Hematology最新文献

{"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":"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":2.0,"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":"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":"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":2.0,"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":"CHAF1A identified as a candidate biomarker and potential therapeutic target in Burkitt lymphoma through integrated bioinformatics and histopathological analysis.","authors":"Wen-Yuan Lin, Bei-Li Chen, Zhi-Mei Wu, Feng Liu, Wen-Fang Du","doi":"10.1080/16078454.2026.2708536","DOIUrl":"https://doi.org/10.1080/16078454.2026.2708536","url":null,"abstract":"<p><strong>Background: </strong>Burkitt lymphoma (BL) is a highly aggressive malignancy with limited effective treatments due to toxicity/resistance. Identifying and prioritizing candidate biomarkers and potential therapeutic targets from complex transcriptomic data, ahead of functional validation, remains a major unmet need.</p><p><strong>Methods: </strong>We integrated differential gene expression analysis across BL vs. control cohorts (Gene Expression Omnibus [GEO] datasets GSE43677/GSE12453) with Random Forest machine learning to prioritize candidates. Validated top genes via immunohistochemistry in an independent cohort (<i>n</i> = 10 BL, <i>n</i> = 10 reactive lymphoid hyperplasia [RLH] controls), followed by immune cell infiltration analysis.</p><p><strong>Results: </strong>This approach identified four candidate genes; only Chromatin Assembly Factor 1 Subunit A (CHAF1A) showed profound protein-level overexpression in BL tumors vs. RLH. In a single-dataset CIBERSORT analysis, CHAF1A expression showed exploratory correlational associations with several immune-cell fractions, most strongly a positive association with M0 macrophages; these in silico associations are hypothesis-generating and do not by themselves establish a mechanistic role in the tumor immune microenvironment.</p><p><strong>Conclusion: </strong>CHAF1A is identified as a candidate biomarker associated with BL that, in exploratory single-dataset analysis, also correlates with immune-cell infiltration; these findings nominate it as a potential therapeutic target that warrants functional validation in future studies.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2708536"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630353","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":"Integrative bioinformatic analysis delineates a mitochondrial-hematopoietic gene signature for diagnosis and immune characterization in myelodysplastic syndromes.","authors":"Xianchuan Liu, Hong Zhang, Xiangzhu Li","doi":"10.1080/16078454.2026.2724212","DOIUrl":"https://doi.org/10.1080/16078454.2026.2724212","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a mitochondrial and hematopoiesis-related differentially expressed genes (MH-related DEGs) signature for Myelodysplastic syndromes (MDS) diagnosis and to characterize its regulatory network and immune microenvironment.</p><p><strong>Methods: </strong>MH-related DEGs were defined as the intersection of differentially expressed genes from three integrated microarray datasets (GSE145733, GSE19429, GSE81173) with a curated set of mitochondrial- and hematopoiesis-related genes from public databases. Functional enrichment, machine learning (logistic regression, support vector machine, LASSO), regulatory network (transcription factors, miRNA, RNA-binding proteins, and drug targets), immune infiltration characterization (ssGSEA), and RT-qPCR assessment were performed.</p><p><strong>Results: </strong>Twenty-nine MH-related DEGs were identified, significantly enriched in MAPK and PI3K-Akt pathways. A 17-gene diagnostic signature showed high accuracy for MDS detection (AUC = 0.963). <i>FGF2</i> was the highest-weighted predictor, with upregulation supported by RT-qPCR (<i>p</i> < 0.05), and potentially regulated by RUNX1 and miR-15/16/195/424/497 family. Valproic acid was predicted to be associated with multiple signature genes. Two MDS clusters with distinct immune infiltration patterns were identified, where <i>CREB1</i> correlated with effector memory CD4 T cells in Cluster 1 (r = 0.461), while <i>KITLG</i> correlated with T follicular helper cells in Cluster 2 (r = 0.546), potentially co-regulated by the miR-27.</p><p><strong>Discussion: </strong>This study proposes a mitochondrial-hematopoietic regulatory axis in MDS, with <i>FGF2</i> as a candidate hub. The clusters and valproic acid prediction offer insights into advancing personalized diagnostics and combination therapy in MDS.</p><p><strong>Conclusion: </strong>We developed a candidate signature requiring further validation and uncovered regulatory interactions linking mitochondrial dysfunction to immune dysregulation in MDS.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2724212"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880119","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 features and management of GPRC5D-associated adverse events in novel GPRC5D × CD3 bispecific talquetamab-treated relapsed/refractory multiple myeloma patients: the MonumenTAL-1 China cohort experience.","authors":"Gang An, Jie Jin, Zhen Cai, Hongmei Jing, Chengcheng Fu, Pengcheng He, Zhongjun Xia, Qianqian Xu, Rui Liu, Liang Li, Xue Gai, Hong Zhang, Dian Zhu, Xinchao Luo, Michela Campagna, Tara J Masterson, Bonnie W Lau, Thomas Renaud, Christoph Heuck, Lugui Qiu","doi":"10.1080/16078454.2026.2702681","DOIUrl":"10.1080/16078454.2026.2702681","url":null,"abstract":"<p><strong>Objectives: </strong>Talquetamab (G-protein-coupled receptor class C group 5 member D [GPRC5D] × CD3 bispecific antibody) demonstrated antitumor activity in relapsed/recurrent multiple myeloma (RRMM) in the phase I/II MonumenTAL-1 study. We report the safety profile of talquetamab in Chinese patients from MonumenTAL-1, focusing on GPRC5D-associated on-target/off-tumor adverse events (AEs).</p><p><strong>Methods: </strong>Adult Chinese patients with heavily pretreated RRMM and measurable disease received subcutaneous talquetamab 0.4 mg/kg once weekly (QW) or 0.8 mg/kg biweekly (Q2W). Incidence, time to onset, duration, and recovery status of GPRC5D-associated AEs were reported. Data cutoffs: 29 February 2024 (QW cohort); 26 August 2024 (Q2W cohort).</p><p><strong>Results: </strong>A total of 41 adult Chinese patients were included in this study (QW cohort, <i>n</i> = 29; Q2W cohort <i>n</i> = 12). Median treatment duration was 7.7 months (QW cohort) and 7.1 months (Q2W cohort); median follow-up was 16.3 and 13.9 months, respectively. GPRC5D on-target/off-tumor AEs, predominantly grade 1-2 (one grade 3 non-rash skin toxicity; QW cohort), were most commonly oral AEs (dysgeusia, dry mouth), skin AEs (rash, non-rash skin toxicity), and nail disorders; 50%-100% resolved by data cutoff. AEs were managed with supportive therapies. Talquetamab dose modification was needed in one case (grade 2 weight decrease).</p><p><strong>Discussion: </strong>The generally mild GPRC5D-associated AEs were well tolerated and consistent with the known safety profile of talquetamab. Supportive management of these AEs without need for dose modification enabled prolonged treatment.</p><p><strong>Conclusions: </strong>Education of patients with RRMM on potential GPRC5D-associated AEs before starting treatment, and timely management upon experience, may ensure optimum exposure and thus maximum benefit with talquetamab.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2702681"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873839","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":"Research progress on the relationship between autoimmune hemolytic anemia and viral infection.","authors":"Huang Shichun, Zhang Ziying, Zhang Yang, Xing Limin","doi":"10.1080/16078454.2026.2715918","DOIUrl":"https://doi.org/10.1080/16078454.2026.2715918","url":null,"abstract":"<p><strong>Introduction: </strong>Viral infection serves as an important precipitating factor for AIHA, and patients undergoing treatment remain susceptible to such infections.</p><p><strong>Objectives: </strong>This review focuses on the effects of viral infection on AIHA pathogenesis, infection risks associated with treatment, and preventive strategies.</p><p><strong>Methods: </strong>Literature review method.</p><p><strong>Results: </strong>Viruses mainly induce autoimmune hemolytic anemia (AIHA) through direct adsorption, molecular mimicry, and cytokine secretion. During treatment, patients with AIHA are susceptible to viral infections and reactivation of pre-existing viruses due to immunosuppression.</p><p><strong>Discussion: </strong>It points out that clinical practice currently lacks standardized prevention, control, and treatment protocols for virus-associated AIHA, and there are no unified guidelines. Further in-depth basic and clinical research is required in the future to elaborate on the mechanisms linking viral infection and AIHA in detail, laying a foundation for subsequent systematic clinical diagnosis and treatment.</p><p><strong>Conclusion: </strong>Viral infection is a significant risk factor influencing morbidity and mortality in AIHA patients. During clinical management, vigilant monitoring of common viral infections and their potential reactivation is warranted, and prophylactic antiviral strategies may be considered.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2715918"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761241","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":"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":2.0,"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":"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":"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":2.0,"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":"Serologic follow-up in patients with multiple myeloma without repeated bone marrow studies: a single-institution experience.","authors":"Lidia Joanna Alberto-López, Oscar Emigdio Melchor-Melo, Miguel Ángel Gómez-Cabrera, José Rodrigo Velasco-Padilla, Juan Pablo Ramírez-García, Paola Andrea Anaya-Valdés, Sofía Chávez-Martínez, Max Robles-Nasta, Juan Carlos Olivares-Gazca, José María Moraleda, Guillermo José Ruiz-Delgado, Guillermo José Ruiz-Argüelles","doi":"10.1080/16078454.2026.2727801","DOIUrl":"https://doi.org/10.1080/16078454.2026.2727801","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Assessment of measurable residual disease (MRD) in multiple myeloma (MM) often relies on repeated bone marrow evaluations, which are invasive, costly, and not universally accessible. Alternative monitoring approaches based on routinely available laboratory tests may provide clinically relevant prognostic information.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To evaluate whether longitudinal follow-up based exclusively on serologic monitoring can predict survival outcomes in a real-world cohort of patients with MM.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective single-center study included 88 consecutive patients diagnosed with MM between 1999 and 2024. All patients underwent bone marrow evaluation at diagnosis and were subsequently monitored using serial serum protein electrophoresis (SPEP) and immunofixation (IF), with serum free light chain (sFLC) assays when available. Serologic undetectability was defined as negative SPEP/IF together with normalization of the &lt;math&gt;&lt;mi&gt;κ&lt;/mi&gt;&lt;mo&gt;/&lt;/mo&gt;&lt;mi&gt;λ&lt;/mi&gt;&lt;/math&gt; sFLC ratio. Patients with missing sFLC assays were conservatively analyzed in the serologically positive cohort. Overall survival (OS) and progression-free survival (PFS) were analyzed using Kaplan-Meier methods, log-rank testing, and univariable Cox proportional hazards models, taking into account potential guarantee-time (immortal-time) bias associated with post-baseline response endpoints.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 52 patients (59.1%) achieved disappearance of the monoclonal band on SPEP/IF. Twenty-nine patients (33.0%) met all criteria for complete serologic undetectability. Achievement of serologic undetectability was associated with a significantly lower risk of death (hazard ratio [HR] 0.42, 95% confidence interval [CI] 0.19-0.91; &lt;math&gt;&lt;mi&gt;p&lt;/mi&gt;&lt;mo&gt;=&lt;/mo&gt;&lt;mn&gt;0.0483&lt;/mn&gt;&lt;/math&gt;) and significantly longer PFS (HR 0.195, 95% CI 0.091-0.418; &lt;math&gt;&lt;mi&gt;p&lt;/mi&gt;&lt;mo&gt;=&lt;/mo&gt;&lt;mn&gt;0.0028&lt;/mn&gt;&lt;/math&gt;). Disease progression or relapse occurred in 28 patients overall. Among patients who achieved serologic undetectability, those undergoing autologous stem cell transplantation (ASCT) showed a numerical trend toward improved outcomes; however, differences did not reach statistical significance due to sample size constraints.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;These findings suggest that sustained serologic clearance of monoclonal protein reflects deeper disease control and may serve as a clinically meaningful prognostic marker of treatment response. In resource-limited settings or centers where serial bone marrow-based MRD assessment is impractical, comprehensive serologic monitoring offers a feasible, non-invasive alternative for longitudinal disease evaluation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In routine clinical practice, achievement of serologic undetectability defined by standard laboratory assays was associated with superior OS and PFS. These results support the prognostic value of accessible serologic m","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2727801"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880083","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":"Beyond antigen matching: compatibility intelligence theory for transfusion as an emergent biological system.","authors":"Ahmed M Hjazi","doi":"10.1080/16078454.2026.2729588","DOIUrl":"https://doi.org/10.1080/16078454.2026.2729588","url":null,"abstract":"<p><strong>Background: </strong>Despite major advances in serologic testing, extended phenotyping, and blood group genomics, clinically similar transfusion exposures may result in markedly different immune and clinical outcomes. Existing compatibility strategies do not fully explain this biological variability.</p><p><strong>Objectives: </strong>To examine transfusion compatibility as an emergent donor-recipient biological state and propose a systems-level conceptual framework that integrates established biological determinants into a testable model for future precision transfusion medicine.</p><p><strong>Methods: </strong>This narrative review critically synthesizes current evidence from blood group genomics, recipient immunobiology, inflammation, disease-specific biology, transfusion medicine, and computational prediction. The proposed framework distinguishes Compatibility Intelligence Theory (CIT) as a biological interpretation from Precision Transfusion Intelligence (PTI) as its potential clinician-supervised translational application.</p><p><strong>Results: </strong>The review argues that transfusion compatibility is shaped by interactions among donor genetics, recipient immune biology, inflammatory physiology, disease context, transfusion history, and longitudinal adaptation rather than by antigen matching alone. CIT provides an organizational framework for integrating these determinants, whereas PTI describes a possible clinician-supervised translation. To address current feasibility, the revised framework separates variables into routinely measurable, contextually available but incompletely standardized, and research-stage domains, and proposes a staged strategy for deriving rather than assuming their quantitative weights. Any clinical implementation would require comparative validation against current serologic, phenotypic, and genotype-based practice.</p><p><strong>Conclusions: </strong>Compatibility Intelligence Theory offers a testable systems-level framework for understanding transfusion compatibility without replacing established transfusion practices. The framework is not presented as a ready-to-use score: currently measurable variables can be organized for structured risk review, whereas inflammatory, immunogenetic, and multi-omic inputs require prospective standardization and validation. If future studies demonstrate incremental predictive and patient-centered benefit, CIT-informed PTI could support an adaptive, evidence-based extension of current precision transfusion practice.</p>","PeriodicalId":13161,"journal":{"name":"Hematology","volume":"31 1","pages":"2729588"},"PeriodicalIF":2.0,"publicationDate":"2026-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905694","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}