{"title":"Incidence of herpes zoster in transplant-ineligible patients with newly diagnosed multiple myeloma treated with daratumumab, lenalidomide, and dexamethasone.","authors":"Yuichi Horigome, Hirotoshi Kamata, Yusuke Michishita, Maki Yokoyama, Noriyuki Tadera, Kei Hayama, Takahiro Suzuki","doi":"10.1007/s12185-025-03980-8","DOIUrl":"10.1007/s12185-025-03980-8","url":null,"abstract":"<p><p>Combination therapy with daratumumab, lenalidomide, and dexamethasone (D-Rd) has greatly improved outcomes for transplant-ineligible newly diagnosed multiple myeloma (TIE-NDMM). Effective management of herpes zoster (HZ) and other infections is critical to maximize therapeutic benefit and to maintain treatment continuity. However, antiviral prophylaxis for HZ in TIE-NDMM patients receiving D-Rd has unclear efficacy, and is currently not covered by health insurance in Japan. In this study, we retrospectively analyzed the incidence of HZ in 40 TIE-NDMM patients treated with D-Rd. Nine patients (22.5%) developed HZ at a median period of 10.7 months (range, 0.4-34.2 months) after starting D-Rd. The cumulative HZ incidence at 12, 24, and 36 months was 13.3%, 19.5%, and 28.6%, respectively. Development of HZ was not associated with patient characteristics, disease characteristics, or hematologic response. Our data indicate a high incidence of HZ in TIE-NDMM patients receiving D-Rd, and we anticipate that Japanese health insurance should soon cover prophylactic treatment of HZ in D-Rd.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"224-230"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752682","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":"Synergistic effect of asciminib with reduced doses of ponatinib in human Ph + myeloid leukemia with the T315M mutation.","authors":"Thao Nguyen, Daisuke Harama, Minori Tamai, Keiko Kagami, Chiaki Komatsu, Shin Kasai, Koshi Akahane, Kumiko Goi, Takeshi Inukai","doi":"10.1007/s12185-025-03981-7","DOIUrl":"10.1007/s12185-025-03981-7","url":null,"abstract":"<p><p>In Philadelphia chromosome-positive (Ph +) leukemia, substitution of threonine at the 315 position of BCR::ABL1 with isoleucine (T315I) induces severe resistance to tyrosine kinase inhibitors (TKIs). Of clinical importance, the substitution of the baseline T315I mutation by methionine (I315M) was reported in a Ph + leukemia patient treated with ponatinib. The resultant T315M mutation induces severe TKI-resistance in a murine Ba/F3 model. Asciminib, an allosteric inhibitor of BCR::ABL1, is reportedly active in ponatinib-resistant patients with the T315I mutation. Although asciminib alone is not active in a murine Ba/F3 model with the T315M mutation, asciminib and ponatinib show synergistic activities. In the present study, we introduced the T315M mutation into the intrinsic BCR::ABL1 gene of two Ph + myeloid and one Ph + lymphoid leukemia cell lines using the CRISPR/Cas9 system to directly verify the utility of the combined asciminib and ponatinib in human models. All three T315M-acquired sublines were more resistant to TKIs including ponatinib than T315I-acquired sublines. Notably, asciminib exhibited a stronger synergistic effect with reduced doses of ponatinib in the T315M-acquired sublines of two myeloid cell lines, but not in the lymphoid cell line. This indicates that the combination of ponatinib and asciminib may have a clinical utility in human Ph + myeloid leukemia.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"206-216"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994550","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":"Retrospective analysis of treatment discontinuation in minimal residual disease negative multiple myeloma.","authors":"Shuku Sato, Emi Sawazaki, Shun Tsunoda, Wataru Kamata, Tomiteru Togano, Yotaro Tamai","doi":"10.1007/s12185-025-03966-6","DOIUrl":"10.1007/s12185-025-03966-6","url":null,"abstract":"<p><strong>Background: </strong>The prognostic significance of minimal residual disease (MRD) negativity in multiple myeloma (MM) is well-established, and MRD negativity serves as a surrogate marker for treatment outcomes. However, in various clinical trials, achieving MRD negativity often leads to treatment continuation until disease progression. In real-world clinical practice, discontinuing treatment could lower healthcare costs and reduce adverse events.</p><p><strong>Methods: </strong>We retrospectively analyzed patients who reached MRD negativity and discontinued treatment.</p><p><strong>Results: </strong>A total of 39 multiple MM cases were included (17 eligible and 22 ineligible for autologous stem cell transplantation). The median time to next treatment was 42.4 months. Ten patients (25%) required additional treatment due to paraproteins or clinical relapse. Cumulative incidence of relapse at 12 and 48 months was 11.7% (95% confidence interval [CI], 4.5-28.2%) and 26.4% (95% CI, 12.8-49.6%), respectively. Multivariate analysis revealed that elevated lactate dehydrogenase (LDH) at first visit and t(4;14) were the only baseline factors significantly associated with worse outcomes. Eight patients (20%) with International Staging System (ISS) = I and with no risk factors (history of extramural disease, elevated LDH, high-risk cytogenetics) had no recurrence.</p><p><strong>Conclusion: </strong>Although treatment discontinuation in high-risk cases is potentially unsafe, low-risk cases demonstrate potential for treatment-free remission.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"217-223"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585707","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":"Quality of life of children and adolescents with hemophilia receiving low-dose prophylactic treatment.","authors":"Zahra Badiei, Atefeh Mokhtari, Hamid Farhangi, Maryam Heidarian, Elham Bakhtiari","doi":"10.1007/s12185-025-03969-3","DOIUrl":"10.1007/s12185-025-03969-3","url":null,"abstract":"<p><strong>Objective: </strong>Compared to episodic treatment, low-dose prophylaxis (LDP) leads to better quality of life (QOL) by decreasing spontaneous bleeding in severe hemophilia A and B. LDP has been used to treat children under 16 years of age in Iran since 2017. The present study assesses the QOL of these patients.</p><p><strong>Methods: </strong>Patients aged 8-16 years with severe hemophilia A and B receiving escalating LDP were included. Patients and parents completed the Hemophilia Quality of Life Questionnaire for Children (Haemo-QOL).</p><p><strong>Results: </strong>Twenty-five children and 15 adolescents were included. The total score for children and parents was 39.7 ± 14.5 and 39.1 ± 15, respectively (p = 0.88). The total score for adolescents and parents was 36.5 ± 15 and 41 ± 15.3, respectively (p = 0.42). The domains of friends and treatment in children and domains of friends and family in parents of children had the highest and lowest scores, respectively. The domains of sport/school and coping in adolescents and the domains of physical health and coping in parents of adolescents had the highest and lowest scores, respectively. The overall QOL of adolescents was better than that of children.</p><p><strong>Conclusion: </strong>LDP resulted in a marked improvement in most domains of QOL. LDP can be appropriate for societies with limited access to factor concentrate.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"277-283"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779968","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 case of acute promyelocytic leukemia complicated by mitochondrial disease.","authors":"Yukari Sakurai, Masakatsu Yanagimachi, Mieko Ito, Ayana Hirose, Naoyuki Miyagawa, Dai Keino, Tomoko Yokosuka, Fuminori Iwasaki, Satoshi Hamanoue, Masae Shiomi, Shoko Goto, Tomohide Goto, Hiroaki Goto","doi":"10.1007/s12185-025-03992-4","DOIUrl":"10.1007/s12185-025-03992-4","url":null,"abstract":"<p><p>A 15-year-old boy with congenital mitochondrial disease was diagnosed with acute promyelocytic leukemia. He was treated with all-trans retinoic acid, and his anthracycline dose was reduced in response to his underlying condition. He successfully achieved molecular remission and maintained this state for 4 years. In vitro drug sensitivity testing in peripheral mononuclear cells suggests that samples from patients in remission show higher sensitivity to various anticancer drugs than samples from healthy volunteers. Reduced-dose chemotherapy could be a valid treatment option for patients with mitochondrial diseases because exposure to elevated oxidative stress may contribute to increased drug sensitivity in these patients.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"301-304"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982622","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":"Phase 2 multicenter study of pegaspargase in Japanese patients with previously untreated acute lymphoblastic leukemia.","authors":"Katsuyoshi Koh, Yoshiyuki Kosaka, Yasuhiro Okamoto, Naoko Maeda, Atsushi Ogawa, Ryoji Kobayashi, Daisuke Hasegawa, Nobuhiro Koga, Adrien Tessier, Yelena Shvenke, Jian Zhu, Bouchra Benettaib, Keizo Horibe, Chitose Ogawa","doi":"10.1007/s12185-025-03976-4","DOIUrl":"10.1007/s12185-025-03976-4","url":null,"abstract":"<p><p>Pegaspargase is a pegylated formulation of E. coli-derived asparaginase, which when combined with multi-agent chemotherapy is an effective, well-established therapy for acute lymphoblastic leukemia (ALL). This study evaluated the efficacy, safety and pharmacokinetics of lyophilized pegaspargase in the Japanese population. The study had two parts; the primary endpoint for Part 1 was the incidence and nature of treatment-emergent adverse events (TEAEs), including those related to pegaspargase, to determine the number of patients who experience intolerable toxicity during a tolerability assessment period. The primary endpoint for Part 2 was the percentage of patients with plasma asparaginase activity of ≥ 0.1 IU/ml 14 days after administration of the first dose of lyophilized pegaspargase. All 26 patients included in the safety analysis experienced at least one TEAE. Frequently reported TEAEs related to lyophilized pegaspargase included decreases in blood fibrinogen, antithrombin III, white blood cell count, and platelet count. No deaths were reported. Plasma asparaginase activity reached ≥ 0.1 IU/ml 5 min after the first dose of lyophilized pegaspargase and was maintained for 14 days in all patients with evaluable samples. The results of this study show that lyophilized pegaspargase represents an effective and well-tolerated first-line treatment option in Japanese patients with ALL.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"284-294"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752311","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":"Treatment pathways and clinical outcomes in newly diagnosed multiple myeloma outside Europe and North America: The INTEGRATE study.","authors":"Kihyun Kim, Estelle Verburgh, Tatiana Mitina, Wenming Chen, Su-Peng Yeh, Natalia Schutz, Fahad Alsharif, Wee Joo Chng, Zhongwen Huang, Meral Beksac","doi":"10.1007/s12185-025-03972-8","DOIUrl":"10.1007/s12185-025-03972-8","url":null,"abstract":"<p><strong>Background: </strong>Real-world data on multiple myeloma (MM) outside Europe and North America are limited. The INTEGRATE study retrospectively assessed real-world treatment pathways and outcomes in MM from Argentina, China, South Korea, South Africa, Russia, Saudi Arabia, Taiwan, and Türkiye.</p><p><strong>Methods: </strong>Medical records (2010-2011) of patients (≥ 18 years) with newly diagnosed MM were analyzed. The primary endpoint was time to next treatment (TTNT). Secondary endpoints included treatment pathways and clinical outcomes stratified by stem cell transplantation (SCT).</p><p><strong>Results: </strong>Of 1511 patients analyzed (median age: 59.5 years), 32% had IgG kappa MM and 35.9% had International Staging System stage III disease. Bortezomib- and thalidomide-based chemotherapy regimens were the most common first- and second-line treatments; lenalidomide-based regimens were common in later lines. Median TTNT from initiation of first-line treatment was 39.5 months. Only 31.7% of patients received SCT at diagnosis, with improved outcomes versus those without SCT (median overall survival: 114.1 vs 85.9 months; 5-year relapse-free rates after first-line treatment: 58.2% vs 49.3%).</p><p><strong>Conclusion: </strong>Treatment strategies for MM outside Europe and North America align with guideline recommendations. More effective treatments and SCT at treatment initiation are needed. This study can guide future research in these regions utilizing newer treatment options.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"231-246"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018755","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":"Early cardiotoxicity in post-transplant cyclophosphamide-based graft-versus-host disease prophylaxis after HLA-haploidentical hematopoietic stem cell transplantation.","authors":"Toshihiro Matsukawa, Junichi Sugita, Daigo Hashimoto, Masayuki Aiba, Kohei Okada, Takanori Teshima","doi":"10.1007/s12185-025-03970-w","DOIUrl":"10.1007/s12185-025-03970-w","url":null,"abstract":"<p><strong>Introduction: </strong>Post-transplant cyclophosphamide (PTCy)-based prophylaxis for graft-versus-host disease (GVHD) is widely used in HLA-haploidentical hematopoietic cell transplantation (haplo-HCT). One of the major drawbacks of PTCy is the risk of rare but potentially lethal cardiotoxicity, which prompted the development of regimens with reduced doses of PTCy.</p><p><strong>Methods: </strong>We retrospectively compared the incidence of early cardiotoxicity with standard-dose of PTCy (cyclophosphamide 50 mg/kg/day for 2 days, PTCy100) versus reduced-dose (40 mg/kg/day for 2 days, PTCy80). In total, 179 patients underwent PTCy-based haplo-HCT, including PTCy100 (n = 111) and PTCy80 (n = 68).</p><p><strong>Results: </strong>The PTCy80 group included significantly more elderly patients, patients who received reduced-intensity conditioning, and patients with a history of HCT than the PTCy100 group. Nine eligible patients (5.0%) experienced severe cardiotoxicity. The incidence of severe cardiotoxicity did not differ significant between PTCy80 and PTCy100 (4.4% vs. 5.4%; p = 1). The incidence of fatal cardiotoxicity was lower with PTCy80, but the small size may have prevented the difference from reaching statistical significance.</p><p><strong>Conclusion: </strong>Reducing the cyclophosphamide dose in PTCy-based GVHD prophylaxis may lower the risk of fatal cardiotoxicity without significantly altering the overall incidence of severe cardiotoxicity.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"247-256"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692048","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":"Early withdrawal immunosuppression improved mixed chimerism in stem cell transplantation for pediatric aplastic anemia.","authors":"Xinan Wang, Xia Qin, Chengjuan Luo, Changying Luo, Jianmin Wang, Xiaohang Huang, Qiang Mi, Yuchen Lin, Jing Chen","doi":"10.1007/s12185-025-03971-9","DOIUrl":"10.1007/s12185-025-03971-9","url":null,"abstract":"<p><p>Mixed chimerism occurs frequently with the risk of graft rejection for aplastic anemia patients undergoing matched sibling donor hematopoietic stem cell transplantation in cyclophosphamide (CY) and anti-thymocyte globulin (ATG) conditioning. So far, no one knows how to adjust immunosuppression (IS) during MC. We retrospectively analyzed 87 consecutive pediatric patients. Early withdrawal (EW) IS and donor lymphocyte infusion were attempted to reverse MC. The rate of MC was 26% (n = 23). Low dose CY (120-150 mg/kg) was a risk factor for MC (P = 0.0002) and increasing the dosage of fludarabine did not eliminate it. Patients receiving 200 mg/kg CY had the lowest MC rate (8%) and best 3-year graft-versus-host disease/failure-free survival (GFFS; 95%). Donor chimerism in T cells was more sensitive than that in whole blood (P = 0.001). In 17 patients with early-onset MC, EW IS strategy was helpful in improving complete chimerism (CC) (EW cohort: 63 versus non-EW cohort: 295 days; P = 0.008). Our study shows that CY + ATG conditioning needs to be intensified to maintain engraftment and 200 mg/kg CY + 150 mg/m2 FLU is recommended for basic conditioning. The EW IS strategy should be considered as an important option to improve donor chimerism in early-onset MC. Clinical trial registration: URL: https://www.chictr.org.cn ; ChiCTR-1900023509. (Retrospective registration in 2019/5/31).</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"267-276"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127419","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}
Hirokazu Kanegane, Satoshi Miyamoto, Takahiro Kamiya, Hidenori Ohnishi, Ryuta Nishikomori, Andrew R Gennery, Takehiko Mori
{"title":"Allogeneic hematopoietic cell transplantation for autoinflammatory disorders.","authors":"Hirokazu Kanegane, Satoshi Miyamoto, Takahiro Kamiya, Hidenori Ohnishi, Ryuta Nishikomori, Andrew R Gennery, Takehiko Mori","doi":"10.1007/s12185-025-04021-0","DOIUrl":"10.1007/s12185-025-04021-0","url":null,"abstract":"<p><p>The understanding of autoinflammatory disorders, which are caused by the dysregulated activation of the innate immune system, has improved with the discovery of new diseases and the expansion of phenotypes. Inflammation can be controlled using immunosuppressive drugs, biological agents, and molecular-targeted therapies. However, some cases remain refractory to treatment, and certain patients experience side effects associated with the long-term use of corticosteroids. Recently, allogeneic hematopoietic cell transplantation (HCT) was reported to improve symptoms in refractory cases. Based on the previous reports, in this review, we discuss the potential of HCT in the treatment of autoinflammatory disorders.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"190-198"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266171","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}