Acta Haematologica最新文献

{"title":"Deep Learning Applications in Lymphoma Imaging.","authors":"Vera Sorin, Israel Cohen, Ruth Lekach, Sasan Partovi, Daniel Raskin","doi":"10.1159/000547427","DOIUrl":"10.1159/000547427","url":null,"abstract":"<p><strong>Background: </strong>Lymphomas are a diverse group of disorders characterized by clonal proliferation of lymphocytes. While definitive diagnosis relies on histopathology, immunohistochemical, molecular and genomic analyses, imaging modalities including positron emission tomography/computed tomography (PET/CT), computed tomography (CT), and magnetic resonance imaging (MRI) are essential in diagnostic processes and management. Imaging aids in detecting suitable biopsy sites, assessing disease extent, evaluating treatment response, and detecting recurrence. However, accurate diagnosis and staging remain challenging due to tumor heterogeneity, inter-observer variability, and technical imaging issues.</p><p><strong>Summary: </strong>Artificial intelligence (AI), particularly deep learning (DL) models, is transforming lymphoma imaging by enabling automated detection, segmentation, and classification across PET/CT, CT, and MRI modalities. Key applications include automated metabolic response assessment and total metabolic tumor volume quantification in PET/CT, lymph node segmentation and classification in CT, and improved detection of central nervous system involvement in MRI. Despite promising results, significant challenges limit widespread clinical adoption, including variability in imaging protocols affecting model generalizability, reliance on small retrospective datasets, lack of model interpretability, and difficulties integrating AI tools into existing clinical workflows.</p><p><strong>Key messages: </strong>(1) DL applications can automate detection, segmentation, and classification in lymphoma imaging, improving diagnostic accuracy and reducing inter-observer variability across PET/CT, CT, and MRI modalities. (2) Challenges in DL adoption include validating model performance across diverse imaging protocols, addressing data biases, and ensuring generalizability to real-world clinical settings. (3) Integrating AI into clinical workflows requires careful validation to ensure safety, consistency, and alignment with existing diagnostic and treatment standards.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"566-574"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635905","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":"HLA-DRB5 Overexpression Promotes Platelet Reduction in Immune Thrombocytopenia Mice Model by Facilitating MHC-II-Mediated Antigen Presentation.","authors":"Yujuan Ren, Qianqian Ying, Ying Chen, Cong Liao, Anrong Li, Qidong Ye","doi":"10.1159/000538749","DOIUrl":"10.1159/000538749","url":null,"abstract":"<p><strong>Introduction: </strong>Major histocompatibility complex II (MHC-II)-mediated antigen presentation contributes to the pathogenesis of immune thrombocytopenia (ITP). Human leukocyte antigen (HLA)-DRB5 is an MHC-II molecule and this study aims to investigate its role and mechanisms in ITP development.</p><p><strong>Methods: </strong>Guinea pig anti-mouse platelet (PLT) serum-induced ITP mice received tail vein injection of HLA-DRB5 overexpressing adenoviral vector/immune receptor expressed on myeloid cells-1 (IREM-1) monoclonal antibody (mAb). PLT count changes in mice blood were assessed by a hematology analyzer. MHC-II/CD80/CD86 expression in mice blood was measured by quantitative real-time-PCR and immunofluorescence assay. CD8+ T-cell proportion in mice blood was detected by flow cytometry.</p><p><strong>Results: </strong>HLA-DRB5 overexpression exacerbated PLT reduction since the 5th day of the establishment of ITP mice model and enhanced MHC-II/CD80/CD86 expression upregulation as well as CD8+ T-cell ratio elevation in the blood of ITP mice, while its effects were reversed by IREM-1 mAb.</p><p><strong>Conclusion: </strong>HLA-DRB5 overexpression upregulates MHC-II-mediated antigen presentation to CD8+ T cells, thus lowering PLT count in the ITP mice model.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"68-76"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140920761","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":"Long-Term Follow-Up of Eltrombopag Treatment for Patients with Cyclosporin A Refractory/Relapsed Transfusion-Dependent Non-Severe Aplastic Anemia: A Report from a Single Center in China.","authors":"Qinglin Hu, Yuan Yang, Chen Yang, Miao Chen, Bing Han","doi":"10.1159/000539905","DOIUrl":"10.1159/000539905","url":null,"abstract":"<p><strong>Introduction: </strong>Aplastic anemia (AA) is characterized by bone marrow failure and cytopenia. Eltrombopag (ELT) is effective and safe for treating refractory/relapsed AA; however, reports on the long-term outcomes of transfusion-dependent non-severe AA (TD-NSAA) are limited.</p><p><strong>Methods: </strong>Patients with TD-NSAA refractory to immunosuppressive therapy (IST) or relapsed after IST, treated with ELT alone, and followed up for at least 12 months were retrospectively enrolled. The baseline characteristics of patients, efficacy and adverse effects of ELT, and relapse and clone evolution rates after ELT were documented.</p><p><strong>Results: </strong>Of the 55 patients with TD-NSAA included, 24 (43.6%) were men. Median age at diagnosis was 46 (19-80) years. Twenty-four patients had relapsed TD-NSAA, and 31 patients had refractory TD-NSAA. During the median follow-up period of 28 (12-48) months, the overall and complete response rates at 3, 6, and 12 months of ELT treatment were 38.2, 60.0, and 52.7 and 9.1, 14.6, and 9.1%, respectively. After a median follow-up of 28 (12-48) months, 21.2% (7/33) of patients experienced relapse, with a median duration from ELT treatment to relapse of 14 (6-45) months.</p><p><strong>Conclusion: </strong>ELT was effective in patients with relapsed/refractory TD-NSAA, with tolerable adverse effects.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"352-361"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632312","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":"Efficacy of Haploidentical Allogeneic Hematopoietic Cell Transplantation following Two Courses of Venetoclax and Azacytidine Therapy in Patients over 55 Years Old with Acute Myelogenous Leukemia.","authors":"Junjie Cao, Xianxu Zhuang, Danjie Luo, Renzhi Pei, Ying Lu, Dong Chen, Shuangyue Li, Xiaohong Du, Xuhui Liu","doi":"10.1159/000542034","DOIUrl":"10.1159/000542034","url":null,"abstract":"<p><strong>Introduction: </strong>The combination of venetoclax (VEN) and azacytidine (AZA) has demonstrated potential in achieving rapid and effective remissions in elderly patients with acute myeloid leukemia (AML). Allogeneic hematopoietic stem cell transplantation is a promising potential cure for high-risk AML, as VEN-based therapies have a worse prognosis in elderly patients. This study aimed to assess the efficacy of sequential haploidentical HSCT following two courses of VEN and AZA therapy in patients with AML aged 55 years and older.</p><p><strong>Methods: </strong>We conducted a retrospective study on AML patients aged 55-70 years who received intensive chemotherapy or two courses of VEN/AZA therapy, followed by haploidentical allo-HSCT (haplo-HSCT) based on disease risk degree, measurable residual disease status, and patient's preference.</p><p><strong>Results: </strong>Between January 2019 and December 2023, 141 newly diagnosed AML patients received initial treatment with intensive chemotherapy or VEN/AZA therapy. Among them, 64 patients received haplo-HSCT, while 77 did not. The 1-year overall survival (OS) and relapse-free survival (RFS) of patients who received haplo-HSCT were significantly higher than those who did not receive haplo-HSCT (p < 0.05). Among patients who received transplantation, there was no significant difference in 1-year OS and RFS between the VEN/AZA and intensive chemotherapy groups: 76.3% versus 69.3% (p = 0.367) for OS, and 74.5% versus 69.7% (p = 0.473) for RFS. High-risk ELN stratification and the presence of ≥4 gene mutations were associated with lower OS and RFS in both univariate and multivariate analyses.</p><p><strong>Conclusions: </strong>AML patients over 55 years of age who received haplo-HSCT after two courses of VEN/AZA therapy had outcomes similar to those who received haplo-HSCT after intensive chemotherapy, suggesting that two courses of VEN/AZA therapy as a bridge to haplo-HSCT are feasible for patients over 55 years old.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"427-436"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492694","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":"Coronary Artery Disease and Microvascular Ischemia in Patients with Cardiac Amyloidosis.","authors":"Osnat Itzhaki Ben Zadok, Iuliana Vaxman, Sara Hoss, Yeela Talmor-Barkan, Tali Steinmetz, Pia Raanani, Ran Kornowski, Ashraf Hamdan","doi":"10.1159/000542510","DOIUrl":"10.1159/000542510","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of preexisting obstructive coronary artery disease (CAD) and the occurrence of anginal chest pain as a presenting symptom in patients with light-chain (AL) and transthyretin (ATTR) cardiac amyloidosis (CA) are undetermined.</p><p><strong>Methods: </strong>A single-center analysis of clinical, laboratory, imaging, and angiographic characteristics of CA cohort was performed.</p><p><strong>Results: </strong>Included were 98 CA patients (43 AL, 47 wtATTR, 8 mutant ATTR). Eighteen patients (18%) had preexisting obstructive CAD at the time of CA diagnosis. These patients were older and had worse left ventricular ejection fraction, yet revealed similar cardiac biomarkers' levels. The 3-year survival rate was comparable between patients with versus without preexisting CAD (p = 0.974). Anginal chest pain was a presenting symptom of newly diagnosed CA in 24% of patients (n = 19) with no preexisting CAD, 53% (n = 10) of which had AL-CA. Two patients had an acute myocardial infarction. The prevalence of diabetes mellitus, dyslipidemia, hypertension, and smoking was similar among CA patients presenting with versus without chest pain. Of the newly diagnosed CA patients with no preexisting CAD who underwent symptoms evaluation (n = 37), 99mTc-Sestamibi myocardial perfusion scintigraphy demonstrated stress-induced perfusion defects in 45% (9/20) and normal study in 45% (9/20) of patients. Coronary evaluation revealed nonobstructive coronary artery lesions or normal coronaries in 75% of patients (18/24).</p><p><strong>Conclusion: </strong>CA patients may initially present with anginal chest pain and myocardial perfusion defects which may reflect coronary microvascular ischemia. CA should be considered in the differential diagnosis of patients presenting with chest pain, nonobstructive CAD, and elevated cardiac biomarkers.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"452-461"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142714996","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":"Artificial Intelligence in Hematopoietic Stem Cell Transplantation Care and Complication Management.","authors":"Amin T Turki, Alberto Mussetti, Katja Marie Scheidler, Jan Kehrmann, Pietro Crivello, René Hosch, Felix Nensa, Stefano Polizzi","doi":"10.1159/000547767","DOIUrl":"10.1159/000547767","url":null,"abstract":"<p><strong>Background: </strong>The practice of allogeneic hematopoietic stem cell transplantation (alloHCT) has evolved from an experimental therapy with high mortality rates to a routine treatment that is increasingly performed worldwide. Parallel to this expansion, transplantation has become safer and applicable at higher ages through adapted reduced-intensity protocols and improved supportive care. Advancements in artificial intelligence (AI) methods and computing power over recent decades have driven increasing interest in their application to medicine and, more recently, to hematology.</p><p><strong>Summary: </strong>Concurrently, the expansion of large-scale datasets from transplant registries, hospitals, and national care networks has contributed to the emergence of big data in the field. The implementation of standardized data integration processes across hospitals and networks has created new opportunities to enhance diagnosis, therapy, and patient monitoring while providing decision support for physicians. While the majority of AI models and tools remain at the experimental level and are based on single-center studies, their impact on the medical domain appears sustainable. The current global excitement about these tools reflects the digital transformation in the practice of medicine, but more validation and medical device studies are needed to enable clinical integration.</p><p><strong>Key messages: </strong>Here, we review the current state of knowledge and advancements in AI applications within hematology, with a particular focus on alloHCT. We discuss emerging tools for preventing transplant-related complications, including donor selection, reducing non-relapse mortality, managing infection, and controlling graft-versus-host disease.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"527-545"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144787979","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":"Novel Approaches of Cellular Therapy in Multiple Myeloma: Focus on Chimeric Antigen Receptor T-Cells.","authors":"Ravi Kishore Narra, Supriya Peshin, Binod Dhakal","doi":"10.1159/000543265","DOIUrl":"10.1159/000543265","url":null,"abstract":"<p><strong>Background: </strong>Recent advancements in cellular therapies, particularly chimeric antigen receptor T-cells (CAR-T) and T-cell-engaging bispecific antibodies have significantly altered the therapeutic landscape for multiple myeloma. There are two US FDA approved CAR-T products targeting BCMA available for commercial use at this time. Though these innovative therapies have demonstrated considerable efficacy in heavily pretreated multiple myeloma patients, many challenges remain, including accessibility, potential toxicities such as cytokine release syndrome and neurotoxicity and development of resistance through targeted antigen loss and T-cell exhaustion and various other mechanisms. CRISPR edited allogeneic CAR-T cells, CAR-NK cells, and structural makeover of autologous CART with safety switches are being studied to address current limitations in cellular therapy. Additionally, newer target antigens such as GPRC5D, FcRH5, armored CAR-T cells that resist immunosuppressive cytokines such as TGF-β are being investigated.</p><p><strong>Summary: </strong>This review summarizes safety and efficacy of currently available CART, discusses challenges with these therapies, and ongoing research efforts aimed at addressing resistance, mitigate treatment-related toxicities, and refining for broader applicability and prolonged efficacy.</p><p><strong>Key messages: </strong>CART cell therapy has shown significant benefit in treatment of multiple myeloma. Many challenges persist. Novel strategies with structural modifications are being incorporated to overcome the limitations.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"330-345"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902550","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":"Clinical Challenges in Treating Cancer-Associated Thrombosis: A Clinically Oriented Review.","authors":"Idan Goldberg, Galia Spectre, Pia Raanani, Hugo Ten Cate, Avi Leader","doi":"10.1159/000542872","DOIUrl":"10.1159/000542872","url":null,"abstract":"<p><strong>Background: </strong>Managing cancer-associated thrombosis (CAT) is a significant clinical challenge due to several factors such as increased bleeding tendency, frailty, and drug-drug interactions. For many years, the drug of choice for treating CAT was low molecular weight heparin (LMWH). Recently, direct oral anticoagulants (DOACs) entered to the therapeutic milieu of CAT. However, due to the large diversity among patients with CAT in clinical and laboratory characteristics, not all patients will equally benefit from treatment with DOACs. Furthermore, several subgroups of patients with CAT have specific characteristics that influence the anticoagulant decision-making process.</p><p><strong>Summary: </strong>In this review, we present four different theoretical clinical case scenarios, each representing a different challenge that is associated with thrombosis management; brain metastasis, malignancies of the gastrointestinal tract, drug-drug interactions (DDIs), and thrombocytopenia. By reviewing current literature, we suggest our clinical approach for managing these cases in the era of DOACs.</p><p><strong>Key messages: </strong>(1) The management of patients with brain tumors and CAT is challenging due to increased risk for both intracranial hemorrhage and recurrent venous thromboembolism. Both LMWH and DOACs are optional treatment in this setting. (2) There are conflicting data regarding the bleeding risk in patients with GI malignancies. Treatment with LMWH should be considered specifically in patients with advanced disease and unresectable tumors. (3) There is a paucity of data regarding DDI in patients with CAT. However, caution should be exercised when prescribing DOACs to patients receiving concurrent medications that either affect DOAC metabolism or influence bleeding risk. (4) The management of patients with CAT and thrombocytopenia depends on the severity of thrombocytopenia and the timing of the thrombotic event.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"477-493"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811911","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":"[Pharma News].","authors":"","doi":"10.1159/000548309","DOIUrl":"10.1159/000548309","url":null,"abstract":"","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"148 5","pages":"606"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074157","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":"Toxicity of CAR T-Cell Therapy for Multiple Myeloma.","authors":"Aimaz Afrough, Pearl Rajan Abraham, Laura Turer, Gurbakhash Kaur, Aishwarya Sannareddy, Doris K Hansen, Larry D Anderson","doi":"10.1159/000539134","DOIUrl":"10.1159/000539134","url":null,"abstract":"<p><strong>Background: </strong>Idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel) are novel chimeric antigen receptor (CAR)-T cell therapies targeting B-cell maturation antigen (BCMA), and both have recently gained approval by the US Food Drug Administration (FDA) for the treatment of relapsed and refractory multiple myeloma (RRMM).</p><p><strong>Summary: </strong>These therapies offer unprecedented responses in RRMM but present new challenges including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), non-ICANS neurotoxicity, cytopenias, infections, and hypogammaglobulinemia.</p><p><strong>Key messages: </strong>In the evolving CAR-T landscape, a primary objective is to develop innovative strategies for managing associated toxicities. Through meticulous exploration of underlying mechanisms and tailored interventions, we aim to enhance safety and enable broader outpatient utilization. Refinement of protocols, biomarker identification, and robust monitoring are imperative for sustained efficacy. This comprehensive approach guarantees the continuous advancement and optimization of CAR-T therapy.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"300-314"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891042","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}