American Journal of Hematology最新文献

{"title":"Quadruplets in newly diagnosed transplant-ineligible multiple myeloma","authors":"Rajshekhar Chakraborty, Hira Mian","doi":"10.1002/ajh.27473","DOIUrl":"https://doi.org/10.1002/ajh.27473","url":null,"abstract":"<p>To the Editor:</p>\u0000<p>With the advent of proteasome inhibitors (PIs), immunomodulatory drugs (IMiDs), and anti-CD38 monoclonal antibodies (CD38mAbs), the outcomes of transplant-ineligible (TIE) patients with newly diagnosed multiple myeloma (MM) have substantially improved in the last decade.<span><sup>1-3</sup></span> Currently, there are two widely accepted standard-of-care regimens in newly diagnosed TIE MM: daratumumab-lenalidomide-dexamethasone (DRd) and bortezomib-lenalidomide-dexamethasone (VRd), based on the MAIA and S0777 trials, respectively, both of which showed significant progression-free survival (PFS) and overall survival (OS) benefit over Rd.<span><sup>1, 2, 4, 5</sup></span> The major toxicity of concern with the addition of CD38mAb is infection and with bortezomib is peripheral neuropathy. While these triplet regimens have been considered the standard of care, two RCTs have been recently reported that compared a quadruplet regimen to these triplet regimens.<span><sup>6, 7</sup></span> The IMROZ phase III trial evaluated the CD38mAb isatuximab on the backbone of bortezomib, lenalidomide, and dexamethasone (Isa-VRd) compared with VRd alone. The IFM-2020/BENEFIT (hereafter, referred to as BENEFIT) trials evaluated Isa-VRd compared with IsaRd alone. Additionally, a third RCT named GEM2017FIT compared the quadruplet regimen daratumumab-carfilzomib-lenalidomide-dexamethasone (Dara-KRd) against KRd and alternating VMP/Rd (VMP: bortezomib-melphalan-prednisone) in this patient population.<span><sup>8</sup></span> The study design and key outcomes of these trials are summarized in Table 1. Here, we will discuss three key aspects of these trials (inclusion criteria, toxicity, and efficacy) and future directions for optimizing therapy for this patient population.</p>\u0000<div>\u0000<header><span>TABLE 1. </span>Key randomized controlled trials comparing quadruplets versus triplets in transplant-ineligible multiple myeloma.</header>\u0000<div tabindex=\"0\">\u0000<table>\u0000<thead>\u0000<tr>\u0000<td></td>\u0000<th>IFM-2020/BENEFIT (<i>n</i> = 270)</th>\u0000<th>IMROZ (<i>n</i> = 446)</th>\u0000<th>GEM2017FIT (<i>n</i> = 462)</th>\u0000</tr>\u0000</thead>\u0000<tbody>\u0000<tr>\u0000<td colspan=\"4\">Inclusion criteria</td>\u0000</tr>\u0000<tr>\u0000<td style=\"padding-left:2em;\">Age</td>\u0000<td>65–79 years AND non-frail (<i>IMWG Frailty Score <2</i>)</td>\u0000<td>≥18–80 years AND TIE due to ≥65 years or comorbidities</td>\u0000<td>TIE with age <80 years</td>\u0000</tr>\u0000<tr>\u0000<td style=\"padding-left:2em;\">ECOG or Frailty cut-off</td>\u0000<td>ECOG >2 or Frail excluded</td>\u0000<td>ECOG >2 excluded</td>\u0000<td>Geriatric Assessment Hematology score >42</td>\u0000</tr>\u0000<tr>\u0000<td colspan=\"4\">Trial treatment</td>\u0000</tr>\u0000<tr>\u0000<td style=\"padding-left:2em;\">Regimen</td>\u0000<td>Isa-VRd vs. IsaRd</td>\u0000<td>Isa-VRd vs. VRd</td>\u0000<td>VMP-Rd vs. KRd vs. Dara-KRd</td>\u0000</tr>\u0000<tr>\u0000<td colspan=\"4\">Results</td>\u0000</tr>\u0000<tr>\u0000<td style=\"padding-left:2em;\">Age of enrolled patients (median, range unless otherwise specified)</td>\u0000<td>73 (IQR 71–76)</td>\u0000<td>72 (55–80)</td>\u0000<td>72","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142160932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of induction regimens intensity and allogeneic stem cell transplantation on survival of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia: A multi-institutional study","authors":"Talha Badar, Ravi Narra, Alice S. Mims, Michael G. Heckman, Rory M. Shallis, Sheikh Fahad, Cameron Hunter, Vamsi Kota, Tamer Adel Othman, Brian Jonas, Shreya Desai, Guilherme Sacchi de Camargo Correia, Anand Patel, Adam S. DuVall, Neil Palmisiano, Emily Curran, Zulfa Omer, Anjali Advani, Ehab Atallah, Mark Litzow","doi":"10.1002/ajh.27475","DOIUrl":"https://doi.org/10.1002/ajh.27475","url":null,"abstract":"<p>Prior to the advent of <i>BCR</i>::<i>ABL1</i>-directed tyrosine kinase inhibitors (TKI), the long-term survival of patients with Philadelphia chromosome-positive (Ph<sup>+</sup>) acute lymphoblastic leukemia (ALL) was dismal in the range of 5%–15%.<span><sup>1</sup></span> The introduction of TKI in the treatment regimens has significantly improved disease outcomes.<span><sup>2</sup></span> Historically, allogeneic stem cell transplantation (allo-HCT) was considered the consolidation of choice for patients with Ph<sup>+</sup> ALL in first complete remission (CR) given its association with improved long-term survival, which has not changed in the post TKI era.<span><sup>3</sup></span> Recently, it was reported that the survival benefit of consolidation allo-HCT in patients who achieve a <i>BCR</i>::<i>ABL1</i> transcript level of <0.01% via reverse-transcription PCR-based quantitative assay (RT-PCR) by 90 days post induction may be questionable.<span><sup>4</sup></span> In this study, utilizing multi-institutional real-world data, we analyzed the outcomes of patients with Ph<sup>+</sup> ALL with evolving frontline therapies and the significance of allo-HCT in improving long-term outcome.</p>\u0000<p>We conducted a real-world, multi-institutional analysis through the COMMAND (Consortium on Myeloid Malignancies and Neoplastic Diseases). The study was conducted after obtaining approval from the Institutional Review Board (IRB), adhering to the ethical standards of the Declaration of Helsinki. A total of 431 adult (≥ 18 years) patients with Ph<sup>+</sup> ALL diagnosed between May 2003 and December 2022 were evaluated to assess for response and survival with intensive (IC) and nonintensive (NIC) frontline TKI-based treatment combinations. We also assessed the survival benefit of allo-HCT including patients who achieved complete molecular remission (CMR) at 3 months from the time of induction therapy. Details on methods and statistical analysis performed are available in Supplementary Material.</p>\u0000<p>The median age of patients was 52 years (range [R] 19–85), and 50% were male (Supplementary Table 1). The most common <i>BCR::ABL1</i> breakpoint was the p190 fusion protein (51%), 55% of patients had additional cytogenetic (CG) abnormalities apart from t (9;22), and 35 (8%) patients had CNS disease at diagnosis. Most patients received TKI in combination with an IC (<i>n</i> = 317 [74%]), with 26% (<i>n</i> = 112) receiving TKI with an NIC; data are not available on two patients. During induction, most patients received a second-generation TKI (70% [<i>n</i> = 298]); 87 patients (20%) received imatinib and 41 patients (10%) received ponatinib. A total of 205 of 431 (47.5%) patients received allo-HCT in CR1. The complete remission (CR/CRi) rate was 95% (<i>n</i> = 412 of 431 were evaluable for response). Fifty-one percent of patients achieved MRD negativity by multiparameter flow cytometry (MFC) after induction and 67% (<i>N</i> = 335 evaluable) had CMR ","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142161033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haploidentical hematopoietic cell transplantation as a platform for natural killer cell immunotherapy.","authors":"Rémy Duléry, Sara Piccinelli, Mohmad Shahnawaz Beg, Ji Eun Jang, Rizwan Romee","doi":"10.1002/ajh.27471","DOIUrl":"https://doi.org/10.1002/ajh.27471","url":null,"abstract":"<p><p>An innovative approach is crucially needed to manage relapse after allogeneic hematopoietic cell transplantation (HCT) in patients with advanced hematological malignancies. This review explores key aspects of haploidentical HCT with post-transplant cyclophosphamide, highlighting the potential and suitability of this platform for natural killer (NK) cell immunotherapy. NK cells, known for their unique abilities to eliminate cancer cells, can also exhibit memory-like features and enhanced cytotoxicity when activated by cytokines. By discussing promising results from clinical trials, the review delves into the recent major advances: donor-derived NK cells can be expanded ex vivo in large numbers, cytokine activation may enhance NK cell persistence and efficacy in vivo, and post-HCT NK cell infusion can improve outcomes in high-risk and/or relapsed myeloid malignancies without increasing the risk of graft-versus-host disease, severe cytokine release syndrome, or neurotoxicity. Looking ahead, cytokine-activated NK cells can be synergized with immunomodulatory agents and/or genetically engineered to enhance their tumor-targeting specificity, cytotoxicity, and persistence while preventing exhaustion. The ongoing exploration of these strategies holds promising preliminary results and could be rapidly translated into clinical applications for the benefit of the patients.</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":10.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hodgkin lymphoma: 2025 update on diagnosis, risk-stratification, and management.","authors":"Stephen M Ansell","doi":"10.1002/ajh.27470","DOIUrl":"https://doi.org/10.1002/ajh.27470","url":null,"abstract":"<p><strong>Disease overview: </strong>Hodgkin lymphoma (HL) is an uncommon B-cell lymphoid malignancy affecting 8570 new patients annually and representing ~10% of all lymphomas in the United States.</p><p><strong>Diagnosis: </strong>HL is composed of two distinct disease entities: classical HL and nodular lymphocyte predominant HL (also called nodular lymphocyte predominant B-cell lymphoma). Nodular sclerosis, mixed cellularity, lymphocyte depletion, and lymphocyte-rich HL are subgroups of classical HL.</p><p><strong>Risk stratification: </strong>An accurate assessment of the stage of disease in patients with HL is critical for the selection of the appropriate therapy. Prognostic models that identify patients at low or high risk for recurrence, as well as the response to therapy as determined by positron emission tomography (PET) scan, are used to optimize therapy.</p><p><strong>Risk-adapted therapy: </strong>Initial therapy for HL patients is based on the histology of the disease, the anatomical stage and the presence of poor prognostic features. Patients with early-stage disease are typically treated with combined modality strategies utilizing abbreviated courses of combination chemotherapy followed by involved-field radiation therapy, whereas those with advanced stage disease receive a longer course of chemotherapy often without radiation therapy. However, newer agents including brentuximab vedotin and anti-PD-1 antibodies are now standardly incorporated into frontline therapy.</p><p><strong>Management of relapsed/refractory disease: </strong>High-dose chemotherapy (HDCT) followed by an autologous stem cell transplant (ASCT) is the standard of care for most patients who relapse following initial therapy. For patients who fail HDCT with ASCT, brentuximab vedotin, PD-1 blockade, non-myeloablative allogeneic transplant or participation in a clinical trial should be considered.</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":10.1,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher survival following transplantation with a mismatched unrelated donor with posttransplant cyclophosphamide-based graft-versus-host disease prophylaxis than with double unit umbilical cord blood in patients with acute myeloid leukemia in first complete remission: A study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation","authors":"Frédéric Baron, Myriam Labopin, Jurjen Versluis, Jan Vydra, Peter A. von dem Borne, Emma Nicholson, Didier Blaise, Rachel Protheroe, Alexander Kulagin, Claude Eric Bulabois, Montserrat Rovira, Patrice Chevallier, Edouard Forcade, Jenny Byrne, Jaime Sanz, Annalisa Ruggeri, Mohamad Mohty, Fabio Ciceri","doi":"10.1002/ajh.27466","DOIUrl":"https://doi.org/10.1002/ajh.27466","url":null,"abstract":"The best donor option for acute myeloid leukemia (AML) patients lacking an HLA-matched donor has remained intensively debated. We herein report the results of a large retrospective registry study comparing hematopoietic cell transplantation (HCT) outcomes between double-unit umbilical cord blood transplantation (dCBT, <i>n</i> = 209) versus 9/10 HLA-matched unrelated donor (UD) with posttransplant cyclophosphamide (PTCy)-based graft-versus-host disease (GVHD) prophylaxis (UD 9/10, <i>n</i> = 270) in patients with AML in first complete remission (CR1). Inclusion criteria consisted of adult patient, AML in CR1 at transplantation, either peripheral blood stem cells (PBSC) from UD 9/10 with PTCy as GVHD prophylaxis or dCBT without PTCy, transplantation between 2013 and 2021, and no in vivo T-cell depletion. The 180-day cumulative incidence of grade II-IV acute GVHD was 29% in UD 9/10 versus 44% in dCBT recipients (<i>p</i> = .001). After adjustment for covariates, dCBT recipients had a higher non-relapse mortality (HR = 2.35, 95% CI: 1.23–4.48; <i>p</i> = .01), comparable relapse incidence (HR = 1.12, 95% CI: 0.67–1.86; <i>p</i> = .66), lower leukemia-free survival (HR = 1.5, 95% CI: 1.01–2.23; <i>p</i> = .047), and lower overall survival (HR = 1.66, 95% CI: 1.08–2.55; <i>p</i> = .02) compared with patients receiving UD 9/10 HCT. In summary, our results suggest that transplantation outcomes are better with UD 9/10 with PTCy-based GVHD prophylaxis than with dCBT for AML patients in CR1. These data might support the use of UD 9/10 with PTCy-based GVHD prophylaxis over dCBT in AML patients lacking an HLA-matched donor.","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posttraumatic stress disorder increases thrombosis risk: Evidence from a biobank data set","authors":"Hui Chong Lau, Sinead M. Sinnott, Shady Abohashem, Giovanni Civieri, Wesam Aldosoky, Krystel Karam, Maria Khalil, Iqra Qamar, Rachel P. Rosovsky, Michael T. Osborne, Ahmed Tawakol, Antonia V. Seligowski","doi":"10.1002/ajh.27468","DOIUrl":"https://doi.org/10.1002/ajh.27468","url":null,"abstract":"Depression and anxiety are linked to deep venous thrombosis (DVT) and posttraumatic disorder (PTSD) increases risk of venous thromboembolism in women. However, the mechanisms underlying this relationship remain unknown. We hypothesized that PTSD would associate with increased DVT risk, that neuroimmune mechanisms would mediate the PTSD-DVT link, and that these associations would be stronger in women. This cohort study included <i>N</i> = 106 427 participants from a large biobank. PTSD and DVT were defined using ICD-10 codes. A subset (<i>N</i> = 1520) underwent imaging, from which we assessed stress-associated neural activity (SNA). High-sensitivity C-reactive protein (hs-CRP) levels and heart rate variability (HRV) were used as indicators of systemic inflammation and autonomic activity, respectively. Linear, logistic, and Cox regressions and mediation analyses were used to test our hypotheses. Of 106 427 participants, 4192 (3.9%) developed DVT. PTSD associated with increased DVT risk (HR [95% CI]: 1.66 [1.34, 2.07], <i>p</i> &lt; .001), and this finding remained significant after adjustment for age, sex, and traditional DVT risk factors. When analyzed separately by sex, PTSD was significantly associated with DVT risk in women but not men. Further, heightened SNA and lower HRV mediated the effect of PTSD on DVT risk. Results suggest that individuals with PTSD are at increased risk for DVT, and that risk is higher in women. This relationship was partially driven by alterations in stress-associated neural activity and autonomic function, suggesting potential targets for preventive therapies. Future studies are needed to investigate whether intervening on PTSD-DVT mechanisms has downstream beneficial effects on DVT, especially among women.","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of renal AL amyloidosis patients undergoing autologous stem cell transplantation: Validating the performance of the renal staging system","authors":"Eli Muchtar, Morie A. Gertz, Raphael Mwangi, Hamza Hassan, Angela Dispenzieri, Nelson Leung, Francis K Buadi, David Dingli, Andrew Staron, Vaishali Sanchorawala","doi":"10.1002/ajh.27460","DOIUrl":"https://doi.org/10.1002/ajh.27460","url":null,"abstract":"Renal AL amyloidosis can be complicated by end-stage renal disease (ESRD) requiring renal replacement therapy (RRT). In this study, we describe the long-term outcomes of renal AL amyloidosis patients undergoing autologous stem cell transplantation (ASCT) and assess the utility of the renal staging system. Retrospective study of renal AL patients (<i>n</i> = 697; Mayo Clinic, Boston University) who underwent ASCT between 2003 and 2020. Renal stage was assigned based on 24-h proteinuria and estimated glomerular filtration rate measurements. Renal survival was defined as the time from ASCT until initiation of RRT, while patients who were not placed on RRT were censored at their last follow-up. With a median follow-up of 10.4 years, RRT was required in 149 patients (21%). The median time from ASCT to ESRD was 3.4 years, with late events of progression to ESRD seen &gt;10 years from ASCT. Pre-ASCT renal stage was significantly associated with the cumulative incidence of RRT: 3-year RRT rate was 3%, 10%, and 37% for renal stages I, II, and III, respectively. However, in the 2012–2020 period subset, a significant decrease in ESRD risk was noted across all renal stages (3-year RRT 0%, 5%, and 24%, respectively). In multivariate analysis, renal survival was independently associated with the pre-ASCT renal stage, lambda isotype, bone marrow plasmacytosis ≥20%, post-ASCT hematologic response, and year of ASCT. Long-term outcomes of renal AL amyloidosis treated with ASCT are presented. Renal stage reliably predicts renal outcomes in patients with AL undergoing ASCT, despite a reduction in the proportion of patients progressing to RRT in recent years.","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":12.8,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142100839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes and microenvironment profiling in relapsed/refractory multiple myeloma patients with extramedullary disease receiving anti-BCMA CAR T-cell-based therapy.","authors":"Yuekun Qi, Hujun Li, Kunming Qi, Feng Zhu, Hai Cheng, Wei Chen, Zhiling Yan, Depeng Li, Wei Sang, Xiaoming Fei, Weiying Gu, Yuqing Miao, Hongming Huang, Ying Wang, Tingting Qiu, Jianlin Qiao, Bin Pan, Ming Shi, Gang Wang, Zhenyu Li, Junnian Zheng, Kailin Xu, Jiang Cao","doi":"10.1002/ajh.27469","DOIUrl":"https://doi.org/10.1002/ajh.27469","url":null,"abstract":"<p><p>Relapsed/refractory multiple myeloma patients with extramedullary disease (EMD) have unfavorable prognosis and lack effective therapy. Chimeric antigen receptor (CAR) T-cell activities in EMD have yet to be determined; how EMD-specific microenvironment influences the clinical outcomes of CAR T-cell therapy remains of great interest. In this prospective cohort study, patients with histologically confirmed extra-osseous EMD were enrolled and treated with combined anti-BCMA and anti-CD19 CAR T-cell therapy from May 2017 to September 2023. Thirty-one patients were included in the study. Overall response occurred in 90.3% of medullary disease and 64.5% of EMD (p = .031). Discrepancies in treatment response were noted between medullary and extramedullary diseases, with EMD exhibiting suboptimal and delayed response, as well as shortened response duration. With a median follow-up of 25.3 months, the median progression-free and overall survival were 5.0 and 9.7 months, respectively. Landmark analysis demonstrated that progression within 6 months post-infusion is strongly associated with an increased risk of death (HR = 4.58; p = .029). Compared with non-EMD patients, patients with EMD showed inferior survival outcomes. Unique CAR-associated local toxicities at EMD were seen in 22.6% patients and correlated with the occurrence and severity of systemic cytokine release syndrome. To the cutoff date, 65% treated patients experienced EMD progression, primarily in the form of BCMA⁺ progression. The pretherapy EMD immunosuppressive microenvironment, characterized by infiltration of exhausted CD8⁺ T cells, was associated with inferior clinical outcomes. CAR T cells have therapeutic activity in relapsed/refractory EMD, but the long-term survival benefits may be limited. EMD-specific microenvironment potentially impacts treatment. Further efforts are needed to extend EMD remission and improve long-term outcomes.</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":10.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oh node: Extranodal nodular involvement of chronic lymphocytic leukemia in the colon.","authors":"Michael Keith Alister Zimmerman, Lindsay Wilde","doi":"10.1002/ajh.27467","DOIUrl":"https://doi.org/10.1002/ajh.27467","url":null,"abstract":"","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":10.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase 2 trial of mini-hyper-CVD, blinatumomab, and ponatinib in Philadelphia positive acute lymphoblastic leukemia.","authors":"Wei-Ying Jen, Elias Jabbour, Nicholas J Short, Ghayas C Issa, Fadi G Haddad, Nitin Jain, Naveen Pemmaraju, Naval G Daver, Lucia Masarova, Gautam Borthakur, Kelly Chien, Rebecca Garris, Hagop M Kantarjian","doi":"10.1002/ajh.27463","DOIUrl":"https://doi.org/10.1002/ajh.27463","url":null,"abstract":"<p><p>Twenty adults with newly diagnosed (ND) or relapsed/refractory (RR) Ph-positive acute lymphoblastic leukemia (ALL), or chronic myeloid leukemia in lymphoid blast phase (CML-LBP), were treated with mini-hyperCVD, ponatinib, and blinatumomab. Complete molecular response was achieved in 78% of ND patients, while CR/CRi was achieved in 100% of RR and CML-LBP. The 3-year overall survival rate was 76% (95% CI, 47%-90%).</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":10.1,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}