Clinical Lymphoma, Myeloma & Leukemia最新文献

{"title":"Delphi Survey on Measurable Residual Disease in Multiple Myeloma: Prevailing Practices and the Way Forward in India.","authors":"Smeeta Gajendra, Tanima Dwivedi, Karthik Bommannan, Ranjit Kumar Sahoo, Nupur Das, Prashant Tembhare, Khaliqur Rahman, Ajay Gogia, Raja Pramanik, Nitin Dayal, Rakhee Kar, Jyoti Kotwal, Sanjeev, Asish Rath, Diksha Dev, Ganesh Kumar Viswanathan, Man Updesh Singh Sachdeva, Mukul Aggarwal, Devasis Panda, Prashant Mehta, Sreejesh Sreedharanunni, Uday Yanamandra, Arun Kumar Arunachalam, Bhausaheb Bagal, Prabhat S Malik, Anil Handoo, Sanjeev Kumar Gupta, Sameer Bakhshi, Atul Sharma, Deepak Kumar Mishra, Pankaj Malhotra, Lalit Kumar, Ritu Gupta","doi":"10.1016/j.clml.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.016","url":null,"abstract":"<p><strong>Background: </strong>Measurable residual disease (MRD) is becoming a cornerstone in the multiple myeloma (MM) management; however, its implementation in India faces several challenges. This Delphi survey aimed to gather expert consensus on the current practices, and barriers in MRD monitoring in MM in India.</p><p><strong>Methods: </strong>A 3-round Delphi process (2 e-surveys and 1 in-person meeting) was conducted with hematologists, pathologists, and oncologists managing MM in India. Consensus (≥ 75% agreement) led to recommendations for standardized MRD practices.</p><p><strong>Results: </strong>Twenty-five experts participated, agreeing on key protocols: processing first-pull bone marrow aspirates within 24 hours, using a single tube with at least a 10-color panel, acquiring at least 3 million events for 10⁻⁵ sensitivity under proper environmental control, and by adequately trained staff. At least 4 monoclonal antibodies for gating of plasma cells and at least 3 parameters among mast cells, myeloid precursors, hematogones, normal plasma cells, should be used to assess hemodilution. Guidance on modulation of treatment decisions, including maintenance therapy based on MRD status remains inconclusive. Though, there is an agreement that MRD negativity in MM improves survival and lowers relapse risk but currently it does not influence maintenance therapy decisions. MRD testing was advised at postinduction, pre/post-transplant, and annually during maintenance. Challenges identified included protocol variability, interpretation issues, and lack of an external quality assessment program. Experts emphasized the need for advanced flow cytometry training.</p><p><strong>Conclusions: </strong>The findings of this study will guide clinical adoption and future research, particularly for high-risk populations and novel therapies.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293375","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":"Retreatment With Anti-CD38-Based Combinations in Multiple Myeloma in Real-Life: Results From the Emmy Cohort Study.","authors":"Alexis Talbot, Cyrille Hulin, Aurore Perrot, Margaret Macro, Karim Belhadj Merzoug, Mohamed Mohty, Arthur Bobin, Lionel Karlin, Salomon Manier, Laure Vincent, Abderrazak El Yamani, Wajed Abarah, Regis Kaphan, Thomas Chalopin, Daniel Ré, Adrienne de Labarthe, Olivier Fitoussi, Chanaz Lounis, Ronan Garlantezec, Olivier Decaux","doi":"10.1016/j.clml.2025.05.015","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.015","url":null,"abstract":"<p><strong>Introduction: </strong>Anti-CD38 monoclonal antibodies (aCD38) are increasingly used in early lines of therapies in multiple myeloma (MM). Retreatment with aCD38-based regimen is a widely used practice in later lines. However, data coming from clinical trials are currently limited. EMMY is a noninterventional, prospective dynamic cohort study conducted in 73 centers in France to assess the real-life management of MM in France and which can explore the efficacy of aCD38-based retreatment.</p><p><strong>Methods: </strong>Patients who initiated a second line of treatment with aCD38-based combinations after a first exposure to aCD38 were identified and described and the outcomes of progression-free survival (PFS) and overall survival (OS) were estimated.</p><p><strong>Results: </strong>In the EMMY cohort, 286 patients received 2 lines of treatment including aCD38. For all aCD38-retreated patients, median PFS was estimated at 5.1 months. Median PFS was 23.6 m in patients sensitive to aCD38 and 4.6 in nonsensitive patients, P = .0003. Median OS was estimated at 17.3 months for all patients,14.8 months in patients nonsensitive to aCD38, and not reached (NR) in sensitive patients, P = .0004. No significant differences in PFS or OS were observed between the refractory and nonrefractory to aCD38 groups.</p><p><strong>Conclusion: </strong>These results of aCD38 retreatment in a large sample of real-life patients (n = 286) in extensively pretreated patients show that retreatment may be a meaningful strategy for aCD38 sensitive patients. These findings need to be investigated further while the use of aCD38 is emerging as a first-line treatment for newly diagnosed patients.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301235","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":"Practical Guidance on the Clinical Management of Belantamab Mafodotin for Patients With Relapsed/Refractory Multiple Myeloma: Recommendations From the Middle East and North Africa Expert Panel.","authors":"Meral Beksaç, Esra Sahli, Ahmed Rabea, Guray Saydam, Anil Tombak, Ahmad Alhuraiji, Enas Yahya Mutahar, Mohamed Hosny, Ayman Alhejazi, Mervat Mattar, Mehmet Sinan Dal, Mahmoud Marashi, Melis Palamar","doi":"10.1016/j.clml.2025.05.019","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.019","url":null,"abstract":"<p><p>Multiple myeloma (MM) remains a substantial cause of mortality in the Middle East and North Africa, with incidence rising in the region. MM is challenging to treat because many people relapse and/or become refractory to standard of care. Additional challenges in the Middle East and North Africa region include reduced access to newer therapies, resulting in poorer outcomes than in other regions. Belantamab mafodotin-a first-in-class antibody-drug conjugate targeting B-cell maturation antigen-has shown significant efficacy in the recent DREAMM-7 and DREAMM-8 phase 3 trials for patients with relapsed/refractory MM. However, participants experienced a high incidence of ocular adverse events, due to the off-target effects of monomethyl auristatin F, a microtubule inhibitor responsible for belantamab mafodotin's antimyeloma activity. Belantamab mafodotin is currently under regulatory review in several countries; thus, healthcare providers need specific regional guidance to manage these ocular side effects. A panel of 13 experts in hematology/oncology and ophthalmology from Turkey, Egypt, Saudi Arabia, the United Arab Emirates and Kuwait developed these practical recommendations. The recommendations, formulated through detailed discussions, evidence review and clinical experience, focused on several themes around identification and management of ocular adverse events with a specific emphasis on prevention of severe ocular events.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511636","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 Phase I/II Trial of Ruxolitinib with Chemotherapy for Patients with Relapsed and/or Refractory Philadelphia-like Acute Lymphoblastic Leukemia.","authors":"Hannah Goulart, Elias Jabbour, Nicholas J Short, Tapan M Kadia, Naveen Pemmaraju, Koichi Takahashi, Farhad Ravandi, Marina Konopleva, Nitin Jain","doi":"10.1016/j.clml.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.013","url":null,"abstract":"<p><strong>Background: </strong>Philadelphia chromosome-like (Ph-like) acute lymphoblastic leukemia (ALL) represents a high-risk subtype of B-ALL. The disease is driven by a range of kinase-activating mutations, resulting in a similar gene expression profile to that of Ph-positive ALL, and one which may be targetable by JAK- or ABL-directed kinase inhibition.</p><p><strong>Patients and methods: </strong>We conducted a phase I/II trial to explore the safety and efficacy of ruxolitinib or dasatinib in combination with Hyper-CVAD chemotherapy for patients ≥ 10 years of age with relapsed and/or refractory Ph-like ALL (clinicaltrials.gov/NCT02115295).</p><p><strong>Results: </strong>A total of 11 patients were enrolled (ruxolitinib cohort, n = 10; dasatinib cohort, n = 1) with a median age of 24 years. The median number of prior lines of treatment was 3. Genetic aberrations included CRLF2 overexpression (n = 8), HMBOX1-JAK2 fusion (n = 1), IGH-EPOR fusion (n = 1), and NUP214-ABL1 (n = 1). We observed no dose-limiting toxicities in the first 2 cohorts of patients receiving ruxolitinib (15 mg BID, n = 5 and 20 mg BID, n = 3), however enrollment of the third cohort (25 mg BID, n = 2) was terminated early due to slow accrual. The most common ≥ grade 3 adverse events were related to infectious complications. We observed overall low efficacy with 1/10 patients receiving ruxolitinib achieving complete remission with incomplete platelet count recovery.</p><p><strong>Conclusion: </strong>Continued efforts should focus on identifying optimal treatment strategies for this high-risk group of patients.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274302","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":"Comparing Outcomes of First-Line Intensive Chemotherapeutic Regimens in Adult Patients With Acute Lymphoblastic Leukemia at a Tertiary Center.","authors":"Ahmed Mohamed, Emily C Zabor, Meera Patel, Hadil Zureigat, Moath Albliwi, Mark Jinan Chen, Joy Nakitandwe, David S Bosler, Heena Kurish, Akriti G Jain, John C Molina, Sophia Balderman, Abhay Singh, Aaron T Gerds, Sudipto Mukherjee, Hetty E Carraway, Anjali S Advani, Moaath K Mustafa Ali","doi":"10.1016/j.clml.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.012","url":null,"abstract":"<p><strong>Background: </strong>Survival outcomes of acute lymphoblastic leukemia (ALL) in adults remain inferior to those in the pediatric population. Limited data is present directly comparing different first-line intensive regimens in adult patients with ALL.</p><p><strong>Methods: </strong>We conducted a retrospective study comparing outcomes of first-line intensive chemotherapeutic regimens utilized in adult ALL patients at Cleveland Clinic. Outcomes included composite complete response (CCR), minimal residual disease (MRD) flow cytometry (FC-MRD) response, overall survival (OS) and event-free survival (EFS). Multivariable regression and propensity score (PS) weighting were used for adjustment.</p><p><strong>Results: </strong>Out of 161 adult patients with ALL between January, 2017 and August, 2023, 100 received an intensive regimen. Of those, 33% (n = 33) received a pediatric-inspired regimen (PIR) (CALGB-10403, n = 32 (97%)), 39% (n = 39) received CALGB-19802, and 28% (n = 28) received Hyper-CVAD. The median age (IQR) was 27 (21-34) for PIR group, 59 (52-65) years for CALGB-19802 group, and 57 (41-66) years for Hyper-CVAD group. The CCR rates were 88%, 82%, and 81% in PIR, CALGB-19802, and Hyper-CVAD groups. The 3-year OS was 78% (95% CI, 63-95), 58% (95% CI, 44-77), and 70% (95% CI, 52-93) (P = .2) in the above groups, respectively. Hyper-CVAD was associated with a higher odds of FC-MRD negative response to CALGB-19802 (PS-adjusted odds ratio: 3.72, 95% CI, 1.05-14.7, P = .041). The 3-year PS-adjusted OS in Hyper-CVAD was 71% (95% CI, 52-97) compared to 49% (95% CI, 33-73) in CALGB-19802 (P = .14).</p><p><strong>Conclusions: </strong>Compared to an asparaginase-utilizing regimen, CALGB-19802, Hyper-CVAD was associated with higher FC-MRD negative responses. The long-term survival outcomes for patients receiving PIR in young individuals were comparable to those of Hyper-CVAD. Future combination therapies involving blinatumomab and inotuzumab ozogamicin are expected to enhance these outcomes.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274303","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 | Update on Tailoring Therapy in T Cell Lymphomas.","authors":"Christina Moe, Jasmine Zain","doi":"10.1016/j.clml.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.009","url":null,"abstract":"<p><p>Peripheral T cell lymphomas are rare and heterogenous diseases with no clear curative options in the relapsed setting. Treatments based on paradigms for aggressive B cell lymphomas have yielded poor outcomes and there is an immense need for therapies that are directed towards PTCL. Understanding the biology and pathologic pathways for this group of diseases has allowed the development of more specific targeted therapies. The are initially evaluated in the relapsed setting with the hope that these agents will then be combined with more traditional lymphoma directed therapies for improved outcomes. This approach has also elucidated that PTCL subtypes differ in biology and treatments should be tailored depending accordingly.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301236","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":"Feasibility of Bruton's Tyrosine Kinase Inhibitor Discontinuation in Chronic Lymphocytic Leukemia: The Patient Perspective.","authors":"Deborah M Stephens, Chris Stewart, Liza Avruch, Catherine C Coombs, Alexey Danilov, Brian Hill, Mazyar Shadman, Alina Gerrie, Christopher E Jensen, Marc Hoffmann, Allison Winter, Daniel A Ermann, Paul M Barr, Susan O'Brien, Brian Koffman, John C Byrd","doi":"10.1016/j.clml.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.011","url":null,"abstract":"<p><strong>Background: </strong>Bruton's tyrosine kinase inhibitors (BTKi) have prolonged survival in chronic lymphocytic leukemia (CLL), however continuous administration increases toxicity. Little is known about clinical outcomes of patients who discontinue BTKi for reasons other than CLL progression. We aimed to report these outcomes.</p><p><strong>Patients/methods: </strong>With the CLL Society, we solicited volunteers with CLL who self-reported BTKi discontinuation for reasons other than CLL progression to participate in a web-based survey.</p><p><strong>Results: </strong>In 170 patients, BTKi was discontinued for toxicity, because CLL was in remission, or personal choice in 62%, 14% and 8%, respectively. When asked how they felt about stopping the BTKi, most were relieved that they may eliminate toxicity (45%), could focus less on CLL (11%), and would not have to pay for the medicine (7%), while 29% experienced anxiety. A statistically significant increase in perceived quality of life (QOL) was observed from prior- versus post-BTKi discontinuation. Of patients who reported that they experienced clinical CLL progression (n = 80), 46% reported that these events did not happen for ≥ 1 year after BTKi discontinuation. Those that were on a BTKi for ≥ 2 years before discontinuation had more time without CLL relapse.</p><p><strong>Conclusions: </strong>These data provide a unique report of patient experiences. The data suggest that BTKi may be feasible and result in a period of treatment-free remission. The data also indicate that patients are generally relieved when they anticipate BTKi discontinuation and observe significant QOL improvements after BTKi discontinuation. As such, these data should prompt prospective study of time-limited BTKi therapy for CLL.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246758","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":"Incidence and Risk Factors for Pneumonitis Associated With Checkpoint Inhibitors in Relapsed or Refractory Lymphoma.","authors":"Felipe Soto, Ugochi Ebinama, William P Brasher, William C Harding, Alberto Goizueta, Jeremy R Walder, Alexandra Ewing, Vickie R Shannon, Saadia A Faiz, Mehmet Altan, Girish Shroff, Lei Feng, Sattva Neelapu, Sairah Ahmed, Loretta J Nastoupil, Ajay Sheshadri","doi":"10.1016/j.clml.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.008","url":null,"abstract":"<p><strong>Introduction: </strong>Immune checkpoint inhibitors (ICI) have revolutionized relapsed/refractory lymphoma treatment but can cause severe immune-related adverse events (irAEs), including pneumonitis. The incidence and risk factors for ICI-pneumonitis in real-world lymphoma cohorts remain unreported.</p><p><strong>Methods: </strong>We retrospectively reviewed 302 lymphoma patients treated with PD-1 inhibitors at MD Anderson (2015-2022). A multidisciplinary team adjudicated grade ≥ 2 pneumonitis (CTCAEv5). We analyzed demographic, clinical, and treatment data. Cox proportional hazards models assessed univariate and multivariate associations (P < .1 for inclusion).</p><p><strong>Results: </strong>Pneumonitis occurred in 16/302 patients (5%). Univariate analysis identified risk factors: CTLA-4 combination (13.5, 95% CI, 1.7-104.7, P = .01), pre-ICI hypoxemia (HR = 9.2, 95% CI, 2.9-29, P < .001), pre-ICI dyspnea (HR = 3.1, 95% CI, 1.1-8.6, P = .02), CD25-ADC (HR = 4.6, 95% CI, 1.04-21.03, P = .04), and IAP antagonists (HR = 9.2, 95% CI, 1.18-71.2, P = .03). In multivariate analysis, independent risk factors included pre-ICI dyspnea (HR = 4.6, 95% CI, 1.5-14, P = .007), CTLA-4 combination (HR = 24, 95% CI, 2.9-204, P = .003), IAP antagonists (HR = 23.8, 95% CI, 2.6-218, P = .005), and PI3K inhibitors (HR = 14.6, 95% CI, 1.7-123, P = .01). Pneumonitis was not associated with mortality (HR = 0.7, 95% CI, 0.2-2.5, P = .69).</p><p><strong>Discussion: </strong>ICI-pneumonitis incidence was 5%, typically low-grade. CD25-ADC's link to pneumonitis may stem from regulatory T cell depletion. IAP antagonists, which enhance Th1/TNF-α responses, may result in cytotoxic pulmonary injury. PI3K inhibitors, which have been independently associated with pneumonitis, may synergize with ICIs to potentiate risk for pneumonitis.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293376","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 | The Evolving Landscape of Prognostic Models in Chronic Lymphocytic Leukemia.","authors":"Stefano Molica, Ahmad Ibrahim, David Allsup","doi":"10.1016/j.clml.2025.05.010","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.010","url":null,"abstract":"<p><p>The advent of targeted therapies has profoundly altered the prognostic landscape of chronic lymphocytic leukemia (CLL), demanding a reassessment of established predictive models. Initial frameworks, such as the CLL International Prognostic Index (CLL-IPI), primarily relied on clinical and genetic parameters. However, the growing clinical utility of targeted agents highlights the ongoing need to refine these prognostic tools. Although the CLL-IPI remains a valuable metric for progression-free survival (PFS), its capacity to accurately predict overall survival (OS) has been attenuated by the evolution of therapeutic approaches. Novel prognostic models hold promise by leveraging advanced technologies, sophisticated statistical methods, and computational analytics to improve risk stratification. These innovations address the inherent limitations of conventional models, enabling more precise and individualized prognostic assessments. To maintain clinical utility, however, these models must continuously adapt alongside the rapidly advancing therapeutic landscape of CLL. Optimizing patient outcomes requires a fundamental paradigm shift that integrates a broader and more dynamic array of patient-specific data into prognostic evaluations.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246760","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":"Comparative Efficacy and Safety of Daratumumab-Integrated Quadruple Therapy Versus Triple Therapy in Transplant-Eligible Newly Diagnosed Multiple Myeloma: A Systematic Review and Meta-Analysis.","authors":"Kleuber Arias Meireles Martins, Leonardo Januário Campos Cardoso, Filipe Melo Ribeiro, André Luís Pereira, Pedro Henrique Gibram Gontijo, João Pedro Oliveira, Pedro Luiz Lage Bodour Danielian, André Dias Américo, Phillip Scheinberg","doi":"10.1016/j.clml.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.007","url":null,"abstract":"<p><strong>Background: </strong>The standard treatment for newly diagnosed, transplant-eligible multiple myeloma (NDMM) patients typically involves triplet therapy (TT) with bortezomib, lenalidomide or thalidomide, and dexamethasone, followed by autologous stem-cell transplantation. Adding daratumumab, a CD38-targeting monoclonal antibody, to TT has shown promise, though available evidence remains limited. This study systematically reviews and analyzes the impact of adding daratumumab to TT in these patients.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and Cochrane databases were searched for articles comparing the daratumumab integrated QT and standard TT for NDMM. Endpoints included overall response rate (ORR), complete response (CR) or better, disease progression or death, progression-free survival (PFS), overall survival (OS), minimal residual disease (MRD) negativity rate, and adverse events (AEs). Pooled relative risk (RR), and hazard ratios (HR) with 95% CI were calculated using a random-effects model. Heterogeneity was assessed using I² statistics.</p><p><strong>Results: </strong>Five studies involving 3407 patients (1,371 received QT) were included. Disease progression or death was significantly lower in the quadruplet group. Patients receiving QT presented significantly higher PFS and OS, along with higher rates of ORR, and MRD negativity rate. Additionally, the QT group showed a trend towards an increase in CR or better. The risk for both hematological and non-hematological AEs was higher in the QT group.</p><p><strong>Conclusion: </strong>The findings suggest that incorporating daratumumab into standard TT for treating transplant-eligible NDMM patients is associated with higher response rates and reduced disease progression and mortality. However, it is important to note that this regimen also comes with a higher incidence of AEs.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233377","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}