Seminars in hematology最新文献

{"title":"Integration of PET in DLBCL","authors":"Katharine L Lewis ,&nbsp;Judith Trotman","doi":"10.1053/j.seminhematol.2023.12.003","DOIUrl":"10.1053/j.seminhematol.2023.12.003","url":null,"abstract":"<div><div>F-fluorodeoxyglucose positron emission tomography-computerized tomography (¹⁸FDG-PET/CT) is the gold-standard imaging modality for staging and response assessment for most lymphomas. This review focuses on the utility of ¹⁸FDG-PET/CT, and its role in staging, prognostication and response assessment in diffuse large B-cell lymphoma (DLBCL), including emerging possibilities for future use.</div></div>","PeriodicalId":21684,"journal":{"name":"Seminars in hematology","volume":"60 5","pages":"Pages 291-304"},"PeriodicalIF":5.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139036919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second-line treatment of diffuse large B‐cell lymphoma: Evolution of options","authors":"N. Fabbri ,&nbsp;A. Mussetti ,&nbsp;A. Sureda","doi":"10.1053/j.seminhematol.2023.12.001","DOIUrl":"10.1053/j.seminhematol.2023.12.001","url":null,"abstract":"<div><div>In the era of immunochemotherapy, approximately 60%-70% of diffuse large B-cell lymphoma (DLBCL) patients achieve remission with first-line rituximab-based chemoimmunotherapy<span><span><span><span>. However, 30%-40% relapse after initial response to first-line therapy and, out of them, 20%-50% are refractory or experience early relapse. The second-line therapy algorithm for DLBCL has recently evolved, thanks to the recent approval of new therapeutic agents or their combinations. The new guidelines suggest a stratification of relapsed/refractory (R/R) DLBCL based on the time to relapse. For transplant-eligible patients, autologous stem cell transplant remains the preferred option when the patient relapses after 12 months from diagnosis, while anti-CD19 CART-cell therapy is the current preferred choice for high-risk DLBCL, defined as primary refractory or relapse ≤12 months. For transplant-ineligible or CAR T-cell therapy-ineligible patients, the therapeutic arsenal historically lacked effective options. However, new therapeutic options, including </span>polatuzumab vedotin<span> combined with bendamustine-rituximab and tafasitamab with lenalidomide<span>, have been recently approved, and novel agents such as loncastuximab tesirine, </span></span></span>selinexor, anti-CD19 CAR T-cell therapy, and </span>bispecific antibodies have shown promising efficacy and manageable safety in this setting offering new hope to patients in this challenging scenario.</span></div></div>","PeriodicalId":21684,"journal":{"name":"Seminars in hematology","volume":"60 5","pages":"Pages 305-312"},"PeriodicalIF":5.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138744989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based management of primary and secondary CNS lymphoma","authors":"Jahanzaib Khwaja ,&nbsp;Lakshmi Nayak ,&nbsp;Kate Cwynarski","doi":"10.1053/j.seminhematol.2023.11.003","DOIUrl":"10.1053/j.seminhematol.2023.11.003","url":null,"abstract":"<div><div><span><span><span>Central nervous system (CNS) lymphoma has traditionally had very poor outcomes however advances in management have resulted in dramatic improvements and long-term survival of patients. We describe the evidence for treatment strategies for these aggressive disorders. In </span>primary CNS lymphoma there are randomized trial data to inform treatment decisions but these are lacking to guide management in secondary CNS lymphoma. Dynamic assessment of patient fitness and </span>frailty<span><span> is key throughout treatment, alongside delivery of CNS-bioavailable therapy and enrolment in clinical trials, at each stage of the disease. Intensive high-dose methotrexate-containing induction followed by consolidation with </span>autologous stem cell transplantation with thiotepa-based conditioning is recommended for patients who are fit. Less intensive </span></span>chemoimmunotherapy<span><span>, novel agents (including Bruton tyrosine kinase inhibitors, cereblon targeting immunomodulatory agents, and checkpoint inhibitors in the context of clinical trials), and </span>whole brain radiotherapy may be reserved for less fit patients or disease which is chemoresistant. Data regarding the efficacy of chimeric antigen receptor T-cells therapy is emerging, and concerns regarding greater toxicity have not been realized. Future areas of prospective studies include the identification of those at high risk of developing CNS lymphoma, management in elderly or frail patients as well as incorporating novel agents into regimens, particularly for those with chemoresistant disease.</span></div></div>","PeriodicalId":21684,"journal":{"name":"Seminars in hematology","volume":"60 5","pages":"Pages 313-321"},"PeriodicalIF":5.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138506375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to series: Diffuse large B-cell lymphoma","authors":"Sonali M. Smith ,&nbsp;Laura Pasqualucci","doi":"10.1053/j.seminhematol.2024.01.010","DOIUrl":"10.1053/j.seminhematol.2024.01.010","url":null,"abstract":"","PeriodicalId":21684,"journal":{"name":"Seminars in hematology","volume":"60 5","pages":"Pages 251-254"},"PeriodicalIF":5.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139584487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective sequencing of chimeric antigen receptor T-cell therapy in the treatment of LBCL in 2023","authors":"Christine E. Ryan,&nbsp;Caron A. Jacobson","doi":"10.1053/j.seminhematol.2023.12.002","DOIUrl":"10.1053/j.seminhematol.2023.12.002","url":null,"abstract":"<div><div><span><span>Over the last decade, CD19-targeting chimeric antigen receptor (CAR) T-cell therapy has profoundly changed the management of relapsed/refractory large-B-cell lymphoma (LBCL). At present, there are three FDA-approved anti-CD19 CAR T-cell products for LBCL: </span>axicabtagene ciloleucel (axi-cel), </span>lisocabtagene maraleucel (liso-cel), and tisagenlecleucel (tisa-cel). Two of these (axi-cel &amp; liso-cel) are approved for use in the second-line setting under certain conditions. As CAR T-cell therapy continues to define a new role in the treatment armamentarium for LBCL, questions remain regarding which product to use and how to sequence CAR T-cell therapy with other therapeutic options. Here we will briefly review the key features of each FDA-approved anti-CD19 CAR T-cell product and the data that led to regulatory approval for each. Next, we will focus on the recent landmark studies that have established the use of CAR T-cell therapy as second-line treatment. While no direct prospective head-to-head comparisons exist of the 3 constructs, we will review some retrospective studies that suggest some emerging differences between the products. Lastly, we will turn our attention to the horizon as we explore some of the ongoing questions of how to best leverage the curative potential of CAR T-cell therapy for the most effective management of LBCL. These areas include the consideration of CAR T-cell therapy in the frontline setting, the optimal timing for CAR T-cell referral, the optimal bridging approach, and how to continue advancing novel CAR T-cell approaches in the context of the current treatment landscape.</div></div>","PeriodicalId":21684,"journal":{"name":"Seminars in hematology","volume":"60 5","pages":"Pages 322-328"},"PeriodicalIF":5.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138818624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking to achieve cure the first time around for DLBCL patients who are older and/or with co-morbidities","authors":"Elizabeth A. Brem ,&nbsp;Laurie H. Sehn","doi":"10.1053/j.seminhematol.2024.01.008","DOIUrl":"10.1053/j.seminhematol.2024.01.008","url":null,"abstract":"<div><div><span>Diffuse large B-cell lymphoma (DLBCL) is an aggressive but often curable malignancy. Older patients, especially those 80 years and older, have poor outcomes compared to those &lt; 60, likely due to a number of reasons including disease biology, comorbidities, and treatment intolerance. Prospective data informing the treatment of older patients and those with multiple co-morbidities is limited. Here, we intend to review available data for regimens other than standard R-CHOP (rituximab, </span>cyclophosphamide<span><span>, adriamycin, prednisone) or R-pola-CHP (rituximab, polatuzumab vedotin [pola], </span>cyclophosphamide<span>, adriamycin, prednisone), tools available that may aid in treatment selection, and future directions, including the incorporation of newer treatment modalities into therapy for more vulnerable patients.</span></span></div></div>","PeriodicalId":21684,"journal":{"name":"Seminars in hematology","volume":"60 5","pages":"Pages 285-290"},"PeriodicalIF":5.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139554151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of lymphoma diagnosis, prognosis, and treatment monitoring in countries with limited access to pathology services","authors":"Clara Chamba,&nbsp;William Mawalla","doi":"10.1053/j.seminhematol.2023.07.004","DOIUrl":"10.1053/j.seminhematol.2023.07.004","url":null,"abstract":"<div><p>The world is moving towards precision medicine for cancer. This movement goes hand in hand with the development of newer advanced technologies for early, precise diagnosis of cancer and personalized treatment plans with fewer adverse effects for the patient. Liquid biopsy is one such advancement. At the same time, it has the advantage of minimal invasion and avoids serial invasive biopsies. In countries with limited access to pathology services, such as sub-Saharan Africa, liquid biopsy may provide an opportunity for early detection and prognostication of lymphoma. We discuss the current diagnostic modalities for lymphoma, highlighting the existing challenges with tissue biopsy, and how feasible it is for countries with limited pathology resources to leverage advancements made in the clinical application of liquid biopsy to improve lymphoma care.</p></div>","PeriodicalId":21684,"journal":{"name":"Seminars in hematology","volume":"60 4","pages":"Pages 215-219"},"PeriodicalIF":3.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0037196323000562/pdfft?md5=5d043a805c643eede0343a10554cf43e&pid=1-s2.0-S0037196323000562-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative care needs of patients with hematologic malignancies and family caregivers and challenges of palliative care provision in Asia: A review of evidence","authors":"Yupawadee Kantabanlang ,&nbsp;Cheng-Pei Lin ,&nbsp;Kittikorn Nilmanat ,&nbsp;Ping Guo","doi":"10.1053/j.seminhematol.2023.07.002","DOIUrl":"10.1053/j.seminhematol.2023.07.002","url":null,"abstract":"Patients with hematologic malignancies often experience fatigue, lack of vitality, and energy, and high psychological distress. High levels of unmet care needs of patients with hematologic malignancies in Asia were identified. This review provides an overview of current evidence on the experiences and palliative care needs of patients with hematologic malignancies and their families and the barriers and challenges of integrating palliative care into hematology care in Asia. Patients with hematologic malignancies who received palliative care could benefit from less aggressive end-of-life treatments. However, the uncertain and variable nature of the prognosis and illness trajectories of hematologic malignancies increase the difficulties of integrating palliative care into hematologic care. Patients and their families are often referred to palliative care services late, which leaves a short window for palliative care teams to provide holistic needs assessment and person-centered care for those who need it. In addition, cultural differences in medical decision-making patterns and complex social norms and interactions among patients, families, and healthcare staff make it even more challenging to initiate palliative care conversations in Asia. Future research should focus on the development and evaluation of culturally appropriate palliative care for patients with hematologic malignancies and their family caregivers in Asia, given that the low rate of service intake and poor public awareness of the important role of palliative care in disease trajectories were reported. The socio-cultural context surrounding individuals should be taken into consideration to ensure the provision of person-centered care for this group of patients. Digital health could be one of the possible solutions forward to address local needs and challenges.","PeriodicalId":21684,"journal":{"name":"Seminars in hematology","volume":"60 4","pages":"Pages 220-225"},"PeriodicalIF":3.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0037196323000550/pdfft?md5=d02193cb245ff3dd12fb337015a070ad&pid=1-s2.0-S0037196323000550-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10273670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Debate: Should the loss of disability adjusted life years (DALY) define the focus of Global Hematology?","authors":"David J. Roberts ,&nbsp;Aggrey Dhabangi","doi":"10.1053/j.seminhematol.2023.09.001","DOIUrl":"10.1053/j.seminhematol.2023.09.001","url":null,"abstract":"<div><p>Setting priorities in healthcare is always contentious given the array of possible services at primary, secondary, and tertiary levels of care, not to mention potential public health interventions. The central goals in global policy have been reducing inequity within and between countries, protecting vulnerable groups (particularly women and children) and reducing the major communicable diseases which have historically been a major burden in lower- and middle-income countries. Here limited relative and absolute spending on healthcare have spurred a series of initiatives in Global Health over the last 50 years which have led to significant gains in measures of morbidity and mortality.</p><p>Against this background there remains the continuing question of how to adapt current medical practice in higher income countries for training and planning of services in lower- and middle-income countries. Here, the historical development of Global Health is outlined, and lessons drawn from the surveys of the global burden of disease and health economic analysis to understand how we can apply these principles to define Global Hematology.</p><p>It remains likely that in lower-income countries effort should be concentrated on developing laboratory services and blood transfusion, to allow safe and effective support for the assessment of treatment of anemia, sickle cell disease, maternal and child health and urgent surgery and obstetric services. However, the principles of Global Health, could also be used for hematological malignancies to develop a framework for Global Hematology for all settings.</p></div>","PeriodicalId":21684,"journal":{"name":"Seminars in hematology","volume":"60 4","pages":"Pages 182-188"},"PeriodicalIF":3.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0037196323000719/pdfft?md5=01a879d8520949e2a9404160a1c0ca58&pid=1-s2.0-S0037196323000719-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49681996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future of aplastic anemia treatment in Brazil: Lessons learned for global hematology","authors":"Rodrigo T. Calado","doi":"10.1053/j.seminhematol.2023.09.002","DOIUrl":"10.1053/j.seminhematol.2023.09.002","url":null,"abstract":"<div><p>Aplastic anemia (AA) is a rare serious hematologic disorder caused by hematopoietic stem cell failure in maintaining hematopoiesis. AA is virtually fatal if not treated, and diagnosis and therapy require extensive hematologic infrastructure. Academic medical centers in Brazil have continuously and significantly contributed to diagnostic tools and therapy development, from novel transplant strategies to drug combinations and implementation science in the national public health system. In the present review, we discuss how the collaborative effort among academic centers in hematology has contributed to improving health care for patients with aplastic anemia. We also discuss what needs are still unmet and how to overcome these challenges.</p></div>","PeriodicalId":21684,"journal":{"name":"Seminars in hematology","volume":"60 4","pages":"Pages 200-203"},"PeriodicalIF":3.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0037196323000720/pdfft?md5=d33844a46c2bac667fdb1d6a743cbccd&pid=1-s2.0-S0037196323000720-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41127002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}