ≥ 93% were triple-class exposed (immunomodulatory drug, proteasome inhibitor, anti-CD38 mAb). In PREAMBLE, Connect MM and Flatiron Health, respectively: 80.9%, 68.1% and 77.2% were lenalidomide- and anti-CD38 mAb-refractory; 69.3%, 67.2% and 71.1% were triple-class refractory (TCR); median PFS: 5.2 (95% CI 3.7-6.7), 4.4 (3.5-5.6) and 5.3 months (4.8-6.0); median OS: 19.3 (15.8-26.1), 14.2 (11.0-16.9) and 23.1 months (19.0-28.6). PFS and OS were shorter in lenalidomide- and anti-CD38 mAb-refractory patients versus those who were not refractory to both. A similar pattern was observed for TCR patients versus non-TCR patients.</div></div><div><h3>Conclusion</h3><div>There is no uniform standard of care for patients with RRMM with prior exposure to lenalidomide and anti-CD38 mAbs. Survival outcomes are poor, with a need for effective treatments for these patients.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 5","pages":"Pages 337-348.e2"},"PeriodicalIF":2.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969604","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":"Associations Between Patient Characteristics and Progression to Multiple Myeloma Among Patients With Monoclonal Gammopathy of Undetermined Significance: A Systematic Review","authors":"Yimeng Li ,&nbsp;Sylvia H. Hsu ,&nbsp;Rong Wang ,&nbsp;Poy Theprungsirikul ,&nbsp;Natalia Neparidze ,&nbsp;Su-Hsin Chang ,&nbsp;Shi-Yi Wang","doi":"10.1016/j.clml.2024.12.006","DOIUrl":"10.1016/j.clml.2024.12.006","url":null,"abstract":"<div><div>Monoclonal gammopathy of undetermined significance (MGUS) is a pre-malignant condition of multiple myeloma (MM). Evidence suggested old age, black race, male gender, and obesity as risk factors for MGUS development; however, whether they are associated with an increased risk of progression to MM among patients with MGUS is unclear. A systematic search of PUBMED and EMBASE for cohort studies investigating the association between age/race/gender/obesity and progression to MM. We used the Newcastle-Ottawa Scale (NOS) to assess the methodologic quality of the included studies. Summary risk ratios were calculated using random-effects models. We identified 24 publications, of which 17 articles were included in the main analyses. Overall, the quality of the studies was fair (mean NOS = 5.5). Our meta-analyses showed that old age was positively associated with the risk of the MGUS-MM progression (risk ratio: 2.38; 95% confidence interval [CI] 1.59-3.57), while race was not statistically significantly associated with the risk (blacks vs whites: 1.09; 95% CI: 0.77-1.54). Males had a lower risk of MGUS-MM progression, compared to females (risk ratio: 0.70; 95% CI 0.50-1.0; <em>P</em>-value = .048). High body mass index was significantly associated with an increased risk of MGUS-MM progression (risk ratio: 1.32; 95% CI 1.12-1.57). Based on extant research, old age, female sex, and obesity may be implicated in MGUS-MM progression. However, several studies which found an insignificant association between age/gender and progression did not report the risk estimates. Publication bias exists and our risk estimates may be overestimated. More studies are warranted to confirm our findings.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 4","pages":"Pages e222-e231"},"PeriodicalIF":2.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892441","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":"A Review of Clonal Relationships in Myeloproliferative Neoplasms With Co-Mutations of JAK2, CALR or MPL and BCR::ABL1","authors":"Mohammadamin Noorafrooz ,&nbsp;Sanaz Ghods ,&nbsp;Robert Peter Gale ,&nbsp;Ramin Noorafrooz","doi":"10.1016/j.clml.2024.11.007","DOIUrl":"10.1016/j.clml.2024.11.007","url":null,"abstract":"<div><div><em>BCR::ABL1-</em>negative myelo-proliferative neoplasms (MPNs) are characterized by mutations in <em>JAK2, CALR</em>, or <em>MPL</em>. Usually these mutations are co-exclusive of each other and of <em>BCR::ABL1</em>. We reviewed clonal interactions in 177 subjects with mutations in <em>JAK2, CALR</em>, or <em>MPL</em> and <em>BCR::ABL1</em> including <em>JAK2/BCR::ABL1</em> (<em>N</em> = 142), <em>CALR/BCR::ABL1</em> (<em>N</em> = 31), <em>MPL/BCR::ABL1</em> (<em>N</em> = 3). Co-mutations can arise in the same clone or in different sub-clones. In this review we used clonality data, mutation sequencing and therapy response evaluation to address this question. We found that in subjects with <em>JAK2/BCR::ABL1</em> co-mutations there is a complex, branched clonal evolution. In contrast, in subjects with <em>CALR/BCR::ABL1,</em> co-mutations are in different sub-clones. There are too few data in subjects with <em>MPL/BCR::ABL1</em> to critically analyze. However, indirect methods for assessing clonality limit our conclusions. Understanding clonal architecture of MPNs with co-mutations is needed to understand the underlying biology and give appropriate therapy.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 4","pages":"Pages 249-253"},"PeriodicalIF":2.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913881","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":"Clinical Characteristics, Risk Factors and Outcomes of Invasive Fungal Disease in Critically III Patients with Hematological Malignancy: A Retrospective Study","authors":"Changzhen Yang ,&nbsp;Jie Xiong ,&nbsp;Jiakai Wang ,&nbsp;Hongying Bi ,&nbsp;Jianyu Fu ,&nbsp;Xian Liu ,&nbsp;Chun Long ,&nbsp;Qianfu Zhang ,&nbsp;Dehua He ,&nbsp;Yan Tang ,&nbsp;Xu Liu","doi":"10.1016/j.clml.2024.12.005","DOIUrl":"10.1016/j.clml.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Invasive fungal disease (IFD) poses significant challenges for critically ill patients with hematological malignancies (HMs). However, there is limited research on the clinical characteristics, risk factors, and outcomes of IFD within this population.</div></div><div><h3>Method</h3><div>A retrospective study was conducted at a tertiary center in China. The study focused on patients with HMs admitted to the intensive care unit (ICU) between 2014 and 2022.</div></div><div><h3>Results</h3><div>A total of 239 patients were enrolled, among whom 105 (43.9%) were diagnosed with IFD. Further classification revealed that 64.8%, 31.4%, and 3.8% were classified as possible, probable, and proven IFD, respectively. Patients with IFD had significantly prolonged ICU stays compared to those without IFD (median: 4.9 vs. 2.9 days, <em>P</em> &lt; .001). Notably, there was no statistically significant difference in 28-day mortality between the patients with and without IFD (44.8% vs. 54.5%, <em>P</em> = .907). Hypertension, mechanical ventilation (MV) duration exceeding 48 hours, and an extended interval between deterioration and ICU admission emerged as independent risk factors for IFD.</div></div><div><h3>Conclusion</h3><div>IFD is a common complication in critically ill patients with HM and is associated with prolonged length of ICU stay. Additionally, hypertension, prolonged MV duration and delayed ICU transfer are independent risk factors of IFD in these patients.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 4","pages":"Pages e214-e221"},"PeriodicalIF":2.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926615","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}