Hematology最新文献

{"title":"XPO1 inhibitor selinexor suppresses homologous recombination by inhibiting E2F7 nuclear export in acute myeloid leukemia.","authors":"Chunli Xu, Dandan Wang, Ruiqi Chen, Xu Feng, Feng Cheng, Yu Chen","doi":"10.1080/16078454.2026.2664314","DOIUrl":"https://doi.org/10.1080/16078454.2026.2664314","url":null,"abstract":"<p><strong>Objectives: </strong>Aberrant nucleocytoplasmic transport mediated by Exportin 1 (XPO1) contributes to leukemogenesis, yet the molecular basis underlying the limited efficacy of the XPO1 inhibitor Selinexor in acute myeloid leukemia (AML) remains unclear. This study aimed to define the role of XPO1 in AML and elucidate the mechanism by which Selinexor regulates homologous recombination (HR).</p><p><strong>Methods: </strong>Public AML datasets and patient samples were analyzed to assess XPO1 expression and clinical relevance. Functional assays evaluated the effects of XPO1 knockdown on AML cell proliferation, apoptosis, and cell cycle progression. Transcriptomic analysis, immunoprecipitation, subcellular fractionation, DNA damage assays, and direct HR functional assays were used to investigate Selinexor-mediated mechanisms. Drug interaction analyses assessed the combined effect of Selinexor and Mitoxantrone.</p><p><strong>Results: </strong>XPO1 was significantly overexpressed in AML, particularly in relapsed cases, and high expression was associated with poor prognosis. XPO1 knockdown suppressed proliferation, induced apoptosis, and caused cell cycle arrest. High XPO1 expression correlated with activation of the HR pathway. Mechanistically, Selinexor disrupted the interaction between XPO1 and the transcriptional repressor E2F7, resulting in nuclear retention of E2F7 and downregulation of BRCA1 and RAD51. E2F7 silencing reversed Selinexor-induced HR suppression and DNA damage. In addition, Selinexor synergized with Mitoxantrone to enhance DNA damage and apoptosis in AML cells.</p><p><strong>Discussion: </strong>E2F7-mediated HR inhibition is a key mechanism underlying Selinexor activity in AML.</p><p><strong>Conclusion: </strong>The XPO1-E2F7-HR axis represents a potential therapeutic vulnerability, supporting the rational combination of Selinexor with DNA-damaging agents to improve AML treatment outcomes.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2664314"},"PeriodicalIF":1.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770038","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":"Machine learning in the prediction of liver iron concentration and iron chelation therapy adjustment.","authors":"Joanna Bao-Ern Loh, Sangwook Kim, Richard Ward, Soodeh Sagheb, Andrew Binding, Kevin H M Kuo, Chris McIntosh, Kartik Jhaveri","doi":"10.1080/16078454.2026.2647314","DOIUrl":"https://doi.org/10.1080/16078454.2026.2647314","url":null,"abstract":"<p><strong>Objectives: </strong>Iron chelation therapy titration is managed by hematologists who monitor iron levels and adjust medication dosages to achieve patient outcomes. This study developed a machine learning (ML) algorithm to predict the liver iron concentration (LIC) and chelation therapy adjustments.</p><p><strong>Methods: </strong>This retrospective, single-centre cohort study included adult patients who underwent FerriScan MRI to obtain LIC for chelation therapy monitoring. Using an XgBoost-based ML framework, the proximal-time model (PTM) utilised clinical/drug, laboratory and MRI data features from one visit prior to the target visit, whereas the all-time model (ATM) utilised the data from all prior visits.</p><p><strong>Results: </strong>94 patients with 892 consecutive visits between January 2008 and November 2018 were included in this study. We assessed the prediction capabilities of the PTM and ATM in LIC, changes to chelation drug type and dosage changes. The PTM model was superior to the ATM model in all the experiments. When drug features were excluded, the CLICT model for predicting patient iron overload status improved to an AUROC of 0.83 [95% CI 0.75-0.91] for PTM; compared to an AUROC of 0.73 [95% CI 0.66-0.80] when drug features were included.For predicting changes in chelation type, the CLICT model showed AUROC of 0.83 [95% CIs 0.77-0.89] for PTM. There is high concordance of the agreement of hematologists with ML in not changing the chelation drug type.</p><p><strong>Discussion/conclusion: </strong>The ML model is a step toward creating a clinical decision support system tool for the prediction of LIC and iron chelation therapy adjustment in patients with haemoglobinopathies or hemolytic anemias.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2647314"},"PeriodicalIF":1.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591851","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":"The association between serum trace elements and iron deficiency anemia in children and adolescents: a systematic review and meta-analysis.","authors":"Maryam Mobasheri-Shiri, Sepehr Ramezanipour, Zahra Azizi, Faezeh Mobasheri-Shiri, Zeinab Karimi-Moghadam, Sina Kardeh, Mitra Abbasifard, Reza Tabrizi","doi":"10.1080/16078454.2026.2650058","DOIUrl":"https://doi.org/10.1080/16078454.2026.2650058","url":null,"abstract":"<p><strong>Objectives: </strong>Iron deficiency anemia (IDA) remains the most prevalent form of anemia in children and adolescents globally. In addition to iron (Fe), other trace elements, such as zinc (Zn), copper (Cu), and magnesium (Mg), may influence hematopoiesis, yet the extent of their dysregulation in IDA remains unclear.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of observational studies assessing the serum levels of Fe, Zn, Cu, and Mg in pediatric IDA populations. The literature was searched in PubMed, Scopus, Embase, and Web of Science up to January 2025. The data were standardized to consistent units (μmol/L), and pooled weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated. Subgroup, sensitivity, and publication bias analyses were performed. The study protocol was registered online (PROSPERO number: CRD42024578704).</p><p><strong>Results: </strong>Eight articles encompassing twelve datasets and 1105 participants were included. Compared to controls, IDA patients had significantly lower levels of Fe (WMD: -13.07 μmol/L, 95% CI: -16.09 to -10.05), Zn (WMD: -4.33 μmol/L, 95% CI: -5.30 to -3.35), and Mg (WMD: -18.17 μmol/L, 95% CI: -21.00 to -15.33) but higher levels of Cu (WMD: 4.33 μmol/L, 95% CI: 2.21-6.46). High heterogeneity (<i>I</i>² > 95%) was noted for Fe, Zn, and Cu. Subgroup analyses confirmed consistent trends across age, gender, and geography.</p><p><strong>Conclusion: </strong>Pediatric IDA is associated with broad alterations in trace elements, highlighting potential roles for Fe, Zn, Cu, and Mg in the pathophysiology of anemia. These findings may inform comprehensive nutritional strategies in managing IDA.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2650058"},"PeriodicalIF":1.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591962","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":"Mitochondrial dysfunction in chemical anemia: can nursing led exercise programs improve red blood cell production?","authors":"Minqiang Yin, Heng Li, Zhuqing Zhu, Hang Shi","doi":"10.1080/16078454.2026.2650062","DOIUrl":"https://doi.org/10.1080/16078454.2026.2650062","url":null,"abstract":"<p><strong>Introduction: </strong>Chemical anemia, a common consequence of chemotherapy and environmental toxins, is conventionally attributed to bone marrow suppression. This traditional view may oversimplify the underlying pathology, potentially overlooking critical cellular mechanisms that could serve as novel therapeutic targets.</p><p><strong>Objectives: </strong>This review aims to (1) propose a paradigm shift in understanding chemical anemia by reframing it as a disorder of mitochondrial dysfunction within erythroid precursors and (2) evaluate the potential of structured exercise as a multi-targeted countermeasure to restore erythropoiesis by addressing this mitochondrial root cause.</p><p><strong>Methods: </strong>We synthesized evidence from cellular, molecular, and clinical studies to trace the pathway from chemical exposure to erythroid failure. This review integrates data on mitochondrial integrity, oxidative stress, mtDNA damage, heme synthesis, and cell death pathways (ferroptosis/apoptosis). Subsequently, we analyzed the impact of exercise on key molecular regulators (PGC-1α, AMPK) and mitochondrial quality control to assess its therapeutic potential.</p><p><strong>Results: </strong>The synthesis reveals that chemical agents disrupt erythroid maturation primarily by compromising mitochondrial function. This leads to an energetic crisis, stalled heme synthesis, and the activation of ferroptotic and apoptotic pathways, resulting in ineffective erythropoiesis independent of general marrow suppression. Structured exercise is identified as a powerful physiological intervention that activates PGC-1α and AMPK, promoting mitochondrial biogenesis, enhancing mitophagy, and reducing oxidative stress, thereby directly counteracting the proposed pathogenic mechanism.</p><p><strong>Discussion: </strong>By acting as a 'exercise mimetic,' physical activity offers a multi-targeted approach to restore mitochondrial health in erythroid precursors. Nurse-led exercise programs are uniquely positioned to translate this biological rationale into practice. By integrating aerobic and resistance training with patient safety monitoring and technology, nurses can operationalize exercise as a pragmatic, patient-centered, mitochondrial-supportive therapy.</p><p><strong>Conclusion: </strong>Reframing chemical anemia as a mitochondrial disorder highlights critical therapeutic vulnerabilities. Structured exercise, delivered through nurse-led programs, represents a promising complementary approach that targets the root cause of ineffective erythropoiesis, offering the potential to improve red blood cell production and reduce reliance on traditional interventions like transfusions and pharmacotherapy.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2650062"},"PeriodicalIF":1.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147615987","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":"Trends and projections of Burkitt Lymphoma burden (1990-2036): an analysis based on the global burden of disease study 2021.","authors":"Ying Zhou, Jie Zhang, Li Zhu, Qi Jiang, Qian Shen, Yaxun Wu","doi":"10.1080/16078454.2026.2648319","DOIUrl":"https://doi.org/10.1080/16078454.2026.2648319","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to assess the burden of Burkitt lymphoma (BL) at the global, regional, and national levels from 1990-2021 and to project trends over the next 15 years.</p><p><strong>Methods: </strong>Data from the 2021 Global Burden of Disease database was used for analysis.</p><p><strong>Results: </strong>Both the incidence and prevalence rates of BL increased from 1990-2021. BL demonstrated a bimodal age pattern, with incidence peaking among children aged 5-9 years and again in adults older than 65 years. The disease burden was consistently greater in males than in females. A significant positive correlation was found between the sociodemographic index (SDI) and both the incidence and prevalence rates, whereas the mortality and DALY rates were significantly negatively correlated with the SDI. Health inequality analyses revealed that while incidence and prevalence burdens have increasingly concentrated in high<b>-</b>SDI countries, mortality and DALY burdens remain disproportionately higher in low<b>-</b>SDI regions. Frontier analysis demonstrated that in most countries, BL<b>-</b>related DALYs remain above the expected level on the basis of development status. The projected trend shows a slow but continuous decline in global BL age<b>-</b>standardized rates through 2036.</p><p><strong>Conclusions: </strong>Over the past three decades, the global burden of BL has steadily increased, accompanied by pronounced regional and sex<b>-</b>related disparities closely associated with levels of sociodemographic development. This comprehensive analysis offers critical insights and evidence<b>-</b>based guidance to inform targeted strategies for the prevention and control of BL worldwide.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2648319"},"PeriodicalIF":1.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490855","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":"Survival and prognostic features of early-stage diffuse large B-cell lymphoma in older adults.","authors":"Mohammad Ma'koseh, Omar Shahin, Alaa Abufara, Mohammad Al-Rwashdeh, Malek Awamleh, Heba Farfoura, Zaid Abdel Rahman, Khalid Halahleh, Abeer Yaseen, Akram Al-Ibraheem, Kamal Al-Rabi, Hamza Ghatasheh, Fadwa Abdel Rahman, Imad Jaradat, Hikmat Abdel-Razeq","doi":"10.1080/16078454.2026.2653281","DOIUrl":"https://doi.org/10.1080/16078454.2026.2653281","url":null,"abstract":"<p><strong>Background: </strong>Early-stage diffuse large B-cell lymphoma (ESDLBCL) in older adults is understudied, and existing prognostic tools such as the stage-adjusted International Prognostic Index (Sa-IPI) may not adequately account for comorbidity and age-related vulnerability. This study evaluated long-term outcomes and developed a simplified prognostic index for patients aged ≥ 60 years with ESDLBCL.</p><p><strong>Methods: </strong>We retrospectively analyzed adults aged ≥ 60 years with stage I-II DLBCL treated at King Hussein Cancer Center between 2006 and 2023. Survival outcomes were estimated using Kaplan-Meier methods, and prognostic factors were assessed using Cox regression. A prognostic index (KHCC-EPI) incorporating variables independently associated with overall survival (OS) and progression-free survival (PFS) was developed and compared with Sa-IPI using time-dependent ROC curves.</p><p><strong>Results: </strong>Among 127 patients, median age was 68.4 (range: 60-89 years).The complete response rate was 88%, and 5-year OS and PFS were 70.4% and 67.3%, respectively. Most deaths (58%) were unrelated to lymphoma. ECOG performance status > 1, stage IIE, B symptoms, and Charlson Comorbidity Index (CCI) were independently associated with inferior OS and PFS. The KHCC-EPI stratified patients into distinct risk groups (5-year OS: 95.5% vs 60.5%; <i>p</i> = 0.006) and demonstrated improved discrimination compared with Sa-IPI, particularly when CCI was modelled as a continuous variable.</p><p><strong>Conclusion: </strong>Older adults with ESDLBCL achieved favourable long-term outcomes, with competing non-lymphoma mortality playing a major role. The KHCC-EPI improves risk stratification beyond Sa-IPI and warrants external validation to guide treatment optimisation in this population.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2653281"},"PeriodicalIF":1.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591977","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":"Management strategy in aplastic anemia patients with HBV infection following intensive immunosuppressive therapy in Chinese cohort: prophylactic antiviral therapy may not be necessary with close monitoring.","authors":"Yawen Zhang, Xiaoyu Chen, Ting Zhang, Yuemin Gong, Jingnan Sun, Jinsong Jia, Guangsheng He","doi":"10.1080/16078454.2026.2657632","DOIUrl":"https://doi.org/10.1080/16078454.2026.2657632","url":null,"abstract":"<p><strong>Purpose: </strong>Acquired aplastic anemia (AA) results from bone marrow failure, and intensive immunosuppressive therapy (IST) is a standard treatment for AA. However, the elimination of lymphocytes may lead to the reactivation of hepatitis B virus (HBV) in patients with HBV infection, and whether to administer antiviral drugs for prevention remains uncertain.</p><p><strong>Methods: </strong>From May 2014 to July 2023, 137 AA patients who were treated with antithymocyte globulin plus Cyclosporin A were divided into three groups according to their HBV serologic status to estimate their safety and efficacy, as well as HBV reactivation.</p><p><strong>Results: </strong>Seven (5.11%) patients had chronic HBV infection; six of them received antiviral drugs and did not develop HBV reactivation, and one patient developed HBV reactivation due to personal refusal of treatment. For patients with resolved HBV infection (62, 45.26%) or HBV-uninfected patients (68, 49.64%), prophylactic antiviral treatment was not administered, and none of the patients developed HBV reactivation. HBV-uninfected patients achieved a partial response more rapidly (2.62 ± 4.24 vs 3.27 ± 5.23, <i>P</i> = 0.036), and univariate and multivariate analyses revealed that HBV infection (<i>P</i> = 0.037), infection within one month after IST (<i>P</i> = 0.034) were negatively correlated with treatment efficacy. Fifteen deaths occurred during the follow-up period, and HBV infection (<i>P</i> = 0.202) did not affect all-cause mortality.</p><p><strong>Conclusion: </strong>Overall, AA patients with chronic HBV infection need to receive prophylactic antiviral drugs during IST, while stringent surveillance methods are necessary for patients with resolved HBV infection.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2657632"},"PeriodicalIF":1.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672739","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":"Comorbidities in sickle cell disease by age in the Indiana sickle cell data collection (IN-SCDC).","authors":"Jennifer L Gatz, Amanda Okolo, Isaac A Janson, Brandon Hardesty, Brian E Dixon","doi":"10.1080/16078454.2026.2655477","DOIUrl":"https://doi.org/10.1080/16078454.2026.2655477","url":null,"abstract":"<p><strong>Objective: </strong>Survival for individuals with sickle cell disease (SCD) is increasing, and along with it the potential for comorbid conditions that may be caused by cumulative tissue damage. This paper examines the prevalence of comorbidities among individuals with SCD in Indiana and assesses how these vary by age group.</p><p><strong>Methods: </strong>Data from the Indiana Sickle Cell Data Collection program (2015-2021) were used to identify confirmed and probable SCD cases. Comorbidities-asthma, avascular necrosis, stroke, retinopathy, moyamoya disease, and sickle nephropathy-were identified using ICD-9/10 codes.</p><p><strong>Results: </strong>Among the 1689 individuals, the 0-17 age group was the largest (42.9%). Asthma was the most common comorbidity (23.7%), highest in the 18-39 age group. Avascular necrosis, stroke, and retinopathy increased with age, while moyamoya was most common in youth. Logistic regression showed increasing age was associated with the risk of any comorbidity risk.</p><p><strong>Discussion: </strong>This study confirmed a high comorbidity burden among individuals with SCD, and that the risk of having any of the examined comorbidities increased with age. Findings align with national data, though differences in asthma and stroke prevalence highlight the impact of data sources and population characteristics.</p><p><strong>Conclusion: </strong>These results support the need for age-specific, multidisciplinary care strategies and provide valuable insights for clinicians, policymakers, and public health officials to improve outcomes and allocate resources effectively for the SCD population.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2655477"},"PeriodicalIF":1.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633149","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":"Clinical characteristics, treatment options, and prognosis of subcutaneous panniculitis-like T-cell lymphoma from the SEER database.","authors":"Lijuan Zhang, Zehui Chen, Longhua Lu, Bing Xiang","doi":"10.1080/16078454.2026.2648344","DOIUrl":"https://doi.org/10.1080/16078454.2026.2648344","url":null,"abstract":"<p><strong>Introduction: </strong>Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare type of cutaneous lymphoma lacking standardized treatments. Consequently, patient outcomes vary significantly.</p><p><strong>Methods: </strong>This study explored the clinical characteristics and prognostic factors of 205 SPTCL patients from 2000 to 2021 in the Surveillance, Epidemiology, and End Results (SEER) database.</p><p><strong>Results: </strong>Overall survival (OS) at 1, 3, and 5 years were 78.3%, 75.7%, and 66.4%, respectively. Patients diagnosed after 2008 (possibly excluding the γ-δ subtype) (HR = 0.197, 95% CI = 0.106-0.364, <i>p</i> = 0.000) and Asian or Pacific Islanders (HR = 0.210, 95% CI = 0.049-0.902, <i>p</i> = 0.036) were independent predictors of favorable survival, whereas age 50-60 years (HR = 3.213, 95% CI = 1.357-7.607, <i>p</i> = 0.008) and age > 60 years (HR = 5.039, 95% CI = 2.327-10.911, <i>p</i> = 0.000) were independently associated with poor survival. Patients who received radiotherapy alone exhibited a significantly lower hazard risk compared to those receiving no chemotherapy or radiation (HR = 0.216, 95% CI = 0.048-0.983, <i>p</i> = 0.048). No statistically significant differences in prognosis were observed between patients who received no chemotherapy or radiation and those who received either chemotherapy alone (HR = 1.276, 95% CI = 0.644-2.529, <i>p</i> = 0.485) or radiochemotherapy (HR = 1.283, 95% CI = 0.463-3.558, <i>p</i> = 0.632). These associations persisted after IPTW adjustment, with age, race, year of diagnosis, and treatment remaining independent predictors of OS in SPTCL.</p><p><strong>Conclusions: </strong>The Ann Arbor staging was not suitable for SPTCL. Radiotherapy represents an appropriate therapeutic option for patients with single or localized skin lesions. No statistically significant differences in prognosis were observed between patients who received no chemotherapy or radiation and those who received either chemotherapy alone or radiochemotherapy. This finding suggests that immunomodulatory agents may be preferable to cytotoxic therapy as initial treatment for SPTCL, an inflammatory lymphoma.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2648344"},"PeriodicalIF":1.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511704","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 survival prognostic model for high-risk myelodysplastic syndrome patients treated with decitabine.","authors":"Yumei Liu, Haiyue Niu, Yansong Wei, Liyan Yang, Huijuan Jiang, Lijuan Li, Limin Xing, Zonghong Shao, Rong Fu, Huaquan Wang","doi":"10.1080/16078454.2026.2657628","DOIUrl":"https://doi.org/10.1080/16078454.2026.2657628","url":null,"abstract":"<p><strong>Background: </strong>Decitabine is widely used in China for high-risk myelodysplastic syndromes (MDS). However, the prognostic factors associated with overall survival (OS) remain incompletely defined.</p><p><strong>Methods: </strong>We retrospectively analyzed 130 high-risk MDS patients treated with decitabine. Clinical characteristics and laboratory parameters were collected. Treatment response was assessed, and survival outcomes were evaluated using Cox regression models. A prognostic nomogram was developed to improve risk stratification beyond the conventional IPSS/IPSS-R systems.</p><p><strong>Results: </strong>The median age was 60.5 years, with 57.7% male patients. Median OS was 15.5 months. Univariate analysis showed that age ≥50 years, bone marrow blasts ≥10%, and iron overload (serum ferritin ≥500 µg/L) were significantly associated with inferior OS. Multivariate Cox regression confirmed age ≥50 (HR = 2.31, 95% CI: 1.21-4.40, <i>p </i>= 0.011) and elevated bone marrow blasts (HR = 1.92, 95% CI: 1.16-3.17, <i>p </i>= 0.012) as independent adverse prognostic factors. Poor karyotype also conferred poor outcomes. Next-generation sequencing data were available for 92 patients. Given the low mutation rate, the mutational analysis was conducted exploratorily; results suggested that TP53 mutations were significantly associated with adverse prognosis. A prognostic nomogram integrating age, ECOG score, bone marrow blasts, cytogenetics, hemoglobin, platelet count, absolute neutrophil count, ring sideroblasts, and ferritin demonstrated improved risk stratification, though validation was limited to internal cohorts.</p><p><strong>Conclusion: </strong>Decitabine provides short-term hematologic benefits in high-risk MDS, but overall prognosis remains poor. Age, bone marrow blasts, iron overload, and high-risk cytogenetics are key prognostic factors. Incorporating clinical, cytogenetic, and mutational variables into new prognostic models may enhance individualized treatment decision-making for high-risk MDS patients.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2657628"},"PeriodicalIF":1.6,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672675","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}