Advances in Hematology最新文献

{"title":"The Natural Coagulation Inhibitors, Inflammation, and Thrombotic Risk in Sickle Cell Patients in Cameroon: An Analytical Cross-Sectional Study.","authors":"Romaric De Manfouo Tuono, Josué Louokdom Simo, Paule Rita Ngamgwe Tchouanmo, Ingrid Worti Sulem Yong, Maryline Seuko Njopwouo, Claude Tagny Tayou","doi":"10.1155/ah/1400762","DOIUrl":"10.1155/ah/1400762","url":null,"abstract":"<p><strong>Introduction: </strong>Thrombotic risk refers to the likelihood of a thrombus, or blood clot, forming in the vascular system, which can obstruct blood flow and cause serious complications. This risk is closely linked to the function of physiological coagulation inhibitors. The causes of thrombosis are multiple, including damage to the vascular wall caused by blood vessel injury, trauma, surgery, or vascular inflammation; these can initiate stasis, or slow blood flow, thus promoting blood cell aggregation and clot formation. These factors are encountered during several pathological processes, including sickle cell disease. This study aimed to evaluate physiological coagulation inhibitors and their association with inflammation and to deduce the thrombotic risk in patients with sickle cell disease.</p><p><strong>Materials and methods: </strong>We conducted an analytical cross-sectional study over 1 year. The Bafoussam Regional Hospital served as the framework for this research. The study population consisted of homozygous sickle cell patients regularly followed in the hospital and recruited in the hematology department. The collected blood samples were sent to the Hematology and Hemostasis laboratory. The analyses carried out were the hemogram by the flow cytometry method; the determination of the activity of protein C, protein S, and antithrombin with a coagulometer by the magnetic method; and finally, the exploration of inflammation from CRP dosage by the ultrasensitive method and the dosage of interleukin-6 by the ELISA sandwich method. The data obtained were recorded in an Excel 2013 spreadsheet and analyzed using the statistical software <i>R</i> Version 4.1.1.</p><p><strong>Results: </strong>A total of 150 homozygous sickle cell patients were included in this study. Of these, 98 (65.34%) presented a thrombotic risk. A high frequency of anemia (94.7%) was reported. Moreover, 82.7% and 64.0%, respectively, of leukocytosis and thrombocytosis were reported. An elevation of inflammatory parameters was observed characterized by an elevation of CRP (100% of patients at risk versus none in the group without it) and a significantly higher median IL-6 level in the group of patients at thrombotic risk (50.1 [28.7-76.6] [pg/mL]) compared to those without it (32.3 [14.1-44.4] pg/mL) (<i>p</i> = 0.001). A decrease in coagulation inhibitors was observed, notably a significant decrease in protein C in patients with thrombotic risk compared to those without, with respective proportions of 71.6% and 50% (<i>p</i> = 0.001). The median antithrombin level was 79.0% (77.0-92.0) in patients with thrombotic risk and 94.0% (84.0-102) in those without (<i>p</i> < 0.001). Patients at risk of thrombosis had a significant decrease in protein S (76.6% vs. 50% [<i>p</i> < 0.001]); the decrease in the latter was identified as a predictive factor of thrombotic risk during sickle cell disease (aOR = 1.5 [1.1; 5.2]; <i>p</i> = 0.04).</p><p><strong>Conclusion: </stro","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2026 ","pages":"1400762"},"PeriodicalIF":0.0,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13181923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969520","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":"Bispecific Antibodies in Hematologic Malignancies in the Outpatient and Community Settings.","authors":"Amrit S Gonugunta, Asad Haider, Virginia Mohlere, Mahmoud Aljurf, Shahrukh Hashmi, Muhammad Bilal Abid","doi":"10.1155/ah/4529571","DOIUrl":"10.1155/ah/4529571","url":null,"abstract":"<p><p>Bispecific antibodies (BsAbs) are novel antitumor agents that simultaneously engage tumor-associated antigens with CD3 on endogenous effector T cells, leading to cancer cell death. The immune-mediated toxicity rates associated with BsAbs are considerably lower than those seen with CAR T-cell therapy. Hence, widespread utilization of BsAb products in outpatient and community settings will allow greater and more homogeneous access and thus improve patient outcomes. In this review, we discuss the unique toxicities associated with BsAbs currently approved by the U.S. Food and Drug Administration and provide a disease-agnostic framework for the safe community administration of BsAb therapy. With academic, community, and industrial partnerships, broader deployment of BsAbs could be streamlined. Education, provision of in-services, leveraging protocols and experiences, and development of templates and guidelines will make this transition smoother and allow every patient in need of BsAbs to receive timely access to these survival-prolonging therapies.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2026 ","pages":"4529571"},"PeriodicalIF":0.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866438","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":"Impact of Preanalytical Storage Time and Air Exposure on ROTEM and Coagulation Sample Stability.","authors":"Benjamin S Storm, Renathe H Grønli, Kristin Pettersen, Åse E Emblem, Ingrid S Joakimsen, Anne Landsem, Tom E Mollnes, Ole-L Brekke","doi":"10.1155/ah/5145648","DOIUrl":"10.1155/ah/5145648","url":null,"abstract":"<p><strong>Introduction: </strong>The preanalytical phase of blood sample collection, storage, and transportation is crucial in clinical laboratory practice. This study examined the impact of preanalytical storage time and the presence of air in the test tube on viscoelastic and traditional coagulation tests and platelet activation markers.</p><p><strong>Methods: </strong>Blood samples from ten healthy donors were divided into Vacuette sodium citrate and K2E EDTA tubes, with and without air, and stored at room temperature with gentle agitation for up to 48 h. Coagulation tests (ROTEM, APTT, INR, and PTF1 + 2), platelet activation markers (β-thromboglobulin and sP-selectin), blood gases and metabolites (pH, pCO₂, pO₂, bicarbonate, hemoglobin, sO₂, K⁺, Ca²⁺, glucose, and lactate), and hemolysis (free hemoglobin and absorbance) were measured.</p><p><strong>Results: </strong>In citrated blood samples, ROTEM parameters, APTT, and PTF1 + 2 remained stable during 6 hours of storage at room temperature, and INR was stable for 48 h. In EDTA blood, β-thromboglobulin increased initially and then remained stable for 6 hours. sP-selectin remained stable for 6 hours. In EDTA blood samples, hemolysis remained minimal during storage, but cell death revealed by a lactate dehydrogenase increase was observed after 24 h. Blood gases and metabolites exhibited rapid changes, underscoring the need for immediate analysis. No significant differences were observed between samples with and without air in the test tubes.</p><p><strong>Conclusion: </strong>ROTEM, APTT, PTF1 + 2, and platelet activation markers were stable for 6 h and INR was stable for 48 h. Removing ambient air from blood samples did not extend preanalytical stability. These insights are valuable for optimizing preanalytical practices in clinical laboratories, potentially improving patient care and reducing costs.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2026 ","pages":"5145648"},"PeriodicalIF":0.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148824011","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":"Multiple Myeloma and Secondary Immunodeficiency: A Retrospective Database Analysis Assessing Burden of Infection and Treatment Patterns.","authors":"Csaba Siffel, Matthew S Davids, Colin Anderson-Smits, Marta Kamieniak, Kaili Ren, Shirin Ardeshir-Rouhani-Fard, Drishti Shah, Joshua Richter","doi":"10.1155/ah/5340241","DOIUrl":"10.1155/ah/5340241","url":null,"abstract":"<p><p>Patients with multiple myeloma (MM) and secondary immunodeficiency (SID) are at risk of infection-related morbidity and mortality owing to the disease process and treatment toxicity. This retrospective cohort study used anonymized data from the Optum-Humedica database (October 2015-March 2020) to assess the burden of infection in patients with MM and SID versus patients without SID. Patients aged ≥ 18 years with confirmed MM were assigned to SID and no-SID cohorts using an algorithm considering serum IgG levels < 5.0 g/L, hypogammaglobulinemia diagnosis codes, and ≥ 1 major infection. Patients with SID were stratified into those treated or not treated with immunoglobulin replacement therapy (IgRT and no-IgRT cohorts). At 12 months follow-up, a greater proportion of the SID cohort than the no-SID cohort experienced infections (58.9% vs. 31.3%; <i>p</i> < 0.001), severe infections (29.8% vs. 10.6%, <i>p</i> < 0.001), and infection-related hospitalizations (26.9% vs. 9.1%; <i>p</i> < 0.001). Bacterial infections were the most common infection type (SID cohort, 49.2%; no-SID cohort, 26.1%; IgRT cohort, 70.4%; no-IgRT cohort, 45.1%). Use of anti-infectives and healthcare resource utilization was higher in the SID cohort than in the no-SID cohort. Median overall survival was shorter in the SID versus no-SID cohort (12.6 vs. 14.7 months; <i>p</i> < 0.001) and was similar in the IgRT versus no-IgRT cohort (8.5 vs. 12.5 months; <i>p</i> = 0.446). Among patients with MM and SID, the higher infection burden in patients treated with IgRT than no-IgRT suggests the IgRT cohort was a more vulnerable population. A better understanding of SID burden may improve outcomes for patients with MM.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2025 ","pages":"5340241"},"PeriodicalIF":0.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12740457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848786","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":"Positive Indirect Antiglobulin Test in Adult Patients With Primary Warm Autoimmune Hemolytic Anemia: Clinical Significance and Prognostic Effect on Response to Corticosteroids.","authors":"Mahmoud Husni Ayesh Haj Yousef, Muna Al-Khalayleh, Khaled A Abu Hmdeh, Mustafa M Hayajneh, Weam El-Sheyab","doi":"10.1155/ah/2945671","DOIUrl":"10.1155/ah/2945671","url":null,"abstract":"<p><strong>Background: </strong>Primary warm autoimmune hemolytic anemia (PWAIHA) is a subtype of autoimmune hemolytic anemia (AIHA) characterized by premature destruction of red blood cells (RBCs) due to autoantibodies, typically immunoglobulin G (IgG), the cornerstone of which is a positive direct antiglobulin test. The indirect antiglobulin test (IAT) is used as a screening test to detect common and clinically significant RBC alloantibodies in patient serum.</p><p><strong>Objective: </strong>This study aimed to analyze the prevalence, clinical characteristics, and impact of positive IAT in adult patients with PWAIHA at the time of diagnosis, as well as the response to corticosteroids as the first-line treatment.</p><p><strong>Methods: </strong>This single-center retrospective case-control study was conducted between September 2002 and May 2024 at King Abdullah University Hospital. We analyzed data from 80 adult patients diagnosed with PWAIHA, aged a minimum of 16 years. After recording baseline investigations, including IAT and antinuclear antibody (ANA), all patients were treated with corticosteroids as first-line treatment. The response rate and prevalence of ANA were compared between the IAT-positive and -negative PWAIHA groups.</p><p><strong>Results: </strong>Baseline IAT positivity was found in 65% of our patients. Both groups were comparable in terms of age, sex, and hemoglobin levels. Serum LDH presentations were higher in positive IAT patients, response to corticosteroids was numerically higher in patients with negative IAT (54%) than those with positive IAT (33%), and after tapering steroids, patients with a positive IAT had higher rates of relapses compared with those with negative IAT. Positive ANA was found only in IAT-positive patients (25%), which was statistically significant.</p><p><strong>Conclusion: </strong>An association between baseline IAT positivity and lower rates of complete response was observed in PWAIHA patients. The presence of IAT serves as a prognostic indicator and aids in the decision-making process regarding treatment options. Furthermore, positive IAT results are linked to a higher prevalence of ANA positivity.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2025 ","pages":"2945671"},"PeriodicalIF":0.0,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12723080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145825649","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":"Hyper-CVAD in Adults With Acute Lymphoblastic Leukemia in Ecuador: A Multicenter Retrospective Study.","authors":"Brenner Sabando, Jairo Quinonez, Andrés Orquera, Danilo Navarrete, Jhoanna Ramírez, Lorena Sanchez, Teodoro Chisesi, Jorge Oliveros, María A Pacheco, María C Trujillo, Carlos Plaza, Yaira Loor","doi":"10.1155/ah/9995923","DOIUrl":"10.1155/ah/9995923","url":null,"abstract":"<p><strong>Background: </strong>The Hyper-CVAD protocol is a chemotherapy regimen widely used in hematological malignancies. It is considered one of most promising remission-leading treatment option for adults with acute lymphoblastic leukemia (ALL).</p><p><strong>Objective: </strong>To determine the outcomes of adults with ALL treated with the Hyper-CVAD protocol in Ecuador.</p><p><strong>Methods: </strong>This multicenter, retrospective, cross-sectional study compared the outcomes of ALL patients aged 15 years and older treated with hyper-CVAD protocol in 8 specialized centers.</p><p><strong>Results: </strong>139 patients with ALL treated with the Hyper-CVAD protocol were included. A total of 79 were female (56.8%) and the majority had a B-type phenotype 130 (93.5%). A complete response (CR) was achieved in 64.3%. Relapse was confirmed in 52.7% of those who obtained CR. Negative minimal residual disease (MRD) was achieved in 20% of patients. The median overall survival (OS) was 11 months (95% CI: 7.49-14.50) with a 5-year OS of 14.0%. A total of 12 (8.6%) deceased during induction phase.</p><p><strong>Conclusion: </strong>Adult patients treated with the Hyper-CVAD protocol in Ecuador achieve rates of CR, MRD, and OS lower than those presented in international cohorts, as well as higher rates of treatment-related toxicity.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2025 ","pages":"9995923"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766776","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":"Hematological Biomarkers in Predicting Progression and Complications of Chronic Kidney Disease Among Adult Patients.","authors":"Collince Odiwuor Ogolla, Lucy W Karani, Stanslaus Musyoki, Phidelis Maruti","doi":"10.1155/ah/8487716","DOIUrl":"10.1155/ah/8487716","url":null,"abstract":"<p><strong>Background: </strong>CKD is a progressive disorder that is commonly associated with hematological abnormalities.</p><p><strong>Objective: </strong>The objective of the study was to evaluate the role of hematological biomarkers in predicting CKD progression and related complications in adult patients.</p><p><strong>Methods: </strong>The retrospective cross-sectional study evaluated hematological parameters such as hemoglobin, RBC, WBC, platelet, and NLR; comorbidities; and CKD stages were recorded for analysis. Statistical analysis methods used included ANOVA, Chi-square, multiple logistic regression, Pearson correlation analyses, and ROC curve analysis. The study was conducted under strict adherence to the principles and guidelines of the Helsinki Declaration (2013).</p><p><strong>Results: </strong>The mean age was 56.2 ± 14.8 years, with males being 56.7%. About 70.8% of the patients were in CKD Stages 3-5. Anemia was observed in 74.2% of the patients, whose prevalence increased alongside the increase in severity of CKD (<i>p</i> < 0.001). There was a significant decrease in hemoglobin, RBC, and platelet counts with advancing CKD stages, whereas WBC and NLR increased (<i>p</i> < 0.001). Hemoglobin (OR: 0.72; <i>p</i> < 0.001), NLR (OR: 1.43; <i>p</i> = 0.006), and platelet count (OR: 0.98; <i>p</i> = 0.021) were independent predictors of progression to CKD Stage 5. ROC analysis yielded good results for hemoglobin (AUC: 0.81) and NLR (AUC: 0.76) in predicting CKD Stage 5. Hemoglobin and platelet-count levels were significantly correlated with eGFR (<i>r</i> = -0.70 and <i>r</i> = 0.58, respectively).</p><p><strong>Conclusion: </strong>The performance of hematological biomarkers, mainly hemoglobin and NLR, emerges as reliable predictor of CKD progression and complications. Their assessment as part of the CKD workup may then enhance risk stratification and early intervention.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2025 ","pages":"8487716"},"PeriodicalIF":0.0,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12676047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699398","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":"Comparison of Ideal vs. Actual Body Weight Dosing of Intravenous Immunoglobulins for Immune Thrombocytopenia: A Retrospective Analysis.","authors":"Hamdi Lababidi, Valassia Antigone Theocharides, Jimmy Gonzalez","doi":"10.1155/ah/8770122","DOIUrl":"10.1155/ah/8770122","url":null,"abstract":"<p><strong>Introduction: </strong>Intravenous immunoglobulin (IVIG) is a weight-based therapy used to treat immune thrombocytopenia (ITP). Although pharmacokinetic data support the use of ideal body weight (IBW)-based dosing, clinical outcomes for this dosing strategy are lacking.</p><p><strong>Materials and methods: </strong>This retrospective, multicenter chart review was conducted across five institutions compared clinical outcomes and costs for patients with ITP treated with IVIG dosed via actual body weight (ABW) or IBW. Data were collected from November 1, 2019 to April 10, 2024. The primary outcome was early platelet response, and secondary outcomes included length of stay (LOS) and increase in platelet count.</p><p><strong>Results: </strong>A total of 94 patients were included for analysis. No significant differences were noted between the ABW and IBW groups for early platelet response (59.1% vs. 47.2%, <i>p</i> = 0.466), LOS (9 vs. 6 days, <i>p</i> = 0.111), and the increase in platelet count (54.5 vs. 18.5 × 10⁹/L, <i>p</i> = 0.681). The estimated average cost of IVIG per patient was $5231.87 lower for the IBW group.</p><p><strong>Conclusions: </strong>The utilization of IBW-based dosing of IVIG for ITP treatment was not associated with a change in early platelet response, LOS, or increase in platelet count compared with ABW-based dosing but was associated with cost savings.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2025 ","pages":"8770122"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12669801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666636","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":"Clinical Outcomes in Patients With CLL Treated With BTKi at a Large US Cancer Center.","authors":"Kevin H Lin, Lynn Huynh, Xiaoqin Yang, Enrico Zanardo, Daria Liborski, Mikaela M McDonough, Mohammed Z H Farooqui, Enrico De Nigris, Shravanthi R Gandra, Mei Sheng Duh, Jennifer R Brown, Matthew S Davids","doi":"10.1155/ah/7492594","DOIUrl":"10.1155/ah/7492594","url":null,"abstract":"<p><p>Patients with chronic lymphocytic leukemia (CLL) treated with covalent Bruton's tyrosine kinase inhibitors (BTKi) eventually discontinue treatment, but data on outcomes post-BTKi treatment discontinuation are limited. In this single-institution, retrospective chart review of 104 adult patients with CLL treated with a covalent BTKi between July 2011 and April 2019 and who subsequently discontinued for any reason, the majority of patients (59.9%) received the index BTKi in their first (27.5%) or second (32.4%) line of therapy. Median progression-free survival (PFS) from index BTKi initiation was 3.2 years, and median overall survival (OS) was 8.9 years. There was a notable correlation between PFS and OS (<i>r</i> = 0.79). Following the discontinuation of their last BTKi treatment, over half of these patients received subsequent therapies (80.6% of whom received regimens containing B-cell lymphoma 2 inhibitors [BCL2i]). Of the patients who received BCL2i-containing therapy after index BTKi treatment, 77.8% achieved an overall response to BCL2i at first clinical assessment. However, 73.8% of the patients exposed to BTKi and BCL2i eventually discontinued BCL2i treatment and 36.1% died, with a median follow-up of 2.6 years from BCL2i initiation. A subset of patients who were exposed to and were found to be relapsed, refractory, resistant, or intolerant to both BTKi and BCL2i-based regimens (<i>n</i> = 25) had high rates of progressive disease at first assessment (15.0%) and death (44.0%). These findings highlight an unmet clinical need for patients with CLL and underscore the urgency to develop effective new strategies to treat those patients who have already received covalent BTKi and BCL2i.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2025 ","pages":"7492594"},"PeriodicalIF":0.0,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653090","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":"Optimizing Testing Time for Methaemoglobin Reduction Test in G6PD Screening: A Comparative Study of Monica Cheesbrough's Protocol and a Modified Approach at a Hospital in a Resource-Restraint Country, Ghana.","authors":"Richard Vikpebah Duneeh, Emmanuel Appiah-Intsiful, Israel Bedzina, Elliot Elikplim Akorsu, Emmanuel Allotey, Mercy Adzo Klugah, Francis Agyei Amponsah, Wina Ivy Ofori Boadu, Paul Ntiamoah, Alexander Asamoah, Kenneth Ablordey","doi":"10.1155/ah/2919872","DOIUrl":"10.1155/ah/2919872","url":null,"abstract":"<p><strong>Background: </strong>Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an inherited disorder caused by a genetic defect in the red blood cell enzyme G6PD, affecting around 500 million people worldwide. The study investigated the optimum Methaemoglobin Reduction Test (MRT) reaction time for diagnosing G6PD deficiency among patients at Asutifi North District Hospital using Monica Cheesbrough protocol and Asutifi North District Hospital Protocol.</p><p><strong>Methodology: </strong>The study was an experimental study conducted with 643 participants from April, 2024 to July, 2024. The Monica Cheesbrough MRT and the modified approach (Asutifi North Hospital MRT protocols), were compared at various time points (T90, T120, T150, and T180 min). Intraclass Correlation Coefficient (ICC) and Kappa statistics were used to assess reliability and agreement between the results from the two protocols. McNemar's test was utilized to analyse G6PD status differences between the protocols. The prevalence of G6PD deficiency was also determined. Data analyses were done using IBM Statistical Package for the Social Sciences version 26.0 (2019. Armonk, NY: IBM Corp). <i>p</i>-value less than 0.05 was considered statistically significant for all analyses.</p><p><strong>Results: </strong>T90 ICC values were very low (0.005-0.007), indicating poor agreement. From T120 onwards, ICC values were high (0.967-0.996, <i>p</i> < 0.001), demonstrating excellent reliability. Significant differences in G6PD status were found at T90 (<i>p</i> < 0.001), with diminishing differences at later time points. Kappa values indicated slight agreement at T90 (<i>K</i> = 0.164, <i>p</i> < 0.001) and perfect agreement from T120 onwards (<i>K</i> = 1.000, <i>p</i> < 0.001). The majority of participants 606 (94.2%) had normal G6PD status, 29 (4.5%) had a fully defective enzyme, and 8 (1.2%) had a partially defective enzyme activity.</p><p><strong>Conclusion: </strong>The study found the optimum MRT reaction to be 120 min. The study also emphasized lesser volumes of blood samples and reagent give accurate results in the optimum time established. These insights can contribute to faster turnaround times and efficient sample and reagent management especially amongst paediatric patients where it is difficult taking very large volumes of blood for testing.</p>","PeriodicalId":7325,"journal":{"name":"Advances in Hematology","volume":"2025 ","pages":"2919872"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12631168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145585857","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}