Acta Haematologica最新文献

{"title":"Fluoroquinolone Prophylaxis for Febrile Neutropenia in Autologous Hematopoietic Cell Transplantation: Outcomes and Risk Factors.","authors":"Fernanda Batista Rosa Pinto, Fernanda Aline Moreira de Oliveira Meucci, Anita Cassoli Cortez, Ana Costa Cordeiro, Vanessa Dos Anjos Bovolenta, Marina Mattos Nascimento, Jayr Schmidt-Filho, Marjorie Vieira Batista","doi":"10.1159/000550137","DOIUrl":"10.1159/000550137","url":null,"abstract":"<p><strong>Introduction: </strong>Febrile neutropenia (FN) is a frequent complication following autologous hematopoietic cell transplantation (auto-HCT). Prophylactic use of fluoroquinolones (FQs) has been shown to reduce FN incidence; however, its routine use remains controversial due to increasing concerns regarding antimicrobial resistance and uncertain impact on clinically relevant outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including adult patients who underwent auto-HCT at A.C.Camargo Cancer Center between 2016 and 2021. Patients were divided into two groups according to institutional prophylaxis policy: those who received levofloxacin prophylaxis during neutropenia between 2016 and 2018 (Px group, n = 201) and those who did not receive FQ prophylaxis between 2018 and 2021 (NPx group, n = 169). The primary outcome was the incidence of FN. Secondary outcomes included microbiologically documented infections, antimicrobial resistance patterns, and 30- and 100-day all-cause mortality.</p><p><strong>Results: </strong>FN occurred more frequently in the NPx group compared with the Px group (92% vs. 81%, p = 0.002). There were no significant differences between groups in the rate of microbiologically documented infections (23% vs. 14%, p = 0.09), 30-day mortality (3% vs. 1%, p = 0.25), or 100-day mortality (3% vs. 2%, p = 0.48). Antimicrobial resistance profiles differed significantly: the Px group had a lower proportion of pan-susceptible isolates (17% vs. 61%) and higher rates of extended-spectrum β-lactamase-producing organisms (27% vs. 6%) and methicillin-resistant bacteria (36% vs. 10%) compared with the NPx group (all p < 0.001).</p><p><strong>Conclusion: </strong>Although FQ prophylaxis was associated with a lower incidence of FN after auto-HCT, it did not translate into reductions in short-term mortality and was associated with significantly higher rates of antimicrobial resistance. Based on these findings, our institution does not recommend routine FQ prophylaxis for patients undergoing auto-HCT.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"1-11"},"PeriodicalIF":1.1,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tucidinostat Combined with Bortezomib, Liposomal Doxorubicin, and Dexamethasone in Multiple Myeloma Treatment.","authors":"Jingyi Bi, Xuelin Dou, Ruqi Liang, Lei Wen, Yang Liu, Xiaoguang Lei, Liru Wang, Huixia Guo, Xiaojun Huang, Mingdi Wang, Jin Lu","doi":"10.1159/000545709","DOIUrl":"10.1159/000545709","url":null,"abstract":"<p><strong>Introduction: </strong>We conducted a single-arm, open-label dose-exploration study to evaluate the safety and efficacy of the histone deacetylase inhibitor tucidinostat combined with bortezomib, liposomal doxorubicin, and dexamethasone (C-PDD) in treating relapsed and refractory multiple myeloma (RRMM) patients.</p><p><strong>Methods: </strong>Eighteen patients were enrolled from August 2020 to May 2021, receiving 21-day cycles of C-PDD.</p><p><strong>Results: </strong>Eighteen cases were analysed, with a median prior treatment line of 2 (range: 1-4). The median number of completed treatment cycles was 4 (range: 1-8). The overall response rate was 57%, including 14% complete response, 14% very good partial response, and 29% partial response. Both bortezomib-sensitive and refractory groups had a response rate of 57%. The response rate was 100% in patients with extramedullary extraosseous involvement. The median follow-up was 42 months (range: 3-44), with median progression-free survival of 7 months and median overall survival of 24.5 months. Grade 3-4 haematologic adverse events included thrombocytopaenia (50%), neutropenia (33%), and anaemia (33%). Non-haematologic adverse events were mostly grade 1-2, with 1 case of grade 3 peripheral sensory neuropathy.</p><p><strong>Conclusion: </strong>The C-PDD regimen showed efficacy in RRMM, including bortezomib-refractory disease and EME patients. The optimal dose and combination need to be explored in the future.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"211-220"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Challenges in Paediatric Acute Lymphoblastic Leukaemia.","authors":"Shekhar Krishnan, Vaskar Saha","doi":"10.1159/000547506","DOIUrl":"10.1159/000547506","url":null,"abstract":"<p><p><p>Background: Acute lymphoblastic leukaemia (ALL) is the commonest paediatric cancer and represents a fifth of adult leukaemias. Global outcome disparities are linked to variations in socio-demographic indices (SDIs). Summary: In high-SDI regions, established collaborative groups report cure rates surpassing 90% in paediatric ALL. The focus is on reducing treatment toxicity using chemotherapy-free strategies, principally T-cell-directed immunotherapies and targeted small molecules, as exemplified in adult Philadelphia-chromosome-positive ALL. High cure rates limit testing of novel approaches outside niche subgroups, while high costs preclude wider real-world adoption of these advances. Mid-SDI regions (50-80% cure) face challenges in fully implementing contemporary risk-adapted therapy to improve outcomes and reduce costs. This necessitates collaborative practice, standardised high-quality risk-stratification diagnostics, and access to quality-assured generic cytotoxics. Low-SDI regions (<50% cure) report rising disease burden and face more fundamental challenges, including timely diagnosis, access to treatment and expertise, and minimising toxicity and abandonment. Solutions require locally adapted protocols, collaborative partnerships, and sustained patient-support programmes. Key Message: Global partnerships across SDI regions are crucial to address shared challenges in ALL, including access to affordable quality therapeutics, continuing refinement of established treatment elements, tailoring biomarkers for diverse populations, and collaborative frameworks to evaluate new treatments, technologies, and treatment paradigms. </p>.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"39-47"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prelims.","authors":"","doi":"10.1159/000550475","DOIUrl":"https://doi.org/10.1159/000550475","url":null,"abstract":"","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"149 1","pages":"1-4"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146049901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Cellular Therapies: The Expanding Role of Antibody-Driven Immunotherapy in Pediatric Acute Lymphoblastic Leukemia.","authors":"David McCall, Samanta Catueno, Ramya Ramakrishnan, Priti Tewari, Irtiza Sheikh, Amber Gibson, Cesar A Nuñez, Miriam B Garcia, Branko Cuglievan","doi":"10.1159/000546249","DOIUrl":"10.1159/000546249","url":null,"abstract":"<p><strong>Background: </strong>The integration of novel antibody-mediated targeted therapies into both relapsed/refractory (R/R) and frontline pediatric acute lymphoblastic leukemia (ALL) treatment protocols has led to critical advancements in the field. Current research efforts focus on optimizing targeted therapies to enhance precision and efficacy while minimizing toxicity by reducing chemotherapy. A notable example is the addition of blinatumomab, demonstrating superiority over conventional chemotherapy, with an 8% increase in disease-free survival at an interim analysis, reaching 96%. Inotuzumab ozogamicin (InO) has also shown promise, achieving nearly a 70% complete response rate in pediatric R/R B-cell ALL (B-ALL) trials. Additionally, daratumumab in T-cell ALL (T-ALL) and chimeric antigen receptor T-cell therapies, particularly CD19-directed (B-ALL) and CD7-directed (T-ALL) strategies, are under active investigation.</p><p><strong>Summary: </strong>This review will provide an overview of targeted antibody-mediated immunotherapies in both B-ALL and T-ALL, with a focus on their pediatric applications, supporting data, and future prospects.</p><p><strong>Key messages: </strong>The next cycle of frontline trials in pediatric ALL will incorporate more immunotherapy with reduction of chemotherapy. Subsequent trials will utilize more concurrent chemoimmunotherapy blocks as precision testing and risk-adapted therapy will continue to develop. These advancements reflect a paradigm shift toward more precise, less toxic treatment strategies in pediatric ALL.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"84-100"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic Subclassification and Risk Stratification of ALL.","authors":"Anna Østergaard, Ilaria Iacobucci","doi":"10.1159/000547135","DOIUrl":"10.1159/000547135","url":null,"abstract":"<p><strong>Background: </strong>Over the last 2 decades, significant improvements have been made in the understanding of the genomic and biological bases of acute lymphoblastic leukemia (ALL), resulting in enhanced genomic classification, more precise risk stratification, and improved long-term outcomes. ALL is a hematologic malignancy defined by uncontrolled proliferation of immature B- or T-lymphoid blasts in the bone marrow, blood, and other extramedullary tissues. It affects most commonly children, representing the most common childhood cancer, but it also occurs in adults where outcome tends to be poorer compared to pediatric patients.</p><p><strong>Summary: </strong>A variety of genetic aberrations, including structural and numerical chromosome alterations, translocations generating fusion oncoproteins, cryptic genomic rearrangements, sequence mutations, and genomic copy number changes, define multiple genomic subtypes, influence risk stratification and determine response to therapeutic strategies.</p><p><strong>Key messages: </strong>In this review, we describe the updated genomic classification of ALL highlighting new biological insights and discussing their implications for prognostication and outcome.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"8-23"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144525950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Philadelphia-Positive Acute Lymphoblastic Leukemia.","authors":"Anna Torrent, Josep Maria Ribera","doi":"10.1159/000547026","DOIUrl":"10.1159/000547026","url":null,"abstract":"<p><strong>Background: </strong>Philadelphia chromosome-positive acute lymphoblastic leukemia has historically been associated with poor prognosis and limited therapeutic options. Over the past 2 decades, however, the treatment paradigm has markedly shifted.</p><p><strong>Summary: </strong>The introduction of tyrosine kinase inhibitors (TKIs), such as imatinib, dasatinib, and ponatinib, has revolutionized frontline therapy, significantly improving remission rates and long-term survival. These agents, when combined with reduced-intensity chemotherapy or even with corticosteroids, have enabled less toxic regimens, particularly beneficial for older or unfit patients. The implementation of measurable residual disease monitoring has emerged as a pivotal tool for risk stratification and therapeutic decision-making. Consequently, the role of allogeneic hematopoietic stem cell transplantation, considered a cornerstone of curative treatment, is being reevaluated in patients achieving sustained deep molecular responses. More recently, immunotherapeutic strategies - including the bispecific T-cell engager blinatumomab and chimeric antigen receptor (CAR) T-cell therapies - have emerged as effective alternatives to conventional chemotherapy and TKIs.</p><p><strong>Key messages: </strong>While TKIs remain the backbone of treatment, the integration of immunotherapeutic strategies - including bispecific antibodies and CAR T-cell therapy - has expanded therapeutic options, not only in the R/R setting but increasingly in frontline regimens. Ongoing research aimed at optimizing the sequencing, combination, and duration of these therapies is essential to further enhance clinical outcomes.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"24-38"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and Management of Philadelphia-Like Acute Lymphoblastic Leukemia in Adults.","authors":"Hoda Pourhassan, Winston Y Lee, Marc Schwartz, Vinod Pullarkat, Ibrahim Aldoss","doi":"10.1159/000549216","DOIUrl":"10.1159/000549216","url":null,"abstract":"<p><strong>Background: </strong>The entity of Philadelphia (Ph)-like acute lymphoblastic leukemia (ALL) accounts for approximately 20-30% of newly diagnosed adults with B-cell ALL cases in the USA. Compared to other B-cell subtypes, Ph-like ALL is associated with overall poor prognosis and inferior outcomes with high measurable residual disease rates following induction therapy, increased risk of treatment failure and relapse, as well as short event-free and overall survival.</p><p><strong>Summary: </strong>Here we aim to highlight Ph-like ALL genetic subtypes and methods of genomic profiling for diagnosis and disease prognostication and to summarize current management approaches for frontline treatment including multiagent chemotherapy, immunotherapy, tyrosine kinase and small molecule inhibitors, and the role of allogeneic stem cell transplantation.</p><p><strong>Key messages: </strong>Despite the improvement in the treatment outcomes of adult patients with newly diagnosed B-cell ALL, patients with Ph-like ALL continue to do poorly with standard therapy. Thus, tailored therapeutic studies are indeed warranted to refine frontline treatment approaches and to improve outcomes for patients with Ph-like ALL.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"48-60"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145375577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acquired FX Deficiency in Multiple Myeloma without Concomitant Amyloidosis: A Rare Case Report.","authors":"Roi Gat, Svetlana Trestman, Ilya Kirgner","doi":"10.1159/000545479","DOIUrl":"10.1159/000545479","url":null,"abstract":"<p><p><p>Introduction: Acquired factor X (FX) deficiency is a rare coagulopathy. Occurrences in plasma cell dyscrasias (PCDs) independent of amyloid light-chain amyloidosis are exceedingly rare. Case Presentation: This case report presents a rare occurrence of acquired FX deficiency in a patient with multiple myeloma (MM) without concomitant amyloidosis. The patient, a 64-year-old male with prior diagnosis of smoldering MM, presented with abdominal pain and chronic bloody diarrheas and was diagnosed with absolute FX deficiency. Despite initial suspicion of amyloidosis, subsequent investigations ruled out its presence. Treatment with anti-myeloma therapy and supportive measures resulted in the normalization of coagulation parameters. Conclusion: This case underscores the importance of considering acquired FX deficiency in PCD patients presenting with coagulopathy even in the absence of amyloidosis. </p>.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"228-232"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Bibliometric Analysis of Immunotherapy in Diffuse Large B-Cell Lymphoma from 2004 to 2024.","authors":"Yanling Wu, Xiaomin Chen, Yang Liu, Yu Zhao, Lixiu Luo, Qiuwen Mi, Xiaoying Wen, Chunlan Huang","doi":"10.1159/000545152","DOIUrl":"10.1159/000545152","url":null,"abstract":"<p><strong>Introduction: </strong>Immunotherapy in DLBCL (diffuse large B-cell lymphoma) disease has become an active research area with great value and potential. However, bibliometric research in this area is still sparse. Through bibliometric analysis, we aimed to visualize the research hot spots and trends of immunotherapy in DLBCL disease to help understand the future development of basic and clinical research.</p><p><strong>Methods: </strong>The Web of Science Core Collection database was searched for articles and reviews related to the immunotherapy of DLBCL from 2004 to 2024. VOSviewers, CiteSpace, and the R package \"bibliometrix\" were used to conduct the bibliometric analysis.</p><p><strong>Results: </strong>A total of 662 articles were included. The number of immunotherapy treatments in DLBCL increased year by year. The publications came from 55 countries, led by the USA and the People's Republic of China, and 1,349 institutions, with the leading research institutions being The University of Texas MD Anderson Cancer Center and Memorial Sloan Kettering Cancer Center. Leukemia & Lymphoma is the journal with the most research, and Blood is the journal with the most co-citations. We identified 4,833 authors, among which Young and Ken H. had the most significant articles, while Neelapu S.S. had the largest number of co-citations. After analysis, the most common keyword is CAR T (CAR T cells: chimeric antigen receptor T-cell immunotherapy, a current and developing area of research.</p><p><strong>Conclusions: </strong>This is the first bibliometric study to comprehensively summarize research trends and advances in immunotherapy in DLBCL disease. This information will provide a reference for researchers and healthcare providers in immunotherapy research by clarifying recent research frontiers and hot spots such as CAR T cells, bispecific antibodies, and so on.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"168-186"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}