Hematology, Transfusion and Cell Therapy最新文献

{"title":"Are quality of life data reported in clinical trials evaluating CAR T cells in hematologic malignancies?","authors":"Julie Bouaziz-Bohbot,&nbsp;Lionel Karlin,&nbsp;Gilles A. Salles,&nbsp;Catherine Rioufol","doi":"10.1016/j.htct.2026.108542","DOIUrl":"10.1016/j.htct.2026.108542","url":null,"abstract":"<div><h3>Background</h3><div>Increasing indications for CAR T cells in early-line hematological malignancies underscore the need to report patient experiences. However, data regarding patient quality of life in this setting remain limited.</div></div><div><h3>Objective</h3><div>This study aimed to assess the inclusion of Health-Related Quality of Life as an endpoint in clinical trials registered on ClinicalTrials.gov for CAR T-cell therapies in hematological malignancies.</div></div><div><h3>Methods</h3><div>A comprehensive search of the U.S. National Institutes of Health database (ClinicalTrials.gov) was performed for trials registered up to August 28, 2022, using the keywords \"CAR\" AND (\"lymphoma\" OR \"multiple myeloma\" OR \"leukemia\" OR \"hematologic malignancy\"). For each selected trial, data regarding study design, setting, indication, treatment line, relevant outcomes, and evaluation scales were collected.</div></div><div><h3>Main results</h3><div>Out of 1281 records, 429 trials met the inclusion criteria and were analyzed, with over half being phase 1. The most common primary endpoint was safety (47%). Health-Related Quality of Life was assessed as a secondary endpoint in only 11% of trials. A wide variety of questionnaires were identified, and data collection methodologies (baseline assessments, timepoints, and follow-up duration) varied considerably across studies.</div></div><div><h3>Conclusion</h3><div>Establishing a standardized consensus for measuring Health-Related Quality of Life is essential to complement efficacy data in clinical trials and real-world studies evaluating CAR T-cell therapies.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 4","pages":"Article 108542"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor glycosylation and ABO phenotyping alterations in invasive urothelial carcinoma: A case report","authors":"Vanessa Cristina Fanger,&nbsp;Isabelle Carolina Cotrim Gozzi,&nbsp;Marina Cavalcanti de Albuquerque da Veiga Conrado,&nbsp;Regina Aparecida Cardoso,&nbsp;Vanderson Rocha,&nbsp;Alfredo Mendrone-Junior,&nbsp;Carla Luana Dinardo","doi":"10.1016/j.htct.2026.108548","DOIUrl":"10.1016/j.htct.2026.108548","url":null,"abstract":"","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 4","pages":"Article 108548"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Karyotypic complexity and mutated TP53 are associated with myeloid neoplasms with ring chromosomes","authors":"Thaís Gonçalves dos Santos,&nbsp;Mauren Fernanda Moller dos Santos,&nbsp;Renata Kiyomi Kishimoto,&nbsp;Daniela Borri,&nbsp;Caroline Nunes Silveira,&nbsp;Susana Elaine Alves Rosa,&nbsp;Luiz Gustavo Ferreira Cortes,&nbsp;Paulo Campregher,&nbsp;Elvira Deolinda Rodrigues Pereira Velloso","doi":"10.1016/j.htct.2026.108544","DOIUrl":"10.1016/j.htct.2026.108544","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluated the prevalence of ring chromosomes, their association with <em>TP53</em> alterations, and their prognostic impact in myeloid neoplasms.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 12,935 onco-hematological karyotypes from 2017–2022 identified 21 adult patients with myeloid neoplasms harboring ring chromosomes. Fluorescence in situ hybridization was used to assess <em>TP53</em> deletions, while next-generation sequencing detected <em>TP53</em> mutations.</div></div><div><h3>Results</h3><div>Ring chromosomes were identified in 0.29% of the cases. The median patient age was 69 years and 67% were male. Acute myeloid leukemia and myelodysplastic neoplasms were the most frequent diagnoses. The median number of karyotypic abnormalities was nine (range: 1–28). Karyotypic complexity, <em>TP53</em> deletions, mutations, and multi-hit alterations were observed in 81%, 19%, 78%, and 61% of the cases, respectively. ring chromosomes were most frequently derived from chromosomes 6 and 7. Median overall survival was 3.2 months. <em>TP53</em> multi-hit alterations (Hazard ratio: 10.63; p-value = 0.001) and the number of karyotypic abnormalities (Hazard ratio: 1.06; p-value = 0.043) were significantly associated with increased mortality. Patients with very complex karyotypes had a 5.53-fold higher risk of death.</div></div><div><h3>Conclusion</h3><div>Ring chromosomes are rare in myeloid neoplasms and are consistently associated with high karyotypic complexity and <em>TP53</em> alterations. In this cohort, both <em>TP53</em> alterations and karyotypic complexity emerged as independent prognostic factors and were strongly associated with an extremely poor prognosis.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 4","pages":"Article 108544"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and predictors of early blood transfusion in renal transplant recipients: a retrospective study","authors":"Pukar Chandra Shrestha,&nbsp;Kalpana Kumari Shrestha,&nbsp;Arati Rai,&nbsp;Dipesh Shrestha,&nbsp;Sumit Acharya,&nbsp;Rupesh Kumar Jha,&nbsp;Hari Prasad Baral,&nbsp;Rojan Adhikari,&nbsp;Bikash Khadka,&nbsp;Bikkin Dangol,&nbsp;Milan Shrestha,&nbsp;Lochan Shrestha,&nbsp;Sanisha Karki,&nbsp;Chahana Bogati,&nbsp;Puja Khadka,&nbsp;Binita Kutu,&nbsp;Sat Prasad Nepal","doi":"10.1016/j.htct.2026.108547","DOIUrl":"10.1016/j.htct.2026.108547","url":null,"abstract":"<div><h3>Background</h3><div>Anemia associated with chronic kidney disease is driven by reduced erythropoietin synthesis, chronic inflammation, and decreased red blood cell lifespan. During and after renal transplant surgery, recipients may need blood transfusions. Transfusion rates exhibit significant inter-center variability, largely driven by differing clinical criteria among transplant surgery, nephrology, and intensive care units.</div></div><div><h3>Study design and methods</h3><div>A retrospective study was conducted of 407 renal transplant recipients who underwent transplantation from May 15, 2023 to August 16, 2025 at the Shahid Dharmabhakta National Transplant Center, Nepal. Early transfusion was defined as any blood product administration occurring within 14 days post-surgery. Clinical and Laboratory variables were compared between transfused and non-transfused patients using either the Mann–Whitney U test or chi-square test as appropriate. Variables significant in univariate analysis were included in multivariate logistic regression to identify predictors of transfusion.</div></div><div><h3>Results</h3><div>Ninety-five patients (23.34%) required transfusions with leukoreduced red blood cells being the most common blood product. Univariate analysis revealed that preoperative hemoglobin levels, diabetic nephropathy, and the length of hospital stay were significantly associated with transfusion requirements. Multivariate analysis showed that preoperative hemoglobin and length of stay were predictors of transfusion. The hemoglobin nadir for the transfused group reached a mean of 6.3 ± 1.05 g/dL and a median of 6.1 g/dL, with an interquartile range from 4.2 to 10.0 g/dL.</div></div><div><h3>Discussion</h3><div>The results of this study show that a conservative transfusion approach can be effective in achieving good clinical outcomes, especially in resource limited centers.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 4","pages":"Article 108547"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost analysis of allogeneic hematopoietic stem cell transplantation before and after the implementation of therapeutic drug monitoring","authors":"Joice Zuckermann,&nbsp;Ana Paula Beck da Silva Etges,&nbsp;Bruno Mateus de Castro,&nbsp;Renata Garcia Ruschel,&nbsp;Luciana Rodrigues de Lara,&nbsp;Lucas Bastos Beltrami,&nbsp;Elenita Teresinha Chagas,&nbsp;Liane Esteves Daudt,&nbsp;Alessandra Aparecida Paz,&nbsp;Leila Beltrami Moreira","doi":"10.1016/j.htct.2026.106516","DOIUrl":"10.1016/j.htct.2026.106516","url":null,"abstract":"<div><h3>Objectives</h3><div>To estimate the costs of allogeneic hematopoietic stem cell transplantation before and after the implementation of therapeutic drug monitoring.</div></div><div><h3>Methods</h3><div>A retrospective cohort study with historical controls included adult and pediatric patients undergoing related, unrelated and haploidentical allogeneic hematopoietic stem cell transplantation from December 2014 to December 2021. The therapeutic drug monitoring (cyclosporine, tacrolimus, and busulfan) group (TDM Group) was compared to a Control Group without therapeutic drug monitoring. A microcosting study based on Time-Driven Activity-based Costing was conducted to assess the hospitalization cost of hematopoietic stem cell transplantation patients. The values of medications and materials were adjusted for inflation to December 2022 and expressed in U.S. dollars</div></div><div><h3>Results</h3><div>Forty-four patients were included in both groups, with data collection from December 2014 to December 2017 (Control Group) and from January 2019 to December 2021 (TDM Group). The average cost per transplantation patient in the entire cohort was US$ 29.604,23 (SD: ± US$ 27.070,00). The hospitalization cost was US$ 32,639.81 (SD ± 31,903.45) for patients in the Control Group and US$ 26,568.65 (SD: ± US$ 21,013.31) for the TDM Group. Regarding the tests performed, the Control Group resulted in a mean cost of US$ 2338.59, with a reduced cost in the TMD Group to US$ 1391.94 (p-value &lt;0.001). The component with the most significant impact on the total cost was medications, with an overall average of US$ 17,728.43 (SD: ± US$ 24,035.77).</div></div><div><h3>Conclusion</h3><div>The total hospitalization cost for allogeneic hematopoietic stem cell transplantation did not differ significantly between groups, but the TDM Group showed lower exam and medication expenditures, suggesting economic benefits. Despite similar overall costs, therapeutic drug monitoring may provide advantages in other clinical outcomes not assessed in this study. Further research is warranted to explore these endpoints.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 4","pages":"Article 106516"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbial diversity in leg ulcer and skin in Sickle Cell disease","authors":"Franciane Mendes-Oliveira,&nbsp;André Rolim Belisário,&nbsp;Marina Lobato Martins,&nbsp;Roberta Cristina Ruedas Martins,&nbsp;Lucas Augusto Moyses Franco,&nbsp;Nazareno Scaccia,&nbsp;Joyce Vanessa da Silva Fonseca,&nbsp;Isabel Cristina Gomes Moura,&nbsp;Valquíria Reis de Souza,&nbsp;Silvia Figueiredo Costa,&nbsp;Ian Valença,&nbsp;Eduarda Bolina-Santos,&nbsp;Fabíola Gomes Mendes,&nbsp;Elizabeth Castro Moreno,&nbsp;Alice Timponi,&nbsp;Jordana Grazziela Alves Coelho dos Reis,&nbsp;Olindo Assis Martins-Filho,&nbsp;Anna Bárbara Carneiro-Proietti,&nbsp;Ester Cerdeira Sabino","doi":"10.1016/j.htct.2026.108550","DOIUrl":"10.1016/j.htct.2026.108550","url":null,"abstract":"<div><h3>Introduction</h3><div>Leg ulcers are a common, painful, and difficult-to-treat complication of sickle cell disease due to their prolonged healing process. The microbial composition of these wounds remains poorly understood. This study investigated the microbiota diversity in sickle cell disease leg ulcers and associations with laboratory parameters.</div></div><div><h3>Methods</h3><div>Samples were collected from leg ulcers, intact skin adjacent to the ulcers, and intact skin from healthy controls. Microbiome profiling was performed by sequencing the V4 region of the 16S ribosomal RNA (rRNA) gene. The laboratory results of patients with sickle cell disease leg ulcers were analyzed alongside the identified taxa using correlation-based analyses.</div></div><div><h3>Results</h3><div>Microbial diversity was significantly lower in sickle cell disease leg ulcers compared to intact skin. Additionally, leukocytes and mean corpuscular volume were statistically associated with the relative abundance of bacteria of the genera <em>Pseudomonas</em> and <em>Aeromonas. Staphylococcus</em> spp. was the predominant genus identified in leg ulcers and was negatively associated with <em>Pseudomonas</em> spp., reflecting a dysbiotic microbial profile characterized by taxa commonly associated with chronic wounds.</div></div><div><h3>Conclusions</h3><div>The observed associations between bacterial taxa and laboratory parameters are exploratory, do not imply causality, and contribute to the characterization of the microbial ecology of sickle cell disease leg ulcers.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 4","pages":"Article 108550"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enteral nutritional therapy practices in pediatric hematopoietic stem cell transplant centers in Brazil","authors":"Vitória Soares Viau,&nbsp;Andressa Florencio da Silva,&nbsp;Soraia Poloni,&nbsp;Vera Lucia Bosa,&nbsp;Estela Beatriz Behling","doi":"10.1016/j.htct.2026.108543","DOIUrl":"10.1016/j.htct.2026.108543","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to analyze the use of enteral nutritional therapy in pediatric hematopoietic stem cell transplantation centers in Brazil, addressing its application, challenges, and current practices.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted from May to October 2023 in Brazilian pediatric hematopoietic stem cell transplantation centers. Data were collected via a structured questionnaire sent to eligible centers, covering the use of prophylactic nasoenteral tubes, formula selection, and adaptations for gastrointestinal symptoms.</div></div><div><h3>Results</h3><div>Seventeen transplant centers participated, predominantly located in the Southeastern region (6.91%). Among them, 82.4% routinely used prophylactic nasoenteral tubes, with polymeric formulas being the first choice in 82.4% of cases. Normocaloric formulas (0.9–1.2 kcal/mL) were also widely adopted (82.4%). For managing gastrointestinal symptoms, the most common approach was reducing the diet volume (30.6%). This study identified a gap in specialized formulas for children aged 10 to 18 years, with 47.1% of centers opting for formulas designed for adults in this age group due to a lack of alternatives.</div></div><div><h3>Conclusions</h3><div>The study highlights regional disparities in hematopoietic stem cell transplantation services in Brazil and confirms enteral nutritional therapy as the primary nutritional support in pediatric transplantations. It also reveals the absence of consensus regarding the best formulas and management protocols, particularly for the 10- to 18-year age group. The findings point to an urgent need for further research and the development of standardized guidelines to ensure safe and effective nutritional support, improving transplant outcomes, and promoting proper growth and development in these patients.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 4","pages":"Article 108543"},"PeriodicalIF":1.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149199543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"False-positive test results: prevalence, time trends, and factors associated with false-positive serological markers in blood donation screening","authors":"Lucas Kallas-Silva,&nbsp;Leandro Dinalli dos Santos,&nbsp;Valeria de Freitas Dutra,&nbsp;Jose Mauro Kutner,&nbsp;Carolina Bonet-Bub","doi":"10.1016/j.htct.2026.106499","DOIUrl":"10.1016/j.htct.2026.106499","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>False-positive serological results in blood donation screening may arise from antibody cross-reactivity, limitations in assay specificity, or low-level reactivity during early-stage infections, ultimately leading to donor deferral and the discard of viable blood units. This study evaluated the prevalence, time trends, and demographic factors associated with false-positive serologic screening results for transfusion-transmissible infections in a Brazilian blood center.</div></div><div><h3>Materials and Methods</h3><div>A cross-sectional study was conducted including all blood donations collected between 2013 and 2022 at a private blood center in São Paulo, Brazil. Donations were screened with serologic tests for syphilis, human immunodeficiency virus, hepatitis B virus, and hepatitis C virus. Reactive samples underwent confirmatory testing, where a false-positive result was defined as an initially reactive screening assay followed by a nonreactive confirmatory test. Associations between demographic variables and false-positive or true-positive results compared to true negative results were analyzed using multivariable Poisson regression.</div></div><div><h3>Results</h3><div>A total of 129,166 donors were included. Most donors (98.7%) had nonreactive results for all serologic tests. Reactive screening results were observed in 0.5% of donations for both syphilis and hepatitis B virus, 0.2% for hepatitis C virus, and 0.1% for human immunodeficiency virus. False positivity occurred more frequently for human immunodeficiency virus (92.0%) and hepatitis C virus (72.7%). Older age, lower education levels, and first-time donation were associated with false-positive results, whereas male sex, non-white race/skin color, lower education levels, and being single or divorced were associated with true-positive status.</div></div><div><h3>Conclusion</h3><div>False-positive results were more frequent among first-time and less-educated donors. This study found no consistent overlap between demographic factors associated with false positivity and true positivity. This suggests that false positivity mainly occurs by chance or from antibody cross-reactivity.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 3","pages":"Article 106499"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient blood management in Brazilian cardiovascular surgery: An exploratory survey of surgeons’ perceptions and reported practices","authors":"Maria Carolina Guido,&nbsp;Bianca Meneghini,&nbsp;Rosangela Monteiro,&nbsp;Matheus Moitinho,&nbsp;Carlos Manuel Brandão,&nbsp;Vinicius Nina,&nbsp;Guilherme Rabello,&nbsp;Fabio Jatene","doi":"10.1016/j.htct.2026.106500","DOIUrl":"10.1016/j.htct.2026.106500","url":null,"abstract":"<div><h3>Introduction</h3><div>Although the clinical benefits of patient blood management are internationally recognized, data regarding its implementation in Brazilian cardiovascular surgery remain limited. This study evaluated knowledge on patient blood management, reported practices, and perceived barriers among Brazilian cardiovascular surgeons.</div></div><div><h3>Methods</h3><div>This cross-sectional survey was conducted among 1,105 cardiovascular surgeons registered with the Brazilian Society of Cardiovascular Surgery. A 30-item questionnaire assessing professional characteristics, preoperative anemia management, perioperative transfusion practices, and patient blood management adoption was distributed via email. Descriptive and inferential statistical analyses were performed.</div></div><div><h3>Results</h3><div>The response rate was 19.4% (n = 205). Most respondents were male (91%) and based in the southeastern region. Preoperative anemia screening and management were heterogeneous. Thirty-one percent estimated the prevalence of preoperative anemia at 5%–15% in their institutions, and 43% reported hemoglobin testing 1–2 days before surgery. Approximately 25% routinely calculated erythrocyte mass and blood volume. Institutional transfusion risk protocols were reported by 48% of respondents, and 62% indicated standardized blood component request parameters. Antifibrinolytics and hemostatic agents were the most frequently reported coagulation strategies. Interest in patient blood management implementation was reported by 52%; perceived barriers included cultural resistance (43%), financial constraints (24%), and administrative challenges (21%). A statistically significant association was observed between geographic region and reported interest in patient blood management implementation.</div></div><div><h3>Conclusion</h3><div>Patient blood management implementation was reported as heterogeneous across institutions. Respondents identified cultural, economic, and structural barriers to patient blood management implementation. These findings reflect surgeons’ self-reported perceptions and should be interpreted within the limitations of a cross-sectional survey with limited regional representativeness.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 3","pages":"Article 106500"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding BCR::ABL1 kinase domain mutations in chronic myeloid leukemia: Implications for tyrosine kinase inhibitor resistance in a South Asian population","authors":"Fatima Sharif,&nbsp;Rafia Mahmood,&nbsp;Maimoona Roghani,&nbsp;Sikandar Hayat Khan,&nbsp;Ibrahim Khan","doi":"10.1016/j.htct.2026.106502","DOIUrl":"10.1016/j.htct.2026.106502","url":null,"abstract":"<div><h3>Introduction</h3><div>Treatment resistance has become increasingly common in patients with chronic myeloid leukemia. Lack of response to tyrosine kinase inhibitors is associated with mutations in the <em>BCR</em>::<em>ABL1</em> kinase domain. This study aims to report the frequency and types of <em>BCR</em>::<em>ABL1</em> kinase domain mutations in Pakistani chronic myeloid leukemia patients.</div></div><div><h3>Materials and methods</h3><div>This prospective study was conducted from January to June 2025 at the Armed Forces Institute of Pathology in Pakistan. It included adult patients with chronic myeloid leukemia who were non-responsive to treatment based on molecular, hematological, and clinical criteria. Allele-specific real-time polymerase chain reaction was performed to detect four kinase domain mutations: T315I, E255V, E255K and Y253H. Data was analyzed using IBM SPSS v23.</div></div><div><h3>Results</h3><div>The mean age of the 133 treatment-resistant chronic myeloid leukemia patients included in the study was 47.3 ± 13.6 years. The majority of cases (62.4%) were male and 79 (59.4%) patients were currently on imatinib therapy. The median <em>BCR</em>::<em>ABL1</em> level, as measured by quantitative polymerase chain reaction, was 30.73% (range: 1.17–100%) International Scale. <em>BCR</em>::<em>ABL1</em> kinase domain mutations were detected in 57 (42.9%) patients. E255K was the most common mutation detected in 45 (33.8%) cases, followed by E255V in 11 (8.3%), T315I in 1 (0.8%) and the Y253H mutation in 1 (0.8%) patient. The presence of kinase domain mutations was significantly associated with higher total leucocyte count (<em>p</em> = 0.002), while the E255K mutation was significantly associated with blast crisis (<em>p</em> = 0.048).</div></div><div><h3>Conclusion</h3><div>This study revealed a high prevalence of <em>BCR</em>::<em>ABL1</em> kinase domain mutations in Pakistani chronic myeloid leukemia patients. E255K, the most frequently detected mutation, was significantly associated with blast crisis. These findings underscore the significance of molecular testing for personalized treatment.</div></div>","PeriodicalId":12958,"journal":{"name":"Hematology, Transfusion and Cell Therapy","volume":"48 3","pages":"Article 106502"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148611395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}