EJHaem最新文献

{"title":"Before the Blood Drops: Early Clues of Parvovirus B19.","authors":"Joseph Stenberg, Daniel Babu, Nicole Deshmukh","doi":"10.1002/jha2.70165","DOIUrl":"https://doi.org/10.1002/jha2.70165","url":null,"abstract":"","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":"6 5","pages":"e70165"},"PeriodicalIF":1.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281976","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":"Paediatric Acute Myeloid Leukaemia-Myelodysplasia Related With i(17)(q10) Morphologically Mimicking Acute Promyelocytic Leukaemia.","authors":"Kathleen De John, Jan-Edward Koen, Helder De Quintal, Robert Lohlun","doi":"10.1002/jha2.70160","DOIUrl":"https://doi.org/10.1002/jha2.70160","url":null,"abstract":"","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":"6 5","pages":"e70160"},"PeriodicalIF":1.2,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281951","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":"Haplo-Identical Stem Cell Transplant Resolves Ventricular Arrhythmias and Dysfunction in a Sickle Cell Anemia Patient: Case Report and Discussion","authors":"Gonzalo de Luna,&nbsp;Isabelle Genty,&nbsp;Vincent Parinet,&nbsp;Florence Beckerich,&nbsp;Rabah Redjoul,&nbsp;Anoosha Habibi,&nbsp;Sihem Iles,&nbsp;Geneviève Derumeaux,&nbsp;Nicolas Lellouche,&nbsp;Thibaut Moulin,&nbsp;Laurent Boyer,&nbsp;Sébastien Maury,&nbsp;Pablo Bartolucci,&nbsp;Thomas d'Humières","doi":"10.1002/jha2.70161","DOIUrl":"10.1002/jha2.70161","url":null,"abstract":"<p>A Sickle Cell Anemia patient with severe ventricular arrhythmia and left ventricular dysfunction achieved rapid, complete cardiac recovery after haplo-identical stem cell transplantation, raising questions about SCA cardiac pathophysiology and highlighting the potential for reversible cardiac complications following curative treatment.</p><p><b>Trial Registration</b>: The authors have confirmed clinical trial registration is not needed for this submission</p>","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":"6 5","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245873","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":"Anti-Phosphatidylserine/Prothrombin Antibodies Identify a Distinct Form of ITP","authors":"Sofia Camerlo,&nbsp;Massimo Radin,&nbsp;Giorgio Rosati,&nbsp;Melissa Padrini,&nbsp;Barbara Montaruli,&nbsp;Isabella Russo,&nbsp;Cristina Barale,&nbsp;Alice Barinotti,&nbsp;Irene Cecchi,&nbsp;David Galarza,&nbsp;Fulvio Pomero,&nbsp;Marco De Gobbi,&nbsp;Savino Sciascia,&nbsp;Alessandro Morotti","doi":"10.1002/jha2.70154","DOIUrl":"https://doi.org/10.1002/jha2.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Immune thrombocytopenia (ITP) and antiphospholipid syndrome (APS) are distinct autoimmune disorders with clinical intersections. While APS is marked by thrombosis and pregnancy complications, ITP typically presents as isolated low platelet counts with bleeding risk. Thrombocytopenia can also occur in APS, and a subset of ITP patients test positive for antiphospholipid antibodies (aPL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study examined aPL in 90 ITP patients and compared them to 132 APS patients. Among the ITP group, 18.3% were aPL-positive, with lupus anticoagulant most common; 12% had anti-phosphatidylserine/prothrombin (aPS/PT) antibodies. In the APS cohort, 16% exhibited thrombocytopenia (&lt; 100,000/µL), with a mean platelet count of 44,000/µL, and 71% of these were positive for aPS/PT. Platelet levels varied significantly among ITP aPL-negative, ITP aPL-positive and APS-ITP groups (<i>p</i> &lt; 0.001). aPL positivity was linked to less severe thrombocytopenia but affected treatment approaches, showing differences in first-line (<i>p</i> = 0.034) and second-line (<i>p</i> = 0.025) therapies. Patients with ITP secondary to APS had a higher mean platelet count compared to aPL-positive ITP patients and aPL-negative ITP patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Screening for aPL and aPS/PT is vital to identify an ITP subset with milder thrombocytopenia and increased thrombotic risk, and may guide therapeutic decisions such as between thrombopoietin receptor agonists and SYK inhibitor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The authors have confirmed clinical trial registration is not needed for this submission.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":"6 5","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.70154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224367","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":"Insights Into Hemoglobinopathies in Spain: A Comprehensive Review","authors":"Joan-Lluis Vives Corrons","doi":"10.1002/jha2.70093","DOIUrl":"https://doi.org/10.1002/jha2.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hemoglobinopathies, including thalassemia and sickle cell disease (SCD), are increasingly prevalent in Spain due to migration and historical genetic patterns. Despite recent advances in screening and care, regional disparities in diagnosis and treatment persist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To critically assess the current landscape of hemoglobinopathies in Spain, focusing on screening program implementation, healthcare access, therapeutic innovations, and the integration of patient-centered outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review synthesizes data from national registries, recent peer-reviewed publications, and health policy documents, offering a multidisciplinary analysis of clinical, epidemiological, and public health dimensions of hemoglobinopathies in Spain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Spain has progressively implemented neonatal screening programs for SCD and thalassemias, with substantial regional variation. Innovative treatments, including gene-editing approaches, are being piloted, yet accessibility remains limited by cost and infrastructure. Multinational collaborations and national registries have improved patient monitoring and evidence-based care, although healthcare inequalities persist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Spain's efforts in diagnosis, treatment, and research of hemoglobinopathies have been significant, but further action is needed to ensure equitable healthcare access, ethical integration of gene therapies, and incorporation of patient-reported outcomes into clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration:</h3>\u0000 \u0000 <p>The author has confirmed clinical trial registration is not needed for this submission.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":"6 5","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224136","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 Role of Radiotherapy for Patients With Multiple Myeloma in the Modern Era: A Real World Single-Centre Experience","authors":"Dipal Mehta,&nbsp;Maria Gabriel,&nbsp;Nathan Adu-Poku,&nbsp;Nikolaos Kanellias,&nbsp;Xenofon Papanikolaou,&nbsp;Jonathan Sive,&nbsp;Neil Rabin,&nbsp;Rakesh Popat,&nbsp;Eileen M. Boyle,&nbsp;Lydia Lee,&nbsp;Kwee Yong,&nbsp;Agapi Parcharidou,&nbsp;Suganya Sivabalasingham,&nbsp;Karimali Keshwani,&nbsp;Ke Xu,&nbsp;Charalampia Kyriakou","doi":"10.1002/jha2.70141","DOIUrl":"https://doi.org/10.1002/jha2.70141","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Radiotherapy (RT) is a well-established treatment modality in multiple myeloma (MM), particularly for skeletal-related events. However, its role is likely evolving with the introduction of modern systemic treatments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of a large, single-centre MM cohort treated with contemporary protocols to describe current patterns of RT use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RT continues to offer clinical benefit, with shifting patterns of use observed compared to historical cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RT remains relevant in the modern MM landscape and may hold increasing value in later treatment stages. We postulate a future role as bridging therapy prior to CAR-T/bispecific antibody treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The authors have confirmed clinical trial registration is not needed for this submission</p>\u0000 </section>\u0000 </div>","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":"6 5","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.70141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224137","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":"Changes in Common Blood Parameters After Discontinuation of Tyrosine Kinase Inhibitors for Chronic Myeloid Leukaemia","authors":"Fiona Fernando,&nbsp;Claudia Wasko,&nbsp;Bronwen Johns,&nbsp;Simone Claudiani,&nbsp;Afzal Khan,&nbsp;Andrew J. Innes,&nbsp;Dragana Milojkovic,&nbsp;Jane F. Apperley","doi":"10.1002/jha2.70151","DOIUrl":"https://doi.org/10.1002/jha2.70151","url":null,"abstract":"&lt;p&gt;Tyrosine Kinase inhibitors (TKI) have transformed the management of chronic myeloid leukaemia (CML), and whilst previously the primary aim was prevention of disease progression, a more recent goal is treatment-free remission (TFR) [&lt;span&gt;1&lt;/span&gt;]. Patient-reported outcomes have shown improvements in quality of life for those who are able to stop TKIs indefinitely [&lt;span&gt;2, 3&lt;/span&gt;]. In part, this may be related to restoration of normal blood cell parameters, with cessation of any possible myelosuppression and/or electrolyte imbalance.&lt;/p&gt;&lt;p&gt;Reversible dose-dependent haematological toxicity is commonly seen on TKI therapy [&lt;span&gt;4&lt;/span&gt;]. Cytopaenias might represent a reduced bone marrow reserve of Philadelphia-negative haemopoiesis, rather than direct toxicity of TKI [&lt;span&gt;5, 6&lt;/span&gt;], a concept that is reinforced by the low rate of haematological toxicity when TKIs are used for non-haematological diseases [&lt;span&gt;7&lt;/span&gt;]. However, off-target signalling of pathways implicated in normal haemopoiesis, such as C-KIT, SRC and PDGFR, all play a role in myelosuppression and have the potential to disrupt normal haemopoiesis [&lt;span&gt;8&lt;/span&gt;]. Dasatinib is associated with higher rates of myelosuppression than imatinib and nilotinib, which is attributed to its more potent kinase inhibition [&lt;span&gt;7&lt;/span&gt;]. To investigate the reversibility of these effects, we sought to describe alterations in common blood parameters occurring after TKI discontinuation.&lt;/p&gt;&lt;p&gt;We retrospectively reviewed data from 177 patients, treated at Imperial College Healthcare NHS Trust, who discontinued TKI therapy between 7 April 2011 and 19 June 2023. Of these, 104 patients met the eligibility criteria, which included patients in chronic phase treated with any TKI, who met the ELN-defined criteria for treatment discontinuation [&lt;span&gt;1&lt;/span&gt;], remained off TKI for a minimum of 6 months and who had locally available regular blood testing. Predefined exclusion criteria included prior transplant, patients who restarted their TKI within 6 months of stopping and patients with incomplete datasets. Blood parameters, as listed in Table 1, were assessed. C-reactive protein (CRP), lactate dehydrogenase (LDH) and urate levels were excluded due to insufficient data. The median baseline was recorded for each parameter using annual readings over 3 years prior to stopping TKI therapy. The median change from baseline was calculated annually for all parameters. Data for analysis were collected only from patients off TKI therapy. Ethics approval for this analysis was attained by Imperial College Healthcare NHS Trust, as part of a service evaluation.&lt;/p&gt;&lt;p&gt;The median age of our patients was 46 (15–86) years at diagnosis, and 51 (49%) were male.&lt;/p&gt;&lt;p&gt;EUTOS long-term survival (ELTS) scores at diagnosis classified patients as low (&lt;i&gt;n&lt;/i&gt; = 63, 61%), intermediate (&lt;i&gt;n&lt;/i&gt; = 21, 20%) and high risk (&lt;i&gt;n&lt;/i&gt; = 9, 9%). The median age at TKI discontinuation was 58.5 years (25–91) and the median","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":"6 5","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.70151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223921","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":"Results From a UK Consensus via Delphi on Practical Considerations Surrounding Risk Assessment and Patient Monitoring for a Prompt Diagnosis of Severe Veno-Occlusive Disease (VOD) in Adults Post-HSCT","authors":"A. Clark,&nbsp;M. Kenyon,&nbsp;A. Pagliuca,&nbsp;R. Shah,&nbsp;E. Tholouli,&nbsp;J. A. Snowden","doi":"10.1002/jha2.70143","DOIUrl":"10.1002/jha2.70143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Veno-occlusive disease (VOD) is a life-threatening complication of haematopoietic stem cell transplantation (HSCT). The diagnosis remains challenging, with under recognition of the initial signs and symptoms potentially resulting in delayed diagnoses. The aim of this Delphi study is to establish a consensus regarding the optimal risk assessment and onward care of patients with VOD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The process employed a modified Delphi methodology. A steering group of six VOD experts working in the United Kingdom attended a virtual meeting in September 2023, developed 44 statements for testing. Respondents were offered a four-point Likert scale to indicate their level of agreement with each statement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 70 responses were received from healthcare providers working in the area of haematology and oncology in the United Kingdom. All statements achieved consensus. Overall, 82% of statements achieved ≥ 90% (<i>n</i> = 36/44), and 18% achieved ≥ 75% agreement (<i>n</i> = 8/44).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This modified Delphi process achieved consensus across all statements, allowing for a set of recommendations to be developed to support a consistent approach across the United Kingdom for the risk assessment and patient monitoring procedures for VOD post-HSCT.</p>\u0000 \u0000 <p><b>Trial Registration</b>: The authors have confirmed clinical trial registration is not needed for this submission.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":"6 5","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208493","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":"NOTCH1 Mutation Is Associated With Response to Bruton Tyrosine Kinase Inhibitors in Chronic Lymphocytic Leukemia: A Retrospective Study","authors":"Clémence Haméon,&nbsp;Roch Houot,&nbsp;Emmanuel Gyan,&nbsp;Nicolas Vallet,&nbsp;Sébastien Lachot,&nbsp;Michel Ganard,&nbsp;Olivier Herault,&nbsp;Sophie De Guibert,&nbsp;Cédric Pastoret,&nbsp;Caroline Dartigeas","doi":"10.1002/jha2.70146","DOIUrl":"https://doi.org/10.1002/jha2.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic lymphocytic leukemia (CLL) treatment choice remains a challenge in the era of molecular biology and targeted therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a bicentric retrospective analysis of the impact of NOTCH1 mutation according to the treatment of CLL patients in real life.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 45 patients with NOTCH1 mutation have been reported, including 15 patients treated with FCR BR or DRC regimen and 18 patients with a BTK inhibitor. NOTCH1 mutation is the most frequently occurring molecular abnormality in CLL and is closely associated with poor prognosis but is not used in treatment guidelines unlike TP53 and IGHV. In our study, progression-free survival was significantly longer in CLL patients with NOTCH1 mutation treated by BTK inhibitors compared to immunochemotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Routine screening for NOTCH1 mutations could identify patients who may benefit from BTKi treatment. However, the impact of NOTCH1 mutations on combination therapies, such as obinutuzumab-venetoclax or venetoclax-BTKi, is yet to be determined.</p>\u0000 \u0000 <p>The authors have confirmed clinical trial registration is not needed for this submission</p>\u0000 </section>\u0000 </div>","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":"6 5","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146920","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":"Reduced Versus Full-Dose Direct Oral Anticoagulants for Venous Thromboembolism in Cancer Patients: A Systematic Review and Meta-Analysis","authors":"Danyal Bakht,&nbsp;Muhammad Arham,&nbsp;Zarwa Rashid,&nbsp;Maaz Amir,&nbsp;Zarish Nasir,&nbsp;Mustabeen Zahra Naqvi,&nbsp;Maleeha Tahir,&nbsp;Musab Khalil,&nbsp;Esha Gulzar,&nbsp;Hafiz Muhammad Haris,&nbsp;Kinza Bakht,&nbsp;Allah Dad,&nbsp;Haseeb Tareen,&nbsp;Muhammad Numan Awais","doi":"10.1002/jha2.70155","DOIUrl":"https://doi.org/10.1002/jha2.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Venous thromboembolism (VTE) is a serious complication in cancer patients, with malignancy increasing the risk significantly. Direct oral anticoagulants (DOACs) have emerged as a convenient alternative to traditional therapies, though optimal dosing remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a systematic review and meta-analysis on three studies. A comprehensive literature search was performed on PubMed, Embase, the Cochrane Library, and ScienceDirect till April 2025. Analysis was carried out on RevMan 5.4. The risk of bias was assessed via RoB 2.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of three studies with 2416 participants were identified, including 1495 patients in the reduced-dose group and 1232 patients in the full-dose group. No significant difference was observed in recurrent VTE (OR 0.70, 95% CI 0.45–1.09, <i>p</i> = 0.11) or recurrent symptomatic VTE (OR 0.96, 95% CI 0.50–1.84, <i>p</i> = 0.91). However, reduced-dose DOACs were associated with a significantly lower incidence of incidental VTE (OR 0.31, 95% CI 0.14–0.69, <i>p</i> = 0.004). The reduced-dose group also had a lower incidence of CRNMB plus major bleeding (OR 0.69, 95% CI 0.55–0.88, <i>p</i> = 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In terms of venous thromboembolism, bleeding events, and all-cause mortality, reduced-dose DOACs demonstrated a safety profile that was either superior or comparable to that of full-dose DOACs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The authors have confirmed clinical trial registration is not needed for this submission</p>\u0000 </section>\u0000 </div>","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":"6 5","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.70155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146390","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}