Clinical Lymphoma, Myeloma & Leukemia最新文献

{"title":"Heavy Chain Cast Nephropathy in a Gamma Heavy Chain Disease: RESPONSE to High-Dose Therapy Melphalan and Daratumumab.","authors":"Suhaib Al-Sawajneh, Sai Prasad Desikan, Neriman Gokden, Ashton Byington, Maurizio Zangari, Raman Desikan","doi":"10.1016/j.clml.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.clml.2025.06.004","url":null,"abstract":"","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599609","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":"Renal Failure-Related Mortality in Multiple Myeloma: United States Trends From 1999 to 2020.","authors":"Manayiel Rehmat, Ahmed Raza, Fnu Kalpina, Mateen Ahmad, Eman Alamgir, Moeen Ikram, Eiman Zeeshan","doi":"10.1016/j.clml.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.clml.2025.06.002","url":null,"abstract":"<p><strong>Background: </strong>Multiple myeloma (MM) causes the deposition of monoclonal light chains in kidney tubules and glomeruli. This nephrotoxicity is exacerbated by nephrotoxic medicines, sepsis, dehydration and hypercalcemia. This study assesses the temporal, racial, sex-based, and regional disparities in mortality due to renal failure associated with MM in the US from 1999 to 2020.</p><p><strong>Methods: </strong>Data was extracted from the CDC WONDER database. Age-adjusted mortality rates (AAMRs) per 100,000 persons were determined. The change in AAMRs was examined through annual percent Change (APC) and the average annual percent change (AAPC) using Joinpoint regression. Patients aged 45-85+ years were identified using ICD-10 codes for Multiple Myeloma (C90.0) as the UCD and renal failure (N17-N19) as MCD.</p><p><strong>Results: </strong>Between 1999 and 2020, 42,093 total deaths were found. Overall AAMR declined from 1.94 in 1999 to 1.18 in 2020 (AAPC: -2.10). Men had higher overall AAMR (2.16) than women (1.26). NH Blacks had the highest overall AAMR (3.61), followed by NH Whites (1.47), Hispanics (1.38), and NH Asians (0.82). AAMR also varied substantially by region (Midwest: 1.66; South: 1.65; West: 1.58; Northeast: 1.54). Nonmetropolitan areas had higher AAMR (1.69) than metropolitan areas (1.61). States in the top percentiles were District of Columbia, Maryland and South Carolina.</p><p><strong>Conclusions: </strong>The overall AAMR for renal failure-associated MM mortality decreased from 1999 to 2020. We observed the highest AAMR in males, NH Blacks, Midwest, and nonmetropolitan areas of the US. However, NH Blacks also exhibited the greatest decrease in mortality over the study period.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567195","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":"Elderly Acute Lymphoblastic Leukemia: Low-Dose Chemotherapy and Immunotherapy Combinations.","authors":"Perrine Moyer, Aude-Marie Fourmont, Lucie Freiman, Philippe Rousselot, Patrice Chevallier","doi":"10.1016/j.clml.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.clml.2025.06.001","url":null,"abstract":"<p><p>There is an unmet medical need for the treatment of elderly patients with acute lymphoblastic leukemia (ALL), as only a minority of them achieves long-term survival with current anti-ALL chemotherapy. Here, the recent management of these patients is discussed, including current approaches and future directions, as novel agents developed for refractory/relapsed ALL are now being incorporated into front-line therapies with very promising results. The manuscript will sequentially consider Philadelphia chromosome (Ph) negative ALL, then Ph+ and finally T-ALL. Accordingly, novel strategies using chemo-free approaches and new drugs such as inotuzumab ozogamicin, blinatumomab, venetoclax, tyrosine kinase inhibitors and CAR T-cells will be discussed.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511633","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 | Late/Deferred ASCT in Myeloma.","authors":"Clifton C Mo, Yuxin Liu, Monique A Hartley-Brown, Omar Nadeem, Shonali Midha, Paul G Richardson","doi":"10.1016/j.clml.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.clml.2025.06.003","url":null,"abstract":"<p><p>High-dose melphalan with autologous stem cell transplant (HDM-ASCT) remains a standard-of-care for transplant-eligible patients with newly diagnosed multiple myeloma (NDMM), with data from randomized studies demonstrating progression-free survival (PFS) benefit with transplant versus nontransplant approaches. However, with increasing overall survival (OS) in this setting, associated with the substantial efficacy of triplet and quadruplet regimens and multiple novel treatment approaches, strategic considerations are key, together with a holistic approach taking into account patients' preferences and needs, for treatment decision-making. In this context, the approach of deferring HDM-ASCT is being increasingly considered, associated with various drivers. Rationales for deferring HDM-ASCT include the acute and long-term toxicities and sequelae associated with undergoing transplant, such as the increased mutational burden and elevated risk of secondary leukemia arising following HDM. Given these downsides, another driver for considering deferred HDM-ASCT is that substantial variability in magnitude of PFS benefit has been seen across patient subgroups. Furthermore, despite significant PFS benefit, randomized studies have not shown OS benefit in the era of triplet induction/consolidation and multiple active treatment options at relapse. Additionally, very high rates of minimal residual disease (MRD)-negative responses have been demonstrated with emerging standard-of-care quadruplet induction regimens for NDMM, facilitating potential HDM-ASCT-sparing, MRD-adapted treatment approaches. Finally, novel therapies such as chimeric antigen receptor (CAR) T-cell and bispecific antibody therapies are beginning to be investigated as upfront alternatives in transplant-eligible patients. Thus, associated with these multiple drivers, late or deferred HDM-ASCT is emerging as a potential standard-of-care approach for select transplant-eligible patients with NDMM.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526652","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":"Expression of Kappa Myeloma Antigen (KMA) and Lambda Myeloma Antigen (LMA) on Malignant but Not Normal Plasma Cells Offers Novel Therapeutic Targets for Patients With Myeloma, Amyloidosis and Other Plasma Cell Dyscrasias.","authors":"Mary Sartor, Thomas X Lemarchand, Luise Britz, Jeremy Er, Simon J Harrison, Rosanne Dunn, David J Gottlieb","doi":"10.1016/j.clml.2025.05.022","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.022","url":null,"abstract":"<p><strong>Background: </strong>Kappa myeloma antigen (KMA) and lambda myeloma antigen (LMA) are antigens expressed on the surface of malignant plasma cells (PCs) that may have potential as immunotherapy targets. They arise from conformational epitopes in the constant regions of lipid-associated light chains and are not found on PCs in normal bone marrow (BM).</p><p><strong>Materials and methods: </strong>Antibodies to KMA and LMA (KappaMab, LambdaMab) and other antigens were used to compare the expression of KMA, LMA, B cell maturation antigen (BCMA), CD56 and SLAMF7 on bone marrow PCs. QuantiBrite beads were used to calculate antigen densities. LMA expression was evaluated in a panel of normal human and plasmacytoma tissues.</p><p><strong>Results: </strong>Bone marrow aspirates (n = 195) were analyzed from patients with various clonal plasma cell dyscrasias (PCDs) (114 MM, 39 MGUS, 13 plasmacytoma, 9 SMM and 20 AL-amyloidosis). SLAMF7 expression was universal. KMA was present on 87 of 121 (72%) and LMA on 56 of 74 (76%) samples. BCMA expression exceeded KMA and LMA except in AL-amyloidosis, where KMA and LMA were expressed in 18 of 20 cases, including 4 in which LMA was expressed without BCMA. When all PCDs were considered, antigen density of KMA and LMA exceeded that of BCMA. LMA expression was restricted to malignant PCs and occasional mononuclear cells in normal mucosal associated lymphoid tissue.</p><p><strong>Conclusions: </strong>The broad and selective expression of KMA and LMA on malignant PCs and the high antigen density highlight the potential of these as valuable targets for immunotherapies in a variety of PCDs including AL-amyloidosis.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590522","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 Comparison of Carfilzomib, Lenalidomide, and Dexamethasone Versus Ixazomib, Lenalidomide, and Dexamethasone in Patients With Relapsed/Refractory Multiple Myeloma: KMM2004 Study.","authors":"Do Young Kim, Chang-Ki Min, Hyeon-Seok Eom, Jongheon Jung, Kihyun Kim, Jae Hoon Lee, Kwai Han Yoo, Ji Yun Lee, Ja Min Byun, Sung-Hyun Kim, Ji Hyun Lee, Hee Jeong Cho, Sang Min Lee, Young Rok Do, Sungwoo Park, Junglim Lee, Seung-Shin Lee, Hye Jin Kang, Young Hoon Park, Sung-Nam Lim, Ho-Jin Shin","doi":"10.1016/j.clml.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.clml.2025.06.006","url":null,"abstract":"<p><strong>Background: </strong>Lenalidomide-based triplet regimens, specifically carfilzomib, lenalidomide, and dexamethasone (KRd) and ixazomib, lenalidomide, and dexamethasone (IRd), are recognized as effective treatments for relapsed/refractory multiple myeloma (RRMM). Since 2020, South Korea's National Health Insurance Service has covered these combinations, prompting a need for real-world comparisons of their efficacy and safety.</p><p><strong>Methods: </strong>A retrospective analysis of 182 RRMM patients treated with KRd (112) or IRd (70) at 17 South Korean centers from May 2020 to April 2021 was conducted.</p><p><strong>Results: </strong>Better outcomes for the KRd were expected according to previous randomized controlled trials (RCT). However, there was no significant difference in the overall response rate between the two groups (89.1 vs. 87.0%, P = .67). Responses above very good partial response tended to be higher in the KRd (70.9 vs. 58.0%, P = .075), although not statistically significant. In terms of treatment maintenance, the two groups had a 9.3-month difference in progression-free survival, but it was not statistically significant (19.1 vs. 28.4 months, P = .08). Overall survival was longer for IRd (31.6 months vs. not achieved, P = .02). Analysis revealed that the proper toxicity control and dose modification have influenced these results. Subgroup analysis found no difference in treatment outcome between the two treatments in high-risk patients.</p><p><strong>Conclusions: </strong>Comparing the two treatments in the real-world revealed inconsistent outcomes from the predictions based on RCTs. The KRd showed an advantage in the depth of response, while the IRd showed an advantage in the duration of the response. The findings will be helpful in choosing the best strategies of treatment for patients with RRMM.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574924","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":"Definition, Diagnosis, Risk Stratification and Management of Newly Diagnosed Multiple Myeloma: The Saudi Myeloma Working Group Guidelines.","authors":"Ghazi S Alotaibi, Abdullah S Al Saleh, Ayman Alhejazi, Majed Alahmadi, Ibraheem Motabi, Fahad Z Alsharif, Abdullah Alamer, Omar Abduljalil, Imran Tailor, Mohammed Marei, Ahmed S Barefah, Mansour Aljabry, Saud Alhayli, Binyam Usman, Amr Hanbali, Amal Alabdulwahab, Ihab ElHemaidi, Hatem Mahmoud Alahwal, Enas Mutahar, Ahmad Alsaeed","doi":"10.1016/j.clml.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.clml.2025.06.005","url":null,"abstract":"<p><p>Multiple myeloma is a rising concern globally, with increasing incidence and mortality, especially in low- and middle-income countries. In Saudi Arabia, multiple myeloma care faces significant challenges outside tertiary care centers, including delays in diagnosis, limited availability of standardized treatment protocols, and considerable disparities in healthcare infrastructure. These issues are particularly prominent in non-urban and secondary healthcare facilities, where access to specialized diagnostics and therapies may be restricted, impacting early detection and optimal management of the disease. Although treatment advances have improved survival rates, multiple myeloma remains incurable and poses significant financial burdens due to the high cost of therapies, particularly in resource-constrained settings. This updated guideline from the Saudi Myeloma Working Group aims to address the gaps in newly diagnosed multiple myeloma management in Saudi Arabia.xsy.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567153","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":"Plasmablastic Lymphoma-A Crosstalk Between Myeloma and Lymphoma.","authors":"Maha Hameed, Ahmad Iftikhar, Sakina Abbas, Zohaa Faiz, Fathima Shehnaz Ayoobkhan, Sameer Siddiqui, Muhammad Affan Elahi, Shaista Khadim, Faiz Anwer, Muhammad Husnain","doi":"10.1016/j.clml.2025.05.024","DOIUrl":"https://doi.org/10.1016/j.clml.2025.05.024","url":null,"abstract":"<p><p>Plasmablastic lymphoma (PBL) is a rare type of large B-cell lymphoma that primarily affects immunocompromised individuals, often associated with viral infections such as Human Immunodeficiency Virus (HIV) and Epstein-Barr Virus (EBV). The diagnosis of PBL is often difficult to ascertain due to its overlapping clinical and pathological features with multiple myeloma and large B cell lymphoma. The primary organs of involvement are typically the gastrointestinal system, lymph nodes, oral mucosa, with some involvement of the skin. This review explores the critical aspects of plasmablastic lymphoma, including its clinical features, diagnosis, treatment options, and the latest advancements for this rare disease. Understanding plasmablastic lymphoma is necessary for healthcare professionals and patients alike to improve the outcomes and quality of life for those affected by this aggressive form of lymphoma.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511635","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 | Current and Emerging Novel Treatments for Marginal Zone Lymphoma.","authors":"Izidore S Lossos","doi":"10.1016/j.clml.2025.05.021","DOIUrl":"10.1016/j.clml.2025.05.021","url":null,"abstract":"<p><p>Marginal zone lymphoma (MZL) is a heterogeneous disease representing 7% to 10% of non-Hodgkin lymphomas (NHL). There are no clear guidelines defining the need for treatment initiation and no standardized therapeutic approach for patients with MZL. Previously, many treatments were extrapolated from clinical trials that mainly enrolled patients with follicular lymphoma and did not have statistical power to show treatment efficacy specifically in MZL patients. Currently, the field is moving toward conducting specific trials in MZL patients with specific inclusion criteria for each MZL subtype, assessing response distinctively in FDG avid and nonavid MZL tumors and using MZL-relevant primary endpoints. Herein I briefly describe these changes, summarize previous therapeutic studies in MZL and present preliminary publicly available data on novel emerging treatments, including bispecific antibodies, antibody drug conjugates and novel targeted therapies.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526651","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":"Monoclonal Gammopathies in Africa.","authors":"Abiola Bolarinwa, Lateef Odukoya, Francis Buadi, Vincent Rajkumar, Shaji Kumar, Celine Vachon, Lily Paemka, Linda B Baughn, Joselle M Cook","doi":"10.1016/j.clml.2025.05.023","DOIUrl":"10.1016/j.clml.2025.05.023","url":null,"abstract":"<p><p>People of African descent have a reported higher incidence of multiple myeloma (MM) and increased prevalence of its precursor conditions, monoclonal gammopathy of undetermined significance (MGUS) and smoldering MM (SMM). Despite this, research focusing on people of African descent remains sparse. Even in the absence of robust studies across African populations, major disparities are consistently reported. West Africans and South African Black men have a higher prevalence of MGUS than individuals of European descent. MM has been shown to occur in African individuals at a younger age of diagnosis compared to European individuals, with a relatively higher proportion of females (M/F ∼1 vs. 1.4 in Europeans), delayed diagnosis (symptoms to diagnosis 10-12 months), and a higher prevalence of bone disease at presentation. This review summarizes the existing literature on monoclonal gammopathies for African people and highlights critical gaps in our understanding of the disease within the diverse African population. Importantly, differences in disease biology, with respect to cytogenetic and immunologic differences, which contribute to disparate disease outcomes are discussed. Concerted efforts to bridge knowledge gaps through collaborative research initiatives, both within and beyond the African continent, are urgently needed.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511634","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}