Hematology最新文献

{"title":"Effectiveness and safety of brentuximab vedotin-containing regimen versus standard chemotherapy in relapsed or refractory Hodgkin lymphoma: a multicenter cohort study.","authors":"Abdullah M Alrajhi, Bashayer Alshehri, Walaa A Alshahrani, Arwa AlHaj Issa, Amal H Alotaibi, Areej Abumustafa, Ghadah Alyousif, Nora Alkhudair, Mai Alalawi, Nada Alsuhebany, Mohammed Alzahrani, Abrar Alghamdi, Ramesh Vishwakarma, Abrar Bakr, Zahra AlHaj Issa, Abdullah Alateeq, Abeer Ageel Alenazi, Mashael S Alaboud, Badr Alayaf, Homood M As Sobeai, Khalid Al Sulaiman","doi":"10.1080/16078454.2026.2700811","DOIUrl":"10.1080/16078454.2026.2700811","url":null,"abstract":"<p><strong>Objective: </strong>Hodgkin lymphoma (HL) constitutes 3.4% of all cancers in Saudi Arabia, with advanced-stage relapse rates reaching 40%. While the anti-CD30 agent brentuximab vedotin (BV) has established efficacy, local data are limited. This study aims to assess the real-world effectiveness and safety of Brentuximab vedotin (BV)-containing regimens compared to non-BV regimens in relapsed or refractory classical Hodgkin lymphoma (cHL) in Saudi Arabia.</p><p><strong>Methods: </strong>A retrospective, multicenter cohort study was conducted including 93 adult patients with relapsed or refractory cHL in Saudi Arabia between 2016 and 2021. Patients were categorized into a BV-containing group (n = 61) and a control group (n = 32). The outcomes were overall response rate (ORR), complete response (CR), event-free survival (EFS), and post-chemotherapy complications.</p><p><strong>Results: </strong>= The BV group showed a higher ORR compared to the non-BV group (82.5% vs. 76.9%), although this difference was not statistically significant (adjusted odds ratio [aOR] = 9.09; 95% CI = 0.67-122.57; <i>P</i> = 0.10). CR rates were comparable between the two groups, at 59.6% in the BV group vs. 61.5% in the control group (aOR = 1.86; 95% CI = 0.24-14.46; <i>P</i> = 0.55). EFS was significantly longer in the BV group compared with the control group in the crude analysis (22.5 vs. 11.2 months; <i>P</i> = 0.03); however, this finding did not reach statistical significance in the regression analysis (beta coefficient = 7.04; 95% CI = -2.96 to 17.03; <i>P </i>= 0.18). Post-chemotherapy complications were comparable and not statistically significant across both groups.</p><p><strong>Conclusion: </strong>The research indicates that BV may offer a potential clinical advantage for patients with relapsed or refractory cHL. To validate these findings and optimize treatment strategies for this population, larger long-term studies with expanded patient cohorts are required.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2700811"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420972","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":"Effects of long-term cryopreservation at -80 °C on the viability and recovery of peripheral blood stem cells.","authors":"Tomoaki Akagi, Toru Ebina, Fuyuki Meguro, Mitsuki Sakamoto, Tomoko Nihonyanagi, Takuto Tachita, Kohmei Kubo","doi":"10.1080/16078454.2026.2741981","DOIUrl":"https://doi.org/10.1080/16078454.2026.2741981","url":null,"abstract":"<p><strong>Objectives: </strong>Ensuring the long-term stability of cryopreserved peripheral blood stem cells (PBSCs) is critical for optimal patient outcomes. However, it remains unclear how long-term cryopreservation at -80 °C without controlled-rate freezing in a mechanical freezer affects these cells. Temperature changes may damage cells, reducing their viability. Therefore, in this study, we investigated the effects of long-term storage and the presence of other cells on the viability and recovery of cryopreserved PBSCs.</p><p><strong>Methods: </strong>Autologous and allogeneic PBSC samples (<i>n</i> = 115) were cryopreserved at -80 °C in a mechanical freezer without controlled-rate freezing. Subsequently, CD34⁺ cell viability and recovery were evaluated after storage for up to 60 months using flow cytometry. The effects of co-existing blood cells on the cryopreservation of CD34⁺ cells were also examined.</p><p><strong>Results: </strong>Cryopreservation for <24 months did not significantly reduce the viability and recovery of CD34⁺ cells, while decreases were observed following storage for >24 months. Further, cryopreservation with ≥10% granulocytes decreased CD34⁺ cell viability and recovery.</p><p><strong>Discussion: </strong>The present findings suggest that storage beyond 24 months and containing a high proportion of granulocytes may have a negative impact on CD34⁺ cell viability and recovery. Attention to storage duration and contaminating cell populations could help support more stable outcomes during cryopreservation at -80 °C.</p><p><strong>Conclusions: </strong>The cryopreservation conditions employed in this study did not significantly reduce CD34⁺ cell viability and recovery during storage for up to 24 months. A higher granulocyte content was associated with lower post-thaw CD34⁺ viability and recovery.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2741981"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080462","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":"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":"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":2.0,"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":"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":2.0,"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 role of von Willebrand factor in gastrointestinal angiodysplasia and obscure gi bleeding: a narrative review.","authors":"Ojan Ghodsi, Ali Ghasemi, Saleh Ahangari","doi":"10.1080/16078454.2026.2702256","DOIUrl":"https://doi.org/10.1080/16078454.2026.2702256","url":null,"abstract":"<p><strong>Objective: </strong>Gastrointestinal bleeding (GIB) is a major cause of morbidity in von Willebrand disease (vWD), most commonly resulting from angiodysplasia. Current obscure gastrointestinal bleeding (OGIB) algorithms are primarily anatomy-based and often overlook underlying hemostatic disorders, delaying diagnosis and promoting recurrent bleeding. This review summarizes current evidence on the molecular basis, diagnosis, and management of vWD-associated GIB and proposes a mechanism-oriented diagnostic framework.</p><p><strong>Methods: </strong>A comprehensive narrative review of experimental, translational, and clinical studies was conducted, focusing on inherited vWD, acquired von Willebrand syndrome (AvWS), gastrointestinal angiodysplasia, endothelial biology, and diagnostic and therapeutic strategies.</p><p><strong>Results: </strong>Deficiency or dysfunction of high-molecular-weight von Willebrand factor (vWF) multimers promotes angiodysplasia by disrupting Weibel-Palade body homeostasis, enhancing Ang-2/Tie2 and VEGF signaling, impairing integrin αvβ3 function, and fostering pro-inflammatory endothelial activation. Genetic and epigenetic modifiers, including FLI1, STXBP5, ABO blood group, and miR-24, further influence vascular susceptibility. Based on these mechanisms, we propose a four-stage diagnostic framework integrating bleeding assessment, platelet function screening, and targeted vWF testing with conventional endoscopic evaluation to facilitate earlier recognition of vWD/AvWS in patients with recurrent or obscure GIB. This strategy supports mechanism-based treatment combining hemostatic replacement therapies with selected anti-angiogenic approaches.</p><p><strong>Conclusion: </strong>vWD-associated GIB should be regarded as a systemic vascular-hemostatic disorder rather than an isolated structural gastrointestinal disease. Integrating hemostatic evaluation into OGIB pathways may improve diagnostic accuracy, reduce unnecessary procedures, and enable personalized management of patients with recurrent bleeding.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2702256"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436651","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":"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":2.0,"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":"The correlation between cardiac T2*MRI and B-Type natriuretic peptides in patients with transfusion-dependent anemias and systemic iron overload: a systematic review and meta-analysis.","authors":"Mohamad Amin Kharaghani, Reza Samiee, Amirhossein Shahsavand, Shayan Forghani, Mahta Moradi, Tahereh Jangjoo Pirbazari, Elham Shahgholi","doi":"10.1080/16078454.2026.2644716","DOIUrl":"10.1080/16078454.2026.2644716","url":null,"abstract":"<p><strong>Objectives: </strong>Systemic iron overload in transfusion-dependent anemias leads to progressive myocardial iron accumulation, a major cause of morbidity and mortality. This study evaluated the relationship between cardiac T2* magnetic resonance imaging (MRI) values and natriuretic peptide levels in patients with systemic iron overload.</p><p><strong>Methods: </strong>Cardiac T2* MRI magnetic resonance imaging (MRI) is the gold standard for assessing myocardial iron, but it is costly and not widely available. B-type natriuretic peptides (BNP and NT-proBNP), which reflect myocardial stress, may offer a practical biomarker alternative. This systematic review and meta-analysis evaluated the relationship between cardiac T2* MRI values and natriuretic peptide levels in patients with systemic iron overload. Nine studies involving 783 patients were included in the systematic review, and pooled analyses were performed using data from seven studies.</p><p><strong>Results: </strong>Pooled data from seven studies showed a moderate inverse correlation between T2* values and natriuretic peptide levels (r = -0.30, 95% CI -0.51 to -0.06), indicating higher peptide levels with greater myocardial iron deposition. Patients with cardiac iron overload (T2* < 20 ms) had significantly higher peptide levels (standardized mean difference = -0.71, 95% CI -1.32 to -0.11), with pooled mean concentrations of 321.1 (95% CI 248.3-393.9) compared with 179.0 (95% CI 134.3-223.6) in those without cardiac iron overload (T2* > 20 ms).</p><p><strong>Discussion: </strong>These findings suggest that natriuretic peptide levels reflect myocardial stress associated with cardiac iron burden and may provide clinically relevant information on myocardial iron overload.</p><p><strong>Conclusion: </strong>Although natriuretic peptides cannot replace cardiac MRI, they may serve as accessible, low-cost adjunct biomarkers for screening, monitoring, and early warning of myocardial iron overload, particularly where MRI is limited. Further prospective studies are warranted to validate their role in longitudinal assessment and risk prediction.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2644716"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456871","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":"Relationship between major depressive disorder and venous thromboembolism: a five-ancestry genetic analysis.","authors":"Qian Liu, Qian Jing, Jinyu Zuo, Lihong Zhao","doi":"10.1080/16078454.2026.2677249","DOIUrl":"10.1080/16078454.2026.2677249","url":null,"abstract":"<p><strong>Objectives: </strong>Major depressive disorder (MDD) and venous thromboembolism (VTE) frequently co-occur and impose substantial public health burdens. Previous Mendelian randomization (MR) studies examined their causal association but were limited to European (EUR) ancestry. This study utilizes trans-ethnic MR (TEMR) to address this limitation.</p><p><strong>Methods: </strong>MDD data for EUR, African (AFR), Hispanic (HIS), East Asian (EAS), and South Asian (SAS) ancestries were obtained from the Psychiatric Genomics Consortium (PGC). VTE discovery and replication datasets were provided by the Global Biobank Meta-analysis Initiative and Million Veteran Program. Independent genome-wide significant variants (<i>P</i> < 5 × 10^-8) served as instrumental variables. The Nelder-Mead simplex algorithm was the primary optimizer in the TEMR framework, with EUR ancestry as auxiliary population. Validation included BFGS, CG, L-BFGS-B, and SANN. Sensitivity analyses comprised MRLap, the Steiger test, and assessments of heterogeneity and pleiotropy.</p><p><strong>Results: </strong>Validation confirmed bidirectional causal associations between MDD and VTE in EUR ancestry (OR > 1, <i>P</i> < 0.05). Forward TEMR showed genetically predicted MDD increased VTE risk in AFR ancestry (OR: 1.241, 95% CI: 1.149-1.340, <i>P</i> = 0.019). Reverse analysis indicated genetically predicted VTE increased MDD risk in EAS (OR: 1.014, 95% CI: 1.013-1.015, <i>P</i> = 8.74×10^-16), SAS (OR: 1.078, 95% CI: 1.044-1.113, <i>P</i> = 0.028), AFR (OR: 1.076, 95% CI: 1.074-1.078, <i>P</i> = 2.51×10^-109), and HIS (OR: 1.123, 95% CI: 1.111-1.134, <i>P</i> = 8.41×10^-6) ancestries. Sensitivity and validation analyses supported robustness.</p><p><strong>Conclusion: </strong>This TEMR study enhanced detection power by identifying increased MDD risk in EUR and AFR ancestries. It established a causal link from VTE to elevated MDD risk across all five ancestries, underscoring ancestry heterogeneity and improving generalizability.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2677249"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147981492","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":"Sirolimus-based treatment regimens for antinuclear antibody (ANA)-positive immune thrombocytopenia: a retrospective single-center cohort study.","authors":"Aoxue Tan, Jia Liu, Xiaoli Chen, Yimei Feng, Xi Zhang","doi":"10.1080/16078454.2026.2678626","DOIUrl":"10.1080/16078454.2026.2678626","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the efficacy and safety of sirolimus-based treatment regimens in patients with antinuclear antibody (ANA)-positive immune thrombocytopenia (ITP).</p><p><strong>Methods: </strong>This retrospective single-center study enrolled patients with a clear clinical diagnosis of ANA-positive ITP. They were divided into two groups based on different treatment regimens: the sirolimus monotherapy group (SRL group) and the sirolimus plus dexamethasone combination group (combination group).</p><p><strong>Results: </strong>During treatment, the combination group achieved the initial overall response (ORR) significantly faster than the SRL group (<i>p < </i>0.05); additionally, in the early treatment phase (Week 1, Week 4), there were statistically significant differences in efficacy between the two groups, while no statistically significant difference in efficacy was observed during subsequent follow-up. Regarding treatment safety, all adverse events were Grade 1-2; no Grade 3 or higher adverse events were reported and no treatment-related deaths occurred. The most frequently observed adverse events were oral ulcers, gastrointestinal distress, and elevated liver enzymes. There was no statistically significant difference in the total incidence of adverse events between the two groups.</p><p><strong>Conclusion: </strong>In this retrospective single-center study, sirolimus-based regimens showed favorable efficacy and acceptable safety in ANA-positive ITP. Adding dexamethasone to sirolimus led to faster initial responses versus sirolimus alone, though no significant difference was seen in follow-up. These findings support the feasibility and potential efficacy of sirolimus-based regimens in ANA-positive ITP, warranting prospective controlled studies.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2678626"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015341","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":"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":2.0,"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}