Case Reports in Hematology最新文献

{"title":"Concurrent Brucellosis and Acute Lymphoblastic Leukemia: A Case Report.","authors":"Parisa Bahramian, Marziyeh Ghalamkari, Mahdi Khatuni, Saeed Kalantari, Behnaz Varaminian","doi":"10.1155/crh/1752123","DOIUrl":"10.1155/crh/1752123","url":null,"abstract":"<p><strong>Introduction: </strong>Acute lymphoblastic leukemia (ALL) is a rare hematologic malignancy that leads to significant qualitative and quantitative lymphocyte deficits. These immunological gaps predispose patients to various bacterial and opportunistic infections. Brucellosis, an intracellular infection endemic in many regions including Iran, presents with nonspecific symptoms such as prolonged fever, malaise, and organomegaly, which closely mimic the clinical manifestations of leukemia. Their co-occurrence, even in brucellosis-endemic areas, is actually rare. In addition, their similarity in clinical presentation can result in diagnostic delay or misdiagnosis.</p><p><strong>Case presentation: </strong>A 47-year-old male shepherd from an endemic region in Iran presented with a 1-month history of progressive weight loss, fever (38.4°C), and muscle cramps. Initial physical examination revealed pallor and tachycardia without lymphadenopathy. Laboratory investigations showed severe leukocytosis (103 × 10³/μL) and elevated lactate dehydrogenase (1190 U/L). Although initial serological tests for brucellosis (Wright and 2-ME) were negative, bone marrow aspiration and flow cytometry confirmed B-cell ALL. Cytogenetic analysis identified the Philadelphia chromosome (<i>t</i> (9; 22), p210 transcript). The patient began induction chemotherapy with the hyper-CVAD regimen combined with dasatinib. Despite hematological improvement, persistent fever and diaphoresis prompted a re-evaluation for infectious etiologies. Repeated brucellosis testing yielded strongly positive results (Wright 1/320 and 2-ME 1/640), suggesting a potential prozone effect in initial tests or recent acquisition. Antibiotic therapy with rifampin and doxycycline was integrated into the oncological protocol. The patient showed rapid clinical improvement within 1 week and subsequently achieved complete remission, which was maintained throughout a 2-year follow-up.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering brucellosis in the differential diagnosis of febrile patients with hematologic malignancies in endemic areas. Overlapping symptoms can lead to diagnostic delays. It is crucial to repeat serological tests or use serial dilutions to circumvent the prozone effect when clinical suspicion persists in immunocompromised patients.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2026 ","pages":"1752123"},"PeriodicalIF":0.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413325","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":"Case of Myelodysplastic Syndrome 15 Years After Kidney Transplantation Under Long-Term Immunosuppression.","authors":"Shuai Su, Sijia Yan, Liting Chen, Yi Xiao","doi":"10.1155/crh/1471228","DOIUrl":"10.1155/crh/1471228","url":null,"abstract":"<p><p>In solid organ transplant recipients receiving long-term immunosuppression, persistent or progressive pancytopenia is often initially attributed to infections or drug toxicity, thereby potentially delaying the recognition of clonal myeloid disorders and germline predispositions. We report the case of a kidney transplant recipient who had predominantly maintained tacrolimus-based immunosuppression and presented with progressive pancytopenia and marked reticulocytopenia. Bone marrow evaluation revealed severe hypocellularity with suppression of granulopoiesis and erythropoiesis, as well as prominent dysmegakaryopoiesis. Flow cytometry showed a small population of immunophenotypically aberrant myeloid blasts, supporting a diagnosis of hypocellular myelodysplastic syndrome. Myeloid gene next-generation sequencing detected a FANCA missense variant (c.3630C > A; p.F1210L; variant allele frequency 47.2%), prompting consideration of germline-associated marrow failure or genetic susceptibility and the need for confirmatory testing in nonhematopoietic tissues. During hospitalization, the patient developed severe opportunistic infections that rapidly progressed to respiratory failure and hemodynamic instability. This case highlights the need for early marrow evaluation and genetic risk stratification in transplant recipients with unexplained cytopenia and for the dynamic balancing of hematopoietic rescue against preservation of allograft function to reduce diagnostic delays and subsequent complications.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2026 ","pages":"1471228"},"PeriodicalIF":0.7,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391994","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":"Unmasking Evans Syndrome: A Case of New Onset Anemia and Thrombocytopenia in a Pregnant Patient With Systemic Lupus Erythematosus.","authors":"Christian Bittner, Niels A Ryden, Charles Jacocks, Chung-Ting J Kou","doi":"10.1155/crh/9110168","DOIUrl":"10.1155/crh/9110168","url":null,"abstract":"<p><p>Evans Syndrome (ES) is an immune-mediated disorder defined by the presence of two or more autoimmune cytopenias, typically autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP), with or without associated neutropenia. The disease can be classified as primary (i.e., idiopathic) or secondary to other underlying conditions, such as systemic lupus erythematosus (SLE), lymphoproliferative disorders, infections, and immunodeficiency states. We present a case of ES in a 21-year-old pregnant woman (G1P0, 19 weeks and 2 days gestation) secondary to SLE. The patient was treated with high-dose steroids and intravenous immunoglobulin therapy (IVIG), resulting in marked improvement in her cell counts. Following delivery, she was diagnosed with SLE and began treatment with rituximab and hydroxychloroquine, leading to remission of her symptoms and normalization of her anemia and thrombocytopenia. The varied presentations and associated conditions make ES a challenging diagnostic conundrum. Differentiating between primary and secondary ES is crucial for prognosis and management.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2026 ","pages":"9110168"},"PeriodicalIF":0.7,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376394","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":"Extranodal Nasal Type NK/T-Cell Lymphoma of the Transverse Colon With Gastrointestinal Perforation in a 15-Year-Old: Durable Remission With Modified SMILE Chemotherapy and HSCT.","authors":"Devon D Christoffel, Ingrid S Tam, Kris Milbrandt, Yue Wu, Rupesh Chawla, Victor A Lewis, Paul R D'Alessandro","doi":"10.1155/crh/5148970","DOIUrl":"10.1155/crh/5148970","url":null,"abstract":"<p><p>NK/T-cell lymphoma (NKTCL) is an aggressive lymphoma associated with Epstein-Barr virus (EBV), with higher incidence in Asian populations. Typically, patients present in their fifth decade with extranodal disease in the upper aerodigestive tract. Pediatric NKTCL is rare, with no established pediatric standard of care treatment. We describe the case of a healthy 15-year-old Filipino-Canadian male who presented with transverse colon perforation and was diagnosed with extranodal EBV + nasal type NKTCL of the gastrointestinal (GI) tract. After a complicated initial surgical course, we elected to treat him using six cycles of modified SMILE (dexamethasone, PEG-asparaginase, ifosfamide, and etoposide) chemotherapy and consolidative hematopoietic stem cell transplant (HSCT). The post-HSCT course involved cytomegalovirus reactivation (buccal lesions, viremia); adenovirus reactivation (positive nasal swab, viremia); zoster reactivation; acute and chronic oral/upper GI graft-versus-host disease (GVHD); chronic skin GVHD (vitiligo); and avascular necrosis. At the most recent follow-up, surveillance imaging and investigations at 2 years post-transplant showed durable CR1 and 100% donor chimerism. To our knowledge, this is the fourth reported case of primary GI NKTCL in a pediatric/adolescent patient; the only patient treated with an asparaginase-containing regimen; and the only patient to undergo consolidative HSCT. Our patient's outcome supports the utilization of an aggressive approach to treat GI NKTCL in young, fit patients similar to Stage III/VI nasal NKTCL. Our case also highlights unique treatment considerations for adolescent cancer patients, including delayed diagnoses and lack of standardized protocols.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2026 ","pages":"5148970"},"PeriodicalIF":0.7,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377642","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":"Molecular Relapse After a Second Treatment-Free Remission Attempt Following Asciminib in Chronic Myeloid Leukemia: A Case Report.","authors":"Nobue Sato, Ryo Yoshimaru, Yong-Mei Guo, Hirotaka Nakamura, Kensuke Matsuda, Yosuke Minami, Junichiro Yuda","doi":"10.1155/crh/1621284","DOIUrl":"10.1155/crh/1621284","url":null,"abstract":"<p><p>Treatment-free remission (TFR) has become an important therapeutic goal in chronic myeloid leukemia (CML). Although the outcomes of TFR following adenosine triphosphate (ATP)-competitive tyrosine kinase inhibitors (TKIs) have been established, data on TFR after asciminib discontinuation remain limited. In this study, we report the case of a man in his 60s with chronic-phase CML who experienced molecular relapse 8 months after a second TFR attempt following asciminib treatment. The patient was diagnosed with CML approximately 15 years earlier and achieved deep molecular response 4.5 (MR4.5), representing a 4.5-log reduction in <i>BCR::ABL1</i> transcripts, with first-line imatinib. After the first TFR attempt, major molecular response (MMR) was lost, and ponatinib was initiated but discontinued because of cerebral infarction. Asciminib was subsequently introduced as third-line therapy at a dose of 40 mg twice daily, and <i>BCR::ABL1</i> transcripts remained undetectable for more than 3 years. Based on the sustained deep molecular response and patient preference, asciminib was discontinued. Eight months after discontinuation, however, loss of MR4.0 (BCR::ABL1 > 0.01% IS) was detected. This threshold was used to guide treatment reinitiation, rather than waiting for loss of MMR as recommended by the ELN guidelines, in the view of the clinical context of a second TFR attempt following prior failure. Imatinib was reintroduced, leading to the reachievement of a deep molecular response. This case underscores the importance of careful patient selection and long-term molecular monitoring following TFR attempts, including those involving novel TKIs such as asciminib.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2026 ","pages":"1621284"},"PeriodicalIF":0.7,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346950","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":"Common Clonal Origin of Core-Binding-Factor AML in Both Donor and Recipient Following Kidney Transplantation.","authors":"F E M In 't Hout, M Roerink, R J Maas, K M Hebeda, B A van der Reijden, W J F M van der Velden, S M C Langemeijer","doi":"10.1155/crh/5549699","DOIUrl":"10.1155/crh/5549699","url":null,"abstract":"<p><p>Kidney transplant recipients are at higher risk of developing malignancies compared with the general population, which are mostly recipient in origin¹. We describe a patient who developed a donor-derived acute myeloid leukemia (AML) five years after kidney transplantation. His donor developed AML four years earlier, providing proof of transmission of leukemia-initiating cells in solid organ transplant (SOT).</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2026 ","pages":"5549699"},"PeriodicalIF":0.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346838","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":"T-Cell Lymphoma With Sarcoid-Like Reaction and Secondary Myelofibrosis: A Unique Case Report and Literature Review.","authors":"Renee Morecroft, Azalfa Lateef, Joseph Brandon Parker, Rachel Sauls, Jordan Phillipps, Patricia Chipi, Emily Wolf, Candido Rivera, Kirk Bourgeois, Benjamin Wang, Vikas Majithia, Sehreen Mumtaz","doi":"10.1155/crh/6857208","DOIUrl":"10.1155/crh/6857208","url":null,"abstract":"<p><strong>Introduction: </strong>T-cell lymphomas are rare, comprising 10%-15% of non-Hodgkin lymphomas (NHLs). Their etiology remains unclear, and pathophysiology varies widely among subtypes. Sarcoid-like reactions (SLRs) have been reported in approximately 7.3% of NHLs, including T-cell lymphomas, and can closely resemble sarcoidosis clinically/histologically. This overlap complicates diagnosis, particularly when secondary myelofibrosis-a rare and poorly understood complication-arises. Myelofibrosis has also been observed in sarcoidosis, further blurring the distinction between these entities. Treatment for T-cell lymphoma-associated secondary myelofibrosis is not standardized, with predominantly CHOP-based regimens showing variable efficacy. This warrants further research to guide diagnostic and management frameworks.</p><p><strong>Case description: </strong>We report the case of a 57-year-old male with known systemic sarcoidosis who developed recurrent symptomatic hypercalcemia and new-onset transfusion-dependent pancytopenia. Initial evaluation revealed bone marrow fibrosis with noncaseating granulomas, raising concern for sarcoidosis-driven secondary myelofibrosis. However, repeat bone marrow biopsy demonstrated T-cell lymphoma with a SLR. Primary myelofibrosis was excluded, supporting a secondary lymphoma-driven process. The patient is currently undergoing treatment with BV-CHP with close hematologic monitoring.</p><p><strong>Conclusion: </strong>T-cell lymphoma-associated SLR can closely mimic sarcoidosis and should be considered in the differential, particularly in patients with atypical presentations or cytopenias. Despite similar clinical and histological features, the underlying pathophysiology differs, necessitating thorough molecular and immunophenotypic evaluation. Though rare, this entity can lead to secondary myelofibrosis, underscoring the importance of excluding a primary myeloproliferative process. Further research is needed to define optimal therapy, with BV-CHP representing a promising option in the evolving landscape of T-cell lymphoma management.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2026 ","pages":"6857208"},"PeriodicalIF":0.7,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333548","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":"Ivermectin Treatment for <i>Strongyloides stercoralis-</i>Associated Recurrence of Nongastric MALT Lymphoma.","authors":"Ani Misirian, Cameron M Quon, Michael Maranzano, Eric Tam","doi":"10.1155/crh/7226796","DOIUrl":"10.1155/crh/7226796","url":null,"abstract":"<p><p>A healthy 64-year-old male originally from Peru presented with fever and abdominal pain and was successfully treated for <i>Campylobacter</i> colitis. An interval colonoscopy revealed mucosa-associated lymphoid tissue (MALT) lymphoma initially in remission after four doses of rituximab and radiation with 24 Gy in 12 fractions. Two years after treatment, his symptoms returned, with a workup revealing recurrence of his MALT lymphoma. Biopsies revealed an underlying duodenal <i>Strongyloides</i> infection. In lieu of systemic chemotherapy, the patient was treated with oral ivermectin, which resulted in a complete response. MALT lymphoma is an indolent malignancy that can respond to treatment of an underlying infectious cause, and clinicians should be mindful of broad infectious etiologies, especially in immigrant populations.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2026 ","pages":"7226796"},"PeriodicalIF":0.7,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296725","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 Challenge of Differentiating Mixed Histiocytosis: A Case Report.","authors":"Lydia Harris, Rosalia Arnolda, David Ogburn, Padmaja Mallidi","doi":"10.1155/crh/7099157","DOIUrl":"10.1155/crh/7099157","url":null,"abstract":"<p><p>Langerhans cell histiocytosis (LCH) and Erdheim-Chester Disease (ECD) are two forms of histiocytic disease with some overlapping features. They can have multisystem involvement, which makes it a diagnostic challenge. In this report, we present a patient who was diagnosed with both LCH and ECD over the span of 7 years. A 69-year-old female with a past medical history of hypertension, hyperlipidemia, and diabetes mellitus presented with right ear pressure and was subsequently diagnosed with LCH after a mastoid bone biopsy in 2017. She then underwent mass resection. Two years later, during an abdominal MRI for evaluation of cholestatic disease, a large pericardial effusion with pericardial thinning was discovered. Cardiac MRI was concerning for a soft tissue mass anterior and superior to the right atrium, suggestive of infiltrative processes such as histiocytosis. Seven years after the initial presentation, she underwent a pericardial biopsy that diagnosed ECD. It is important to recognize that even though mixed disease is rare, clinical suspicion needs to be high. This is particularly true for patients with cardiac features that would be atypical in LCH to ensure prompt treatment.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2026 ","pages":"7099157"},"PeriodicalIF":0.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13277757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148296679","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":"Synchronous Presentation of Chronic Myelomonocytic Leukemia and Multiple Myeloma in a Treatment-Naïve Patient.","authors":"Moutaz W Sweileh, Naim Qamhia, Amal Batta, Hisham Asaad, Razan Yousef Odeh, Mamoun Swaileh","doi":"10.1155/crh/5531249","DOIUrl":"10.1155/crh/5531249","url":null,"abstract":"<p><strong>Background: </strong>Chronic myelomonocytic leukemia (CMML) is a clonal myelodysplastic/myeloproliferative neoplasm characterized by persistent peripheral blood monocytosis and dysplastic bone marrow morphology. Multiple myeloma (MM) is a plasma cell malignancy defined by clonal plasma cell proliferation and myeloma-defining events. The synchronous occurrence of CMML and MM is exceptionally rare, particularly in treatment-naïve and relatively young patients.</p><p><strong>Case presentation: </strong>We present a 42-year-old-male presenting with progressive fatigue and leukocytosis. Laboratory evaluation revealed marked absolute monocytosis (16.4 × 10⁹/L), anemia, and neutropenia. Bone marrow examination demonstrated an expanded abnormal monocytic population, further confirmed by multiparametric flow cytometry. Conventional cytogenetic analysis revealed monosomy 7, supporting the presence of a clonal myeloid neoplasm consistent with CMML. Concurrently, bone marrow biopsy showed 10%-15% plasma cells. Serum protein electrophoresis identified an IgG kappa monoclonal paraprotein (3.5 g/dL), and imaging showed a lytic bone lesion and biopsy-provided extramedullary plasmacytoma, meeting the diagnostic criteria of symptomatic MM. The patient has no prior exposure to cytotoxic therapy. He received one cycle of azacitidine with subsequent worsening cytopenias, underscoring therapeutic complexity.</p><p><strong>Conclusions: </strong>This case describes a rare concurrent presentation of CMML and MM in a young, treatment-naïve patient. The combination of persistent monocytosis, dysplastic marrow findings, and monosomy 7 supported the presence of clonal myeloid process coexisting with plasma cell myeloma. Recognizing concurrent hematologic malignancies is essential, as diagnostic overlap and treatment interactions present substantial management challenges. Additional molecular characterization of similar cases may elucidate potential pathogenetic connections and guide tailored therapeutic approaches.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":"2026 ","pages":"5531249"},"PeriodicalIF":0.7,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253761","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}