Lancet Haematology最新文献

{"title":"High time for risk-adapted treatment in mantle cell lymphoma.","authors":"Ingrid Glimelius, Anna Nikkarinen, Leo Meriranta, Simon Husby, Christiane Pott","doi":"10.1016/S2352-3026(26)00127-4","DOIUrl":"https://doi.org/10.1016/S2352-3026(26)00127-4","url":null,"abstract":"<p><p>Mantle cell lymphoma has multiple treatment options, yet the disease is difficult to cure. Relapses are common, treatments can cause severe side-effects, and current recommendations are still largely based on age rather than biology. Although suitability for intensive treatment was previously the decisive parameter, increasing knowledge on the biology of mantle cell lymphoma and less toxic targeted therapies has made non-risk adapted treatments outdated. TP53 mutations or deletions, blastoid histology, and a high Ki-67 proliferation index consistently identify patients at high risk of relapse. Additionally, positive measurable residual disease serves as a powerful surrogate endpoint to identify patients with an inadequate treatment response who might benefit from treatment modification. Similarly, markers of indolent mantle cell lymphoma, toxicity, and tolerability need to be further refined and might permit chemotherapy-free approaches. We outline future initiatives aimed at refining risk stratification, harmonising treatment, and integrating multiparameter biomarkers to improve prognosis and provide the biological rational for combination strategies. These efforts are essential to accelerate the translation of biological insights into clinical practice.</p>","PeriodicalId":48726,"journal":{"name":"Lancet Haematology","volume":" ","pages":""},"PeriodicalIF":20.4,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epcoritamab with rituximab and lenalidomide as first-line treatment for follicular lymphoma (EPCORE NHL-2): an open-label, multicentre, phase 1/2 b trial.","authors":"Lorenzo Falchi, Joost S P Vermaat, Joshua D Brody, Lori Leslie, Fritz Offner, Jacob Haaber Christensen, Marcel Nijland, David Belada, Björn Engelbrekt Wahlin, Kristina Drott, Pilar Gomez Prieto, Kateřina Kopečkova, Alejandro Martín García-Sancho, Jian P Mei, Işıl Altıntaş, Malene Risum, Aidan Reilly, Jun Zou, Pau Abrisqueta","doi":"10.1016/S2352-3026(26)00198-5","DOIUrl":"10.1016/S2352-3026(26)00198-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chemotherapy-free regimens, such as rituximab and lenalidomide, are attractive first-line treatment options for follicular lymphoma, but combinations providing deeper, more durable responses are needed. We aimed to assess 3-year activity and safety of epcoritamab, a subcutaneously administered CD3 × CD20 bispecific antibody, plus rituximab-lenalidomide as first-line treatment for follicular lymphoma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;EPCORE NHL-2 is an open-label, phase 1b/2, clinical trial. Arm 6 of the study was conducted at 20 hospitals in six countries in Europe (Spain, the Netherlands, Czech Republic, Sweden, Belgium, and Denmark) and the USA in patients aged 18 years and older with CD20&lt;sup&gt;+&lt;/sup&gt;, histologically confirmed grade 1-3A follicular lymphoma, and an Eastern Cooperative Oncology Group performance status of 0-2. Patients received intravenous rituximab 375 mg/m&lt;sup&gt;2&lt;/sup&gt; once per week in cycle 1 (28 days per cycle) and every 4 weeks in cycles 2-6; oral lenalidomide 20 mg daily on days 1-21 of cycles 1-12; and subcutaneous epcoritamab in a two-step-up dosing regimen of a 0·16 mg priming dose, followed by a 0·8 mg intermediate dose, then full 48 mg doses in cycle 1, 48 mg once per week in cycle 2, and 48 mg every 4 weeks in subsequent cycles for up to 2 years. The primary endpoint was investigator-assessed overall response rate by Lugano Response Criteria for Malignant Lymphoma. The full analysis set and the safety set included all patients who received one or more doses of trial drug. This study is registered with ClinicalTrials.gov (NCT04663347) and is ongoing (closed to new participants).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between Sept 23, 2021, and May 3, 2022, 45 patients were assessed for eligibility in Arm 6, 41 of whom were eligible and included in the full analysis and safety sets. 21 (51%) of 41 patients were male and 20 (49%) were female; 27 (66%) of patients were White, one (2%) was Asian, one (2%) was of another race, and 12 (29%) did not have race reported. At a median follow-up of 35·9 months (IQR 35·8-36·6) the overall response rate was 95% (95% CI 84-99; 39 of 41 patients). The most common grade 3-4 adverse events were neutropenia (20 [49%] of 41 patients), infections (12 [29%]), COVID-19 (six [15%]), and alanine aminotransferase increase (five [12%]). Serious adverse events occurred in 29 (71%) patients, including cytokine release syndrome (13 [32%]), serious infections (13 [32%]; one grade 2), pyrexia (three [7%]), organising pneumonia (one [2%]), pleural effusion (one [2%]), pneumonitis (one [2%]), pulmonary embolism (one [2%]), maculopapular rash (two [5%]), toxic skin eruption (one [2%]), atrial fibrillation (one [2%]), diarrhoea (one [2%]), dehydration (one [2%]), ovarian epithelial cancer (one [2%]), cerebrovascular accident (one [2%]), and thrombophlebitis (one [2%]). Treatment-related deaths occurred in three (7%) patients due to septic shock, progressive multifocal leukoenceph","PeriodicalId":48726,"journal":{"name":"Lancet Haematology","volume":"13 9","pages":"e614-e625"},"PeriodicalIF":20.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CD19 CAR T-cell therapy (GLPG5101) for relapsed or refractory B-cell non-Hodgkin lymphoma (ATALANTA-1): phase 1 results from a single-arm, multicentre, phase 1/2 study.","authors":"Marie José Kersten, Maria T Kuipers, Pim G N J Mutsaers, Evelyne Willems, Kirsten Saevels, Martin Dreyling, Caron Jacobson, Michael R Bishop, Maarten Zandvliet, Stavros Milatos, Chiara Lobetti-Bodoni, Sandra Blum, Kirsten Van Hoorde, Jigar Desai, Lorenzo Acciarri, Margot J Pont, Anna van Muyden, Omotayo Fasan, Joost S P Vermaat, Sébastien Anguille","doi":"10.1016/S2352-3026(26)00192-4","DOIUrl":"10.1016/S2352-3026(26)00192-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chimeric antigen receptor (CAR) T-cell therapies have transformed the treatment of B-cell non-Hodgkin lymphoma, but centralised manufacturing-with its complex logistics and long vein-to-vein times-drives up costs and restricts access. We aimed to evaluate the safety of GLPG5101, a fresh, CD19 CAR T-cell product manufactured through a decentralised process, and determine the recommended phase 2 dose.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This phase 1 dose-escalation part of the ATALANTA-1 phase 1/2, single-arm study, was executed in five hospitals in the Netherlands and Belgium. Patients aged 18 years or older, with histologically confirmed diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, marginal zone lymphoma (MZL), or mantle cell lymphoma (MCL) after two or more lines of therapy, measurable disease according to the Lugano classification, Eastern Cooperative Oncology Group Performance Status 0-2, and adequate organ function were enrolled. Patients were treated with a single intravenous infusion at one of three dose levels of GLPG5101 (dose level 1 [35-50 × 10&lt;sup&gt;6&lt;/sup&gt; viable CAR&lt;sup&gt;+&lt;/sup&gt; T-cells], dose level 2 [85-110 × 10&lt;sup&gt;6&lt;/sup&gt; viable CAR&lt;sup&gt;+&lt;/sup&gt; T-cells], and dose level 3 [200-250 × 10&lt;sup&gt;6&lt;/sup&gt; viable CAR&lt;sup&gt;+&lt;/sup&gt; T-cells]). The phase 1 part of the study applied a Bayesian Optimal Interval design and the primary endpoints were safety (incidence of adverse events and serious adverse events until end of treatment [week 14], and dose-limiting toxicities [DLTs] until day 28) in patients who received fresh GLPG5101 at any dose (excluding recipients of non-conforming product [not meeting prespecified release criteria other than dose]) and determination of the recommended phase 2 dose. The study was registered with ClinicalTrials.gov (NCT06561425) and is closed for recruitment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;From March 15, 2022, to Sept 10, 2024, 27 patients were screened for eligibility, 24 of whom were enrolled, underwent leukapheresis and lymphodepleting chemotherapy and received GLPG5101. Data cutoff was June 1, 2025. In the intention-to-treat population (n=24), the median age was 66·5 years (IQR 59·0-71·5), 15 (63%) patients were male, nine (38%) were female, and 21 (88%) were White. One of the 24 patients received a non-conforming product and was excluded from the safety analysis population. Median follow-up was 24·0 months (IQR 20·7-24·9). Five DLTs were reported: grade 3 thrombocytopenia (n=1, dose level 1), death from intra-abdominal haemorrhage (n=1, dose level 2), and grade 4 prolonged neutropenia not resolving to grade 2 or lower within 28 days (n=1 at dose level 1 and n=2 at dose level 2). All 23 patients in the safety analysis population had grade 3 or higher treatment-emergent adverse events; the most common were neutropenia (22 [96%]), leukopenia (nine [39%]), lymphopenia (seven [30%]), anaemia (six [26%]), and thrombocytopenia (five [22%]). Treatment-related deaths occurred","PeriodicalId":48726,"journal":{"name":"Lancet Haematology","volume":"13 9","pages":"e648-e659"},"PeriodicalIF":20.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haematopoietic stem cell transplantation in hepatosplenic T-cell lymphoma: a retrospective analysis of the EBMT Lymphoma Working Party.","authors":"Imke E Karsten, Norbert Schmitz, Mathilde Fekom, Laurence de Leval, Irma Khvedelidz, Hervé Finel, Won Seog Kim, Depei Wu, Laura Magnano, Fengrong Wang, Xiao-Jun Huang, Peter Dreger, Johan Maertens, Paolo Corradini, Grzegorz Helbig, Wolfgang Bethge, Christopher L Bacon, Jan Vydra, Aitana Balaguer-Roselló, Matthias Stelljes, Georg Lenz, Alina Tanase, Anna Sureda, Gandhi Damaj, Ali Bazarbachi, Bertram Glass","doi":"10.1016/S2352-3026(26)00147-X","DOIUrl":"10.1016/S2352-3026(26)00147-X","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hepatosplenic T-cell lymphoma is a rare and aggressive lymphoma with no established standard therapy. Chemotherapy is generally associated with poor outcomes. We aimed to better define the roles of allogeneic haematopoietic stem cell transplantation (allo-HSCT) and autologous HSCT (auto-HSCT) in patients with hepatosplenic T-cell lymphoma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted an analysis of patients aged 18 years or older who were registered with the European Society for Blood and Bone Marrow Transplantation (EBMT) and cooperating Asian centres. 64 centres from Europe and Asia contributed patients who received allo-HSCT and auto-HSCT. For this analysis, a database query of the registry was performed, and the necessary information, such as baseline characteristics, previous treatments, transplantation data, and follow-up data, was collected via a survey sent to all participating centres. Hepatosplenic T-cell lymphoma was diagnosed by local pathologists, and patients with a diagnosis (confirmed or consistent with the disease) were included. The main outcomes were progression-free survival, overall survival, non-relapse mortality, and relapse incidence at 3 years from HSCT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;94 patients (median age 36 years [IQR 28-46]; 65 [69%] males and 29 [31%] females) who underwent allo-HSCT between Dec 1, 2005, and Jan 29, 2024, and 27 patients (37 years [29-53]; 17 [63%] males and ten [37%] females) who underwent auto-HSCT between Aug 20, 2004, and Feb 8, 2022, were included. 95 (83%) of 115 patients were from Europe and 20 (17%) were from Asia. 57 (47%) of 121 patients received first-line therapy with cyclophosphamide, doxorubicin, vincristine, and prednisolone or variants. The majority of patients were in complete remission when they underwent transplantation: 41 (44%) of 93 patients with remission data before allo-HSCT and 20 (74%) of 27 patients before auto-HSCT. With a median follow-up of 4·5 years (IQR 3·4-5·6) in patients who underwent allo-HSCT, 3-year progression-free survival was 50·5% (95% CI 39·4-60·5) and 3-year overall survival was 55·0% (43·9-64·8). With a median follow-up of 5·0 years (IQR 4·3-6·6) for patients treated with auto-HSCT, 3-year progression-free survival was 38·9% (95% CI 17·5-60·0) and 3-year overall survival was 63·5% (41·3-79·3). 3-year non-relapse mortality was 11·7% (95% CI 5·9-19·5) and the 3-year relapse incidence was 37·9% (27·6-48·1) for patients who underwent allo-HSCT. The 3-year non-relapse mortality was 11·1% (95% CI 1·7-30·7) and the 3-year relapse incidence was 50·0% (24·9-70·8) for patients who underwent auto-HSCT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;We showed that allo-HSCT is an effective and potentially curative treatment option for patients with hepatosplenic T-cell lymphoma; auto-HSCT is frequently followed by relapse and might be only recommended to patients with a complete response and ineligible for allo-HSCT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Funding: ","PeriodicalId":48726,"journal":{"name":"Lancet Haematology","volume":" ","pages":"e639-e647"},"PeriodicalIF":20.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venetoclax added to dose-adjusted EPOCH-R for newly diagnosed double-hit lymphomas: phase 2 results from ALLIANCE A051701, an open-label, randomised, controlled, phase 2-3 trial.","authors":"Jeremy S Abramson, Susan Geyer, Sharmila Giri, Levi Pederson, Ann Hudson, Eric D Hsi, Neha Mehta-Shah, Patrick M Reagan, Richard L Deming, Richard F Little, Steven Gore, Shira N Dinner, Anusha Vallurupalli, Daniel J Landsburg, Brad Kahl, Jonathan W Friedberg, Nancy L Bartlett, John P Leonard","doi":"10.1016/S2352-3026(26)00191-2","DOIUrl":"10.1016/S2352-3026(26)00191-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;High-grade B-cell lymphoma with rearrangements of MYC and BCL2 and/or BCL6, known as double-hit lymphoma, is a highly aggressive malignancy with poor outcomes after standard chemoimmunotherapy. We aimed to study whether the addition of the BCL2-inhibitor venetoclax to chemoimmunotherapy in patients with double-hit lymphoma resulted in superior efficacy compared with chemotherapy alone.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;ALLIANCE A051701 is an open-label, randomised, controlled, phase 2-3 trial in separate cohorts of patients with double-hit lymphoma and patients with double-expressor lymphoma. In this analysis, we report phase 2 results from the double-hit lymphoma cohort. Patients aged 18-80 years with newly diagnosed double-hit lymphoma and Eastern Cooperative Oncology Group (ECOG) performance status 0-2 were recruited from 41 hospitals and outpatient clinics in the USA. Patients were randomly assigned (1:1) to receive DA-EPOCH-R (dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) either alone (DA-EPOCH-R group) or with venetoclax (DA-EPOCH-R plus venetoclax group) using permuted block randomisation schedule. All patients and investigators were aware of group assignment. DA-EPOCH-R was administered on a 21-day schedule for up to six total cycles. Venetoclax was given as 600 mg by mouth daily on days 4-8 of cycle 1 and on days 1-5 of cycles 2-6. The primary endpoint was progression-free survival in the modified intent-to-treat population inclusive of all eligible patients with centrally confirmed double-hit lymphoma. The safety analysis population consisted of all evaluable patients who received at least one dose of protocol treatment. This trial is registered with ClinicalTrials.gov (NCT03984448) and is closed to enrolment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;36 patients were randomly assigned to the DA-EPOCH-R group and 37 to the DA-EPOCH-R plus venetoclax group between Oct 22, 2019, and Sept 18, 2020. Median age was 65 years (IQR 56-73) and baseline demographic factors were well balanced between groups, with 30 (45%) female and 36 (55%) male patients. Most patients (59 [89%]) were white, two (3%) were Asian, one (2%) was Black or African American, and four (6%) had unknown or unreported ethnicity. The majority of patients had MYC-BCL2 double-hit lymphoma (59 [89%] patients), advanced stage disease (57 [86%] patients), and high-intermediate/high-risk IPI score (42 [64%] patients). Median follow-up was 34·7 months (IQR 30·1-36·8). Median progression-free survival was 28·4 months (95% CI 5·2-not estimable) in the DA-EPOCH-R group (n=30) and 7·7 months (95% CI 4·7-NE) in the DA-EPOCH-R plus venetoclax group (n=36; hazard ratio [HR] 1·13, 95% CI 0·53-2·37; p=0·75). Deaths on treatment occurred in one (3%) patient in the DA-EPOCH-R group (due to dyspnoea; possibly related to treatment) and six (17%) patients in the DA-EPOCH-R plus venetoclax group (four due to sepsis [three at l","PeriodicalId":48726,"journal":{"name":"Lancet Haematology","volume":"13 9","pages":"e626-e638"},"PeriodicalIF":20.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining plasma cell leukaemia.","authors":"S Vincent Rajkumar, Shaji Kumar","doi":"10.1016/S2352-3026(26)00131-6","DOIUrl":"https://doi.org/10.1016/S2352-3026(26)00131-6","url":null,"abstract":"<p><p>Plasma cell leukaemia is an aggressive plasma cell malignancy characterised by the presence of a high percentage of circulating clonal plasma cells on conventional peripheral blood smear examination. We argue that plasma cell leukaemia must no longer be considered as a separate disease entity but as a type of high-risk multiple myeloma. With the adoption of more strict criteria for defining high-risk multiple myeloma and the relaxation of criteria in defining plasma cell leukaemia, the clinical implications of the terms have converged. Circulating plasma cells-the defining feature of plasma cell leukaemia-are present in almost all patients with multiple myeloma. Thus, the term plasma cell leukaemia merely reflects the high end of a continuum, with the main difference being a quantitative arbitrary threshold based on the percentage of circulating plasma cells. One of the key drivers of our proposal is to make progress against this aggressive malignancy, and to include such patients in clinical trials for multiple myeloma. The term plasma cell leukaemia creates substantial confusion and concern to patients, and it is time for a change. Finally, we provide counterarguments to our proposal and highlight the need to harmonise these proposed changes in disease definitions used by health organisations.</p>","PeriodicalId":48726,"journal":{"name":"Lancet Haematology","volume":" ","pages":""},"PeriodicalIF":20.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haematopoietic cell transplantation for relapsed or refractory classical Hodgkin lymphoma: a retrospective, registry-based cohort study of 19 498 patients from the EBMT Lymphoma Working Group.","authors":"Ali Bazarbachi, Mathilde Fekom, Carmen Martinez, Irma Khvedelidze, Nour Moukalled, Karl S Peggs, Khalid Halahleh, Stefania Bramanti, Sebastian Giebel, Mahmoud Aljurf, Ioanna Sakellari, Malek Benakli, Francesca Bonifazi, Raffaella Cerretti, Raynier Devillier, Alexander Kulagin, Emma Nicholson, Edouard Forcade, Jan Walewski, Alina Tanase, Anna Sureda","doi":"10.1016/S2352-3026(26)00169-9","DOIUrl":"https://doi.org/10.1016/S2352-3026(26)00169-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Autologous haematopoietic cell transplantation (auto-HCT) is the recommended treatment for chemosensitive relapsed Hodgkin lymphoma, while allogeneic haematopoietic cell transplantation (allo-HCT) is indicated for patients who had unsuccessful auto-HCT. The introduction of novel therapeutic agents, alongside advances in donor selection, conditioning regimens, and graft-versus-host disease prophylaxis, might improve post-transplantation outcomes, however supporting data remain limited. We aimed to evaluate changes in post-transplantation outcomes over the period 2010-22, and to identify predictors of these outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective, registry-based cohort study of patients aged 18 years or older with relapsed or refractory classical Hodgkin lymphoma undergoing first auto-HCT or first allo-HCT between Jan 1, 2010, and Dec 31, 2022, registered with the European Society for Blood and Marrow Transplantation (EBMT), with data from more than 600 transplantation centres, across 53 countries, reporting all HCTs and yearly follow-ups. Patients who received allo-HCT for relapse after auto-HCT were included but tandem transplantations were excluded. For allo-HCT, we included patients who received grafts from matched related donors, mismatched related donors, and unrelated donors. The primary endpoints were overall survival and progression-free survival, which were assessed with the Kaplan-Meier method at 2 years and 5 years after HCT. Multivariate analyses were performed using the Cox proportional-hazards regression model to identify predictive factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;We identified 22 047 patients who received a first transplantation for relapsed or refractory Hodgkin lymphoma, after excluding 1324 patients with missing follow-up data and 1225 patients with nodular lymphocyte predominant Hodgkin lymphoma, 19 498 patients were retained: 15 648 received auto-HCT (6772 [43%] were female and 8839 [57%] were male, data were missing for 37 patients); median age at HCT was 35 years [IQR 27-47]; median follow-up was 2·4 years [IQR 2·3-2·5]), and 3850 received allo-HCT (1572 [41%] female and 2273 [59%] were male, data were missing for five patients; median age at HCT 32 years [IQR 26-42]; median follow-up was 3·9 years [IQR 3·8-4·1]). For auto-HCT, from years 2010-14 to years 2019-22, the 2-year progression-free survival increased from 63% (95% CI 62-65) to 73% (71-74) and overall survival increased from 85% (95% CI 84-86) to 93% (91-94). Partial response (hazard ratio [HR] 1·92 [95% CI 1·74-2·11]) or stable or progressive disease (2·45 [2·17-2·76]) at transplantation negatively affected progression-free survival. For allo-HCT, from years 2010-14 to years 2019-22, the 2-year progression-free survival, and overall survival, increased from 44% (95% CI 41-46) to 62% (58-66), and from 66% (63-68) to 72% (68-75), respectively. Partial response (HR 1·58 [95% CI 1·39-1·78]) or stab","PeriodicalId":48726,"journal":{"name":"Lancet Haematology","volume":"13 8","pages":"e519-e532"},"PeriodicalIF":20.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Between rules and reality.","authors":"Josephine Kievit","doi":"10.1016/S2352-3026(26)00140-7","DOIUrl":"10.1016/S2352-3026(26)00140-7","url":null,"abstract":"","PeriodicalId":48726,"journal":{"name":"Lancet Haematology","volume":" ","pages":"e517-e518"},"PeriodicalIF":20.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faggot cells in pericardial fluid.","authors":"Shuhei Kida, Ai Matsuura, Jun Ishiko","doi":"10.1016/S2352-3026(26)00097-9","DOIUrl":"https://doi.org/10.1016/S2352-3026(26)00097-9","url":null,"abstract":"","PeriodicalId":48726,"journal":{"name":"Lancet Haematology","volume":"13 8","pages":"e602"},"PeriodicalIF":20.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose ruxolitinib for graft-versus-host disease prevention in haploidentical haematopoietic stem-cell transplantation: a multicentre, open-label, randomised, controlled, phase 3 trial.","authors":"Hengwei Wu, Wenming Shi, Zhuoyue Shi, Yi Luo, Jian Yu, Weijie Cao, Junjie Cao, Xiaojun Xu, Xiaoxia Hu, Ying Lu, Huarui Fu, Lizhen Liu, Xiaoyu Lai, Luxin Yang, Yishan Ye, Congxiao Zhang, Jimin Shi, He Huang, Yanmin Zhao","doi":"10.1016/S2352-3026(26)00167-5","DOIUrl":"10.1016/S2352-3026(26)00167-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acute graft-versus-host disease (GVHD) remains a major cause of morbidity and mortality after haploidentical haematopoietic stem-cell transplantation (HSCT). Ruxolitinib, a Janus kinase (JAK) 1/2 inhibitor with established activity in steroid-refractory GVHD, has shown promise for prophylaxis in early studies, but there is little evidence from randomised trials in the haploidentical HSCT setting. We investigated whether, within a backbone of antithymocyte globulin, calcineurin inhibitor, and short-course methotrexate, replacing mycophenolate mofetil with low-dose ruxolitinib could reduce acute GVHD after haploidentical HSCT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this multicentre, open-label, randomised, controlled, phase 3 trial conducted at five centres in China, eligible patients were aged 12-70 years, had haematological malignancies for which allogeneic HSCT was indicated, had a Karnofsky performance status of at least 70 or a Lansky score of at least 70 for patients younger than 16 years, and were undergoing their first myeloablative haploidentical HSCT. Patients were randomly assigned (1:1) to receive antithymocyte globulin, a calcineurin inhibitor, short-course methotrexate, and low-dose ruxolitinib, or standard prophylaxis with antithymocyte globulin, a calcineurin inhibitor, short-course methotrexate, and mycophenolate mofetil. Randomisation was stratified by centre and patient age (&lt;40 years vs ≥40 years) using computer-generated permuted blocks with random block sizes. Oral ruxolitinib was started on day 1 at 5 mg twice daily for patients weighing at least 50 kg and 5 mg once daily for those weighing less than 50 kg, continued up to day 60, and then tapered to day 90 in the absence of grade II-IV acute GVHD. The primary endpoint was the cumulative incidence of grade II-IV acute GVHD by day 100. Efficacy and safety were analysed in the modified intention-to-treat population, which included all randomly assigned patients who received at least one dose of the assigned prophylaxis, excluding those with major protocol deviations. This trial is registered with ClinicalTrials.gov, NCT04838704, and is complete.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between April 1, 2021, and Dec 28, 2023, 215 patients were randomly assigned, of whom 206 were included in the modified intention-to-treat population (103 in the ruxolitinib prophylaxis group and 103 in the standard prophylaxis group). The median recipient age was 40 years (IQR 24-48), 98 (48%) patients were female and 108 (52%) were male, and all participants were Chinese. Among surviving patients, the median follow-up was 26·4 months (IQR 20·0-33·3). By day 100, grade II-IV acute GVHD occurred in seven (cumulative incidence of 6·8% [95% CI 1·9-11·7]) of 103 patients in the ruxolitinib prophylaxis group and 38 (36·9% [27·5-46·3]) of 103 patients in the standard prophylaxis group (subdistribution hazard ratio 0·15, 95% CI 0·07-0·34; p&lt;0·0001). The most common grade 3-4 adverse","PeriodicalId":48726,"journal":{"name":"Lancet Haematology","volume":"13 8","pages":"e533-e544"},"PeriodicalIF":20.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}