{"title":"Comparable outcomes with low-dose and standard-dose horse anti-thymocyte globulin in the treatment of severe aplastic anemia.","authors":"Arihant Jain, Aditya Jandial, Thenmozhi Mani, Kamal Kishore, Charanpreet Singh, Deepesh Lad, Gaurav Prakash, Alka Khadwal, Reena Das, Neelam Varma, Subhash Varma, Pankaj Malhotra","doi":"10.1007/s44313-024-00003-z","DOIUrl":"10.1007/s44313-024-00003-z","url":null,"abstract":"<p><strong>Background: </strong>The standard dose (SD) of horse anti-thymocyte globulin (hATG) ATGAM (Pfizer, USA) or its biosimilar thymogam (Bharat Serum, India) for the treatment of Aplastic Anemia (AA) is 40 mg/kg/day for 4 days in combination with cyclosporine. Data on the impact of hATG dose on long-term outcomes are limited. Here, we describe our comparative experience using 25 mg/kg/day (low-dose [LD]) hATG for 4 days with SD for the treatment of AA.</p><p><strong>Methods: </strong>We retrospectively studied patients with AA (age > 12 years) who received two doses of hATG combined with cyclosporine. Among 93 AA patients who received hATG, 62 (66.7%) and 31 (33.3%) patients received LD and SD hATG with cyclosporine, respectively. Among these,seventeen(18.2%) patients also received eltrombopag with hATG and cyclosporine. Overall response rates [complete response (CR) and partial response (PR)] of LD and SD hATG groups at 3 months (50% vs. 48.4%; p = 0.88), 6 months (63.8% vs. 71.4%; p = 0.67), and 12 months (69.6% vs. 79.2%; p = 0.167) were comparable. The mean (Standard Deviation) 5-year Kaplan-Meier estimate of overall survival and event-free survival was 82.1 (4.6)% and 70.9 (5.5)% for the study population. The mean (standard deviation) 5-year Kaplan-Meier estimate of overall survival and event-free survival of those who received LD hATG versus SD hATG dose was 82.9 (5·3)% versus 74.8 (10·3)% (P = 0·439), and 75.2 (6.2)% versus 61.4(11.2)% (P = 0·441).</p><p><strong>Conclusion: </strong>Our study revealed that the response rates of patients with AA and LD were similar to those of patients with SD to hATG combined with cyclosporine in a real-world setting.</p>","PeriodicalId":46224,"journal":{"name":"Blood Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132789","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}
Blood ResearchPub Date : 2024-02-26DOI: 10.1007/s44313-024-00009-7
Hye Won Lee, Ja Young Lee
{"title":"Peripheral T-cell lymphoma, NOS in bone marrow and heart.","authors":"Hye Won Lee, Ja Young Lee","doi":"10.1007/s44313-024-00009-7","DOIUrl":"10.1007/s44313-024-00009-7","url":null,"abstract":"","PeriodicalId":46224,"journal":{"name":"Blood Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10917705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132791","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":"Adding MYC/BCL2 double expression to NCCN-IPI may not improve prognostic value to an acceptable level.","authors":"Naree Warnnissorn, Nonglak Kanitsap, Pimjai Niparuck, Paisarn Boonsakan, Prapasri Kulalert, Wasithep Limvorapitak, Lantarima Bhoopat, Supawee Saengboon, Chinnawut Suriyonplengsaeng, Pichika Chantrathammachart, Teeraya Puavilai, Suporn Chuncharunee","doi":"10.1007/s44313-024-00006-w","DOIUrl":"10.1007/s44313-024-00006-w","url":null,"abstract":"<p><strong>Background: </strong>MYC/BCL2 double expression (DE) is associated with poor prognosis in patients with diffuse large B-cell lymphoma (DLBCL) receiving rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). This study aimed to determine whether the addition of DE to the National Comprehensive Cancer Network Internal Prognostic Index (NCCN-IPI) could improve the prediction of disease progression in patients with DLBCL treated with R-CHOP.</p><p><strong>Methods: </strong>This confirmatory prognostic factor study retrospectively recruited patients with newly diagnosed DLBCL between January 1, 2014, and January 31, 2018, at Ramathibodi Hospital (RA) and Thammasat University Hospital (TU). The follow-up period ended on July 1, 2022. Tumors expressing MYC ≥ 40% and BCL2 ≥ 50% were classified as DE. We calculated the hazard ratios (HR) for progression-free survival (PFS) from the date of diagnosis to refractory disease, relapse, or death. Discrimination of the 5-year prediction was based on Cox models using Harrell's concordance index (c-index).</p><p><strong>Results: </strong>A total of 111 patients had DE (39%), NCCN-IPI (8%), and disease progression (46%). The NCCN-IPI adjusted HR of DE was 1.6 (95% confidence interval [CI]: 0.9-2.8; P = 0.117). The baseline NCCN-IPI c-index was 0.63. Adding DE to the NCCN-IPI slightly increased Harrell's concordance index (c-index) to 0.66 (P = 0.119).</p><p><strong>Conclusions: </strong>Adding DE to the NCCN-IPI may not improve the prognostic value to an acceptable level in resource-limited settings. Multiple independent confirmatory studies from a large cohort of lymphoma registries have provided additional evidence for the clinical utility of DE.</p>","PeriodicalId":46224,"journal":{"name":"Blood Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10903517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132846","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}
Blood ResearchPub Date : 2024-02-19DOI: 10.1007/s44313-024-00002-0
Saba Manoochehrabadi, Morteza Talebi, H. Pashaiefar, S. Ghafouri-Fard, Mohammad Vaezi, M. Omrani, M. Ahmadvand
{"title":"Upregulation of lnc-FOXD2-AS1, CDC45, and CDK1 in patients with primary non-M3 AML is associated with a worse prognosis","authors":"Saba Manoochehrabadi, Morteza Talebi, H. Pashaiefar, S. Ghafouri-Fard, Mohammad Vaezi, M. Omrani, M. Ahmadvand","doi":"10.1007/s44313-024-00002-0","DOIUrl":"https://doi.org/10.1007/s44313-024-00002-0","url":null,"abstract":"","PeriodicalId":46224,"journal":{"name":"Blood Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139958526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Blood ResearchPub Date : 2023-12-31Epub Date: 2023-11-06DOI: 10.5045/br.2023.2023152
Jung Hwan Lee, Hee Young Ju, Ju Kyung Hyun, So Jin Kim, Hee Won Cho, Jae Kyung Lee, Ji Won Lee, Ki Woong Sung, Keon Hee Yoo
{"title":"Treatment outcome and prognostic factors in relapsed pediatric acute myeloid leukemia.","authors":"Jung Hwan Lee, Hee Young Ju, Ju Kyung Hyun, So Jin Kim, Hee Won Cho, Jae Kyung Lee, Ji Won Lee, Ki Woong Sung, Keon Hee Yoo","doi":"10.5045/br.2023.2023152","DOIUrl":"10.5045/br.2023.2023152","url":null,"abstract":"<p><strong>Background: </strong>Despite improved outcomes for pediatric patients with acute myeloid leukemia (AML), the prognosis for relapse remains poor. This study aimed to examine the clinical factors associated with prognosis in relapsed pediatric AML.</p><p><strong>Methods: </strong>We conducted a chart review of pediatric patients with AML who experienced their first relapse and received treatment at our institution between 2008 and 2019. Risk stratification at diagnosis was performed according to the definition suggested by the ongoing AML 2012 study in Korea, and the clinical factors associated with prognosis were analyzed.</p><p><strong>Results: </strong>A total of 27 pediatric patients with relapsed AML were identified. The 5-year overall survival (OS) and event-free survival (EFS) rates were 32.9% and 32.9%, respectively. A duration ≥12 months from diagnosis to relapse had a favorable impact on survival outcomes (5-yr OS, 64.0% vs. 15.7%; <i>P</i>=0.007). Patients who achieved complete remission (CR) after 1 course of chemotherapy following relapse (N=15) had a 5-year OS rate of 59.3%, while none of the other patients survived (<i>P</i><0.0001). Additionally, the 5-year OS differed significantly based on the risk group at initial diagnosis (62.3% [favorable and intermediate prognosis groups, N=11] vs. 13.3% [poor prognosis group, N=15]; <i>P</i>=0.014).</p><p><strong>Conclusion: </strong>Patients with a longer duration of CR before relapse, who achieved CR following 1 course of reinduction chemotherapy, and were in the favorable or intermediate prognosis group at diagnosis demonstrated better outcomes. These findings emphasize the importance of tailoring treatment strategies based on the expected prognosis at relapse in pediatric patients with AML.</p>","PeriodicalId":46224,"journal":{"name":"Blood Research","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10758629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487239","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}