Clinical Lymphoma, Myeloma & Leukemia最新文献

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

{"title":"Matching-Adjusted Indirect Comparison of Daratumumab-Pomalidomide-Dexamethasone and Pomalidomide-Bortezomib-Dexamethasone in Relapsed/Refractory Multiple Myeloma.","authors":"Wee Joo Chng, David Bin-Chia Wu, Cathy Kwang-Wei Wu, Aaron Springford, Caitlin H Daly, Sung-Hoon Jung","doi":"10.1016/j.clml.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.007","url":null,"abstract":"<p><strong>Background: </strong>Standard-of-care treatment for patients with multiple myeloma (MM) typically includes frontline lenalidomide until disease progression, making lenalidomide-refractoriness a challenge in relapsed/refractory MM (RRMM). Lenalidomide-sparing triplet therapies, daratumumab, pomalidomide, and dexamethasone (DPd) and pomalidomide, bortezomib, and dexamethasone (PVd), demonstrated efficacy in lenalidomide-exposed patients in the APOLLO and OPTIMISMM trials, respectively. Without head-to-head trial data, we assessed the comparative effectiveness of DPd versus PVd via matching-adjusted indirect comparison (MAIC).</p><p><strong>Materials and methods: </strong>Using APOLLO individual patient data (IPD) and OPTIMISMM aggregate covariate data plus pseudo-IPD for outcomes, the APOLLO population was re-weighted to match OPTIMISMM aggregate baseline characteristics. Bayesian posterior distributions of DPd versus PVd for progression-free survival (PFS) and overall survival (OS) were estimated using a likelihood-weighted Bayesian Cox model with fixed weights.</p><p><strong>Results: </strong>At baseline, APOLLO included a higher proportion of patients who received ≥ 2 prior lines of therapy, were refractory to prior therapies, and had advanced International Staging System stage versus OPTIMISMM, which would otherwise disadvantage APOLLO versus OPTIMISMM. The PFS hazard ratio (HR) favored DPd over PVd at 0.59 (95% credible interval [CrI]: 0.36, 0.89) with 99% probability of DPd superiority versus PVd. The OS HR appeared to favor DPd over PVd at 0.80 (95% CrI: 0.45, 1.30), with 83% probability of DPd superiority versus PVd; however, the estimated OS benefit was not conclusive.</p><p><strong>Conclusion: </strong>This analysis suggests that DPd improves PFS and might improve OS versus PVd in patients with RRMM. Additional evidence from head-to-head trials or real-world patient databases are warranted to confirm these results.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585076","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":"Antibody Response to Pneumococcal, Influenza, and COVID-19 Vaccination in Patients With Multiple Myeloma.","authors":"Pranjal Singh, Charanpreet Singh, Kamaljeet Kamaljeet, Vijayalakshmi Aravindan Arun, Radha Kanta Ratho, Archana Angrup, Arihant Jain, Sreejesh Sreedharanunni, Gaurav Prakash, Alka Khadwal, Pankaj Malhotra","doi":"10.1016/j.clml.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.006","url":null,"abstract":"<p><strong>Introduction: </strong>Vaccination for common pathogens implicated in causing respiratory illness in patients with Multiple Myeloma (MM) is now recommended by most experts. However, there is limited data regarding the effectiveness of vaccination in these patients.</p><p><strong>Methods: </strong>We conducted a prospective study on the efficacy of pneumococcal, influenza, and COVID-19 vaccination in patients with newly diagnosed MM treated at our center between January and June 2021.</p><p><strong>Results: </strong>Thirty patients completed the vaccination and were analyzed for the effectiveness of the vaccines. A significant rise in pneumococcal (2.87 U/ml vs. 0.68 U/ml; P < .001), Influenza (0.25 IU/L vs. 0.08 IU/L; P < 0.001) and COVID-19 (3.86 IU/L vs. 0.24 IU/L; P < .001) antibody titres was seen in our patients. Nineteen patients (63.3%), 16 patients (53.3%), and 16 patients (53.3%) achieved seroconversion for pneumococcus, influenza, and COVID-19 postvaccination, respectively, and exhibited a 4-fold rise in antibody titer. No serious adverse events were reported after vaccination in the cohort. During the 6-month follow-up, ten patients developed respiratory tract infections- 4 with lower respiratory tract and 6 with upper respiratory tract infections. None of the patients had infections attributable to pneumococcus, influenza, or COVID-19.</p><p><strong>Conclusion: </strong>Our study showed a 50% to 60% seroconversion after vaccination against 3 common respiratory pathogens in patients with newly diagnosed MM.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623782","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":"Corrigendum to \"Pharmacokinetics and Efficacy of Generic Melphalan is Comparable to Innovator Formulation in Patients With Multiple Myeloma Undergoing Autologous Stem Cell Transplantation\" [Clin Lymphoma Myeloma Leuk. 20/2 (2020) 130-135.e1].","authors":"","doi":"10.1016/j.clml.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.clml.2025.01.015","url":null,"abstract":"","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425105","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 Acute Myeloid Leukemia: Current Status and Next Questions.","authors":"Vishrut Shah, Farhad Ravandi","doi":"10.1016/j.clml.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.001","url":null,"abstract":"<p><p>Advances in understanding leukemogenesis in acute myeloid leukemia (AML) have led to new drug approvals in the past 4 years. Ongoing preclinical research is expected to produce more targeted therapies, reducing the need for traditional chemotherapy, while also enhancing classification systems and patient prognostication. In newly diagnosed AML, the mainstay of induction still is 7+3 regimen. In unfit adults, combination of venetoclax and hypomethylating agent has emerged to be the standard of care. Introduction of FLT3 inhibitors with the 7 plus 3 regimen has improved outcomes in FLT3 mutant patients. IDH inhibitors have recently been approved for induction in medically unfit adult. Studies focusing on triplet regimen are underway. FLT3 inhibitors and IDH inhibitors have also been approved for Relapsed and Refractory AML. Menin inhibitors are another novel class of drugs which are currently being studied for both de novo as well as relapsed and refractory AML. For consolidation in fit patients, high dose cytarabine and Allogenic transplant are still the mainstay of treatment whenever feasible. FLT3 inhibitors have been studied as long term maintenance after allogenic stem cell transplantation. As potent regimens achieve high-quality remissions, the need for sensitive assays to detect measurable residual disease (MRD) and predict relapse risk will grow. MRD monitoring using flow cytometry and molecular methods have been effective with cytarabine-based treatments and will be crucial for venetoclax therapies. Eradicating MRD is a key goal for AML subsets, with research focused on targeted and immune- based therapies to eliminate MRD and understand relapse through clonal evolution. Allogeneic stem cell transplant is the most effective treatment for residual leukemia in resistant AML but is limited by toxicity and donor availability. Immune-based strategies, including antibodies and bispecific molecules, show promise in early trials, and safer cellular therapies could expand treatment options.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585116","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: Treatment Options for Marginal Zone Lymphoma.","authors":"Maria Cristina Pirosa, Anastasios Stathis, Davide Rossi, Emanuele Zucca","doi":"10.1016/j.clml.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.clml.2025.02.002","url":null,"abstract":"<p><p>Current classifications identify 3 primary types of marginal zone lymphoma (MZL): extra nodal, splenic, and nodal MZL. MZLs typically have excellent long-term outcomes and often do not require immediate treatment. For asymptomatic patients, active surveillance (watch-and-wait) is the standard approach. However, exceptions exist. Asymptomatic patients with Helicobacter pylori-positive gastric MZL should receive antibiotic eradication therapy upon diagnosis. Similarly, asymptomatic patients infected with hepatitis C virus (HCV) should receive antiviral therapy. Surgical resection is generally not indicated. Involved-site radiotherapy (ISRT) is recommended for localized disease (20-24Gy, depending on the anatomical site). While higher doses are often needed for curative intent, very low-dose ISRT (2×2 Gy) can achieve long-term control and provide effective palliation with minimal toxicity when a definitive cure is not the goal. Symptomatic patients with advanced-stage disease may benefit from systemic rituximab-based treatment. Rituximab monotherapy is suitable for patients who cannot tolerate chemotherapy or prioritize a low-toxicity initial approach. The combination of rituximab with bendamustine or chlorambucil can result in longer response duration and progression-free survival, but not in improved overall survival, and may be preferred for severely symptomatic patients with advanced disease. More intensive doxorubicin-containing regimens, which are more toxic, should be reserved for patients with histological transformation, aggressive presentations, or bulky masses. Although data from clinical trials are limited, several new therapies have shown encouraging results, including bispecific antibodies, chimeric antigen receptor (CAR)-T cell therapy, and small molecules. Treatment choices depend on the MZL subtype, stage, age, comorbidities, and therapeutic goals.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585117","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 Impact of Next-Generation Sequencing of T-Cell Lymphomas: A Single Institution Experience.","authors":"Omar Elghawy, Julia Wang, Olivia J Leung, Nishwant Swami, Veronica Carvajal, Guang Yang, Daniel J Landsburg, Jakub Svoboda, Sunita D Nasta, Elise A Chong, Stephen J Schuster, Colin J Thomas, Jordan S Carter, Adam Bagg, Stefan K Barta","doi":"10.1016/j.clml.2025.01.017","DOIUrl":"https://doi.org/10.1016/j.clml.2025.01.017","url":null,"abstract":"<p><strong>Background: </strong>The understanding of T-cell lymphoma (TCL) pathobiology has grown substantially due to gene expression profiling and high-throughput next-generation sequencing (NGS). However, real-world data on mutational profiles of mature T-cell lymphomas (TCLs) are limited, and their impact on clinical decision making has not been reported.</p><p><strong>Methods: </strong>A single-institution study of biopsies from patients with histopathologically confirmed T-cell lymphomas and available NGS data between January 1, 2021, to July 1, 2023, was performed. Reported variants were classified as disease-associated or pathogenic variants (DAV), or variants of unknown significance (VUS). Individual physicians were surveyed via email regarding the impact of NGS results on next steps in patient care.</p><p><strong>Results: </strong>About 94% of patients (n = 93) had ≥ 1 variants identified; at least 1 pathogenic variant or likely pathogenic variant was identified in 71% of patients (n = 70). Variants were detected in 90 unique genes with 41% (37/90) having disease-associated variants (DAV). The genes with mutations most frequently resulting in disease-associated variants in this study were TET2, RHOA, DNMT3A and TP53, IDH2, and PLCG1. NGS results were integral to clinical management in 19% of patients per physician survey.</p><p><strong>Conclusion: </strong>This work gives insight into the real-world utility of NGS regarding clinical decision making for patients with T-cell lymphoma. Given the impact of NGS on prognostication, evaluation of therapeutic options, as well as cessation of potentially unhelpful treatments, these findings support the role of NGS as an important part in the management of T-cell lymphomas.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472402","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":"mRNA Expression in DLBCL Patients who are CD20 Dim With an Eye Towards More Thoughtful Design of R/R Trials, Possibly Incorporating BCMA Bite Therapy.","authors":"Bruce Hough, Maher Albitar","doi":"10.1016/j.clml.2025.01.016","DOIUrl":"https://doi.org/10.1016/j.clml.2025.01.016","url":null,"abstract":"","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482274","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":"VCd versus VRd in Newly Diagnosed Multiple Myeloma: Matched Real-World Analysis from the Balkan Myeloma Study Group (BMSG)","authors":"Efstathios Kastritis ,&nbsp;Meral Beksac ,&nbsp;Sorina Nicoleta Badelita ,&nbsp;Eirini Katodritou ,&nbsp;Jelena Bila ,&nbsp;Emmanouil Spanoudakis ,&nbsp;Guldane Cengiz Seval ,&nbsp;Zorica Cvetkovic ,&nbsp;Olivera Markovic ,&nbsp;Selami Koçak Toprak ,&nbsp;Dimitra Dalampira ,&nbsp;Daniel Coriu ,&nbsp;Zoi Bezirgiannidou ,&nbsp;Mario Pirsic ,&nbsp;Toni Valkovic ,&nbsp;Iulia Ursuleac ,&nbsp;Aleksandra Sretenovic ,&nbsp;Angeliki Sevastoudi ,&nbsp;Josip Batinic ,&nbsp;Sinziana Barbu ,&nbsp;Meletios A. Dimopoulos","doi":"10.1016/j.clml.2024.08.007","DOIUrl":"10.1016/j.clml.2024.08.007","url":null,"abstract":"<div><h3>Background</h3><div>Bortezomib, dexamethasone and cyclophosphamide (VCd) remains a popular regimen, due to its activity and low toxicity, while bortezomib, lenalidomide and dexamethasone (VRd) is widely used in US and Europe; both are combined with anti-CD38 monoclonal antibodies but VCd and VRd have not been compared directly in adequately powered prospective trials.</div></div><div><h3>Aim</h3><div>We compared the outcomes of 1216 patients treated with VCd (<em>N</em> = 690) or VRd (<em>N</em> = 526) in a real-world setting.</div></div><div><h3>Results</h3><div>Patients treated with VCd had more often severe renal dysfunction, ISS-3 disease, hypercalcemia, elevated LDH, anemia, thrombocytopenia, poor performance while VRd-treated were older and received less often autologous transplant but more frequently maintenance but the duration of induction was similar. VRd was associated with substantially higher overall response and CR/VGPR rates to induction(<em>P</em> &lt; .001) and improved PFS and OS in univariate analysis, especially among patients with standard risk disease, without renal dysfunction and in the elderly; however, in multivariate analysis there was no significant difference in either PFS or OS. In patients strictly matched 1:1 for major prognostic variables (188 in each group, total <em>N</em> = 376), the superiority of VRd in terms of responses rates and depth of response was confirmed, but without significant PFS or OS difference.</div></div><div><h3>Conclusion</h3><div>VRd is a more active induction regimen than VCd, although use of maintenance with lenalidomide may dilute the PFS or OS benefit. VCd induction remains an option in special circumstances. With the implementation of monoclonal antibodies, VCd backbone can be considered for patients without access to or who do not tolerate VRd.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 2","pages":"Pages e71-e81"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281238","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":"Outcomes of Peripheral Blood Haploidentical Stem Cell Transplantation With Post-Transplant Cyclophosphamide and Earlier Initiation of Immunosuppression.","authors":"Mohammad Ma'koseh, Zaid Abdel Rahman, Abeer Yaseen, Ahmad Mesmar, Husam Abu-Jazar, Salwa Saadeh, Duaa Mufarrej, Rozan Alfar, Waleed Da'na, Khalid Halahleh, Hasan Hashem, Akram Al-Ibraheem, Kamal Al-Rabi, Hikmat Abdel-Razeq","doi":"10.1016/j.clml.2025.01.023","DOIUrl":"https://doi.org/10.1016/j.clml.2025.01.023","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral blood (PB) grafts are increasingly used in haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with post-transplant cyclophosphamide (PT-Cy). The optimal timing for initiation of immunosuppression (IS) with calcineurin inhibitors (CNI) and mycophenolate mofetil (MMF) in PB haplo-HSCT is unclear. This study evaluates the outcomes of early initiation of IS prior to PT-Cy.</p><p><strong>Methods: </strong>Medical records of adult patients with hematologic malignancies who received PB haplo-HSCT with PT-Cy between 2017 and 2022 were retrospectively reviewed. IS with CNI and MMF were started on day 0 and 1 postinfusion. Statistical analyses for survival outcomes were performed using the Kaplan-Meier method, and cumulative incidence (CI) models were used to account for competing risks for relapse, and nonrelapse mortality (NRM).</p><p><strong>Results: </strong>A total of 51 patients were included, with a median age of 37 years (range: 19-63) and a median follow-up of 44 months (range: 37.8-53 months). Neutrophil and platelet engraftment were achieved in 98% and 96% of patients, respectively. CRS occurred in 35.3% of patients, predominantly grade I, with only 1 patient developing grade II CRS. At 3 years, overall survival (OS) and progression free survival (PFS) were 51.8% and 50.2%, respectively, and GVHD-relapse free survival (GFRS) was 43.1%. The CI of relapse and NRM at 3 years were 28.2% and 21.6%, respectively.</p><p><strong>Conclusion: </strong>Early initiation of IS in PB haplo-HSCT was associated with high rates of engraftment, low rates of CRS, and favorable long-term survival outcomes. Prospective studies are needed to validate these findings and refine IS timing.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514873","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}