Clinical Lymphoma, Myeloma & Leukemia最新文献

{"title":"Outcomes with Allogeneic Hematopoietic Stem Cell Transplantation in Therapy Related Myeloid Neoplasms: A Systematic Review and Meta-Analysis","authors":"Moazzam Shahzad ,&nbsp;Muhammad Kashif Amin ,&nbsp;Muhammad Fareed Khalid ,&nbsp;Amir Kasaeian ,&nbsp;Iman Menbari Oskouie ,&nbsp;James Yu ,&nbsp;Sarmad Zaman Warraich ,&nbsp;Ahmad Basharat ,&nbsp;Atif Butt ,&nbsp;Maheen Zaidi ,&nbsp;Iqra Anwar ,&nbsp;Michael V. Jaglal ,&nbsp;Muhammad Umair Mushtaq","doi":"10.1016/j.clml.2024.12.018","DOIUrl":"10.1016/j.clml.2024.12.018","url":null,"abstract":"<div><div>Therapy-related myeloid neoplasms (t-MN), which include acute myeloid leukemia (t-AML), myelodysplastic syndrome (t-MDS), and myelodysplastic/myeloproliferative neoplasms are secondary malignancies occurring as a late complication following chemotherapy or radiation therapy for an antecedent disorder. Allogeneic hematopoietic stem cell transplant (allo-HCT) is a potentially curative treatment option in t-MN patients. This systematic review and meta-analysis aimed to explore the outcomes of allo-HCT in t-MN. Following PRISMA guidelines, a comprehensive literature search was performed on PubMed, Cochrane, and Clinicaltrials.gov. Survival data were extracted from Kaplan–Meier curves to calculate overall survival (OS) and disease-free survival (DFS) probabilities. A total of 7785 (t-AML: 67.3%, t-MDS: 26.5%, and mixed presentation: 6%) patients from 33 original studies reporting outcomes of allo-HCT in t-MN patients were included for analysis. The patients age ranged from 2 to 89 years, and 61.7% were female. The pooled median OS was 16.9 months (95% CI: 13.7-21.1), whereas the estimated mean OS was 46.0 months (95% CI: 42.1-49.6). The pooled median DFS was 8.8 months (95% CI: 7.4-11.2), and the mean DFS was 35.5 months (95% CI: 33.4-41.9). The pooled proportion of acute graft-versus-host disease (aGvHD) was 34% (95% CI: 0.35-0.45, I^²: 91.71%, <em>P</em> &lt; .0001). Relapse of the myeloid neoplasm was the most common cause of mortality, followed by infections, relapse of the underlying disease, and GvHD. Despite these challenges, allo-HCT remains a potential treatment option with promising outcomes for carefully selected t-MN patients.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 5","pages":"Pages e319-e335"},"PeriodicalIF":2.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074033","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":"Effect of TKI Maintenance Therapy After Allogeneic Hematopoietic Stem Cell Transplantation on Recurrence of Philadelphia Chromosome‐Positive Acute Lymphoblastic Leukemia p190 and p210 Transcripts: A Multicentre Study","authors":"Jiayi Zhen ,&nbsp;Shuping Lai ,&nbsp;Xiangzhong Zhang ,&nbsp;Lijun Huang ,&nbsp;Ping Li ,&nbsp;Yue Lin ,&nbsp;Duorong Xu ,&nbsp;Ganlin He","doi":"10.1016/j.clml.2024.12.014","DOIUrl":"10.1016/j.clml.2024.12.014","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the impact of tyrosine kinase inhibitor (TKI) maintenance therapy following allogeneic hematopoietic stem cell transplantation (HSCT) in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL) on recurrence rates and prognosis for the 2 transcripts, p190 and p210.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of clinical data from 58 patients diagnosed with Ph + ALL who underwent HSCT. All patients received TKI maintenance therapy following hematopoietic reconstruction post-transplantation. We compared the clinical characteristics and prognostic differences between 2 transcript types: p190 (<em>n</em> = 43) and p210 (<em>n</em> = 15).</div></div><div><h3>Result</h3><div>In terms of clinical characteristics, no significant differences were observed between patients with the 2 transcripts. Multivariate analysis revealed that the T3151 mutation (HR = 5.021, 95% CI [1.129-22.3], <em>P</em> = .034) was an independent risk factor for relapse-free survival (RFS) post-transplantation. Additionally, TKI maintenance therapy for over 1 year was identified as a protective factor for RFS (HR = 0.315, 95% CI [0.115-0.86], <em>P</em> = .025). The median RFS was 89.4 months for the p190 group compared to 59.1 months for the p210 group, which was statistically significant (<em>P</em> = .031). In the subgroup with more than 1 year of TKI maintenance therapy, the median RFS times for p190 and p210 were 95.3 and 90.5 months, respectively, with no statistically significant difference in RFS (<em>P</em> = .080).</div></div><div><h3>Conclusion</h3><div>The p190 group demonstrated longer RFS compared to the p210 group. However, with early HSCT following induction remission and long-term TKI maintenance therapy post-transplant, the poor prognosis associated with p210 could be mitigated, leading to a trend towards equivalence in outcomes between the 2 transcripts.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 5","pages":"Pages e282-e289"},"PeriodicalIF":2.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058168","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":"Viral and Fungal Infections Early After HLA-Mismatched Hematopoietic Stem Cell Transplantation Using Low-Dose Antithymocyte Globulin in High-Risk Patients With Hematological Malignancies Not in Remission","authors":"Makoto Hirosawa,&nbsp;Tsukasa Nakanishi,&nbsp;Aya Tanaka,&nbsp;Kenichi Akao,&nbsp;Takehiro Higashi,&nbsp;Hiroaki Morimoto,&nbsp;Junichi Tsukada","doi":"10.1016/j.clml.2025.01.001","DOIUrl":"10.1016/j.clml.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>In vivo T-cell depletion with antithymocyte globulin (ATG), especially at high-doses has been shown to be associated with increased incidence of infections after allogeneic hematopoietic stem cell transplantation (HSCT). However, it remains unclear whether ATG, even at low-doses increases the risk of posttransplant infections in the high-risk HSCT setting.</div></div><div><h3>Patients and Methods</h3><div>We conducted a single-center retrospective study of viral and fungal infections early after transplantation, using the data from 82 patients with hematological malignancies. Among them, 42 underwent HLA-mismatched HSCT using low-dose (2.5 mg/kg <em>n</em> = 41, 2.0 mg/kg <em>n</em> = 1) thymoglobulin (ATG patients), and 40 control patients received HSCT without ATG (non-ATG patients) during the same period. Cord blood transplantation patients were excluded. All ATG patients had hematological malignancies not in remission at the time of transplantation, and were considered to be at high-risk for posttransplant infections.</div></div><div><h3>Results</h3><div>There were no appreciable between-group differences in the incidence of clinically significant cytomegalovirus infection (csCMVi), late-onset CMV reactivation after discontinuation of letermovir, invasive fungal diseases or Epstein-Barr virus (EBV)-associated posttransplant lymphoproliferative disease. Peak values of CMV antigenemia were almost equal in ATG and non-ATG patients. The prevention of csCMVi with letermovir was constant in the 2 groups. However, ATG patients showed earlier reactivation of CMV and higher incidence of EBV viremia than non-ATG patients. Among their underlying diseases, mature T-cell neoplasm was a significant risk factor for CMV/EBV reactivation.</div></div><div><h3>Conclusion</h3><div>The use of low-dose thymoglobulin in HLA-mismatched HSCT for nonremission hematological malignancies is a reasonable strategy under careful monitoring for viral reactivation.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 6","pages":"Pages e348-e358"},"PeriodicalIF":2.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045736","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":"Epidemiology, Treatment Outcomes, and Prognosis of Myelodysplastic Syndromes/Neoplasms in Taiwan: Real-World Insights and Trends","authors":"Wan-Hsuan Lee ,&nbsp;Chien-Chin Lin ,&nbsp;Xavier Cheng-Hong Tsai ,&nbsp;Feng-Ming Tien ,&nbsp;Min-Yen Lo ,&nbsp;Yuan-Yeh Kuo ,&nbsp;Shan-Chi Yu ,&nbsp;Ming-Chih Liu ,&nbsp;Chang-Tsu Yuan ,&nbsp;Ming Yao ,&nbsp;Bor-Sheng Ko ,&nbsp;Hwei-Fang Tien ,&nbsp;Hsin-An Hou ,&nbsp;Wen-Chien Chou","doi":"10.1016/j.clml.2024.12.021","DOIUrl":"10.1016/j.clml.2024.12.021","url":null,"abstract":"<div><h3>Background</h3><div>Myelodysplastic syndromes/neoplasms (MDS) are a diverse group of clonal myeloid disorders. Advances in molecular technology lead to the development of new classification systems. However, large-scale epidemiological studies on MDS in Asian countries are currently scarce.</div></div><div><h3>Patients</h3><div>Data were retrospectively collected from 1,095 patients with primary MDS, Patients with prior chemotherapy, radiotherapy, or hematologic malignancies were excluded.</div></div><div><h3>Methods</h3><div>Patients with cryopreserved bone marrow (BM) samples were sequenced using the TruSight Myeloid Panel and HiSeq platform. KaplanMeier analysis was used to generate survival curves, with significance assessed via the log-rank test.</div></div><div><h3>Results</h3><div>This analysis revealed significant changes in MDS subtypes, treatments, and prognoses over time, with more patients receiving hypomethylating agents (HMA) with and without venetoclax and allogeneic hematopoietic stem cell transplantation (HSCT) in recent years. Survival analysis revealed that both IPSS-R and IPSS-M did well stratified MDS patients and improved outcomes in the patients who underwent HSCT. Although the number of patients was limited in current study, combination therapy with HMA and venetoclax resulted in improved treatment responses and a higher rate of successful bridging to HSCT. These findings underscore the need for further large-scale studies to investigate the impact of combination treatment on MDS patients undergoing transplantation.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 6","pages":"Pages e336-e347.e14"},"PeriodicalIF":2.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037499","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":"CD19 CAR-T With Axicabtagene Ciloleucel in R/R Large B-Cell Lymphoma With/Without Prior Autologous Stem Cell Transplant","authors":"David T. Chen ,&nbsp;Olga Goloubeva ,&nbsp;Aaron P. Rapoport ,&nbsp;Saurabh Dahiya ,&nbsp;Djordje Atanackovic ,&nbsp;Nancy Hardy ,&nbsp;Mehmet Kocoglu ,&nbsp;Forat Lutfi ,&nbsp;Hanan Alkhaldi ,&nbsp;John Preston Claiborne ,&nbsp;Seung Tae Lee ,&nbsp;Kathryn Kline ,&nbsp;Jennie Y. Law ,&nbsp;Jean A. Yared","doi":"10.1016/j.clml.2024.12.019","DOIUrl":"10.1016/j.clml.2024.12.019","url":null,"abstract":"<div><h3>Background</h3><div>Anti-CD19 CAR-T therapy has been a breakthrough in treatment of primary refractory or relapsed large B-cell lymphoma (r/r LBCL) and is poised to supplant previous second line of high dose chemotherapy and autologous stem cell transplantation (HDT/ASCT). However, in clinical practice, high risk patients with chemoimmunotherapy sensitive disease continue to receive salvage chemoimmunotherapy or cannot access CAR-T in a timely manner and thus may still proceed to HDT/ASCT. Little is known about clinical outcomes of CAR-T in patients who receive HDT/ASCT compared to those who are transplant-naïve.</div></div><div><h3>Design</h3><div>We conducted a retrospective study of patients with r/r LBCL who previously underwent HDT/ASCT or were transplant-naïve (n = 97) and received axicabtagene ciloleucel after at least 2 prior therapy lines between 1/1/2018 to 12/31/2021. Primary endpoint was progression-free survival (PFS). Secondary endpoints were overall survival (OS), nonrelapse mortality (NRM), and cumulative incidence of relapse/progression.</div></div><div><h3>Results</h3><div>82 (84.5%) patients were transplant-naïve and 15 (15.5%) previously received HDT/ASCT. No differences were found in the incidence of high-grade cytokine release syndrome or immune effector cell-associated neurotoxicity syndrome, length of hospital admission, or incidence of cytopenia at day 30. 90-day response, PFS, OS, cumulative incidence of relapse/progression, and NRM were not different. Factors that adversely affected outcomes were prior bridging therapy, elevated LDH or thrombocytopenia at time of lymphodepleting chemotherapy, and worse ECOG performance status.</div></div><div><h3>Conclusion</h3><div>Prior treatment with HDT/ASCT does not compromise the safety and efficacy of anti-CD19 CAR-T therapy, suggesting a continued role for HDT/ASCT in treatment of select patients with r/r DLBCL.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 6","pages":"Pages 432-439"},"PeriodicalIF":2.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045727","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":"Prognostic Value of Dynamic Measurable Residual Disease Monitoring by Multiflowcytometry in Elderly Patients With Nonintensively Treated Acute Myeloid Leukemia","authors":"Yue Sun ,&nbsp;XiaoFeng Han ,&nbsp;YiWei Zhang,&nbsp;WanBin Fu,&nbsp;Yi Fang,&nbsp;Jia Liu,&nbsp;Lan Xu,&nbsp;Ting Wang MD,&nbsp;Hua Zhong MD","doi":"10.1016/j.clml.2024.12.020","DOIUrl":"10.1016/j.clml.2024.12.020","url":null,"abstract":"<div><h3>Purpose</h3><div>The clinical prognostic value of monitoring minimal residual disease (MRD) in acute myeloid leukemia (AML) patients undergoing nonintensive treatment remains insufficiently established. The aim of this work was to examine MRD status at various time points, highlighting the potential for pre-emptive therapy to improve patient outcomes.</div></div><div><h3>Methods</h3><div>Inpatient data from 2017 to 2024 were used in this retrospective study. Bone marrow samples were analyzed for MRD using multiparametric flow cytometry at the end of cycles 1, 2, 4, and 7, before the next therapy course. Kaplan-Meier method and Cox regression were used to assess factors affecting overall survival (OS) and disease-free survival (DFS), and logistic regression evaluated the interaction between MRD and baseline features.</div></div><div><h3>Results</h3><div>A total of 108 patients were enrolled for MRD evaluation. MRD1, MRD2, MRD4, and MRD7 was significantly associated with both OS and DFS. Early MRD negativity leads to longer survival time, and the later MRD turns negative, the higher the risk of relapse, and ELN 2017 high risk and myeloid gene mutation are adverse factors affecting time to MRD negative status.</div></div><div><h3>Conclusion</h3><div>Dynamic MRD monitoring has predictive value for nonintensive treatment in AML patients. Proper use of MRD and baseline features allows treatment adjustments based on an accurate estimation of relapse risk.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 6","pages":"Pages 440-448"},"PeriodicalIF":2.7,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037500","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":"Analysis of Histologic, Immunohistochemical and Genomic Features of Large B Cell Lymphoma Tumors May Predict Response to Polatuzumab Vedotin Based Therapy in Patients With Relapsed/Refractory Disease","authors":"Michael Schneider,&nbsp;Sunita D. Nasta,&nbsp;Stefan K. Barta,&nbsp;Elise A. Chong,&nbsp;Jakub Svoboda,&nbsp;Stephen J. Schuster,&nbsp;Daniel J. Landsburg","doi":"10.1016/j.clml.2024.08.010","DOIUrl":"10.1016/j.clml.2024.08.010","url":null,"abstract":"<div><h3>Background</h3><div>Large B cell lymphoma (LBCL) is the most common form of lymphoma. Polatuzumab vedotin (polatuzumab) is an effective therapy for patients diagnosed with LBCL; however, only limited information regarding pathologic features detected by clinical laboratory assays is available to determine which patients are most likely to benefit from polatuzumab based therapies.</div></div><div><h3>Patients and Methods</h3><div>We collected data from real world patients with relapsed or refractory LBCL whose tumors underwent next generation sequencing and were treated with polatuzumab based therapy at a single large academic cancer center. Tumor and patient characteristics were analyzed to look for factors that predict response to polatuzumab based therapies.</div></div><div><h3>Results</h3><div>We identified high grade B cell lymphoma (HGBL) -NOS or <em>MYC/BCL2</em> histology and presence of <em>MYC</em> rearrangement as factors that predict inferior response to polatuzumab based therapy. Patients with germinal center B cell of origin (GCB COO) LBCL without these factors had a high response rate (73%) to polatuzumab based therapy.</div></div><div><h3>Conclusion</h3><div>In a single center real world retrospective analysis of R/R LBCL patients with available genomic data, polatuzumab based therapy may be less effective in patients with HGBL-NOS or <em>MYC/BCL2</em> histology and <em>MYC</em> rearrangements, but not in patients with GCB COO LBCL without these features. Routine performance of more comprehensive pathologic analysis of tumors may inform the use of polatuzumab based therapy in patients with LBCL.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 1","pages":"Pages 45-51"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364644","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":"Comparison of Long-Term Outcomes of Double Unit Cord Blood Versus Haploidentical Donor Transplantation in Adult Patients With Acute Lymphoblastic Leukemia Regarding KIR-Ligand Mismatch","authors":"Seonghan Lee ,&nbsp;Jae-Ho Yoon ,&nbsp;Daehun Kwag,&nbsp;Gi-June Min,&nbsp;Sung-Soo Park,&nbsp;Silvia Park,&nbsp;Sung-Eun Lee,&nbsp;Byung-Sik Cho,&nbsp;Ki-Seong Eom,&nbsp;Yoo-Jin Kim,&nbsp;Hee-Je Kim,&nbsp;Chang-Ki Min,&nbsp;Seok-Goo Cho,&nbsp;Seok Lee","doi":"10.1016/j.clml.2024.11.004","DOIUrl":"10.1016/j.clml.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Haploidentical donor transplantation (HIDT) or cord blood transplantation (CBT) are common alternatives for patients lacking human-leukocyte antigen (HLA)-matched donors. In addition to the donor source, NK cell alloreactivity due to HLA-mismatch setting may affect outcomes in alternative-donor hematopoietic cell transplantation (HCT). However, a limited number of studies have evaluated their impacts in adult acute lymphoblastic leukemia (ALL).</div></div><div><h3>Objectives</h3><div>We aimed to assess the effects of donor source and KIRL-MM on outcomes of alternative-donor HCT, with a special focus on adult ALL.</div></div><div><h3>Study Design</h3><div>We retrospectively compared clinical outcomes between HIDT (n=47) and double unit CBT (DCBT) (n=134). Patients received fludarabine and busulfan-based reduced toxicity conditioning before HIDT, and TBI-based myeloablative conditioning before DCBT. KIR ligands were determined using a web-based calculator. For DCBT, donor KIR ligand groups were defined by the dominant CB unit after engraftment.</div></div><div><h3>Results</h3><div>After a median follow-up of 39.4 months, DCBT showed higher 3-year non-relapse mortality (NRM) (22.8% vs. 9.0%, p=0.038), whereas the cumulative incidence of relapse (CIR) was significantly higher in HIDT (47.9% vs. 18.9%, p&lt;0.001). Estimated disease-free survival (DFS) was comparable (DCBT 58.5% vs. HIDT 44.3%, p=0.106). GVH direction KIRL-MM showed lower incidence of acute GVHD in both HIDT and DCBT. However, GVH direction KIRL-MM was associated with poorer DFS (37.2% vs. 66.0%, p=0.008) only in the DCBT subgroup, mostly due to specifically higher NRM rate (35.0% vs 18.4%, p=0.057).</div></div><div><h3>Conclusion</h3><div>Our study supports the usefulness of DCBT in the HIDT-dominant era and suggests potential ways to improve survival outcomes of DCBT.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 1","pages":"Pages e11-e25.e1"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791296","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":"Dementia Incidence in Survivors of Multiple Myeloma: A National Case-Control Study Conducted in Korea (The CAREMM-2106 Study)","authors":"Jeonghoon Ha ,&nbsp;Suein Choi ,&nbsp;Seulji Moon ,&nbsp;Jinseon Han ,&nbsp;Jeongyoon Lee ,&nbsp;Sung-Soo Park ,&nbsp;Sheng-Min Wang ,&nbsp;Seunghoon Han ,&nbsp;Chang-Ki Min","doi":"10.1016/j.clml.2024.08.001","DOIUrl":"10.1016/j.clml.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Dementia, a growing global health issue, affects older adults and specific groups like long-term cancer survivors. The link between cancer survival and dementia is debated. Multiple myeloma (MM), a common blood cancer in older adults, is often linked with cognitive issues. This study investigated dementia incidence in long-term MM survivors using Korean national data.</div></div><div><h3>Methods</h3><div>A retrospective case-control study used data from the Korea National Health Insurance Service (KNHIS), covering about 50 million Koreans. Patients diagnosed with MM between 2009 and 2020 formed the case cohort, while the control cohort included matched individuals without MM using propensity-score matching. Analyzing baseline characteristics, comorbidities, and socioeconomic status, the primary outcome was dementia incidence identified via ICD-10 codes. Statistical methods included Kaplan-Meier plots, cause-specific and Fine–Gray subdistribution hazard models, and a 3-year landmark analysis for immortal time bias.</div></div><div><h3>Results</h3><div>The study included 33,864 patients, with 16,932 in each cohort. The overall cumulative dementia incidence was lower in the MM cohort compared to controls. However, in the first 3 years, MM patients had a higher dementia risk (HR: 1.711, 95% CI, 1.562-1.874) than controls. After 3 years, the risk significantly decreased (HR: 0.625, 95% CI, 0.560-0.696). Age-specific analysis showed a consistent pattern, particularly among MM patients aged 70-79, where dementia risk increased post-3 years.</div></div><div><h3>Conclusion</h3><div>This study reveals a lower long-term dementia risk in MM survivors compared to non-MM individuals. Further prospective studies are needed to confirm these findings and explore the underlying mechanisms.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 1","pages":"Pages e40-e49"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145267","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":"Brazilian Real-Life Experience of Multiple Myeloma (MMyBRAve): Improvement in Outcomes, But Remaining Diagnostic and Therapeutic Gaps","authors":"Vania Hungria ,&nbsp;Rosane Isabel Bittencourt ,&nbsp;Gracia Aparecida Martinez ,&nbsp;Juliana de Andrade Santos ,&nbsp;Denise Ramos de Almeida ,&nbsp;Vera Lucia de Piratininga Figueiredo ,&nbsp;Danielle Leão Cordeiro de Farias ,&nbsp;Karla Richter Zanella ,&nbsp;Larissa Barchi Muniz ,&nbsp;Juliana Tosta Senra ,&nbsp;Rodrigo Martins Abreu ,&nbsp;Éderson Roberto Mattos","doi":"10.1016/j.clml.2024.10.002","DOIUrl":"10.1016/j.clml.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed at describing the demographic and clinical characteristics, treatment patterns and overall survival of patients with MM in Brazil to identify gaps in the disease diagnosis and treatment.</div></div><div><h3>Methods</h3><div>MMyBRAve (NCT03506386) was a multicenter, observational study of patients diagnosed with MM in Brazil between January 2008 and December 2016, with data collection between August 2018 and September 2019 at 17 participating centers.</div></div><div><h3>Results</h3><div>Of 943 patients included, 914 had complete data for overall survival (OS) analysis. The most used frontline regimens were cyclophosphamide, thalidomide and dexamethasone; bortezomib, cyclophosphamide and dexamethasone; and thalidomide and dexamethasone. After a median follow-up of 63 months, the median OS from diagnosis was 70 months. These results indicate continuous improvements in comparison with previous observational studies from Brazil. The median OS in transplantation-ineligible (N = 491) and eligible (N = 452) patients were 49 and 93 months, respectively (hazard ratio [HR] = 0.52; 95% confidence interval [CI], 0.43 to 0.63; <em>P</em> &lt; .001). The median OS also differed between patients with and without known prognostic factors.</div></div><div><h3>Conclusion</h3><div>Despite the improvements, our results suggest that access to novel agents and transplantation continue to hinder further progress in patient outcomes in Brazil and countries with similar health-care constraints.</div></div>","PeriodicalId":10348,"journal":{"name":"Clinical Lymphoma, Myeloma & Leukemia","volume":"25 1","pages":"Pages 26-31"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564015","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}