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

{"title":"[Indolent leukemic non-nodal mantle cell lymphoma with TP53 mutation misdiagnosed as chronic lymphocytic leukemia: a case report and literature review].","authors":"T L Qiu, Y P Zhang, Y Wang, Y J Wu, W Y Shi, Y Xia","doi":"10.3760/cma.j.cn121090-20241205-00538","DOIUrl":"10.3760/cma.j.cn121090-20241205-00538","url":null,"abstract":"<p><p>Patients with leukemic non-nodal mantle cell lymphoma (nnMCL) typically exhibit an indolent clinical course, and when asymptomatic and without treatment indications, a watchful observation follow-up can be adopted. This article presents a retrospective summary of a case of nnMCL, misdiagnosed as chronic lymphocytic leukemia (CLL) and carrying a TP53 mutation, along with a literature review. The case highlights the importance of differential diagnosis between nnMCL and CLL, and suggests that for nnMCL patients, the presence of high-risk biological markers such as TP53 mutations does not necessarily indicate an immediate need for treatment; rather, a strict watch-and-wait strategy may be a more appropriate option.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 2","pages":"174-178"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711384","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 study of orelabrutinib combined with R-CHOP regimen for newly diagnosed high-risk non-GCB diffuse large B-cell lymphoma with extranodal involvement].","authors":"B P Guo, M Y Wang, C C Liao, D Zhou, Q Ke, Z Li, H Cen","doi":"10.3760/cma.j.cn121090-20240914-00347","DOIUrl":"10.3760/cma.j.cn121090-20240914-00347","url":null,"abstract":"<p><p><b>Objective:</b> To explore the efficacy and safety of orelabrutinib combined with R-CHOP in patients with high-risk nongerminal center B-cell (non-GCB) diffuse large B-cell lymphoma (DLBCL) with extranodal involvement. <b>Methods:</b> This retrospective study was conducted on 35 patients who were seen at Guangxi Medical University Cancer Hospital and were immunohistochemically confirmed to have non-GCB DLBCL, had an International Prognostic Index score of 3 - 5, and confirmed to have ≥2 extranodal involvement on PET/CT. The treatment comprised the standard R-CHOP regimen combined with oral orelabrutinib (150 mg/day) for six cycles. In patients who developed neutropenia or grade 3 neutropenia with fever during treatment, administration of prophylactic pegylated granulocyte colony-stimulating factor 48 h after the end of chemotherapy was started on the next cycle. The endpoints included overall response rate (ORR), complete response (CR) rate, progression-free survival (PFS) time, overall survival (OS) time, and safety assessment. <b>Results:</b> The 35 eligible patients enrolled had a median age of 53 years (21 - 72 years) and a median follow-up time of 28 months (12 - 36 months) ; 19 patients had double-expressor (DE) status. The ORR was 88.6%, and the CR rate was 68.6%. The 2-year PFS and OS rates were 68.6% (95% <i>CI</i> 54.0% - 7.2%) and 87.5% (95% <i>CI</i> 76.7% - 100%), respectively. The 2-year PFS rate was significantly lower in patients with DE status than in those without DE status [54.4% (95% <i>CI</i> 35.4% - 84.2%) <i>vs</i>. 85.2% (95% <i>CI</i> 68.3% - 100%), <i>P</i>=0.048]. Serious adverse events included febrile neutropenia, pneumonia, and atrial flutter, but no treatment-related deaths. <b>Conclusion:</b> In patients with high-risk non-GCB DLBCL and extranodal involvement, the combination of orelabrutinib with R-CHOP regimen had good efficacy and manageable toxicity.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 2","pages":"169-173"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711394","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 guidelines for diagnosis and treatment of chronic lymphocytic leukemia/small lymphocytic lymphoma in China (2025)].","authors":"","doi":"10.3760/cma.j.cn121090-20241209-00551","DOIUrl":"10.3760/cma.j.cn121090-20241209-00551","url":null,"abstract":"<p><p>Chronic lymphocytic leukemia (CLL) / Small lymphocytic lymphoma (SLL) is a mature B cell neoplasm with specific immunophenotype, mainly occurs in the middle-aged and elderly population. In recent years, there has been significant progress in the basic and clinical research of CLL/SLL, especially in the field of new drug treatments. To improve the diagnostic, differential diagnostic, and standardized treatment levels of CLL/SLL for medical workers in China, Hematological Oncology Committee of China Anti-Cancer Association, Hematology Committee of Chinese Medical Association, Chinese Working Group for Chronic Lymphocytic Leukemia have revised the guidelines for the diagnosis and treatment of Chinese CLL/SLL (2022 edition) and formulated this version of the guidelines.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 2","pages":"105-112"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711472","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":"[Chinese expert consensus on the application of flow cytometry in the diagnosis and detection of minimal residual disease in B-cell non-Hodgkin lymphoma (2025)].","authors":"","doi":"10.3760/cma.j.cn121090-20241124-00476","DOIUrl":"10.3760/cma.j.cn121090-20241124-00476","url":null,"abstract":"<p><p>B-cell non-Hodgkin lymphoma (B-NHL) is made up of multiple subtypes, whose precise diagnosis relies on multidisciplinary collaboration, including pathological morphology, immunohistochemistry, flow cytometry (FCM), cytogenetics, molecular biology, imaging and clinical features. FCM plays an irreplaceable role in the diagnosis of B-NHL and minimal/measurable residual disease (MRD) monitoring due to its unique advantages of simplicity, rapidness, objectivity, high sensitivity, and multi-parameter analysis. With the publication of the 5th edition of the World Health Organization (WHO) Classification of Haematolymphoid Tumours and the International Consensus Classification (ICC), the classification of B-NHL has become more refined, with significant changes in some classification methods and nomenclature. To improve the diagnostic and therapeutic monitoring ability of B-NHL and standardize the diagnosis and treatment procedures of B-NHL in China, the Hematological Oncology Committee of the China Anti-Cancer Association organized relevant domestic experts to develop this expert consensus after multiple discussions. The consensus focuses on the application of FCM in the diagnosis and MRD detection of mature B-NHL including the sources and preparation of samples for FCM, the immunophenotypic characteristics of different subclasses of B-NHL, result analysis and reporting, and quality control.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 2","pages":"113-119"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711378","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":"[Efficacy and safety of PEMD regimen in newly diagnosed early-stage non-upper respiratory digestive tract or advanced extranodal natural killer/T-cell lymphoma].","authors":"X Y Zhang, K X Du, H R Shen, J Z Wu, Y Li, H Yin, L Wang, J H Liang, J Y Li, W Xu","doi":"10.3760/cma.j.cn121090-20241120-00463","DOIUrl":"10.3760/cma.j.cn121090-20241120-00463","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy and safety of the pegaspargase, etoposide, methotrexate, and dexamethasone (PEMD) regimen in patients with early-stage nonupper respiratory digestive tract or advanced extranodal natural killer/T-cell lymphoma (ENKTL) . <b>Methods:</b> This retrospective analysis included 38 patients with newly diagnosed early-stage non-upper respiratory digestive tract or advanced ENKTL who received PEMD regimen for induction chemotherapy at the First Affiliated Hospital of Nanjing Medical University from January 2016 to December 2022. Survival outcomes and prognostic factors were examined by Kaplan-Meier, and the Log-rank test was used to compare survival. <b>Results:</b> The study population had a median age of 48 years (range, 26-72 years) and included 30 males (78.9%) and 8 females (21.1%). 7 patients' age >60 years (18.4%). The Eastern Cooperative Oncology Group (ECOG) performance score was >1 in 7 patients (18.4%) ; 20 patients (52.6%) had elevated lactate dehydrogenase levels; and 37 patients (97.4%) exhibited extranodal involvement. Using the Ann Arbor staging system, 37 patients (97.4%) were classified as stage Ⅲ-Ⅳ. The median number of treatment cycles was 5 (1-6), and the median follow-up duration was 60 months (24 - 101 months). Interim efficacy assessment revealed an overall response rate of 52.7%. At 2 and 4 years, the progression-free survival (PFS) rates were 34.2% (95% <i>CI</i> 22.0%-53.2%) and 25.5% (95% <i>CI</i> 14.7%-44.4%), respectively, and the overall survival rates were 50.0% (95% <i>CI</i> 36.4%-68.7%) and 45.5% (95% <i>CI</i> 31.4%-65.7%), respectively. The risk factors for worse PFS were ECOG performance score >1 [<i>HR</i>=3.711 (95% <i>CI</i> 1.494-9.218), <i>P</i>=0.005]; bone marrow infiltration [<i>HR</i>=2.251 (95% <i>CI</i> 1.026 - 4.938), <i>P</i>=0.043]; and Prognostic Index for Natural Killer/T-Cell Lymphoma score of 3 - 5 [<i>HR</i>=2.350 (95% <i>CI</i> 1.009 - 5.476), <i>P</i>=0.048]. Multivariate analysis identified ECOG performance score >1 as an independent risk factor for PFS [<i>HR</i>=7.971 (95% <i>CI</i> 2.222 - 28.591), <i>P</i>=0.001]. The main adverse effect was anemia in 31 patients (81.6%) . <b>Conclusion:</b> The PEMD regimen was safe and effective for patients with newly diagnosed early-stage non-upper respiratory digestive tract or advanced ENKTL.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 2","pages":"147-151"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711400","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":"[How I treat lymphomas associated with HIV infection].","authors":"Y Liu, C Y Wang","doi":"10.3760/cma.j.cn121090-20241108-00441","DOIUrl":"10.3760/cma.j.cn121090-20241108-00441","url":null,"abstract":"<p><p>The overall incidence of lymphomas associated with HIV infection is low, and only few hematological oncology specialties provide standardized treatment. Newly diagnosed patients with impaired immune function have a high incidence of complications, such as infections during induction chemotherapy, which increases treatment difficulties. For patients with relapse/refractory status, salvage treatment options are extremely limited, because new drug clinical trials are lacking. At present, both domestic and international clinical practices have shown that patients with lymphomas associated with HIV infection can achieve long-term survival after standardized combination antiretroviral therapy (cART) with targeted immunochemotherapy, followed by autologous hematopoietic stem cell transplantation (auto-HSCT) immediately after achieving complete remission. In recent years, some new drugs, such as XPO1 inhibitors, immune checkpoint inhibitors, antibody-drug conjugates (ADC drugs), bispecific antibodies, and small-molecule drugs, have been tentatively incorporated into treatment regimens for patients with lymphomas associated with HIV infection, and preliminary clinical data have been obtained. Based on two patients with lymphomas associated with HIV infection who were admitted to our center, this study proposed a standardized diagnostic and treatment pathway and provided corresponding references for clinicians to apply new drugs. The aim of this study was to promote diagnostic and treatment capabilities and improve the survival and quality of life of patients of lymphomas associated with HIV infection in China.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 2","pages":"120-125"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711404","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":"[A multicenter retrospective clinical study of a simplified comprehensive geriatric assessment system in elderly patients with diffuse large B-cell lymphoma].","authors":"J Y Leng, Y H Cai, X P Ge, N P Zhao, Q Q Su, Z X Jia, J Qian, B Z Li, H Y Hua, X Z Lu, H Y Zhu, J Y Li, W Y Shi","doi":"10.3760/cma.j.cn121090-20241121-00467","DOIUrl":"10.3760/cma.j.cn121090-20241121-00467","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the predictive value of simplified geriatric assessment (sGA) in elderly Chinese patients diagnosed with diffuse large B-cell lymphoma (DLBCL) . <b>Methods:</b> It retrospectively analyzed the relationships of sGA with the clinical characteristics, outcome, and prognosis of 219 patients aged ≥60 years who were newly diagnosed with DLBCL at six hospitals in Jiangsu province between January 2018 and December 2022. <b>Results:</b> The median age of 219 patients was 68 years (60-87 years). According to the sGA system criteria, 101 (46.1%), 103 (47.0%), and 15 (6.8%) elderly patients with DLBCL were categorized as fit, unfit, and frail, respectively. The most common adverse reactions after chemotherapy were hematologic, and the incidence of grade >2 hematologic adverse reactions was similar among the three groups (47.5% <i>vs</i> 41.7% <i>vs</i> 46.7%, respectively; <i>χ</i>(2)=0.712, <i>P</i>=0.700). Compared with the fit and unfit groups, the frail group showed tendencies toward for higher proportions of grade >2 gastrointestinal, pulmonary, and infectious adverse reactions (<i>P</i>>0.05 for all). The fit, unfit, and frail groups had respective remission rates of 74.3%, 46.6%, and 20.0% (<i>χ</i>(2)=25.249, <i>P</i><0.001) ; disease progression rates of 5.9%, 11.7%, and 26.7% (<i>χ</i>(2)=6.763, <i>P</i><0.05) ; 2-year overall survival rates of 92.1% (95% <i>CI</i> 86.6% to 97.9%), 77.6% (95% <i>CI</i> 69.5% to 86.6%), and 70.1% (95% <i>CI</i> 49.4% to 99.6%) (<i>P</i><0.05) ; and 2-year progression-free survival rates of 76.8% (95% <i>CI</i> 67.0% to 84.8%), 69.7% (95% <i>CI</i> 61.8% to 82.0%), and 65.7% (95% <i>CI</i> 53.3% to 100%) (<i>P</i>=0.399) . <b>Conclusion:</b> sGA can effectively predict treatment adverse effects and efficacy, disease progression, and long-term survival in elderly DLBCL.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 2","pages":"126-133"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711370","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":"[Efficacy and safety analysis of venetoclax in combination with multidrug chemotherapy in patients with newly diagnosed acute leukemia of ambiguous lineage].","authors":"T Luo, Y R Fang, W J Liu, Q Sun, P Xu, M Hong, S X Qian","doi":"10.3760/cma.j.cn121090-20240419-00149","DOIUrl":"10.3760/cma.j.cn121090-20240419-00149","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy and safety of venetoclax in combination with multidrug chemotherapy in patients with newly diagnosed acute leukemia of ambiguous lineage (ALAL) . <b>Methods:</b> A retrospective analysis of clinical data was performed on patients with newly diagnosed ALAL who were hospitalized at Jiangsu Provincial People's Hospital from June 2021 to July 2024. Of the 13 patients who received initial induction therapy with venetoclax combined with multidrug chemotherapy, 8 received VAA+P regimen, and 5 received V+IA regimen. Patients with FLT3 mutation were treated with FLT3 inhibitor, and Ph(+) patients received an additional tyrosine kinase inhibitor. Overall survival (OS), disease-free survival (DFS), and adverse events were analyzed. <b>Results:</b> According to the World Health Organization 5th edition of the classification of hematolymphoid tumors, the immunophenotypes were T/myeloid mixed-phenotype acute leukemia (MPAL) (<i>n</i>=4), B/myeloid MPAL (<i>n</i>=7), and ALAL- not otherwise specified (<i>n</i>=2). Of the seven patients with B/myeloid MPAL, four were Ph(+) and belonged to the group with specific gene abnormalities of ALAL. Three patients had FLT3 mutation (one with FLT3-TKD mutation and two with FLT3-ITD mutation). Prior to the second course of consolidation therapy, the efficacy of venetoclax induction therapy was evaluated, and a complete response rate of 100% was achieved in 13 patients. In the subsequent consolidation therapy phase, one patient discontinued treatment and was lost to follow-up; nine patients underwent allogeneic hematopoietic stem cell transplantation, four of whom died due to posttransplant complications and five achieved DFS. Of the three patients (≥70 years old) who received consolidation therapy as before, two achieved DFS and one died due to central nervous system leukemia. The median OS time was not reached in 13 patients; the 75th percentile survival time was 12.0 months, with a 12-month cumulative survival rate of 64.5%. The median DFS time was not reached in all patients; the 75th percentile DFS time was 8.2 months, with a 12-month cumulative DFS rate of 67.1%. All patients experienced grade 3 or 4 hematologic toxicity, including neutropenia and thrombocytopenia, during and after induction therapy. All patients recovered hematopoietic function after the initial induction therapy, with no fatal hemorrhage, tumor lysis syndrome, neurological adverse events, or grade 3 or higher organ toxicity, excluding preexisting conditions. <b>Conclusion:</b> Venetoclax in combination with multidrug chemotherapy was effective and associated with tolerable adverse reactions in patients with newly diagnosed ALAL.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 2","pages":"161-168"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711397","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":"[Mechanism of BIM-induced ibrutinib resistance in chronic lymphocytic leukemia].","authors":"J L Zhang, B H Pan, J Z Wu, Y L Kong, L Wang, W Xu","doi":"10.3760/cma.j.cn121090-20241121-00466","DOIUrl":"10.3760/cma.j.cn121090-20241121-00466","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the relationship between the BCL2 family protein BIM and ibrutinib resistance in chronic lymphocytic leukemia (CLL) and to analyze its regulatory mechanisms on apoptosis and autophagy. <b>Methods:</b> RNA sequencing (RNA-seq) was used to examine changes in the expression of BCL2 family proteins in samples from patients with CLL, MEC1 cell lines, and ibrutinib-resistant cell lines (MR). Western blot was used to analyze changes in BIM protein expression during apoptosis in MR. shRNA knockdown was used to assess the effects of BIM on cell proliferation and apoptosis. RNA-seq and the autophagy inhibitor chloroquine treatment were used to study autophagy-related changes in MR. <b>Results:</b> BIM expression was significantly downregulated before and after drug resistance in CLL primary cells and MEC1 cell lines (<i>P</i><0.0001). Knockdown of BIM in CLL cells inhibited ibrutinib-induced apoptosis and promoted cell proliferation (<i>P</i><0.05 for both). In addition, protective autophagy was increased in MR and apoptosis was increased after administration of chloroquine and small interfering RNA. The increased expression of LC3-Ⅱ protein in BIM-knockdown cell lines (<i>P</i><0.01) suggested that reduction of BIM may mediate autophagy activation. <b>Conclusion:</b> Downregulation of BIM may be a key factor in promoting ibrutinib resistance in CLL by activating protective autophagy. These findings provided a potential target for improving CLL treatment.</p>","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 2","pages":"152-160"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711390","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":"[Rituximab combined with intensive immunochemotherapy for sporadic adult Burkitt lymphoma: efficacy and prognosis analyse].","authors":"C M Dong, H S Zou, W Zhang, W Liu, Y Wang, H M Liu, T Xie, H Li, Q Wang, W Y Huang, S H Yi, G An, L G Qiu, D H Zou","doi":"10.3760/cma.j.cn121090-20241130-00505","DOIUrl":"10.3760/cma.j.cn121090-20241130-00505","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the therapeutic efficacy and prognostic factors of combined rituximab and intensive chemotherapy for sporadic adult Burkitt lymphoma (BL) . &lt;b&gt;Methods:&lt;/b&gt; This retrospective study examined the clinical and survival data of 30 patients newly diagnosed with BL between July 2011 and February 2023 at the Blood Diseases Hospital. Kaplan-Meier method was used for survival analysis, and the log-rank test was used for univariate analysis of prognostic factors. &lt;b&gt;Results:&lt;/b&gt; The median age of the 30 patients was 43 years (24 - 66 years), and the male to female ratio was 3: 2. Extranodal invasion was present in 80% of the patients, with involvement of the bone marrow in 53.3% and central nervous system in 10.0%. The Ann Arbor stage was Ⅲ and Ⅳ in 86.7%. According to the number of Burkitt Lymphoma International Prognostic Index (BL-IPI) risk factors, patients were classified as low risk (0) in 20.0%, intermediate risk (1) in 43.3%, and high risk (≥2) in 36.7%. All patients were treated with an induction regimen of rituximab combined with intensive chemotherapy, with objective and complete response rates of 80.0% and 76.7%, respectively. The median follow-up was 49 months (6-153 months), and the 5-year progression-free survival (PFS) and overall survival (OS) rates were both (76.7±7.7) %. All patients with limited stage (&lt;i&gt;n&lt;/i&gt;=4) achieved continuous complete remission (CCR). Patients who had high risk, advanced stage sensitive to induction therapy (&lt;i&gt;n&lt;/i&gt;=10) sequentially received first-line autologous hematopoietic stem cell transplantation (auto-HSCT) as consolidation therapy; 9 patients achieved CCR, whereas 1 patient with central nervous system invasion developed early disease progression and died. The BL-IPI low, intermediate, and high risk groups had respective 5-year PFS rates of (83.3±15.2) %, 100.0%, and (45.5±15.0) % (&lt;i&gt;P&lt;/i&gt;=0.0069) and OS rates of (83.3±15.2) %, 100.0%, and (45.5±15.0) % (&lt;i&gt;P&lt;/i&gt;=0.0075). The main adverse effects of induction therapy were myelosuppression and secondary infections, which were effectively managed by appropriate symptomatic treatment. Univariate analysis demonstrated that worse PFS was associated with BL-IPI score ≥2 (&lt;i&gt;HR&lt;/i&gt;=4.90, 95% &lt;i&gt;CI&lt;/i&gt; 1.02-23.45, &lt;i&gt;P&lt;/i&gt;=0.0329) ; extranodal invasion at ≥2 sites (&lt;i&gt;HR&lt;/i&gt;=12.62, 95% &lt;i&gt;CI&lt;/i&gt; 2.59-61.62, &lt;i&gt;P&lt;/i&gt;=0.0021) ; and failure to achieve first complete response (CR1) after induction therapy (&lt;i&gt;HR&lt;/i&gt;=31.86, 95% &lt;i&gt;CI&lt;/i&gt; 4.19-242.20, &lt;i&gt;P&lt;/i&gt;&lt;0.0001) . &lt;b&gt;Conclusions:&lt;/b&gt; Intensive immunochemotherapy regimens were effective and well-tolerated by adult patients with highly aggressive BL. Treatment efficacy was ideal in patients with limited-stage disease, whereas prognosis was unsatisfactory in patients with high-risk BL-IPI. Sequential first-line auto-HSCT consolidation therapy may further improve outcomes in patients with high-risk advanced-stage disease who are sensitive to induction therapy. BL-IPI score ≥2, ext","PeriodicalId":24016,"journal":{"name":"Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi","volume":"46 2","pages":"134-139"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711471","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}