{"title":"Site- and Stage-Adapted Treatment Strategies for Gastrointestinal Diffuse Large B-Cell Lymphoma.","authors":"Yu Yagi, Yusuke Kanemasa, Yuki Sasaki, Mariko Matsubayashi, Yasuhiko Yamamura, Kaho Fujino, Takahiro Kuga, Nozomi Kanai, Yusuke Masuda, Kumiko Fujita, Kento Ishimine, Yudai Hayashi, Mano Mino, Ai Takahara, Taichi Tamura, Shohei Nakamura, Toshihiro Okuya, Shinichiro Matsuda, Takuya Shimizuguchi, Haruhiko Cho, Kazushige Kawai, Tatsu Shimoyama","doi":"10.1111/ejh.14440","DOIUrl":"https://doi.org/10.1111/ejh.14440","url":null,"abstract":"<p><strong>Objectives: </strong>Although gastrointestinal diffuse large B-cell lymphoma (GI-DLBCL) is managed variously, the optimal approach remains controversial.</p><p><strong>Methods: </strong>We retrospectively analyzed 701 patients with DLBCL at our institution between March 2004 and June 2024, including 160 with GI-DLBCL. We compared baseline characteristics and survival outcomes of GI-DLBCL with non-GI-DLBCL and further analyzed gastric and intestinal DLBCL by stage.</p><p><strong>Results: </strong>No significant difference in survival outcomes was observed between GI and non-GI DLBCL groups after a median follow-up of 5.1 years. Among patients with gastric DLBCL, advanced disease was associated with poorer overall survival (OS) (hazard ratio [HR]: 1.75; 95% confidence interval [CI]: 1.18-2.58; p = 0.003) than localized disease. Similar findings were observed in intestinal DLBCL (HR: 1.60; 95% CI: 1.13-2.27; p = 0.006). Combined chemoradiation and chemotherapy yielded similar survival outcomes for localized gastric DLBCL although the former showed a higher cumulative incidence of secondary gastric cancer (p = 0.04). In localized intestinal DLBCL, multivariate analysis identified surgery followed by chemotherapy as a favorable prognostic factor for OS (HR: 0.23; 95% CI: 0.067-0.83; p = 0.024).</p><p><strong>Conclusions: </strong>Gastrointestinal diffuse large B-cell lymphoma had survival outcomes comparable to those of non-GI-DLBCL, suggesting site- and stage-specific therapies may confer a survival benefit.</p>","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Characteristics and Clinical Outcomes of Multiple Myeloma in Adolescents and Young Adults.","authors":"Ayobami Olafimihan, Chiamaka Nwachukwu, Inimfon Jackson, Oboseh John Ogedegbe, Olanipekun Lanny Ntukidem, Praise Fawehinmi, Hafeez Shaka, Benjamin Mba, Marwah Wafa Farooqui","doi":"10.1111/ejh.14437","DOIUrl":"https://doi.org/10.1111/ejh.14437","url":null,"abstract":"<p><strong>Introduction: </strong>Though evidence suggests that multiple myeloma (MM) in adolescents and young adults (AYA) (< 50 years) has significant biological differences from that in older individuals (≥ 50 years), the understanding of the disease in this group is limited. We examined the outcomes in AYA hospitalizations with MM.</p><p><strong>Methods: </strong>Using the National Inpatient Sample database, we examined sociodemographic, hospital-level, and clinical characteristics between AYA and older populations with MM.</p><p><strong>Results: </strong>Among 183 846 non-elective MM hospitalizations, 13 765 (7.5%) were AYA. There was a higher proportion of males in the AYA group compared to the older group (58.6% vs. 54.8%, p < 0.001) but a lower distribution of non-Hispanic Whites (40.6% vs. 56.7%, p < 0.001). The AYA group had lower odds of mortality (aOR: 0.59, p < 0.001) relative to the older adult group. They were more likely to receive autologous stem cell transplantation (aOR: 1.80, p < 0.001) but had similar odds of acute venous thromboembolism (aOR: 0.87; p = 0.24) and severe sepsis (aOR: 0.89; p = 0.52).</p><p><strong>Conclusion: </strong>We highlight the unique characteristics and outcomes of AYA-MM, emphasizing the need for their greater representation in clinical research. Additionally, we underscore the importance of further investigation to better understand and optimize survivorship care in AYA patients with MM.</p>","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roberta Della Pepa, Aldo Leone, Simona Avilia, Fabrizio Pane
{"title":"Isatuximab, Carfilzomib, and Dexamethasone Combined With Late Autologous Stem Cell Transplantation: A Synergistic Strategy for First Relapse Multiple Myeloma.","authors":"Roberta Della Pepa, Aldo Leone, Simona Avilia, Fabrizio Pane","doi":"10.1111/ejh.14436","DOIUrl":"https://doi.org/10.1111/ejh.14436","url":null,"abstract":"","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laurène Fenwarth, Benjamin Podvin, Loïc Vasseur, Delphine Lebon, Guillaume Couillez, Céline Berthon, Alexis Caulier, Elise Fournier, Claire Bories, Benjamin Carpentier, Sabine Tricot, Kevin-James Wattebled, Catherine Roche-Lestienne, Valentin Lestringant, Carine Hauspie, Karine Celli-Lebras, Maël Heiblig, Hervé Dombret, Raphael Itzykson, Jean-Pierre Marolleau, Loïc Garçon, Claude Preudhomme, Nicolas Duployez, Thomas Boyer
{"title":"Myeloid Neoplasms With Erythroid Predominance and Excess Blasts in Young Adults Exhibit Distinct Genetic Profiles.","authors":"Laurène Fenwarth, Benjamin Podvin, Loïc Vasseur, Delphine Lebon, Guillaume Couillez, Céline Berthon, Alexis Caulier, Elise Fournier, Claire Bories, Benjamin Carpentier, Sabine Tricot, Kevin-James Wattebled, Catherine Roche-Lestienne, Valentin Lestringant, Carine Hauspie, Karine Celli-Lebras, Maël Heiblig, Hervé Dombret, Raphael Itzykson, Jean-Pierre Marolleau, Loïc Garçon, Claude Preudhomme, Nicolas Duployez, Thomas Boyer","doi":"10.1111/ejh.14435","DOIUrl":"https://doi.org/10.1111/ejh.14435","url":null,"abstract":"<p><p>The evolution of acute myeloid leukemia (AML) classifications has progressively shifted the diagnostic focus toward genetic criteria. Nevertheless, morphology remains a key element in clinical practice, often serving as the initial trigger for additional molecular investigations. The diagnosis of acute erythroleukemia (AEML), initially defined by the FAB group, is no longer recognized as a distinct entity in the latest WHO and ICC classifications. Some studies have indicated that AEML shares similarities with myelodysplastic neoplasms, including a high frequency of TP53 mutations and adverse karyotypes. Here, we conducted a retrospective analysis in adults with AEML defined using historical morphologic criteria (≥ 50% erythroid precursors and ≥ 20% blasts among non-erythroid cells). In contrast to older patients, young adults (18-60 years) exhibit unique genetic profiles including a high prevalence of normal karyotypes (65%), NPM1 (35%) and UBTF (23%) mutations. AEML morphology in NPM1-mutated cases did not impact clinical outcomes but was associated with specific molecular features, including an enrichment of WT1 and cohesin gene mutations. In this age group, our findings support that morphologically defined AEML often corresponds to AML according to current genetic criteria, consistent with recent classification systems that prioritize molecular features over morphology.</p>","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Learning-Based Classification of B- and T-Cell Lymphoma on Histopathological Images: A Multicenter Study.","authors":"Yuhua Ru, Xing Tong, Jiaxi Lin, Fang Chen, Zhe Wang, Xiangdong Shen, Jie Zhao, Yutong Jing, Yiyang Ding, Jinjin Zhu, Mimi Xu, Jinzhou Zhu, Jia Chen, Depei Wu","doi":"10.1111/ejh.14433","DOIUrl":"https://doi.org/10.1111/ejh.14433","url":null,"abstract":"<p><p>Lymphoma, a clonal malignancy from lymphocytes, includes diverse subtypes requiring distinct immunohistochemical stains for accurate diagnosis. Limited biopsy specimens often restrict the use of multiple stains, complicating diagnostic workflows. Lymphomas are typically classified into B-cell and T-cell types, each with specific markers. This study represents the first feasibility study in deploying deep learning models for B- and T-cell lymphoma classification on histopathological images. We analyzed 1510 H&E-stained sections (750 B-cell, 760 T-cell) with CNN models (Xception, NASNetL, ResNet50, EfficientNet), enhanced by Convolutional Block Attention Modules (CBAMs). All models demonstrated strong classification capabilities, with EfficientNet achieving the highest accuracy at 91.5% and the best precision at 91.9%, while Xception performed the best recall at 91.5%. Furthermore, the deep learning models significantly outperformed human pathologists in classification accuracy and inference speed, processing images in milliseconds compared to the several seconds required for manual diagnosis. These findings underscore the effectiveness of advanced CNN models in improving diagnostic precision while reducing dependency on manual staining and interpretation, and the integration of AI-driven classification can provide valuable support for pathologists.</p>","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Genetic Landscape and Risk Stratification of AML With Hyperdiploid Karyotype.","authors":"Ehsan Bahrami Hezaveh, Jiong Yan, Davidson Zhao, Collins Wangulu, Winnie Lo, Cuihong Wei, Hong Chang","doi":"10.1111/ejh.14434","DOIUrl":"https://doi.org/10.1111/ejh.14434","url":null,"abstract":"<p><p>Hyperdiploid karyotype (HK) (49-65 chromosomes) in acute myeloid leukemia (AML) is rare. Recently, HK-AML with only numerical changes has been reclassified into an intermediate risk group in the updated 2022 European LeukemiaNet (ELN) risk classification, which has historically been classified into an adverse risk group. However, there are limited data in the literature concerning whether these new exclusion criteria are appropriate, and the genetic landscape of HK-AML remains unclear. We retrospectively analyzed a cohort of HK-AML diagnosed at our institution. Among 124 cases, 72 (58.1%) had concurrent adverse risk cytogenetic abnormalities (HK-ADV), 33 (26.6%) had other concurrent structural abnormalities (HK-STR) and 19 (15.3%) had numerical changes alone (HK-NUM). The most frequently gained chromosomes were chromosomes 8, 22, 21, and 19. TP53 mutation was associated with HK-ADV, and a higher frequency of mutations in DNA methylation genes was present in HK-NUM and HK-STR. Patients with HK-NUM had significantly longer overall survival (OS) and event-free survival (EFS) compared to those with HK-ADV. In the adjusted model accounting for confounders, the HK-STR outcome was superior to that of HK-ADV but was not significantly different from that of HK-NUM. In addition, patients with a modal chromosome number of 49-53 had more favorable survival than those with ≥ 54 chromosomes. Our data support the reclassification of HK-NUM patients in the intermediate risk group and suggest that HK-STR might also be more appropriately classified into the intermediate risk group.</p>","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to \"Venetoclax-Based Therapy for Relapsed or Refractory Acute Myeloid Leukaemia Following Intensive Induction Chemotherapy\".","authors":"","doi":"10.1111/ejh.14424","DOIUrl":"https://doi.org/10.1111/ejh.14424","url":null,"abstract":"","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bastian von Tresckow, Pau Abrisqueta, Irene Zamanillo, Ángel Serna Pareja, Yuting Kuang, Jennifer Uyei, Mohsin Shah, Laura Walsh, Eileen Thorley, Krystal Cantos, Emaan Rashidi, Christian Hampp, Jessica J Jalbert, Alexi N Archambault, Yingxin Xu, Shivani Aggarwal, Srikanth Ambati, Hesham Mohamed, Qiufei Ma, Ana Jiménez-Ubieto
{"title":"Prognostic Factors and Effect Modifiers in Patients With Relapse or Refractory Diffuse Large B-Cell Lymphoma After Two Lines of Therapy: A Systematic Literature and Expert Clinical Review.","authors":"Bastian von Tresckow, Pau Abrisqueta, Irene Zamanillo, Ángel Serna Pareja, Yuting Kuang, Jennifer Uyei, Mohsin Shah, Laura Walsh, Eileen Thorley, Krystal Cantos, Emaan Rashidi, Christian Hampp, Jessica J Jalbert, Alexi N Archambault, Yingxin Xu, Shivani Aggarwal, Srikanth Ambati, Hesham Mohamed, Qiufei Ma, Ana Jiménez-Ubieto","doi":"10.1111/ejh.14423","DOIUrl":"https://doi.org/10.1111/ejh.14423","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this systematic literature review (SLR) combined with expert clinical review was to identify and rank prognostic factors and effect measure modifiers (EMMs) systematically and comprehensively in patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) who initiate treatment after ≥ 2 prior lines of therapy (LoTs; 3L+ R/R DLBCL).</p><p><strong>Methods: </strong>We performed an SLR of studies published between 2016 and 2021 and extracted study characteristics, prognostic factors, and EMMs. This was followed by clinical review and ranking of findings by subject matter experts using questionnaires, follow-up interviews, and quantitative ranking.</p><p><strong>Results: </strong>Across 46 included studies, the SLR identified 36 prognostic factors significantly associated with ≥ 1 clinical outcome. Based on subject matter expert ranking of the SLR-derived list, the five most important prognostic variables in descending order are: early chemo-immunotherapy failure, Eastern Cooperative Oncology Group performance status, refractory to last LoT, number of prior LoTs, and double- or triple-hit lymphoma.</p><p><strong>Conclusions: </strong>This SLR and expert clinical review is the first to provide a comprehensive assessment of prognostic factors for 3L+ R/R DLBCL. No statistically significant EMMs were identified. This robust multi-method approach can assist in selecting prognostic variables for comparative analyses between real-world studies and clinical trials.</p>","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nihar Desai, Sergio Rodriguez-Rodriguez, Carol Chen, Tommy Alfaro Moya, Eshrak Al-Shaibani, Igor Novitzky-Basso, Ivan Pasic, Fotios V Michelis, Auro Viswabandya, Dennis Kim, Rajat Kumar, Jonas Mattsson, Arjun Datt Law
{"title":"Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation for Myelodysplastic/Myeloproliferative Overlap Neoplasms.","authors":"Nihar Desai, Sergio Rodriguez-Rodriguez, Carol Chen, Tommy Alfaro Moya, Eshrak Al-Shaibani, Igor Novitzky-Basso, Ivan Pasic, Fotios V Michelis, Auro Viswabandya, Dennis Kim, Rajat Kumar, Jonas Mattsson, Arjun Datt Law","doi":"10.1111/ejh.14430","DOIUrl":"https://doi.org/10.1111/ejh.14430","url":null,"abstract":"<p><p>Myelodysplastic/myeloproliferative overlap neoplasms (MDS/MPN) are rare hematological malignancies. We analyzed the outcomes of 75 patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) for MDS/MPN. Graft-versus-host disease (GvHD) prophylaxis included post-transplantation cyclophosphamide (PTCy) in 71% of patients, with 44 (59%) receiving a combination of anti-thymocyte globulin (ATG) and PTCy. The median follow-up was 44.4 months. Primary graft failure occurred in three patients (4%). The incidence of grade III-IV acute GvHD at day 100 was 13% (95% CI: 6-22). At 2 years, the incidence of moderate-severe chronic GvHD, non-relapse mortality (NRM), relapse, GvHD-free/relapse-free survival (GRFS), and overall survival (OS) was 31.7% (95% CI 20.7-43.2), 37.9% (26-49), 17.4% (95% CI: 10-27), 24.8% (95% CI: 15-36), and 51.6% (95% CI: 39-63), respectively. PTCy-based GvHD prophylaxis seemed to be associated with improved OS (HR: 0.5, 95% CI: 0.3-0.9, p = 0.03), NRM (HR: 0.4, 95% CI: 0.2-0.9, p = 0.03), and GRFS (HR: 0.5, 95% CI: 0.3-0.8, 0.009). On multivariable analysis, the use of the PTCy-containing regimen seemed to be associated with improved NRM (HR: 0.41; 95% CI: 0.2-0.8; p = 0.03), GRFS (HR: 0.47; 95% CI: 0.3-0.8; p = 0.009), and OS (HR: 0.49; 95% CI: 0.2-0.9; p = 0.03) without an increased risk of relapse.</p>","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}