{"title":"Effect of erythropoiesis-stimulating agents on malignant neoplasms: FAERS database and Mendelian randomization.","authors":"Cuilv Liang, Qiaohong Wang, Peihong Wang, Yin Zhang","doi":"10.1080/17474086.2025.2468400","DOIUrl":"10.1080/17474086.2025.2468400","url":null,"abstract":"<p><strong>Background: </strong>The relationship between erythropoiesis-stimulating agents (ESAs) and malignant neoplasms (MNs) has been controversial in previous studies. Our study aimed to explore the correlation between ESAs and MNs.</p><p><strong>Research design and methods: </strong>Drug-target Mendelian randomization (MR) analyses were conducted to evaluate the causal associations of ESAs for 12 classifications of MNs. Meanwhile, a pharmacovigilance study was performed by extracting adverse events (AEs) from the FDA Adverse Event Reporting System (FAERS) database to validate and complement our findings. MR analysis revealed negative association of ESAs with MN of ovary (<i>p</i> = 0.047), liposarcoma (<i>p</i> = 0.001), small cell lung cancer (<i>p</i> = 0.017), colorectal cancer (<i>p</i> = 0.004), and brain meningioma (<i>p</i> = 0.004) and revealed positive association of ESAs with MN of bladder (<i>p</i> = 0.001), eye and adnexa (<i>p</i> = 0.012), heart, mediastinum, and pleura (<i>p</i> = 0.032), lip (<i>p</i> = 0.041), larynx (<i>p</i> = 0.015), non-small cell lung cancer (<i>p</i> = 0.009), and malignant melanoma (<i>p</i> = 0.001). Positive signals were found in MN of hematological system, digestive organs, central nervous system, eye and adnexa, head and neck cancer, lung cancer, and mucinous and mucinous cystic tumor in FAERS database (all reporting odds ratio and proportional reporting ratio >1).</p><p><strong>Conclusion: </strong>ESAs were causally correlated with many types of MNs. The use of ESAs in these tumors needs more attention.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"239-247"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432042","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":"lncRNA GAS 5 rs145204276 as a risk factor for primary immune thrombocytopenia in the Chinese Han population.","authors":"Ting Liang, Hong Yi, Huanyu Guo, Yingjie Xie, Jianhua Hu, Yongchun Chen","doi":"10.1080/17474086.2025.2483669","DOIUrl":"10.1080/17474086.2025.2483669","url":null,"abstract":"<p><strong>Background: </strong>Recent studies suggest that long noncoding RNA (lncRNA) GAS 5 plays a crucial role in the pathogenesis of primary immune thrombocytopenia (ITP). Identification of genetic variations affecting GAS 5 expression may provide insights into ITP mechanisms. This study aimed to explore the association between GAS 5 variants rs145204276 andrs55829688 and ITP risk in a Chinese Han population.</p><p><strong>Research design and methods: </strong>The genotypes of rs145204276 and rs55829688 were analyzed in 302 ITP patients and 300 age-matched healthy controls. GAS 5 expression levels were quantified using quantitative real-time PCR (qRT-PCR) in both groups.</p><p><strong>Results: </strong>Significant differences in allele and genotype frequencies of rs145204276 were observed between ITPpatients and healthy controls. Specifically, the deletion allele of rs145204276 was associated with a reduced risk of ITP and higher GAS 5 expression inpatients. However, no significant association was found for rs55829688 in any analysis.</p><p><strong>Conclusions: </strong>The rs145204276polymorphism in GAS 5 is significantly associated with ITP susceptibility and may serve as a potential biomarker for ITP prevention and treatment.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"283-289"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691629","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":"A retrospective single-center study on the effectiveness and tolerability of emicizumab in patients with hemophilia a with and without inhibitors.","authors":"Sheikh Bilal Ahmad, Asifa Amin, Malik Rohi, Sarwat Muzaffar, Sheikh Fahad","doi":"10.1080/17474086.2025.2471862","DOIUrl":"10.1080/17474086.2025.2471862","url":null,"abstract":"<p><strong>Background: </strong>Hemophilia A (HA) is an X-linked disorder due to deficient/defective coagulation factor VIII (FVIII), which causes excessive bleeding either traumatic or spontaneous. Frequent FVIII replacement is complicated by the development of inhibitors. The bispecific monoclonal antibody emicizumab, offers a novel approach by bridging activated factors IXa and X for effective hemostasis.</p><p><strong>Research design and methods: </strong>This retrospective study analyzed emicizumab treatment outcomes in 73 patients with severe HA at a tertiary care center in Jammu and Kashmir, India. Data included demographic profiles, bleeding rates, joint health scores, and adverse events (AEs).</p><p><strong>Results: </strong>Emicizumab demonstrated significant efficacy and safety in the study with median patient age of 14 years, with 17/73 patients having FVIII inhibitors. It resulted in a 100% reduction in annualized bleeding rate (ABR) for patients with inhibitors (from 20.7 to 0.0) and a 99.5% reduction for those without inhibitors (from 7.7 to 0.04). All inhibitor-negative patients showed ABR improvements and significant reduction in joint bleeds and resolution of all target joints. Tolerability was favorable with only one patient reporting a non-significant AE.</p><p><strong>Conclusions: </strong>Emicizumab prophylaxis effectively reduces ABRs and enhances joint health in severe HA patients, irrespective of inhibitor presence, providing a convenient, well-tolerated alternative to FVIII therapy.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"275-281"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515094","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}
Sara El-Sayed Abd El-Ghani, Lina Ayman Mahmoud Mohamed, Mohamed Roshdi El-Masry, Hala M Abdelhamid, Mohamed Fateen, Marwa Salah Mohamed
{"title":"CD8+CD25+ Tregs as a predictor of glucocorticoid sensitivity in patients with immune thrombocytopenia.","authors":"Sara El-Sayed Abd El-Ghani, Lina Ayman Mahmoud Mohamed, Mohamed Roshdi El-Masry, Hala M Abdelhamid, Mohamed Fateen, Marwa Salah Mohamed","doi":"10.1080/17474086.2025.2467386","DOIUrl":"10.1080/17474086.2025.2467386","url":null,"abstract":"<p><strong>Background: </strong>ITP is an immune-mediated disorder showing increased platelet destruction and reduced platelet production. Glucocorticoids are the first-line treatment, but 10-20% of patients are insensitive to them. We should avoid the irrational use of steroids for treating ITP. No markers exist to predict treatment responses in ITP. Recently, a few studies showed abnormal ratio and function of Tregs in ITP patients and that the levels of Tregs change after glucocorticoid treatment. We aimed to study the value of CD8+ CD25+ Tregs in predicting glucocorticoid sensitivity in newly diagnosed ITP patients.</p><p><strong>Research design and methods: </strong>This cohort (longitudinal) study included 60 ITP patients. The baseline platelet counts and levels of CD8+ CD25+ Tregs were measured at diagnosis. The response to steroids was evaluated after 2 weeks of treatment, then after 3 months and 6 months.</p><p><strong>Results: </strong>The ROC curve was plotted, and the <i>p</i> value was not significant; therefore, the optimal critical value, specificity and sensitivity could not be determined.</p><p><strong>Conclusions: </strong>This study couldn't confirm the value of CD8+CD25+ Tregs in predicting glucocorticoid sensitivity in ITP, but there was a significant positive correlation between the CD8+CD25+ Tregs percentage and the steroids' response after 2 weeks. Therefore, further studies are recommended.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"257-264"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406523","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":"Extracellular vesicles secreted by leukemic cells as mediators of dysregulated hematopoiesis: acute myeloid leukemia as a case in point.","authors":"Vishakha Kasherwal, Vaijayanti Kale, Anuradha Vaidya","doi":"10.1080/17474086.2025.2471860","DOIUrl":"10.1080/17474086.2025.2471860","url":null,"abstract":"<p><strong>Introduction: </strong>Acute myeloid leukemia (AML) cells exhibit a profound capacity for resistance to conventional chemotherapeutic agents, posing a substantial challenge to existing therapeutic paradigms. Interestingly, this happens in the face of a luxuriant proliferation of leukemic blasts in the peripheral blood. This paradox of concurrent proliferative activity and cellular quiescence underscores a complex biological phenomenon that is intricately mediated by AML-derived Extracellular vesicles (EVs).</p><p><strong>Areas covered: </strong>An extensive literature review search was done on PubMed/Scopus/Web of Sciences databases to identify studies published between 2013 and 2024 elucidating and demonstrating the effect of AML-derived EVs, Microvesicles (MVs) and Exosomes (Exos) in regulating the normal and dysregulated bone marrow (BM) niche.</p><p><strong>Expert opinion: </strong>The review delves into understanding the molecular mechanisms underlying the dual behavior of AML cells - proliferation and quiescence, with a special focus on the role of the EVs and their subtypes viz. Exos and MVs in establishing a discrete BM microenvironment that is subversive to chemotherapy. It offers a novel perspective on the intricate interplay between the leukemic cells and their microenvironment, with implications for therapeutic interventions targeting AML persistence and drug resistance.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"225-237"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499825","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}
Tze Wei Chan, Hein Than, Tertius Tuy, Yeow Tee Goh
{"title":"Pegcetacoplan: the first and only C3-targeted therapy for the treatment of adults with paroxysmal nocturnal hemoglobinuria.","authors":"Tze Wei Chan, Hein Than, Tertius Tuy, Yeow Tee Goh","doi":"10.1080/17474086.2024.2440101","DOIUrl":"10.1080/17474086.2024.2440101","url":null,"abstract":"<p><strong>Introduction: </strong>Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired disorder of hematopoietic stem cells, characterized by somatic mutations of the Phosphatidylinositol Glycan Class A Gene, resulting in increased hemolysis. The advent of complement inhibitors has since changed the way clinicians approach treating PNH. Pegcetacoplan is a C3 inhibitor that has shown promise in this field and improved outcomes for patients who have been diagnosed with PNH.</p><p><strong>Areas covered: </strong>This review article will aim to examine the pathophysiology of PNH and the current treatments available, with a focus on pegcetacoplan. It will focus on the pharmacodynamics, pharmocokinetics and evidence in the use of pegcetacoplan in PNH. Electronic sources including PubMed, MEDLINE, were utilized with studies in the last 5 years prioritized, especially the phase 3 Prince and Pegasus studies.</p><p><strong>Expert opinion: </strong>The results from phase 3 studies for pegcetacoplan have been promising, showing good efficacy and improvements in patients' conditions. More research is required to evaluate the use of pegcetacoplan, especially in combination with existing treatment in patients who are having suboptimal results. Nonetheless, with more results on the way and new agents to treat PNH in the vicinity, this remains a very exciting time for both clinicians and patients.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"11-20"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799950","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}
Jan Astermark, Tyler W Buckner, Laurent Frenzel, Anthony J Hatswell, David Hinds, Sandra Santos, Robert Klamroth, Tobias Becker, Deon York
{"title":"A plain language summary on indirectly comparing bleeding after valoctocogene roxaparvovec gene therapy to bleeding with emicizumab prophylaxis.","authors":"Jan Astermark, Tyler W Buckner, Laurent Frenzel, Anthony J Hatswell, David Hinds, Sandra Santos, Robert Klamroth, Tobias Becker, Deon York","doi":"10.1080/17474086.2025.2467861","DOIUrl":"10.1080/17474086.2025.2467861","url":null,"abstract":"","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"177-193"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647879","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}
Alessandro Laganà, Emilia Scalzulli, Maria Laura Bisegna, Claudia Ielo, Maurizio Martelli, Massimo Breccia
{"title":"Understanding and overcoming resistance to tyrosine kinase inhibitors (TKIs) in Chronic myeloid leukemia (CML).","authors":"Alessandro Laganà, Emilia Scalzulli, Maria Laura Bisegna, Claudia Ielo, Maurizio Martelli, Massimo Breccia","doi":"10.1080/17474086.2024.2440776","DOIUrl":"10.1080/17474086.2024.2440776","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic myeloid leukemia (CML) represents one of the first neoplasms whose molecular pathogenesis was successfully unraveled, with tyrosine kinase inhibitors (TKIs) representing one of the first-targeted therapies. TKIs have revolutionized long-term outcomes of CML patients and their life expectancy. Nonetheless, a minority of patients will develop TKI resistance due to a complex and multifactorial process that ultimately leads to the emergence of an unresponsive cancer clone. Overcoming TKI resistance is considered one of the major challenges in CML management.</p><p><strong>Areas covered: </strong>In this review, the main findings extrapolated from published research, guidelines, and clinical trials regarding TKI resistance (published before October 2024) are discussed. Data have been obtained through broad research on Medline, Embase, Pubmed, and archives from EHA and ASH congresses.</p><p><strong>Expert opinion: </strong>Nowadays, asciminib and ponatinib have expanded the therapeutic arsenal for resistant-CML management and allogenic transplant still represents an important alternative in the context of multiple TKI failures. Off-label use of TKIs combination therapies, although theoretically appealing, lacks robust clinical evidence and regulatory approval. Looking ahead, the introduction of novel technologies such as digital PCR (dPCR) and next generation sequencing (NGS) holds great potential to revolutionize the management of TKI-resistant CML cases.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"65-79"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794456","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":"Spontaneous regression in mature T-cell non-Hodgkin lymphoma.","authors":"Akihiro Ohmoto, Shigeo Fuji","doi":"10.1080/17474086.2024.2439469","DOIUrl":"10.1080/17474086.2024.2439469","url":null,"abstract":"<p><strong>Introduction: </strong>Spontaneous regression (SR) is observed in some patients with mature T-cell non-Hodgkin lymphoma (MTCL), including adult T-cell leukemia/lymphoma (ATL), although the incidence is rare.</p><p><strong>Area covered: </strong>We extracted 31 cases with MTCL who experienced SR based on a literature search and summarized the patient characteristics and clinical outcomes.</p><p><strong>Expert opinion: </strong>MTCL with SR included various subtypes, the most common being ATL (<i>n</i> = 17). Five of 24 cases (21%) maintained SR for more than 5 years, and the median duration of SR was 2 years. Sixteen of 31 cases (52%) experienced tumor relapse after SR. Two retrospective studies including ATL cases showed SR rates of 18% and 4%, respectively. Representative triggers are infection and surgical biopsies, and possible mechanisms include immunological mechanisms such as cross-reactivity of virus-specific T cells with tumor antigens. The diagnostic criteria for SR are not standardized among reports, and the clinical outcomes are not fully described. Practically, observation is the only accepted strategy after SR was achieved. In the era of molecular targeted therapy or immunotherapy, new strategies including maintenance therapy after SR could be discussed, although clinical data are lacking.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"47-55"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791485","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}
Thoraya M Abdelhamid, Yasmine Y Hassaneen, Mohamed Ghareeb, Eman O Rasekh
{"title":"The influence of lymphoid enhancer binding factor-1 expression on the outcome of adult acute promyelocytic leukemia patients.","authors":"Thoraya M Abdelhamid, Yasmine Y Hassaneen, Mohamed Ghareeb, Eman O Rasekh","doi":"10.1080/17474086.2025.2467870","DOIUrl":"10.1080/17474086.2025.2467870","url":null,"abstract":"<p><strong>Background: </strong>Acute promyelocytic leukemia (APL) is considered one of the greatest success stories in cancer therapy. However, early deaths remain the leading cause of treatment failure. This study aimed to analyze <i>LEF1</i> expression in adult APL patients to evaluate its impact on survival outcomes, particularly early deaths.</p><p><strong>Research design and methods: </strong><i>LEF1</i> expression was analyzed by RT-qPCR in 78 denovo adult APL samples and 20 bone marrow samples from healthy matched donors as a control group. The cutoff for <i>LEF1</i> fold change was set at 0.2250 using the receiver operating characteristic curve.</p><p><strong>Results: </strong><i>LEF1</i> expression was down regulated in APL patients as compared to the control group with statistically significant difference between the two groups (<i>p</i> < 0.001). The incidence of early deaths was higher in the low-<i>LEF1</i> expressers than in high expressers (<i>p</i> = 0.018). <i>LEF1</i> was determined to be an independent factor affecting early deaths. The high-risk patient group with low <i>LEF1</i> expression had the worst overall survival.</p><p><strong>Conclusions: </strong>This study supports the potential of <i>LEF1</i> to be a prognostic parameter in APL and a predictor of early deaths. Incorporating <i>LEF1</i> into risk stratification could help to minimize early deaths. Future studies should explore combined risk factor analyses for improved prognosis in APL patients.</p>","PeriodicalId":12325,"journal":{"name":"Expert Review of Hematology","volume":" ","pages":"265-273"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440496","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}