Hematological Oncology最新文献

{"title":"Adaptation and Performance of the Self-Report-Generated Charlson Comorbidity Index in the Lymphoma Epidemiology of Outcomes (LEO) Cohort","authors":"James R. Cerhan,&nbsp;Tereza Sokolova,&nbsp;Elliott J. Cahn,&nbsp;Mazie Tsang,&nbsp;Christopher S. Strouse,&nbsp;Michelle A. T. Hildebrandt,&nbsp;Allison C. Rosenthal,&nbsp;Andrew L. Feldman,&nbsp;David L. Jaye,&nbsp;Peter Martin,&nbsp;Jonathon B. Cohen,&nbsp;Brad S. Kahl,&nbsp;Izidore S. Lossos,&nbsp;Jonathan W. Friedberg,&nbsp;Loretta J. Nastoupil,&nbsp;Brian K. Link,&nbsp;Thomas M. Habermann,&nbsp;Matthew J. Maurer,&nbsp;Carla Casulo,&nbsp;Carrie A. Thompson,&nbsp;Annalynn M. Williams,&nbsp;Christopher R. Flowers","doi":"10.1002/hon.70137","DOIUrl":"https://doi.org/10.1002/hon.70137","url":null,"abstract":"<div>\u0000 \u0000 <p>Newly diagnosed patients with non-Hodgkin lymphoma (NHL) often have a history of other diseases, and these comorbidities can impact patient treatment and management options, as well as overall survival (OS). We developed the Lymphoma Epidemiology of Outcomes (LEO) comorbidity index (LCI) as a sum of 10 comorbidities adapted from the Self-Report-Generated Charlson Comorbidity Index (SRG-CCI) for use in the LEO cohort, a national prospective study of newly diagnosed NHL. Of the 5502 participants with self-reported comorbidity data, 3107 (56.4%) were male and the mean age at diagnosis was 60.9 years (range, 18–99 years). The LCI ranged from 0 to 6, with 48.6% having 0, 30.2% having 1, 21.2% having 2 or more comorbidities. With a median follow-up of 62.4 months among surviving participants, 2099 patients had an event and 1219 died. Continuous LCI similarly predicted both 1-year mortality (c-statistic = 0.654) and OS (c-statistic = 0.655), while it showed a weaker but still statistically significant predictive ability for lymphoma-specific (c-statistics = 0.617) and event-free (c-statistic = 0.574) survival. Participants with 1 (HR = 1.21, 95% CI 1.05–1.39) and 2+ (HR = 1.80, 95% CI 1.56–2.08) comorbidities had inferior OS compared to those with no comorbidities after adjustment for age and sex (c-statistic = 0.654), and performance strengthened after adjustment for the International Prognostic Index (c-statistic = 0.672). LCI predicted OS most strongly in marginal zone (c-statistics = 0.748) and weakest in T-cell (c-statistic = 0.579) lymphoma. The cumulative incidence of death due to lymphoma, lymphoma treatment, and other causes all increased with increasing comorbidities, with the greatest increase observed for death due to other causes. The LCI performs comparable to other published comorbidity indices, supporting its use in the LEO cohort to better model real-world outcomes and more generally providing an approach to implementing comorbidity indices in cancer survivorship cohorts.</p>\u0000 </div>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237070","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":"Review of the Management of Relapsed/Refractory Follicular Lymphoma: An Italian Perspective","authors":"Giacomo Loseto,&nbsp;Maria Chiara Tisi,&nbsp;Antonella Anastasia,&nbsp;Alessandro Broccoli,&nbsp;Ilaria Del Giudice,&nbsp;Caterina Patti,&nbsp;Benedetta Puccini,&nbsp;Caterina Stelitano,&nbsp;Vittorio Zilioli,&nbsp;Stefano Luminari","doi":"10.1002/hon.70140","DOIUrl":"https://doi.org/10.1002/hon.70140","url":null,"abstract":"<p>Follicular lymphoma (FL) is an indolent disease characterized by multiple relapses and eventual refractoriness to therapy. Despite advancements in therapeutic approaches, FL treatment algorithm and management remain not well-established, necessitating both ongoing research into novel therapeutic strategies and in stating patient journey. We propose a comprehensive overview of current standard treatments for relapsed or refractory (R/R) FL, including chemoimmunotherapy and stem cell transplantation, and insights into emerging therapies such as chimeric antigen receptor (CAR) T-cell therapy and bispecific antibodies. We discuss the efficacy and safety profiles of these innovative treatments, their integration into the therapy armamentarium, and the potential they hold in altering the natural history of FL. Additionally, we propose a therapeutic flow depending on POD24 (i.e., progression of disease within 24 months), transformed disease, early relapse and fast/low progression, with the aim to provide a useful tool to all physicians dealing with this disease for achieving sustained remission and improving the quality of life in patients with R/R FL.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70140","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237073","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}

{"title":"Routine Monitoring of CAR-T-Cells Expansion and Persistence in Patients With Aggressive Large B-Cell Lymphoma by Flow Cytometry: A Single-Center Experience","authors":"Alexandra Zduniak,&nbsp;Jérémie Martinet,&nbsp;Emilie Lévêque,&nbsp;Stéphanie Becker,&nbsp;David Tonnelet,&nbsp;Elodie Dos Santos,&nbsp;Claire Leroy,&nbsp;Mustafa Alani,&nbsp;Jean Rouvet,&nbsp;Marine Brousseau,&nbsp;Camille Giverne,&nbsp;Alexis Cuffel,&nbsp;Serge Jacquot,&nbsp;Arnaud Roucheux,&nbsp;Alice Veuiller,&nbsp;Nicolas Lecornu,&nbsp;Misa Eugene Norbert,&nbsp;Olivier Boyer,&nbsp;Hervé Tilly,&nbsp;Fabrice Jardin,&nbsp;Jean-Baptiste Latouche,&nbsp;Vincent Camus","doi":"10.1002/hon.70139","DOIUrl":"https://doi.org/10.1002/hon.70139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>This retrospective, single-center study evaluated routine flow cytometry (FC) monitoring of CAR-T-cells in 45 patients with aggressive large B-cell lymphoma (LBCL). CAR-T-cells expansion was assessed from Day 0 to Month 12. Peak expansion occurred on Day 7 after axi-cel (median 39.3% of total lymphocytes; 87 cells/mm³) and Day 10 for tisa-cel (median 8.1%; 33.2 cells/mm³). Greater CAR-T-cells expansion was associated with immune-related toxicity, with median peak levels reaching 52.8% in patients with grade 2 cytokine release syndrome (CRS) versus 6.6% in those without (<i>p</i> &lt; 0.001) and 60.8% in patients with immune effector cell-associated neurotoxicity syndrome (ICANS) versus 15.3% in those without (<i>p</i> &lt; 0.001). Prolonged cytopenia was observed in 65% of patients and more frequently among those with greater CAR-T-cells expansion. This study highlights FC as a practical tool for monitoring CAR-T-cells dynamics in routine practice, with potential implications for early toxicity risk assessment and personalized supportive care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 6","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237072","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}

{"title":"A SWOT-Consensus for CAR-T in Follicular Lymphoma: Fine Tuning of Patient Journey and Selection","authors":"Monia Marchetti,&nbsp;Paolo Corradini,&nbsp;Luca Arcaini,&nbsp;Stefania Bramanti,&nbsp;Alice Di Rocco,&nbsp;Marco Ladetto,&nbsp;Stefano Luminari,&nbsp;Luigi Rigacci,&nbsp;Pier Luigi Zinzani","doi":"10.1002/hon.70125","DOIUrl":"10.1002/hon.70125","url":null,"abstract":"<p>Over the past 2 decades, advancements in follicular lymphoma (FL) treatment, particularly with anti-CD20 antibodies, have significantly improved patient survival. However, a subset of FL patients experiences early relapse and progression within 24 months (POD24) after first line treatment, which is a sign of poor prognosis. Current guidelines recommend various second-line treatments, but there is no consensus on an optimal treatment sequence for relapsed/refractory (r/r) FL. Moreover, despite available treatments, reduced survival after second-line therapies and diminishing responses with each relapse highlight the unmet need for more effective options. Chimeric antigen receptor T-cell (CAR-T) therapy has emerged as a promising treatment for r/r FL beyond 2^nd line therapy, with three FDA/EMA-approved therapies (axicabtagene ciloleucel, tisagenlecleucel, and lisocabtagene maraleucel) showing high efficacy and manageable side effects. However, challenges remain in determining which patients will benefit most from CAR-T, especially given its high cost, safety concerns, and logistical barriers. A consensus study was conducted to guide CAR-T patient selection and treatment sequencing for patients in 3rd line or beyond. Key findings suggest that younger patients, those with high disease burden or poor first-line responses, should be prioritized for CAR-T. Additionally, CAR-T is recommended as a third-line option for patients with POD24, double refractoriness (failure to respond to two subsequent lines of immunochemotherapy), or early autologous stem cell transplant failure. The study underscores the importance of early assessment of treatment response, careful second-line therapy selection, and patient adherence to ensure optimal outcomes. The results, based on expert consensus, support CAR-T therapy as a viable option for r/r FL patients, offering hope for durable remissions in this challenging cohort.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124532","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}

{"title":"Efferocytosis and M2 Macrophage Polarization Gene Expression Correlates With Relapsed and Refractory Classical Hodgkin Lymphoma Patients: A Multi-Omic Analysis","authors":"Juan Quarroz Braghini,&nbsp;María Cecilia Cabral Lorenzo,&nbsp;Laura Kornblihtt,&nbsp;Mariana S. De Lorenzo,&nbsp;Stella Maris Ranuncolo,&nbsp;Guillermo Blanco","doi":"10.1002/hon.70135","DOIUrl":"https://doi.org/10.1002/hon.70135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Classical Hodgkin Lymphoma (cHL) exhibits rare malignant Hodgkin-Reed Sternberg (HRS) cells within a reactive immune microenvironment. This study developed an HRS cell gene expression signature to identify HRS cells in single-cell RNA sequencing (scRNA-seq) data, investigated cognate interactions, analyzed bulk transcriptomes, and assessed predictors of treatment failure. Differentially expressed genes (DEGs) from RelB-silenced U-HO1 cells were identified, and scRNA-seq data was processed to annotate cell types. Cognate interactions were analyzed using CellPhoneDB, and bulk transcriptome deconvolution was performed using CIBERSORT. Ridge regression models were built and evaluated. A 37-gene HRS cell signature identified HRS cells (2.7%) in scRNA-seq data, revealing efferocytosis pathway enrichment. Macrophages showed the highest cognate interactions, including efferocytosis-related interactions with HRS cells. Bulk transcriptome analysis of 130 cHL patients showed increased M2 macrophage proportions correlated with poorer treatment response (<i>p</i> &lt; 0.001). Ridge regression predicted response to treatment (RtoT) with an AUC of 0.83, identifying HRS cells and M2 macrophages as key predictors. Hierarchical clustering based on 19 genes revealed distinct RtoT outcomes, with high efferocytosis/M2 gene expression correlating with poor response. Increased MerTK, CD209, CD14, and CD36 expression was associated with poorer outcomes. Combining gene expression and cell type proportions improved RtoT prediction (AUC 0.87). A validated HRS cell gene expression signature enabled precise HRS cell identification and accurate estimation of cell proportions. HRS cell and M2 macrophage proportions, along with efferocytosis-related genes, predicted treatment failure. Efferocytosis-mediated M2 macrophage polarization, controlled by HRS cells, may be a critical immune checkpoint in cHL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111126","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 C-Reactive Protein/Platelet Ratio as a Biomarker Prior to Allogeneic Hematopoietic Stem Cell Transplantation in Malignant Lymphoma","authors":"Akihiko Izumi,&nbsp;Takayoshi Tachibana,&nbsp;Hiroto Ishii,&nbsp;Shin-ichiro Fujiwara,&nbsp;Yuho Najima,&nbsp;Chikako Ohwada,&nbsp;Kota Yoshifuji,&nbsp;Yuto Hibino,&nbsp;Masatsugu Tanaka,&nbsp;Shinichi Kako,&nbsp;Shun-ichi Kimura,&nbsp;Masaharu Tamaki,&nbsp;Shingo Yano,&nbsp;Hiroki Yokoyama,&nbsp;Daisuke Minakata,&nbsp;Shokichi Tsukamoto,&nbsp;Emiko Sakaida,&nbsp;Noriko Doki,&nbsp;Akira Yokota,&nbsp;Takuya Miyazaki,&nbsp;Nobuyuki Aotsuka,&nbsp;Yoshinobu Kanda","doi":"10.1002/hon.70136","DOIUrl":"https://doi.org/10.1002/hon.70136","url":null,"abstract":"<div>\u0000 \u0000 <p>Previous studies have shown that the pre-transplant C-reactive protein (CRP)/platelet ratio (CP ratio) is a predictor of survival. The aim of this multicenter retrospective study was to evaluate the clinical significance of CP ratio in patients with malignant lymphoma (ML) who underwent allogeneic hematopoietic stem cell transplantation (alloHCT). The cohort included patients with ML who underwent first alloHCT from 2007 to 2021. CP ratio was defined as CRP [mg/dL]/platelet [10^4/μL] and evaluated prior to alloHCT. The cutoff value for CP ratio was set at 0.05 based on previous studies. A total of 311 cases were analyzed, of which 134 were mature B cell lymphoma, 177 were T/NK cell lymphoma (including 70 cases of adult T-cell leukemia/lymphoma), and 17 were Hodgkin's lymphoma. The median age was 53 years (range: 17–69 years). High CP ratio was associated with status of disease, presence of infections, poor performance status at alloHCT, and high transfusion volume received prior to alloHCT. Overall survival (OS) at 2 years according to CP ratio (low vs. high) was 61.1% versus 30.1% (<i>p</i> &lt; 0.001), non-relapse mortality (NRM) was 21.4% versus 40.7% (<i>p</i> = 0.001), and the relapse rate was 23.7% versus 32.6% (<i>p</i> = 0.061), respectively. In multivariate analysis, the high CP ratio group was associated with poor OS (HR = 2.20, 95% CI: 1.61–3.02, <i>p</i> &lt; 0.001) and higher NRM (HR = 1.90, 95% CI: 1.28–2.81, <i>p</i> = 0.0014). High CP ratio was found to be associated with poor post-transplant OS and NRM, and was a suitable prognostic biomarker for stratifying the risk of patients with ML who are candidates for alloHCT.</p>\u0000 </div>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012194","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":"Correction to “Isocitrate Dehydrogenase 2 Mutation Promotes Cytarabine Resistance in Acute Myeloid Leukemia by Warburg Effect”","authors":"","doi":"10.1002/hon.70133","DOIUrl":"https://doi.org/10.1002/hon.70133","url":null,"abstract":"<p>J. Yang, Z. Wang, K. Wu, et al. Isocitrate Dehydrogenase 2 Mutation Promotes Cytarabine Resistance in Acute Myeloid Leukemia by Warburg Effect. <i>Hematological Oncology</i> 42, no. 6 (2024): e3316. https://doi.org/10.1002/hon.3316.</p><p>In the article, there were errors in Figures 1, 2 and 3. The representative flow cytometry results for HL-60 cell apoptosis, such as (KD-IHD2 group in Figure 1, WT + Enasidendb group in Figure 2, and IDH2 mutated group in Figure 3) were inadvertently used from different batches.</p><p>The corrected figures are shown below. The authors confirmed that these corrections do not affect or alter the conclusion of the article.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012162","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}

{"title":"CAR T-Cell Therapies for Patients With Relapsed and Refractory Aggressive Lymphomas: Real-World Experiences From a Single Center on the Use of Radiotherapy","authors":"J.T. Jutzi,&nbsp;J. Wampfler,&nbsp;C. Ionescu,&nbsp;M.N. Kronig,&nbsp;B. Jeker,&nbsp;M. Hoffmann,&nbsp;I. Reusser,&nbsp;C. Haslebacher,&nbsp;S. Sendi Stamm,&nbsp;M. Schletti,&nbsp;B.P. Lüscher,&nbsp;V.U. Bacher,&nbsp;M. Wehrli,&nbsp;M. Daskalakis,&nbsp;T. Pabst,&nbsp;U. Novak","doi":"10.1002/hon.70124","DOIUrl":"https://doi.org/10.1002/hon.70124","url":null,"abstract":"<p>In this retrospective analysis on patients treated with CAR T-cells at our center, we report on the use of radiotherapy in this setting. Our real-world cohort of 90 patients with aggressive lymphomas was treated with CARs from 2019 until December 2022. We found that the outcome of a localized relapse after CARs treated with radiotherapy was comparable to patients without a relapse. With the knowledge from the collected real-world data, we should launch prospective clinical trials to further improve the use of radiotherapy, and overall the efficacy of CAR T-cell therapies for patients with aggressive lymphomas.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144920558","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}

{"title":"Upregulated miR-29a-3p Prevent Malignant Features of Lymphoma Cells by Targeting MCL1","authors":"Tengfei Shi,&nbsp;Xiali Wu,&nbsp;Aichun Liu","doi":"10.1002/hon.70130","DOIUrl":"https://doi.org/10.1002/hon.70130","url":null,"abstract":"<div>\u0000 \u0000 <p>Diffuse large B-cell lymphoma (DLBCL) is the most prevalent adult lymphoma, which exhibits aggressive clinical behavior with rapid progression. Accumulating evidence implicates microRNAs (miRNAs) in the pathogenesis of various human tumors. Investigating miR-29a-3p expression and mechanism may reveal novel therapeutic targets for DLBCL pathogenesis and monitoring. The levels of miR-29a-3p in DLBCL tissue, serum and cell samples were determined by PCR reactions. ROC curve reflected the screening ability of miR-29a-3p for DLBCL patients. The target of miR-29a-3p was verified by dual-luciferase activity assay. Transfection assays were employed to upregulate miR-29a-3p and MCL1 expression, followed by functional characterization using CCK-8, Transwell assays and flow cytometry. miR-29a-3p is downregulated in DLBCL, which has a high potential to identify DLBCL patients. MCL1 is a validated miR-29a-3p target prominently expressed in DLBCL. miR-29a-3p mimic notably suppressed DLBCL cell activity and adverse behavior, which was partially counteracted by MCL1 overexpression. High levels of miR-29a-3p target MCL1 to prevent DLBCL cell malignant behavior, highlighting that miR-29a-3p/MCL1 axis may be a candidate therapeutic and monitoring marker for DLBCL.</p>\u0000 </div>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144915006","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":"Late Cardiac Toxicity After Anthracyclines and Radiotherapy for Lymphoma—A Regression Analysis of Dose-Response","authors":"Lotte Nygård,&nbsp;Ivan Richter Vogelius,&nbsp;Klaus F. Kofoed,&nbsp;Søren Bentzen,&nbsp;Lena Specht","doi":"10.1002/hon.70134","DOIUrl":"https://doi.org/10.1002/hon.70134","url":null,"abstract":"<p>Late cardiac toxicity after radiation therapy and/or systemic therapy with anthracyclines for lymphomas is a serious concern. To estimate the risks with different treatment combinations, reliable estimates of the dose-response relationships are needed. We performed a literature-based regression analysis of long-term cardiac events after lymphoma treatment. The objective was to identify dose-response relationships for anthracycline and radiotherapy regarding congestive heart failure (CHF), ischemic heart disease (IHD), and valvular heart disease (VHD). We included papers published January 2000-December 2022 with data on long term cardiac outcomes in lymphoma patients, radiation doses to the heart, and anthracycline doses. Papers without dose/response information were excluded. We identified six eligible papers including 22,916 patients. The excess relative risk (ERR) of CHF for anthracyclines per 100 mg/m2 (corresponding to 2 cycles of ABVD or CHOP chemotherapy) was 92% (CI: 74%–101%), and for radiotherapy per Gray (Gy) of mean heart dose it was 6.1% (CI: 4.4%–7.6%). Corresponding numbers for the other endpoints were: IHD: No effect of anthracyclines, ERR = 4.4%/Gy (CI: 2.7%–6.1%) and VHD: ERR = 25%/100 mg/m2 (CI: 13%–37%) and ERR = 10%/Gy (CI: 6%–13%). Data agree with a linear no threshold dose-response relationship for related endpoints, that is, there are no “safe” lower doses of either anthracyclines or radiotherapy. Late cardiac toxicity risks for all three endpoints can be assessed in each patient by a combined estimate from the cumulative doses of anthracyclines and radiation to the heart. This estimate can guide future treatment allocation in lymphoma patients.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 5","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144910193","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}