New England Journal of Medicine最新文献

{"title":"The Plight of \"Dual Noneligible\" People in the United States.","authors":"David E Velasquez, Eric T Roberts, Jose F Figueroa","doi":"10.1056/NEJMp2413121","DOIUrl":"10.1056/NEJMp2413121","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":"105-107"},"PeriodicalIF":96.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933703","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":"Early-Stage Results with Transcatheter Tricuspid-Valve Replacement.","authors":"Patrick T O'Gara","doi":"10.1056/NEJMe2413200","DOIUrl":"10.1056/NEJMe2413200","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":"196-197"},"PeriodicalIF":96.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548969","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":"Led Astray.","authors":"Ann Cheung, Kimberly Knoper, Emily Ling, Caren G Solomon","doi":"10.1056/NEJMp2414533","DOIUrl":"https://doi.org/10.1056/NEJMp2414533","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"392 2","pages":"e7"},"PeriodicalIF":96.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959168","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":"Safety of Kidney Transplantation from Donors with HIV Infection. Reply.","authors":"Christine M Durand, Dorry L Segev, Andrew D Redd","doi":"10.1056/NEJMc2414602","DOIUrl":"10.1056/NEJMc2414602","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"392 2","pages":"204-205"},"PeriodicalIF":96.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959257","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":"Talquetamab plus Teclistamab in Relapsed or Refractory Multiple Myeloma.","authors":"Yael C Cohen, Hila Magen, Moshe Gatt, Michael Sebag, Kihyun Kim, Chang-Ki Min, Enrique M Ocio, Sung-Soo Yoon, Michael P Chu, Paula Rodríguez-Otero, Irit Avivi, Natalia A Quijano Cardé, Ashwini Kumar, Maria Krevvata, Michelle R Peterson, Lilla Di Scala, Emma Scott, Brandi Hilder, Jill Vanak, Arnob Banerjee, Albert Oriol, Daniel Morillo, María-Victoria Mateos","doi":"10.1056/NEJMoa2406536","DOIUrl":"10.1056/NEJMoa2406536","url":null,"abstract":"<p><strong>Background: </strong>Talquetamab (anti-G protein-coupled receptor family C group 5 member D) and teclistamab (anti-B-cell maturation antigen) are bispecific antibodies that activate T cells by targeting CD3 and that have been approved for the treatment of triple-class-exposed relapsed or refractory multiple myeloma.</p><p><strong>Methods: </strong>We conducted a phase 1b-2 study of talquetamab plus teclistamab in patients with relapsed or refractory multiple myeloma. In phase 1, we investigated five dose levels in a dose-escalation study. Talquetamab at a dose of 0.8 mg per kilogram of body weight plus teclistamab at a dose of 3.0 mg per kilogram every other week was selected as the recommended phase 2 regimen. The primary objective was to evaluate adverse events and dose-limiting toxic effects.</p><p><strong>Results: </strong>A total of 94 patients received treatment, with the recommended phase 2 regimen used in 44. The median follow-up was 20.3 months. Three patients had dose-limiting toxic effects (including grade 4 thrombocytopenia in 1 patient with the recommended phase 2 regimen). Across all dose levels, the most common adverse events were cytokine release syndrome, neutropenia, taste changes, and nonrash skin events. Grade 3 or 4 adverse events, most commonly hematologic events, occurred in 96% of the patients. Grade 3 or 4 infections occurred in 64% of the patients. With the recommended phase 2 regimen, a response occurred in 80% of the patients (including in 61% of those with extramedullary disease); across all dose levels, a response occurred in 78%. The likelihood of patients continuing in response at 18 months was 86% with the recommended phase 2 regimen (82% among those with extramedullary disease) and 77% across all dose levels.</p><p><strong>Conclusions: </strong>The incidence of grade 3 or 4 infections with talquetamab plus teclistamab was higher than has been observed with either therapy alone. A response was observed in a high percentage of patients across all dose levels, with durable responses with the recommended phase 2 regimen. (Funded by Janssen Research and Development; RedirecTT-1 ClinicalTrials.gov number, NCT04586426.).</p>","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"392 2","pages":"138-149"},"PeriodicalIF":96.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959325","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":"Clearance of Driver Mutations after Transplantation for Myelofibrosis.","authors":"Nico Gagelmann, Marie Quarder, Anita Badbaran, Kristin Rathje, Dietlinde Janson, Catherina Lück, Johanna Richter, Franziska Marquard, Sofia Oechsler, Radwan Massoud, Evgeny Klyuchnikov, Ina Rudolph, Mathias Schäfersküpper, Christian Niederwieser, Silke Heidenreich, Carolina Berger, Boris Fehse, Christine Wolschke, Francis Ayuk, Nicolaus Kröger","doi":"10.1056/NEJMoa2408941","DOIUrl":"10.1056/NEJMoa2408941","url":null,"abstract":"<p><strong>Background: </strong>Allogeneic hematopoietic stem-cell transplantation is the only curative treatment for myelofibrosis. Driver mutations are the pathophysiological hallmark of the disease, but the role of mutation clearance after transplantation is unclear.</p><p><strong>Methods: </strong>We used highly sensitive polymerase-chain-reaction technology to analyze the dynamics of driver mutations in peripheral-blood samples from 324 patients with myelofibrosis (73% with <i>JAK2</i> mutations, 23% with <i>CALR</i> mutations, and 4% with <i>MPL</i> mutations) who were undergoing transplantation after reduced-intensity conditioning. Mutations were detected before transplantation and at 30, 100, and 180 days after transplantation to measure clearance and its effect on relapse and cure. The two primary end points were relapse and disease-free survival.</p><p><strong>Results: </strong>At day 30 after transplantation, mutation clearance was found in 42% of the patients who had <i>JAK2</i> mutations, 73% of those who had <i>CALR</i> mutations, and 54% of those who had <i>MPL</i> mutations; the corresponding percentages at day 100 were 63%, 82%, and 100%. The cumulative incidence of relapse at 1 year was 6% (95% confidence interval [CI], 2 to 10) among patients with mutation clearance at day 30 after transplantation and 21% (95% CI, 15 to 27) among those without mutation clearance at day 30. Disease-free and overall survival at 6 years were 61% and 74%, respectively, among patients with mutation clearance at day 30 after transplantation and 41% and 60%, respectively, among those without mutation clearance at day 30. Mutation clearance at day 30 appeared to outperform traditional donor chimerism as a measure of response; it was independently associated with a reduced risk of relapse or progression (hazard ratio, 0.36; 95% CI, 0.21 to 0.61) and appeared to overcome differences in prognosis based on the type of driver mutation (<i>JAK2</i> vs. <i>MPL</i> or <i>CALR</i>).</p><p><strong>Conclusions: </strong>In patients with myelofibrosis, clearance of driver mutations at day 30 after transplantation appeared to influence relapse and survival, irrespective of the underlying driver mutation.</p>","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"392 2","pages":"150-160"},"PeriodicalIF":96.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959157","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":"Human Infection with a Novel Tickborne Orthonairovirus Species in China.","authors":"Ming-Zhu Zhang, Cai Bian, Run-Ze Ye, Xiao-Ming Cui, Yan-Li Chu, Nan-Nan Yao, Xiao-Wei Xu, Jin-Ling Ye, Lin Chen, Ji-Hu Yang, Xiao-Ling Su, Lin Huang, Xiao-Yu Shi, Lin Zhao, Yu-Guo Chen, Yuan-Chun Zheng, Xiao-Min Zheng, Jia-Fu Jiang, Wu-Chun Cao","doi":"10.1056/NEJMc2410853","DOIUrl":"https://doi.org/10.1056/NEJMc2410853","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"392 2","pages":"200-202"},"PeriodicalIF":96.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959206","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":"Total Hip Replacement or Resistance Training for Severe Hip Osteoarthritis. Reply.","authors":"Thomas Frydendal, Kim G Ingwersen, Søren Overgaard","doi":"10.1056/NEJMc2414958","DOIUrl":"https://doi.org/10.1056/NEJMc2414958","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":"392 2","pages":"206"},"PeriodicalIF":96.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958776","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":"Coordinating Multidisciplinary Care - Improving Outcomes after Fragility Fractures.","authors":"Nicola Napoli, Peter R Ebeling, Douglas P Kiel","doi":"10.1056/NEJMp2409086","DOIUrl":"10.1056/NEJMp2409086","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":"109-111"},"PeriodicalIF":96.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933700","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":"Texas Executive Order GA-46 and the Erosion of Trust in Health Care.","authors":"Patricia Mae G Santos, Rachel E Fabi, Lilia Cervantes","doi":"10.1056/NEJMp2414284","DOIUrl":"10.1056/NEJMp2414284","url":null,"abstract":"","PeriodicalId":54725,"journal":{"name":"New England Journal of Medicine","volume":" ","pages":"107-109"},"PeriodicalIF":96.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933702","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}