Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi最新文献

{"title":"[Caplacizumab combined with therapeutic plasma exchange, glucocorticoids, and rituximab for refractory thrombotic thrombocytopenic purpura: a case report and literature review].","authors":"Q Z Wei, C Lu, H W Jiang, J B Hu, Y H Wu, Y Hu","doi":"10.3760/cma.j.cn121090-20251126-00553","DOIUrl":"10.3760/cma.j.cn121090-20251126-00553","url":null,"abstract":"<p><p>The clinical course and management of a patient with refractory immune thrombotic thrombocytopenic purpura (iTTP) admitted to the Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were retrospectively analyzed, alongside a review of pertinent literature. Upon admission, the patient had a PLASMIC score of 6, and emergency therapeutic plasma exchange (TPE) combined with glucocorticoid therapy was immediately initiated. Further examinations revealed an ADAMTS13 activity of 2.9% and a positive inhibitor, thereby confirming iTTP diagnosis. After 5 consecutive days of TPE and glucocorticoid treatment, the patient demonstrated no clinical response, consistent with a diagnosis of refractory iTTP. Rituximab was subsequently added; however, the platelet count continued to decrease, and the disease progressed. After adding caplacizumab to the original regimen, the platelet and lactate dehydrogenase levels rapidly normalized, ADAMTS13 activity recovered to 24.9%, and no serious adverse events occurred during the treatment. This case indicates that incorporating caplacizumab into the combination therapy strategy for patients with refractory iTTP who failed conventional therapies effectively achieves rapid disease control.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"47 3","pages":"280-284"},"PeriodicalIF":0.0,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Advances in research on the mechanisms of reactive oxygen species in platelet activation and thrombosis].","authors":"R Y Shen, K L Xu, J L Qiao, P Fu","doi":"10.3760/cma.j.cn121090-20250710-00327","DOIUrl":"10.3760/cma.j.cn121090-20250710-00327","url":null,"abstract":"<p><p>Platelets play a crucial role in atherosclerosis and thrombus formation, and their activation is regulated by reactive oxygen species (ROS). ROS in platelets primarily originates from nicotinamide adenine dinucleotide phosphate oxidase (NOX). Upon activation of glycoprotein Ⅵ (GPⅥ), ROS generation can be induced through both spleen tyrosine kinase (Syk) -dependent and Syk-independent pathways. In addition, the protease-activated receptor (PAR) signaling pathway not only activates NOX, but our latest research has revealed that it can also induce mitochondria-dependent ROS generation independently of GPⅥ. This finding expands the redox signaling pathways regulated by PAR and suggests mitochondria as a potential novel target for antithrombotic interventions. Endogenous ROS participate in the cascade of platelet activation and thrombus stabilization by modifying key signaling proteins and regulating ion channel function. Therefore, targeting ROS generation pathways associated with GPⅥ/PAR holds promise for developing precise therapeutic strategies for thrombotic diseases. This review summarizes the underlying mechanisms and provides a theoretical basis for the prevention and treatment of conditions such as atherosclerosis.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"47 3","pages":"290-295"},"PeriodicalIF":0.0,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical characteristics and prognosis analysis of newly diagnosed multiple myeloma with t (4;14)].","authors":"R Guo, X Cheng, X X Shen, Y Y Jin, L J Chen","doi":"10.3760/cma.j.cn121090-20250618-00285","DOIUrl":"10.3760/cma.j.cn121090-20250618-00285","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; This study aimed to analyze the clinical characteristics and prognosis of patients with newly diagnosed multiple myeloma (NDMM) with t (4;14) . &lt;b&gt;Methods:&lt;/b&gt; Data of 431 patients with NDMM diagnosed in the First Affiliated Hospital of Nanjing Medical University between April 2017 and October 2024 were retrospectively analyzed. Cytoplasmic light chain immunofluorescence with fluorescence in situ hybridization was used for cytogenetic testing to analyze the clinical characteristics and prognosis of patients with t (4;14) . &lt;b&gt;Results:&lt;/b&gt; Among the enrolled patients, 69 (16.0%) were positive for t (4;14), and 362 (84.0%) were negative. Compared with the t (4;14) -negative group, patients in the t (4;14) -positive group demonstrated significantly higher proportions of IgG subtype, thrombocytopenia, and concomitant gain/amplification of chromosome 1q21 (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). The median progression-free survival (PFS) of patients with t (4;14) was significantly shorter than that of patients with negative t (4;14) (27 months &lt;i&gt;vs&lt;/i&gt; 39 months, &lt;i&gt;P&lt;/i&gt;=0.014). However, no statistically significant difference in median overall survival (OS) was observed between the two groups (not reached &lt;i&gt;vs&lt;/i&gt; not reached, &lt;i&gt;P&lt;/i&gt;=0.056). Among the 69 patients with t (4;14), 18 had isolated t (4;14) and 51 had concomitant high-risk cytogenetic abnormalities (HRCA), including 50 patients with 1q21 gain/amplification or 1p32 deletion. The median PFS was 33 (95% &lt;i&gt;CI&lt;/i&gt;: 24-42) months in patients with isolated t (4;14) and 26 (95% &lt;i&gt;CI&lt;/i&gt;: 16-41) months in those with t (4;14) plus HRCA, whereas the median OS was not reached in either group. Patients with t (4;14) combined with HRCA demonstrated inferior PFS and OS compared with the t (4;14) -negative group (&lt;i&gt;P&lt;/i&gt;=0.030 and &lt;i&gt;P&lt;/i&gt;=0.026, respectively). Among patients with t (4;14), 25 underwent early autologous hematopoietic stem cell transplantation and demonstrated a trend toward longer median PFS compared with those who did not undergo transplantation [41 (95% &lt;i&gt;CI&lt;/i&gt;: 14- not reached) months &lt;i&gt;vs&lt;/i&gt; 26 (95% &lt;i&gt;CI&lt;/i&gt;: 18-35) months], although the difference was not statistically significant (&lt;i&gt;P&lt;/i&gt;=0.135). Treatment response was assessed in 22 transplanted patients, revealing that the rate of ≥ complete response increased from 40.9% before transplantation to 63.6% at 3 months post-transplantation, and the rate of ≥ very good partial response increased from 81.8% to 90.9%. Multivariate Cox regression analysis after adjustment for treatment-related factors identified that t (4;14) remained an independent adverse prognostic factor for PFS in patients with NDMM (&lt;i&gt;HR&lt;/i&gt;=1.608, 95% &lt;i&gt;CI&lt;/i&gt;: 1.103-2.346, &lt;i&gt;P&lt;/i&gt;=0.014), but not for OS. &lt;b&gt;Conclusion:&lt;/b&gt; In the era of novel agents, t (4;14) was identified as an independent risk factor for PFS in patients with NDMM, although it did not significantly affect OS. Patients with t (4;14) combined with other HRCA demonstrated a wor","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"47 3","pages":"255-261"},"PeriodicalIF":0.0,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of conditioning intensity on transplant outcomes following allogeneic hematopoietic stem cell transplantation in patients with myelodysplastic neoplasms: a multicenter retrospective cohort study].","authors":"L Wang, Z L Zhang, R X Zhang, H R Chen, M L Hu, Y M Zhao, W Shi, Y Cao, X X Hu","doi":"10.3760/cma.j.cn121090-20251029-00490","DOIUrl":"10.3760/cma.j.cn121090-20251029-00490","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the effect of transplant conditioning intensity (TCI) on transplant outcomes in patients with myelodysplastic neoplasms (MDS) undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) . &lt;b&gt;Methods:&lt;/b&gt; This multicenter retrospective cohort study included 337 patients with MDS undergoing allo-HSCT between February 2019 and April 2025 in four transplant centers in China. Patients were categorized based on TCI scores into TCI-1 (1-2 points, low intensity), TCI-2 (2.5-3.5 points, moderate intensity), and TCI-3 (4-6 points, high intensity) groups. The Fine-Gray competing risk model was applied to analyze nonrelapse mortality (NRM) and relapse. Overall survival (OS) was estimated employing the Kaplan-Meier method and compared using the log-rank test. Inverse probability of treatment weighting (IPTW) was performed to balance covariates among groups to eliminate baseline confounding bias. Furthermore, a doubly robust (DR) model combined with the Fine-Gray competing risk model was applied to assess the independent effect of TCI on NRM. &lt;b&gt;Results:&lt;/b&gt; Unweighted analysis revealed that the 3-year NRM post-transplantation in the TCI-1, TCI-2, and TCI-3 groups was 7.7% (95% &lt;i&gt;CI&lt;/i&gt;: 0.4%-15.1%), 8.3% (95% &lt;i&gt;CI&lt;/i&gt;: 4.3%-12.3%), and 27.1% (95% &lt;i&gt;CI&lt;/i&gt;: 18.0%-36.3%), respectively (&lt;i&gt;P&lt;/i&gt;=0.008). No significant difference in the risk of NRM was observed between the TCI-1 and TCI-2 groups (&lt;i&gt;sHR&lt;/i&gt;=1.106, 95% &lt;i&gt;CI&lt;/i&gt;: 0.371-3.298, &lt;i&gt;P&lt;/i&gt;=0.857), whereas the risk of NRM in the TCI-3 group was significantly higher than that in the TCI-1 (&lt;i&gt;sHR&lt;/i&gt;=4.023, 95% &lt;i&gt;CI&lt;/i&gt;: 1.414-11.452, &lt;i&gt;P&lt;/i&gt;=0.009) and TCI-2 groups (&lt;i&gt;sHR&lt;/i&gt;=3.673, 95% &lt;i&gt;CI&lt;/i&gt;: 1.951-6.912, &lt;i&gt;P&lt;/i&gt;&lt;0.001). The multivariable analysis identified TCI-3, age of ≥50 years, and hematopoietic cell transplantation-comorbidity index score of &gt;2 points as independent risk factors for NRM. After IPTW adjustment, the results remained consistent: the risk of NRM in the TCI-3 group remained significantly higher than that in the TCI-1 (&lt;i&gt;sHR&lt;/i&gt;=6.090) and TCI-2 groups (&lt;i&gt;sHR&lt;/i&gt;=4.562). The comparison of the contribution of NRM to transplant failure across groups at different time points revealed a significantly increased contribution of NRM to transplant failure with increasing conditioning intensity, especially in the TCI-3 group (&lt;i&gt;sHR&lt;/i&gt;=5.011, 95% &lt;i&gt;CI&lt;/i&gt;: 1.118-22.452, &lt;i&gt;P&lt;/i&gt;=0.035). NRM within 3 years posttransplantation accounted for 39.0% of transplant failures. The Kaplan-Meier curve revealed that the 3-year OS rate was the lowest in the TCI-3 group (61.2%, 95% &lt;i&gt;CI&lt;/i&gt;: 51.5%-72.7%). No statistically significant difference in the 3-year cumulative incidence of relapse was observed across the three groups. &lt;b&gt;Conclusion:&lt;/b&gt; High-intensity conditioning failed to translate into a reduction in relapse rate but rather significantly increased the risk of NRM and compromised OS after allo-HSCT. Low- and moderate-intensity co","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"47 3","pages":"218-226"},"PeriodicalIF":0.0,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment practice and outcomes in 125 patients with autoimmune hemolytic anemia: a single-center retrospective analysis].","authors":"F Yang, R N Li, L L Zhang, Z Gao, H Pan, L Z Tian, Y C Shen, W Y Wang, W W Li, J Y Zhao, L Y Li, X Yu, J Xu, C Xu, Y J Liu, W W Wang, Z X Kuang, N Nie, X X Li, J P Li, J B Huang, X Zhao, J Zhang, L W Fang, Y C Luo, J Shi","doi":"10.3760/cma.j.cn121090-20251209-00582","DOIUrl":"10.3760/cma.j.cn121090-20251209-00582","url":null,"abstract":"<p><p><b>Objective:</b> To explore the clinical characteristics, treatment patterns, and outcomes of patients with autoimmune hemolytic anemia (AIHA) in a single-center retrospective cohort. <b>Methods:</b> Clinical data of 125 patients with AIHA admitted to the Blood Diseases Hospital, Chinese Academy of Medical Sciences, between July 2019 and February 2025, were retrospectively analyzed to investigate their clinical characteristics, treatment patterns, and outcomes. <b>Results:</b> Glucocorticoid monotherapy was the most commonly administered first-line treatment, whereas 78.2% of the patients received glucocorticoids in combination with rituximab during the disease course. The overall response rate (ORR) and the sustained remission rate were 61.3% and 10.7% in 75 patients receiving glucocorticoid monotherapy as first-line treatment and 88.0% and 60.0% in 25 patients treated with glucocorticoids plus rituximab, respectively. The median number of treatment lines was two, with approximately one-third of the patients requiring three or more lines of therapy. In the context of clinical research, 27 (21.6%) patients with relapsed/refractory disease received exploratory treatment with novel targeted agents, with a significantly higher median number of treatment lines compared with those who did not [4 (2-12) <i>vs</i> 2 (1-6), <i>P</i><0.001]. After treatment, 44.4% of patients achieved remission, whereas 40.7% of patients had their HGB levels normalized. Regarding complications, venous thromboembolism occurred in 8 patients (6.4%). Further, 36 patients (28.8%) developed infections, with a significantly higher number of treatment lines in the infection group than in the noninfection group (<i>P</i><0.001) . <b>Conclusion:</b> The therapeutic approaches for AIHA demonstrate remarkable heterogeneity. Glucocorticoid monotherapy remains the most commonly administered first-line treatment; however, its ability to maintain sustained remission is limited. Glucocorticoid treatment in combination with rituximab demonstrated a higher ORR and sustained remission rate. Patients who developed infections during the disease course required significantly more lines of therapy, emphasizing the importance of infection prevention and surveillance in clinical practice.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"47 3","pages":"227-233"},"PeriodicalIF":0.0,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Guidelines for the diagnosis and management of first relapsed multiple myeloma in China (2026)].","authors":"","doi":"10.3760/cma.j.cn121090-20251130-00559","DOIUrl":"10.3760/cma.j.cn121090-20251130-00559","url":null,"abstract":"<p><p>Multiple myeloma (MM) remains an incurable malignancy, and treatment choices after the first relapse are crucial for patients' prognosis. Over the past three years, multiple novel drugs for MM have been approved in China. Based on the first edition, this guideline has been updated to introduce the concept of early relapse, especially functional high-risk, and revise the timing of treatment, therapeutic regimens, particularly the selection of immunotherapy, for patients after the first relapse.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"47 3","pages":"201-207"},"PeriodicalIF":0.0,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The influence of different collagenases on the analysis of immune cells in salivary glands of mice with chronic graft-versus-host disease].","authors":"Z Y Hu, Q X Song, S J Yang, J Wei, X Zhang","doi":"10.3760/cma.j.cn121090-20260122-00048","DOIUrl":"10.3760/cma.j.cn121090-20260122-00048","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To preliminarily explore the influence of different collagenases on the analysis of immune cells in salivary glands of mice with chronic graft-versus-host disease (cGVHD) . &lt;b&gt;Methods:&lt;/b&gt; A major histocompatibility complex mismatch model was established (bone marrow: 5×10(6) cells; spleen: 0.25×10(6) cells), including the non-graft-versus-host disease (GVHD) control group (BALB/c to BALB/c, &lt;i&gt;n&lt;/i&gt;=15) and cGVHD group (C57BL/6c to BALB/c, &lt;i&gt;n&lt;/i&gt;=15). Body weight, clinical scores, and survival rates of the mice were observed after transplantation. On day 45 after transplantation, salivary glands were collected (&lt;i&gt;n&lt;/i&gt;=6-12), and hematoxylin and eosin and Masson trichrome staining were performed to assess the degree of injury and fibrosis. Flow cytometry analysis was conducted to compare immune cell populations and phenotypes among samples without collagenase digestion, with collagenase Ⅱ digestion, and with collagenase D digestion. &lt;b&gt;Results:&lt;/b&gt; Compared with the non-GVHD group, mice in the cGVHD group showed significant weight loss [original body weight percentage on day 60 after transplantation: (66.77±11.72) % &lt;i&gt;vs&lt;/i&gt; (101.20±4.19) %, &lt;i&gt;P&lt;/i&gt;&lt;0.0001], higher symptom scores (2.11±0.59 &lt;i&gt;vs&lt;/i&gt; 0±0, &lt;i&gt;P&lt;/i&gt;&lt;0.0001), and significantly lower survival rates (survival rate on day 60 after transplantation: 50% &lt;i&gt;vs&lt;/i&gt; 100%, &lt;i&gt;P&lt;/i&gt;=0.0011). The salivary glands of cGVHD mice showed acinar atrophy, cellular infiltration (3.67±0.52 &lt;i&gt;vs&lt;/i&gt; 2.00±0, &lt;i&gt;P&lt;/i&gt;&lt;0.0001), and fibrosis [ (14.54±4.05) % &lt;i&gt;vs&lt;/i&gt; (4.11±0.87) %, &lt;i&gt;P&lt;/i&gt;=0.0001]. Collagenase digestion significantly increased the yield and viability of mononuclear cells (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Among the tested protocols, digestion with collagenase Ⅱ resulted in the greatest recovery of mononuclear cells (&lt;i&gt;P&lt;/i&gt;&lt;0.01). However, collagenaseⅡdigestion significantly reduced the proportion of CD4(+) T cells [ (5.64±2.05) % &lt;i&gt;vs&lt;/i&gt; (31.98±12.23) %, &lt;i&gt;P&lt;/i&gt;=0.0052], whereas collagenase D had no significant effect on CD4(+) T cells[ (31.51±16.37) % &lt;i&gt;vs&lt;/i&gt; (31.98±12.23) %, &lt;i&gt;P&lt;/i&gt;=0.9973]. In the cGVHD group, the method containing collagenase D recovered more CD4(+) T cells, whereas the method containing collagenase Ⅱ recovered more CD8(+) T cells (all &lt;i&gt;P&lt;/i&gt; value&lt;0.05). In addition, the number of natural killer (NK) cells was significantly increased in both groups after collagenase digestion (all &lt;i&gt;P&lt;/i&gt; value&lt;0.05). Among myeloid cells, collagenaseⅡdigestion significantly reduced the proportion of Ly6C(low)CD11b(+)Ly6G(+) neutrophils [ (0.05±0.01) % &lt;i&gt;vs&lt;/i&gt; (0.34±0.20) %, &lt;i&gt;P&lt;/i&gt;=0.0171], whereas collagenase D had no significant effect [ (0.49±0.19) % &lt;i&gt;vs&lt;/i&gt; (0.34±0.20) %, &lt;i&gt;P&lt;/i&gt;=0.2800]. In cGVHD tissues, the number of CD11b(+)Ly6C(+)Ly6G(-) monocytes rcovered with collagenase D digestion was significantly higher than that recovered with collagenase Ⅱ digestion [ (0.06±0.05) ×10(5) &lt;i&gt;vs&lt;/i&gt; (0.01±0) ×10(5), &lt;i&gt;P&lt;/i&gt;=0.0384], whereas the number of m","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"47 3","pages":"247-254"},"PeriodicalIF":0.0,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13103605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[CAR-T cell therapy bridging to allogeneic hematopoietic stem cell transplantation for diffuse large B-cell Richter syndrome: a case report and literature review].","authors":"Y Wang, N Gao, Z Y Liu, Y Y Dong, X M Qin, X Liu","doi":"10.3760/cma.j.cn121090-20250830-00406","DOIUrl":"10.3760/cma.j.cn121090-20250830-00406","url":null,"abstract":"<p><p>This study aimed to explore the application of CAR-T cell therapy bridging to allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with diffuse large B-cell Richter syndrome, and to review recent advances in the diagnosis, pathogenesis, and treatment of this disease. We retrospectively analyzed the diagnosis and treatment course of one patient diagnosed with Richter syndrome at Binzhou Medical University Hospital and reviewed relevant literature. The patient was a 49-year-old female with a history of chronic lymphocytic leukemia (CLL) for over two years, who presented with a progressively enlarging right neck mass, and was ultimately diagnosed with transformation of CLL into diffuse large B-cell lymphoma (DLBCL) , i.e., Richter syndrome. The patient initially achieved a partial response after three cycles of R-DA-EPOCH combined with zanubrutinib therapy. Following disease progression, the treatment regimen was adjusted to a combination of PD-1 monoclonal antibody, CD20 monoclonal antibody, XPO1 inhibitor, and zanubrutinib for one cycle. This was followed by infusion of autologous anti-CD19 CAR-T cells and subsequent bridging to allo-HSCT. Assessments at 3 and 8 months post-transplantation both demonstrated disease complete remission.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"47 2","pages":"182-185"},"PeriodicalIF":0.0,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Indolent γδT-cell clone in Felty syndrome: a case report and literature review].","authors":"C Wang, M W Fu, G An, W Y Huang, L J Yang","doi":"10.3760/cma.j.cn121090-20250627-00302","DOIUrl":"10.3760/cma.j.cn121090-20250627-00302","url":null,"abstract":"<p><p>The dynamic evolution of indolent γδT-cell clones in Felty syndrome (FS) and their relationship with progressive splenomegaly remain unclear. This paper reports a case of an FS patient followed for ten years. Serial assessments of γδT-cell clone burden, spleen size, and blood cell levels were performed. The results revealed that the γδT-cell clone burden showed minimal fluctuation over the decade, while the spleen demonstrated progressive enlargement, and blood cells progressively decreased. A newly identified nasopharyngeal hypermetabolic lesion (SUVmax 10.7) on PET-CT was pathologically confirmed as reactive plasmacytosis. This study suggests that indolent proliferation of γδT-cell clones may exist in FS, and the mechanism underlying the progression of splenomegaly might be independent of the lymphocyte clone.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"47 2","pages":"186-188"},"PeriodicalIF":0.0,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical characteristics, treatment, and prognosis of double-hit multiple myeloma with concurrent 1q21+ and t (4;14)].","authors":"Y Guo, N Qiao, Y Tao, K M Liu, H Y Ouyang, Y F Liu, Y Wang, W P Zhang, J Q Mi","doi":"10.3760/cma.j.cn121090-20250520-00238","DOIUrl":"10.3760/cma.j.cn121090-20250520-00238","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the clinical characteristics, therapeutic regimens, and prognosis of double-hit multiple myeloma (DHMM) patients with concurrent 1q21 copy number gain (1q21+) and t (4;14) , and to explore effective strategies to improve outcomes of this high-risk subgroup. <b>Methods:</b> A retrospective analysis was performed on 96 newly diagnosed DHMM patients with both 1q21+ and t (4;14) admitted to Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from September 2014 to September 2024. Baseline clinical characteristics, prognosis, and independent prognostic factors were evaluated. A logistic regression model was used to analyze the correlation between induction regimens, autologous hematopoietic stem cell transplantation (auto-HSCT) , and minimal residual disease (MRD) negativity. <b>Results:</b> The median age of the 96 DHMM patients was 62 (range: 36-79) years. Among them, 50 cases (52% ) were at R2-ISS stage Ⅳ, 11 cases (11% ) had concurrent del (17p) , 35 cases (36% ) underwent auto-HSCT, 39 cases (41% ) received triple-agent induction therapy with proteasome inhibitor (PI) , immunomodulatory drug (IMiD) and anti-CD38 monoclonal antibody (CD38Ab) , 25 cases (26% ) achieved MRD-negative complete response (CR) . The clone size of 1q21+ was positively correlated with that of t (4;14) (<i>r</i>=0.46, <i>P</i><0.001) , while the clonal burden of 1q21+ was significantly lower than that of t (4;14) . With a median follow-up of 36 (range: 6-126) months, the median progression-free survival (PFS) was 26 (95% <i>CI</i>: 22-50) months, and the estimated median overall survival (OS) was 4.3 (95% <i>CI</i>: 2.1-6.4) years. Extramedullary relapse occurred in 22 cases (23% ) . Multivariate analysis showed that newly diagnosed extramedullary involvement of soft tissue was an independent risk factor for both PFS and OS (all <i>P</i><0.05) . Del (17p) shortened PFS, whereas MRD negativity significantly prolonged PFS. Both triple-agent induction therapy (PI+IMiD+CD38Ab) and auto-HSCT improved the MRD-negative rate (all <i>P</i><0.05) . <b>Conclusion:</b> DHMM patients with concurrent 1q21+ and t (4;14) exhibit aggressive clinical features and poor prognosis. Triple-agent induction therapy (PI+IMiD+CD38Ab) and auto-HSCT are associated with MRD negativity and improved PFS, but achieving long-term survival remains challenging for these patients.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"47 2","pages":"123-129"},"PeriodicalIF":0.0,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13008560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}