Clinical Lymphoma, Myeloma & Leukemia最新文献

{"title":"SOHO State of the Art Updates and Next Questions | Atypical Chronic Myeloid Leukemia: Pathogenesis, Diagnostic Challenges and Therapeutic Strategies","authors":"Alessandro Costa ,&nbsp;Massimo Breccia","doi":"10.1016/j.clml.2025.03.007","DOIUrl":"10.1016/j.clml.2025.03.007","url":null,"abstract":"<div><div>Atypical chronic myeloid leukemia (aCML) is a rare and challenging clonal hematopoietic disorder within the myelodysplastic/myeloproliferative neoplasm (MDS/MPN) spectrum. Over the past two decades, substantial progress has been made in understanding the genetic mechanisms driving aCML, revealing a complex and heterogeneous mutational landscape. Key ancestral mutations, such as <em>ASXL1</em> and <em>ETNK1</em>, have been identified, providing a foundation for the pathogenesis and for the possible emergence of secondary abnormalities, particularly in epigenetic regulation (eg, <em>SETBP1</em>), and in splicing process (eg, <em>SRSF2</em>). These molecular insights have been integrated into current diagnostic classifications, refining disease characterization and offering potential targets for precision therapies. Despite these advances, significant clinical challenges persist due to the disease's rarity and the lack of randomized clinical trials. Therapeutic strategies remain inadequately defined, with allogeneic stem cell transplantation being the only curative option. This review provides an overview of the molecular, clinical, and therapeutic information that may pave the way for essential advancements in the proper management of this disease.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 8","pages":"Pages 558-570"},"PeriodicalIF":2.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794370","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":"Analyzing Two Decades of Leukemia Mortality in the U.S. (1999-2020)","authors":"Nouman Aziz ,&nbsp;Waseem Nabi ,&nbsp;Muzamil Khan ,&nbsp;Abu Huraira Bin Gulzar ,&nbsp;Shree Rath ,&nbsp;Asad Ali Ahmed Cheema ,&nbsp;Mirza Ammar Arshad ,&nbsp;Fatima Hussain ,&nbsp;Abraham Titus ,&nbsp;Amar Lal ,&nbsp;Faiz Anwar","doi":"10.1016/j.clml.2025.03.006","DOIUrl":"10.1016/j.clml.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Leukemia is a hematologic malignancy with varying incidence and outcomes influenced by demographic and geographic factors. Understanding mortality trends and disparities is essential for guiding public health policy.</div></div><div><h3>Objective</h3><div>To analyze leukemia mortality trends in the U.S. from 1999 to 2020, focusing on age-adjusted mortality rates (AAMRs), disparities, and geographic patterns.</div></div><div><h3>Methods</h3><div>Data from the CDC WONDER database were analyzed, covering leukemia-related deaths (ICD-10 codes C91-C95). Age groups were stratified into &lt; 45 and ≥ 45 years. Joinpoint regression models estimated annual percentage changes (APCs). Data were examined by demographics, census regions, and urbanization levels.</div></div><div><h3>Results</h3><div>AAMRs for individuals ≥ 45 years declined by an APC of −0.90% but increased slightly from 2018 to 2020. Males, non-Hispanic Whites, and rural populations exhibited higher AAMRs. Among individuals &lt; 45 years old, AAMRs consistently declined with minimal disparities. Acute myeloid leukemia was predominant among older adults, while acute lymphoblastic leukemia affected younger populations.</div></div><div><h3>Conclusion</h3><div>Despite overall declines in leukemia mortality, persistent disparities across age, gender, and geographic regions highlight inequities in healthcare access. Strategic interventions are required to address these gaps and enhance leukemia care nationwide.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 8","pages":"Pages e553-e562"},"PeriodicalIF":2.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794870","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":"Advancing the Management of CH, MDS, and AML From the First Bridging the Gaps in Leukemia, Lymphoma, and Multiple Myeloma Conference","authors":"Hetty E. Carraway ,&nbsp;Andrew M. Brunner ,&nbsp;Catherine E. Lai ,&nbsp;Marlise R. Luskin ,&nbsp;Jae Park ,&nbsp;Alexander E. Perl ,&nbsp;Eytan M. Stein ,&nbsp;Eunice S. Wang ,&nbsp;Amer M. Zeidan ,&nbsp;Joshua F. Zeidner ,&nbsp;Rami Komrokji","doi":"10.1016/j.clml.2025.03.005","DOIUrl":"10.1016/j.clml.2025.03.005","url":null,"abstract":"<div><h3>Purpose</h3><div>The management of myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) have evolved substantially in recent years with the development of targeted therapies and novel nontargeted approaches. However, many questions remain about how to best use current therapies, and there is a large unmet need for effective therapies, particularly for patients with higher-risk MDS, AML, and those with MDS/AML relapsed/refractory (R/R) to prior therapy.</div></div><div><h3>Methods and results</h3><div>A panel of experts was assembled to discuss current controversies and unanswered questions in the care of patients with MDS and AML. Workshop topics included: molecular testing and new classification systems, clonal hematopoiesis, treatment of MDS (lower-risk and higher-risk), frontline treatment of AML, treatment of special populations, treatment of R/R AML, and novel approaches.</div></div><div><h3>Conclusions</h3><div>We identified many areas of ongoing controversy in the diagnosis and management of MDS and AML related to classification and risk assessment, treatment selection, sequencing of therapies, and monitoring of responses. Many clinical trials are ongoing to further improve outcomes for patients with MDS and AML, and we noted potential areas of debate related to study design, selection of endpoints, and assessment of responses. The controversies and gaps in knowledge identified by this panel will inform a follow-up conference in 2025 that will employ a modified Delphi method with a goal of developing and publishing formal consensus recommendations that can provide actionable guidance to clinicians in practice.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 8","pages":"Pages 583-589"},"PeriodicalIF":2.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787869","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":"Expert Perspectives on Current Challenges and Emerging Approaches for Multiple Myeloma: Narrative Review of an Inaugural Bridging the Gaps in Leukemia, Lymphoma, and Multiple Myeloma.","authors":"Ajai Chari, Susan Bal, Sikander Ailawadhi, Amrita Krishnan, Krina K Patel, Jesus G Berdeja, Alfred Garfall, Natalie Callander, Rahul Banerjee, Melissa Alsina, Ajay K Nooka, Binod Dhakal, Cristina Gasparetto, Caitlin Costello","doi":"10.1016/j.clml.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.clml.2025.03.008","url":null,"abstract":"<p><strong>Purpose: </strong>The management of multiple myeloma (MM) is becoming increasingly more complex. The approval of novel treatment approaches provides much-needed opportunities but also raises questions and controversies about how to optimally sequence therapies and select treatments for individual patients.</p><p><strong>Methods and results: </strong>A panel of experts assembled to discuss current controversies in the care of patients with MM across the disease continuum. Workshop topics included: management of smoldering MM; treatment selection for transplant-eligible and transplant-ineligible patients; risk assessment and the possibility of risk-adapted treatment; use of measurable residual disease (MRD) as a clinical trial end point and to guide treatment decisions; management of early relapse; management of triple class-refractory MM; treatment sequencing; and novel therapies.</p><p><strong>Conclusion: </strong>Many controversies remain regarding the management of patients with MM related to risk assessment, treatment selection and sequencing, and the optimal use of current therapies while balancing efficacy, toxicity, patient considerations, and treatment logistics. Ongoing research efforts are needed to further define the optimal use of current therapies and to develop more efficacious therapies for all patients and for particular subset populations with unmet need.</p>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771381","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":"The Monoclonal Gammopathy of Undetermined Significance-Like (MGUS-like) Classifier Stratifies Prognosis in Multiple Myeloma: Results from Real-World Data in Chinese Population","authors":"Wenqiang Yan ,&nbsp;Jieqiong Zhou ,&nbsp;Yuntong Liu ,&nbsp;Jingyu Xu ,&nbsp;Jian Cui ,&nbsp;Chenxing Du ,&nbsp;Shuaishuai Zhang ,&nbsp;Rui Lv ,&nbsp;Weiwei Sui ,&nbsp;Shuhui Deng ,&nbsp;Yan Xu ,&nbsp;Shuhua Yi ,&nbsp;Dehui Zou ,&nbsp;Mu Hao ,&nbsp;Lugui Qiu ,&nbsp;Gang An","doi":"10.1016/j.clml.2025.03.002","DOIUrl":"10.1016/j.clml.2025.03.002","url":null,"abstract":"","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 7","pages":"Pages e452-e456.e4"},"PeriodicalIF":2.7,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742460","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 Data on Outcome of Burkitt Lymphoma and Burkitt Leukemia Treated According to the GMALL B-ALL/NHL 2002 Protocol: A Tertiary Center Experience","authors":"Ricardo Kosch ,&nbsp;Christoph Schaefers ,&nbsp;Christian Frenzel,&nbsp;Walter Fiedler,&nbsp;Katja Weisel,&nbsp;Carsten Bokemeyer,&nbsp;Christoph Seidel ,&nbsp;Finn-Ole Paulsen","doi":"10.1016/j.clml.2025.03.001","DOIUrl":"10.1016/j.clml.2025.03.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Burkitt lymphoma (BL) or leukemia represents a highly aggressive B-cell malignancy requiring intense therapy. Although various different protocols have emerged, few real-world data exist for the GMALL B-ALL/NHL 2002 regimen. Comparative analyses remain challenging because of the disease's rarity.</div></div><div><h3>Methods</h3><div>This retrospective study examined the overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and toxicity in adult patients (pts) with histologically confirmed BL who received the GMALL protocol at the University Medical Center Hamburg-Eppendorf (2012-2022). Statistical analysis identified prognostic factors affecting outcomes.</div></div><div><h3>Results</h3><div>A total of 48 pts (median age 51.5 years, range 22-78) were included. Most presented with Ann Arbor stage IV (68.7%) and high-risk disease by the BL-IPI (54.1%). Burkitt leukemia was present in 27.1%, HIV positivity in 27%, and CNS involvement in 18%. The ORR was 81.6% (73.5% complete response, 8.1% partial response). After a median follow-up of 38 months (range 0-103), the median PFS and OS were not reached; 3-year rates for both PFS and OS were 73%. While not confirmed in multivariate analysis, Burkitt leukemia (HR 3.86, <em>P</em> = .021) and any bone marrow involvement (HR 3.80, <em>P</em> = .049) emerged as adverse prognostic indicators. Severe mucositis (grade ≥ 3) was common (91.7%), and 87.5% experienced at least one febrile neutropenia episode. No grade 5 treatment-related toxicity was observed.</div></div><div><h3>Conclusion</h3><div>These real-world findings underscore the efficacy of the GMALL protocol in BL management, with outcomes comparable to established regimens but coupled with high toxicity rates. Further comparative trials are essential to define the optimal therapeutic strategy.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 7","pages":"Pages e533-e540.e2"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742452","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 Newly Diagnosed Multiple Myeloma Patients Requiring Dialysis","authors":"Despina Fotiou ,&nbsp;Foteini Theodorakakou ,&nbsp;Eirini Solia ,&nbsp;Vasiliki Spiliopoulou ,&nbsp;Ioannis Ntanasis-Stathopoulos ,&nbsp;Panagiotis Malandrakis ,&nbsp;Erasmia Psimenou ,&nbsp;Nikolaos Kanellias ,&nbsp;Maria Roussou ,&nbsp;Magdalini Migkou ,&nbsp;Evangelos Eleutherakis-Papaiakovou ,&nbsp;Angeliki Andrikopoulou ,&nbsp;Stavroula Giannouli ,&nbsp;Maria Gavriatopoulou ,&nbsp;Evangelos Terpos ,&nbsp;Efstathios Kastritis ,&nbsp;Meletios A. Dimopoulos","doi":"10.1016/j.clml.2025.03.003","DOIUrl":"10.1016/j.clml.2025.03.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal impairment (RI) is a common complication in newly diagnosed multiple myeloma (NDMM), with 1-5% of patients presenting with severe RI requiring dialysis, which is associated with significant morbidity and early mortality. Limited real-world data exist on outcomes for these patients.</div></div><div><h3>Aim/Methods</h3><div>We assessed renal response patterns and outcome determinants in 73 consecutive NDMM patients requiring dialysis, treated in a single centre (2010 to 2023).</div></div><div><h3>Results</h3><div>Median age was 69 years; 52% had high-risk cytogenetics. All patients received bortezomib-based induction therapy (19% doublets, 71% triplets, 10% quadruplets; 12% anti-CD38 antibodies). Median follow-up was 37.2 months. Dialysis independence was achieved by 31 patients (42.5%) after a median of 52 days (range 3-247). Dialysis independence was associated with improved survival (median 36 vs. 13.3 months, <em>P</em> = .085) and lower early mortality (3.2% vs. 14.3%, <em>P</em> = .15). Factors associated with independence from dialysis were younger age) OR 0.92, <em>P</em> = .003), hypercalcemia (OR 1.43, <em>P</em> = .013) and hematologic response (≥ PR) at 1 month (OR 3.7, <em>P</em> = .015). In multivariate analysis, younger age (<em>P</em> = .012, OR 0.93) and hematologic response (≥ PR) at 1 month (<em>P</em> = .014, OR 4.94) were independent predictors of dialysis independence. Depth of hematologic response (≥ VGPR) significantly impacted renal recovery (OR 4.0, <em>P</em> = .020). High-risk cytogenetics independently predicted poor outcomes (HR 3.67, <em>P</em> = .003).</div></div><div><h3>Conclusion</h3><div>Dialysis independence is achievable in 42.5% of NDMM patients without special filters in the era of bortezomib-based regimens, with significant impact on outcome. Outcomes remain poor overall for patients who are dialysis-dependent at diagnosis and further evaluation of quadruplet regimens with anti-CD38 antibodies is needed.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 7","pages":"Pages 532-538"},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691372","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":"Disease Phenotype Significantly Influences the Outcome After Discontinuation of Ruxolitinib in Chronic Phase Myelofibrosis","authors":"Francesca Palandri ,&nbsp;Massimo Breccia ,&nbsp;Erika Morsia ,&nbsp;Elena M. Elli ,&nbsp;Giulia Benevolo ,&nbsp;Mario Tiribelli ,&nbsp;Eloise Beggiato ,&nbsp;Mirko Farina ,&nbsp;Giovanni Caocci ,&nbsp;Novella Pugliese ,&nbsp;Alessia Tieghi ,&nbsp;Monica Crugnola ,&nbsp;Gianni Binotto ,&nbsp;Francesco Cavazzini ,&nbsp;Elisabetta Abruzzese ,&nbsp;Alessandro Isidori ,&nbsp;Alessandra Dedola ,&nbsp;Alessandra Iurlo ,&nbsp;Roberto M. Lemoli ,&nbsp;Daniela Cilloni ,&nbsp;Filippo Branzanti","doi":"10.1016/j.clml.2025.02.015","DOIUrl":"10.1016/j.clml.2025.02.015","url":null,"abstract":"<div><h3>Introduction</h3><div>In patients with myelofibrosis (MF), overall survival (OS) after ruxolitinib discontinuation is poor, with leukemic transformation, clonal evolution and thrombocytopenia as the main factors worsening prognosis.</div></div><div><h3>Patients and Methods</h3><div>To assess the impact of disease phenotype on outcome after ruxolitinib discontinuation in chronic phase patients, we performed a sub-analysis of the “RUX-MF” study (NCT06516406), which now includes 1055 MF patients who received ruxolitinib in a real-life context.</div></div><div><h3>Results</h3><div>After a median follow-up of 3.3 years, 397 patients discontinued ruxolitinib therapy while in chronic phase. At treatment end, 208 patients (52.4%) had a severely cytopenic phenotype (defined as platelets &lt; 100 × 10⁹/L and/or hemoglobin &lt; 8 g/dL); among the remaining myeloproliferative 189 patients, 97 had no cytopenia (51.3%) and 92 (48.7%) had mild anemia only (hemoglobin between 8 and 10 g/dL). Overall, 175 patients (44.1%) had a large splenomegaly (palpable at ≥ 10 cm below costal margin).</div><div>After ruxolitinib discontinuation, 3-year OS was 33.4% in severely cytopenic and 54.4% in myeloproliferative patients (<em>P</em> &lt; .001); this was confirmed after adjustment for risk categories. Noncytopenic and mildly anemic patients had comparable OS (<em>P</em> = .73). Patients with large splenomegaly had significantly poorer OS compared to nonsplenomegalic patients (OS: 33.5% vs. 51.6% <em>P</em> = .01). Large splenomegaly confirmed its negative prognostic impact on OS of patients with myeloproliferative MF (60.7% vs. 44.5%, <em>P</em> = .05). In patients with severe cytopenia, the presence of a large splenomegaly did not influence OS (41.7% vs. 26.1%, <em>P</em> = .26).</div></div><div><h3>Conclusions</h3><div>Cytopenic phenotype and large splenomegaly in myeloproliferative MF are key prognostic determinants of outcome after ruxolitinib discontinuation.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 7","pages":"Pages e524-e532.e3"},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708889","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":"Survival, Years of Life Lost and Attrition Rates in Multiple Myeloma Patients in France","authors":"Aurore Perrot ,&nbsp;Fanny Raguideau ,&nbsp;Helene Denis ,&nbsp;Martin Prodel ,&nbsp;Matthieu Javelot ,&nbsp;Marie Pierres ,&nbsp;Cyrille Touzeau","doi":"10.1016/j.clml.2025.03.004","DOIUrl":"10.1016/j.clml.2025.03.004","url":null,"abstract":"<div><h3>Background</h3><div>In a context of strong evolution of multiple myeloma (MM) treatment paradigm, real-world data allow a better understandingthe patients' medical needs.</div></div><div><h3>Methods</h3><div>The present analyses from the MYLORD study were designed to provide recent data on MM patients: characteristics, overall survival (OS), years of life lost (YLL) and attrition rates, using the French National Health Insurance Database (SNDS). It is based on a cohort of 33,032 MM patients who initiated a frontline therapy from 2014 to 2021 in France and who were followed until 2021.</div></div><div><h3>Results</h3><div>The 5-year OS rate is estimated at 51.9% (95% CI: 51.2–52.6). This rate is 78.3% (95% CI: 77.1–79.5) for patients with frontline autologous stem cell transplant (L1T) and 43.6% (95% CI: 42.8–44.4) for those without transplant (L1NT). The excess of mortality in MM patients is revealed by 12.3 YLL versus the matched general population and is higher in L1T patients than those L1NT (17 vs. 11 years). The attrition rate is important in MM patients with 38% of patients who did not benefit from at least 2 lines of treatment and is higher in L1NT patients than those in L1T (41% vs. 29%). Also, the majority of L1NT patients did not receive a L2 because of death, whereas it is because of stay in line status for L1T patients.</div></div><div><h3>Conclusion</h3><div>These results emphasize the urgency to treat MM patients with the best and tailored treatment strategy available, for all MM patients beneficiating or not from a transplant in frontline therapy. Further studies will be needed to assess the impact of new therapeutic options in real life.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 8","pages":"Pages 606-614.e1"},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742455","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":"Chemotherapy Trends in Acute Myeloid Leukemia: 2004 to 2020","authors":"Aditya Ravindra ,&nbsp;Bradley Loeffler ,&nbsp;Luna Acharya ,&nbsp;Avantika Pyakuryal ,&nbsp;Vijaya Raj Bhatt ,&nbsp;Prajwal Dhakal","doi":"10.1016/j.clml.2025.02.014","DOIUrl":"10.1016/j.clml.2025.02.014","url":null,"abstract":"<div><h3>Background</h3><div>Chemotherapy is crucial for treating acute myeloid leukemia (AML), as it improves survival and quality of life. However, prior studies have shown that many eligible patients in the United States do not receive chemotherapy due to demographic and socioeconomic disparities.</div></div><div><h3>Patients and Methods</h3><div>We utilized the National Cancer Database to analyze chemotherapy utilization in 82,755 patients with AML from 2004 to 2020. We examined trends in 2 time periods, 2004 to 2010 and 2011 to 2019, with a separate analysis for 2020 to evaluate the impact of the COVID pandemic on chemotherapy use.</div></div><div><h3>Results</h3><div>Among all patients with AML, 57.1% received multiagent chemotherapy, 20.5% received single-agent chemotherapy, and 22.4% received no chemotherapy. Chemotherapy use rose from 72.9% in 2004 to 81.3% in 2019, then slightly declined to 80.6% in 2020. The odds of receiving chemotherapy increased significantly in 2011 to 2019 compared to 2004 to 2010 based on age (<em>P</em> = .02), race (<em>P</em> &lt; .01), and AML subtype (<em>P</em> = .03). Patients aged 18 to 40 consistently had higher chemotherapy utilization rates, with treatment odds rising across all age groups. While Black patients were less likely than White patients to receive chemotherapy from 2004 to 2010, their odds improved significantly in 2011 to 2019. Despite increased chemotherapy use across all AML subtypes, therapy-related AML consistently showed the lowest odds of treatment. Lower-income patients, those with more co-morbidities, and female patients had reduced chances of receiving chemotherapy, and these inequities remained largely consistent over time.</div></div><div><h3>Conclusion</h3><div>This large database study highlights improved but persistent disparities based on demographic and socioeconomic status, calling for innovative measures to expand chemotherapy use.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 8","pages":"Pages e541-e552"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672918","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}