{"title":"Real-world treatment patterns and outcomes of patients with LR-MDS in Japan: an electronic health record database study.","authors":"Shuji Uno, Mayuko Nakakoji, Shuichi Midorikawa, Takuya Kitano, Ryo Tajiri, Jin Hayakawa, Kenichi Minehata, Takahiro Suzuki","doi":"10.1007/s12185-025-04077-y","DOIUrl":"10.1007/s12185-025-04077-y","url":null,"abstract":"<p><p>Real-world treatment patterns and clinical outcomes for patients with lower-risk myelodysplastic syndromes (LR-MDS) in Japan are insufficiently characterized. This study assessed treatment patterns, clinical outcomes, costs, and healthcare resource utilization of patients with LR-MDS in Japan using the AsMedix electronic health record database. The study included 177 patients aged ≥ 18 years with LR-MDS, identified between April 1, 2017, and March 31, 2022. Of these, 79 were transfusion dependent (TD) and 98 were non-transfusion dependent (NTD). Treatment patterns were diverse, and 57 (32.2%) patients received hypomethylating agents (combination or monotherapy) as first-line treatment. Median (95% confidence interval) overall survival was 32.6 months (17.6-not evaluable) among TD patients who achieved red blood cell transfusion independence (RBC-TI) ≥ 8 weeks during weeks 1-24, compared with 22.3 months (10.1-not evaluable) among those who did not (P = 0.17). Among NTD patients, maintaining NTD status was also associated with longer median overall survival. Furthermore, patients who achieved or maintained RBC-TI incurred roughly half the monthly medical costs per individual compared with those who did not, highlighting the clinical and economic importance of reducing RBC transfusion requirements. Further research is needed to understand the impacts of treatment on patients with LR-MDS-related anemia in Japan.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"196-207"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12913320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Real-world outcomes of venetoclax and azacitidine in Japanese patients with newly diagnosed acute myeloid leukemia (VENUS study).","authors":"Ryota Imanaka, Hiroki Numata, Yuna Katsuoka, Nobuhiko Uoshima, Satoru Hara, Jun Ando, Shuichi Ota, Goichi Yoshimoto, Akihito Matsuoka, Tetsuo Morita, Atsuko Tsutsui, Mizuha Kosugi-Kanaya, Tatsunori Goto","doi":"10.1007/s12185-025-04093-y","DOIUrl":"10.1007/s12185-025-04093-y","url":null,"abstract":"<p><p>Venetoclax (VEN) with azacitidine (AZA) is the standard treatment for patients with acute myeloid leukemia (AML) who are ineligible for intensive chemotherapy. However, real-world evidence on dosing, scheduling, and outcomes is lacking, particularly for patients with prior myelodysplastic syndrome (MDS) or AZA treatment, who have been excluded from clinical trials. This was a multicenter retrospective study of VEN + AZA in 120 patients newly diagnosed with AML between June 2021 and September 2022. The cohort had a median age of 77 years, 52% had secondary AML, 74% had previously been diagnosed with MDS, and 39% had previously received AZA. During cycle 1, half of the patients received 400 mg of VEN for a median of 27 days, with a median holding period of 12 days. With a median follow-up of 13.6 months, the rate of complete remission (CR) or CR with incomplete blood count recovery was 56.7% in VEN + AZA-treated patients in the overall cohort and 56.5% in patients with prior MDS. Median overall survival was 14.8 months for the overall cohort and 15.4 months for those with prior MDS. The real-world outcomes were comparable to those of clinical trials.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"178-188"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12913348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Functional characterization of two protein C variants causing type I deficiency via cellular degradation or retention.","authors":"Ibuki Yasuda, Satomi Nagaya, Rikuto Yui, Yuta Imai, Yamato Kuwajima, Eriko Morishita","doi":"10.1007/s12185-025-04072-3","DOIUrl":"10.1007/s12185-025-04072-3","url":null,"abstract":"<p><p>Hereditary protein C (PC) deficiency is a thrombotic disorder caused by variants in the PC gene (PROC). In this study, we identified a novel variant, p.Leu173Pro (L173P), and a previously reported variant, p.Val241Leu (V241L), in two unrelated Japanese families with venous thrombosis. We investigated the mechanisms by which these variants lead to type I PC deficiency. PC expression vectors were constructed and transiently expressed in human embryonic kidney 293 cells. Cell lysates and culture supernatants were subsequently analyzed by Western blotting, and intracellular trafficking was evaluated. Both PC-L173P and PC-V241L variants exhibited significantly reduced extracellular secretion compared to the wild-type PC. Furthermore, PC-L173P underwent proteasome-mediated intracellular degradation, whereas PC-V241L appeared to accumulate within the endoplasmic reticulum. This study elucidates the mechanism by which type I PC deficiency arises from distinct secretion defects: intracellular degradation and retention. Although both PROC variants result in type I PC deficiency, their differing intracellular fates are likely attributable to the mutation site and the physicochemical properties of the substituted amino acids. These findings underscore the heterogeneity of secretion defects in type I PC deficiency and provide novel insights into its molecular pathophysiology.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"156-165"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130478","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":"Myelodysplastic neoplasms with unbalanced whole-arm translocation der(5;19)(p10;q10): association with double-hit TP53 mutations.","authors":"Kensuke Kojima, Noriko Tsuge, Shohei Yoshida, Dai Umebara, Yoshie Nishida, Shiori Miyazaki, Tadashi Asagiri","doi":"10.1007/s12185-025-04076-z","DOIUrl":"10.1007/s12185-025-04076-z","url":null,"abstract":"<p><p>Unbalanced whole-arm translocation der(5;19)(p10;q10) is a rare but recurrent cytogenetic aberration noted in patients with myelodysplastic neoplasms (MDS) and acute myeloid leukemia (AML). Eight cases of MDS/AML with der(5;19)(p10;q10) have been previously reported. Here, we describe three additional cases of MDS with der(5;19)(p10;q10) at our institution, in which we identified myeloid malignancy-associated mutations using next-generation sequencing. All patients had two TP53 mutations, each with >10% variant allele frequency, suggesting double-hit TP53 mutations. Double-hit TP53 mutations are only found in approximately 2% of patients with MDS, and may be involved in the development of the cytogenetic abnormalities der(5;19)(p10;q10), +19, and complex karyotype, often associated with exposure to alkylating agents. We propose der(5;19)(p10;q10) as a potential cytogenetic indicator of biallelic TP53 inactivation through double-hit mutations. These data suggest that MDS with der(5;19)(p10;q10) is clinically characterized by aberrant CD7 expression in blasts, a tendency for leukemic transformation, resistance to anti-leukemia therapies, and poor survival outcomes. We also noted that cases of der(5;19)(p10;q10) MDS/AML have been reported exclusively by Japanese institutions. Geographical and ethnic factors may contribute to oncogenesis, which can be triggered by exposure to alkylating agents.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"189-195"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148757","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}
Hasan Abdullah Aswad, Azad Abduljabar Haleem, Adil Abozaid Eissaa
{"title":"Late renal, liver, endocrine, and cardiac outcomes of bone marrow transplantation in Kurdish children with β-thalassemia major.","authors":"Hasan Abdullah Aswad, Azad Abduljabar Haleem, Adil Abozaid Eissaa","doi":"10.1007/s12185-025-04067-0","DOIUrl":"10.1007/s12185-025-04067-0","url":null,"abstract":"<p><p>This study investigated late renal, liver, endocrine, and cardiac outcomes in 52 Kurdish children aged 7-18 years who underwent bone marrow transplantation (BMT) for β-thalassemia major (β-TM). Boys had higher levels of hemoglobin and alkaline phosphatase than girls. Conversely, girls exhibited higher levels of SGPT, ferritin, T4, and eGFR. In all patients, BUN (71.15%), ALP (100%), PT (96.15%), TSB (34.62%), and serum ferritin (48.08%) were elevated, while Hb (57.69%) and serum creatinine (42.31%) were lower than normal. At ages 1-5, 6-10, and 11-15 years, patients had significantly lower serum ferritin (1053.0, 212.0, and 105.05; p = 0.0004) and SGOT (30.0, 22.0, and 26.50; p = 0.0231) levels. Echocardiography showed normal heart function in 47 patients (90.39%), with minor abnormalities observed in only 9.61%. The mean eGFR was 89.70 (SD: 22.93), with girls showing a significantly higher average (98.83) than boys (72.70; p < 0.0001). Kidney function was most often mildly decreased (55.77%), followed by normal/increased (40.39%), and mild-to-moderately decreased (3.85%). Girls were more likely to have normal/ increased kidney function (61.54%), while boys predominantly had mildly decreased kidney function (76.92%) with no significant difference between ages in all patients. Most of the children with β-TM had mildly decreased kidney function and higher liver function test values.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"279-290"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086001","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":"Significance of the tendency for relative bradycardia during induction therapy for acute myeloid leukemia.","authors":"Ryutaro Tominaga, Shin-Ichiro Fujiwara, Seina Honda, Daizo Yokoyama, Atsuto Noguchi, Shuka Furuki, Shunsuke Koyama, Rui Murahashi, Hirotomo Nakashima, Kazuki Hyodo, Shin-Ichiro Kawaguchi, Yumiko Toda, Kento Umino, Daisuke Minakata, Masahiro Ashizawa, Chihiro Yamamoto, Kaoru Hatano, Kazuya Sato, Ken Ohmine, Yoshinobu Kanda","doi":"10.1007/s12185-025-04070-5","DOIUrl":"10.1007/s12185-025-04070-5","url":null,"abstract":"<p><p>This study explored the relationship between body temperature (BT) and heart rate (HR) data during acute myeloid leukemia (AML) treatment, using relative bradycardia (RB) as an index. RB trends were also assessed in confirmed infections and during intensive chemotherapy. Data from AML patients who received induction therapy (anthracycline and cytarabine) at Jichi Medical University Hospital between May 2015 and December 2023 were analyzed. A total of 1000 febrile events (axillary temperature ≥ 37.8 °C) in 97 patients were included. Multivariate analysis showed an HR increase of 6.57 bpm (95% CI 4.44-8.70) per 1 °C rise in BT. RB, defined as BT ≥ 37.8 °C with HR < 90 bpm, was observed in 630 events (63.0%). RB was more likely with age ≥ 44 years, hemoglobin ≥ 6.5 g/dL, and reduced-intensity regimens. In contrast, BT ≥ 38.6 °C, diastolic BP ≥ 70 mmHg, oxygen therapy, CRP ≥ 7.13 mg/dL, and incomplete hematologic recovery decreased the likelihood of RB. In addition, RB was significantly associated with documented infection (OR = 2.32, 95% CI 1.17-4.61, p = 0.016). RB frequently occurred during AML induction therapy, and may serve as an indicator of infection.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"166-177"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080608","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 retrospective analysis of clinicopathological and genetic features of synchronous CNS and systemic DLBCL at diagnosis.","authors":"Kayo Egoshi Ohashi, Suguru Fukuhara, Akiko Miyagi Maeshima, Maki Shibata, Haruhi Makino, Daiki Hattori, Hirokazu Sasaki, Shinichi Makita, Noriko Iwaki, Wataru Munakata, Takahiro Fukuda, Miki Ando, Koji Izutsu","doi":"10.1007/s12185-025-04089-8","DOIUrl":"10.1007/s12185-025-04089-8","url":null,"abstract":"<p><p>Synchronous central nervous system (CNS) and systemic diffuse large B-cell lymphoma (synDLBCL) is a rare, aggressive entity with poor prognosis and limited data guiding optimal management. We retrospectively analyzed 25 patients with synDLBCL treated at our institution between 2012 and 2021. Among the 20 patients undergoing curative-intent treatment, most received less-intensive CNS-directed therapies, including R-CHOP with intrathecal chemotherapy or high-dose methotrexate. The 3-year progression-free survival rate was 33%, with CNS progression as the predominant site of treatment failure. Genetic profiling in 12 patients revealed a high prevalence (83%) of the MCD subtype, characterized by frequent MYD88 and CD79B mutations, irrespective of immunohistochemical cell-of-origin classification. These findings align with the genetic landscape of primary CNS lymphoma, underscoring the limitations of less-intensive CNS-directed therapies in achieving durable CNS control in synDLBCL. Our findings highlight the need for CNS-penetrant, intensified frontline strategies and support the investigation of Bruton's tyrosine kinase inhibitor-containing regimens in this population. Multicenter collaborative studies with standardized diagnostic and treatment approaches are essential to improve outcomes in synDLBCL.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"215-224"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421523","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":"Detection of clonal selection by multicolor flow cytometry in TAM with multiple GATA1 mutations.","authors":"Atsushi Kohso, Shotaro Iwamoto, Kaori Niwa, Yasuhito Nannya, Tsutomu Toki, Ryo Hanaki, Hidemi Toyoda, Takao Deguchi, Seishi Ogawa, Kiminori Terui, Etsuro Ito, Masahiro Hirayama","doi":"10.1007/s12185-025-04101-1","DOIUrl":"10.1007/s12185-025-04101-1","url":null,"abstract":"<p><p>Transient abnormal myelopoiesis (TAM) occurs in approximately 10% of neonates with Down syndrome (DS), and about 20% of these cases progress to myeloid leukemia associated with DS (ML-DS) within the first four years of life. TAM usually arises from a single clone harboring an identical GATA1 mutation, but approximately 8% of cases carry heterogeneous clones with distinct GATA1 mutations. To date, no reliable method has been established to determine which clone progresses to ML-DS. Here, we report a unique TAM case with multiple distinct GATA1 mutations in which a minor clone at the time of diagnosis evolved into overt ML-DS by 59 days of age. It is particularly noteworthy that changes in blast surface marker expression detected by flow cytometry (FCM) following a single course of low-dose cytarabine coincided with the emergence of the leukemogenic clone. This case illustrates that the use of FCM may serve as a valuable tool for the early detection of leukemogenic clonal expansion in TAM patients harboring multiple GATA1 mutations.</p>","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"297-301"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458682","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":"Overweight status and chemotherapy dose modification in pediatric leukemia: disease-specific considerations.","authors":"Hirozumi Sano","doi":"10.1007/s12185-025-04154-2","DOIUrl":"10.1007/s12185-025-04154-2","url":null,"abstract":"","PeriodicalId":13992,"journal":{"name":"International Journal of Hematology","volume":" ","pages":"308-309"},"PeriodicalIF":1.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850047","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}