Annals of Hematology最新文献

{"title":"Epidemiology and survival of patients with primary lymphoma of bone: a large retrospective cohort study.","authors":"Xiaojie Liang, Weixiang Lu, Tong Li, Baiwei Luo, Yuzhe Wu, Chaoran Lin, Yang Liu, Liang Wang","doi":"10.1007/s00277-025-06413-y","DOIUrl":"https://doi.org/10.1007/s00277-025-06413-y","url":null,"abstract":"<p><p>Primary lymphoma of bone (PLB) is a rare extranodal lymphoma, and its epidemiology and prognosis remain controversial. We conducted a retrospective analysis of 1,222 patients with PLB in the Surveillance, Epidemiology, and End Results (SEER) database to investigate its epidemiology and prognostic factors. The incidence of PLB peaked in 1992 with an average annual percent change of 1.72 after a significant rise from 1975 to 1992, followed by a general decline. The risk of death from PLB involves both patient and treatment factors. Survival analysis revealed that age, stage, laterality, chemotherapy, and primary site significantly influence both overall survival and disease-specific survival. We integrated and compared 99 machine learning algorithms, and identified the Random Survival Forest (RSF) model as the most effective for predicting PLB outcomes. Patients were stratified into low- and high-risk groups according to the RSF model score. The incidence of PLB began to decrease after 1992, with variations by age, race, and gender. The factors influencing the prognosis of PLB are multifaceted. And the RSF model showed promising performance, aiding clinicians in early prognosis identification and improving clinical outcomes through revised management strategies and patient care.</p>","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of impaired renal function, increased red cell mass and plasma volume on thrombotic risk in PV patients.","authors":"Marko Lucijanic, Danijela Lekovic, Andrija Bogdanovic, Ivan Krecak","doi":"10.1007/s00277-025-06348-4","DOIUrl":"https://doi.org/10.1007/s00277-025-06348-4","url":null,"abstract":"","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life with daratumumab, bortezomib, melphalan, and prednisone versus bortezomib, melphalan, and prednisone alone in transplant-ineligible patients with newly diagnosed multiple myeloma: analysis of the phase 3 OCTANS study.","authors":"Weijun Fu, Soo-Mee Bang, Honghui Huang, Kihyun Kim, Wei Li, Gang An, Je-Jung Lee, Zhen Cai, Jie Jin, Yafei Wang, Chor Sang Chim, Robin Carson, Rui Liu, Man Zhao, Xi Chen, Canchan Cui, Jian Hou, Jianxiang Wang","doi":"10.1007/s00277-025-06303-3","DOIUrl":"https://doi.org/10.1007/s00277-025-06303-3","url":null,"abstract":"<p><p>In the phase 3 OCTANS study, daratumumab plus bortezomib/melphalan/prednisone (D-VMP) significantly improved response rates and progression-free survival versus VMP alone in transplant-ineligible Asian patients with newly diagnosed multiple myeloma (NDMM). Understanding the impact of treatment on patient-reported outcomes (PROs) is of increasing interest. Here, we report on the impact of D-VMP and VMP on PROs in OCTANS. PROs were a secondary endpoint and were assessed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item (EORTC QLQ-C30) and the EuroQol 5-dimensional descriptive system (EQ-5D-5L) questionnaire, administered at screening, every 3 months (Year 1), every 6 months thereafter (until disease progression), and 8 and 16 weeks post disease progression. Treatment effects were estimated using a mixed-effects model with repeated measures. Overall, 220 patients were randomized (D-VMP, n = 146; VMP, n = 74). Compliance rates were 100% at baseline in both treatment groups and remained relatively high by Month 12 (D-VMP, 82.6%; VMP, 67.4%). Comparable improvements from baseline were generally observed between treatment groups across most PRO scores. Significant improvements were observed with D-VMP versus VMP in Global Health Status (GHS) score at 9 months (p = 0.0443) and in social functioning and nausea and vomiting symptom scores at 12 months (p = 0.0042 and p = 0.0012, respectively). In summary, transplant-ineligible Asian patients with NDMM demonstrated improvements in PROs following treatment with D-VMP and VMP; however, greater improvements were observed in GHS, social functioning, and nausea and vomiting symptoms with D-VMP.</p>","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective efficacy of venetoclax in unfit patients with acute myeloid leukemia with myelodysplasia-related gene mutations under low-intensity therapy.","authors":"Jinya Lin, Xiupu Liu, Shuangwei Ying, Yuanyuan Zhu, Weijia Huang, Weiyan Zheng, Xiujin Ye, Jimin Shi, Yi Luo, Jingsong He, Zhen Cai, Yi Zhao, Wenjun Wu, Donghua He, Xiaoyan Han, Gaofeng Zheng, Yanmin Zhao, Yongxian Hu, He Huang, Jie Sun","doi":"10.1007/s00277-025-06399-7","DOIUrl":"https://doi.org/10.1007/s00277-025-06399-7","url":null,"abstract":"<p><p>According to the 2022 International Consensus Classification (ICC) guidelines, nine myelodysplasia-related (MDS-related) gene mutations are classified as adverse-risk markers in acute myeloid leukemia (AML) under intensive therapy (INT). Although venetoclax (VEN) has demonstrated clinical benefit in subsets of AML with MDS-related gene mutations (AML-MR), its efficacy across all nine mutations remains unclear. In this retrospective study involving 453 AML-MR patients, the overall composite complete remission (CRc) rate was 62.6% (275/439). Among fit patients receiving INT, 57.7% (86/149) achieved CRc after a single cycle of induction therapy (IND1), while 62.7% (79/126) of unfit patients receiving low-intensity therapy (LIT) achieved CRc after IND1. VEN significantly improved CRc rates in unfit patients treated with LIT (45.9% vs. 30.0%, P = 0.002), but not in fit patients receiving INT (61.1% vs. 45.0%, P = 0.052). In both groups, CRc after IND1 was strongly associated with improved overall survival (OS). Subgroup analysis showed that hematopoietic stem cell transplantation (HSCT) significantly prolonged OS and relapse-free survival (RFS) in patients without favorable-risk cytogenetics (P = 0.002 for OS, P < 0.001 for RFS), but conferred no survival benefit in those with favorable-risk cytogenetics (P = 0.119 for OS, P = 0.437 for RFS). These findings support the use of VEN to enhance early remission and survival outcomes in unfit AML-MR patients and suggest that HSCT should be considered primarily in those lacking favorable-risk cytogenetics.</p>","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiologic sequential analysis of pure red blood cell aplasia and T-cell large granular lymphocyte leukemia in Korea.","authors":"Sooyong Park, Hyun Kyung Kim","doi":"10.1007/s00277-025-06406-x","DOIUrl":"https://doi.org/10.1007/s00277-025-06406-x","url":null,"abstract":"<p><p>Pure red cell aplasia (PRCA) is a rare hematologic syndrome characterized by anemia with marked reticulocytopenia and, in Asia, is often accompanied by T-cell large granular lymphocyte leukemia (T-LGL). Minimal research has been done on the epidemiology and sequential events of PRCA combined with T-LGL. This study identified 2801 PRCA and 840 T-LGL patients by using big data of the National Health Insurance Service between 2003 and 2022. The average annual crude incidence of PRCA was 2.77 per million and remained stable over 20 years, while T-LGL incidence was 0.82 per million with an increasing trend, possibly reflecting improved diagnostic accessibility. The average age for PRCA and T-LGL onset increased over the study period, consistent with aged society. Associated PRCA conditions are rheumatic diseases (10.5%), thymoma (4.7%), parvovirus infection (1.0%), inflammatory bowel diseases (0.8%), T-LGL (0.6%) and no specific cause (82.4%). Among 18 patients with both PRCA and T-LGL, PRCA preceded T-LGL (50%) or diagnosed concurrently (44%), suggesting that autoreactive T cells in PRCA which suppress erythropoiesis and sequentially evolve into clonal T cell proliferation and, eventually, T-LGL occurrence. This observation supports the hypothesis that both conditions might share a common pathogenic pathway. Further study should identify the causal relationship of PRCA diagnosis followed by T-LGL diagnosis.</p>","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of chronic-phase CML in later lines: a Hong Kong consensus recommendation.","authors":"Carol Yuk Man Cheung, Chung Yin Ha, Bonnie Kho, Chi Kuen Lau, June Sze Man Lau, Shek Ying Lin, Vivien Wai Man Mak, Raymond Siu Ming Wong, Yok Lam Kwong","doi":"10.1007/s00277-025-06416-9","DOIUrl":"https://doi.org/10.1007/s00277-025-06416-9","url":null,"abstract":"<p><p>Chronic myeloid leukemia (CML) usually requires long-term therapy with tyrosine kinase inhibitors (TKIs). While these agents have markedly advanced the clinical management and prognosis of CML, a subset of patients experience treatment resistance or suboptimal response, necessitating multiple lines of TKI therapy. Few treatment options exist for patients who are resistant or intolerant to first- and second-line therapies. To provide guidance for the management of patients in chronic-phase failing at least two lines of treatment, a literature review followed by consensus generation from an expert panel with a modified Delphi process was conducted. This was followed by a meeting in person and subsequent online iterations for the establishment of a list of consensus guidelines. Consensus was defined as ≥ 75% of respondents selecting either 'accept completely' or 'accept with some reservation'. Overall, 17 statements were formulated covering five topics - defining treatment failure and acceptable treatment response, in terms of efficacy and intolerance; sequencing therapy to prevent disease progression and improve quality of life; managing patients with broad resistance, specific mutations, and risk of cardiovascular events; considering timing of cytogenetic or molecular response; and mitigating risk when using novel therapies and allogeneic hematopoietic stem cell transplantation. These comprehensive, evidence-based recommendations will assist clinicians in managing their patients with CML in third and later lines of treatment.</p>","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GPVI-dependent functional competence of buffy coat platelet concentrates (PCs) versus PRP-derived PCs: insights into the effects of biomechanical forces during platelet preparation.","authors":"Ehteramolsadat Hosseini, Pezhman Beshkar, Farshad Heydari, Mehran Ghasemzadeh","doi":"10.1007/s00277-025-06376-0","DOIUrl":"https://doi.org/10.1007/s00277-025-06376-0","url":null,"abstract":"<p><p>Platelet isolation is a decisive stage in the preparation of platelet concentrate (PC), which may affect functional competence of platelets during storage and post-transfusion. Now considering GPVI as a vulnerable receptor that is mainly affected by shear stress and redox state, this study was conducted for the first time to compare preparation methods of Buffy Coat (BC)- and Platelet-Rich Plasma (PRP)-PCs in terms of GPVI-related phenotypic and functional status. BC- and PRP-PCs were subjected to flow cytometry to analyze GPVI expression and intra-platelet ROS generation. Soluble GPVI were determined by ELISA. Platelet aggregation response to collagen and its adhesion to the collagen matrix were examined by aggregometry and fluorescence microscope, respectively. All the parameters were analyzed on days 0, 1, 3, and 5 of storage. Stored-dependent ROS generation showed significantly higher levels in PRP-PCs compared to BC-PCs on days 1 and 3 of storage. GPVI expression decreased in both products, with BC-PCs showing higher levels on 1 and 3 days of storage. However, with a similar trend, PRP-PCs showed higher levels of shedding, which was significant on day 3. Adhesion/spreading to the collagen matrix also decreased during storage, with higher declines observed in PRP-PCs. Platelet aggregation showed the same pattern with significantly lower PRP-PCs responses to collagen than BC-PCs on the third and fifth days of storage. During platelet storage, GPVI-dependent platelet functional capacity in BC-PCs was better preserved than PRP-PCs, suggesting the priority of BC-PCs method for platelet preparation. In this regard, adopting methods such as platelet isolation and storage in optimal additive solutions, especially those containing ROS scavengers, may help maintain the integrity of GPVI in PRP products. However, further studies, particularly using animal models of thrombus formation, are needed to determine whether the enhanced GPVI function in BC-PCs compared with PRP-PCs can translate into superior efficacy after blood transfusion.</p>","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular analysis of T-cell Acute Lymphoblastic Leukemia arising after Essential Thrombocythemia foreshadows a distinct clonal route for lymphoid blast crisis in Philadelphia-negative chronic myeloproliferative neoplasm: a case report with literary review.","authors":"Francesco Grimaldi, Mara Memoli, Simona Avilia, Roberta Russo, Giulia Scalia, Roberta Visconti, Santa Errichiello, Barbara Izzo, Fabrizio Pane","doi":"10.1007/s00277-025-06404-z","DOIUrl":"https://doi.org/10.1007/s00277-025-06404-z","url":null,"abstract":"<p><p>Progression to Acute Myeloid Leukemia is a well-known complication of classical philadelphia-negative chronic myeloproliferative neoplasms, while disease progression to Acute Lymphoblastic Leukemia remains an extremely unfrequent event. A molecular explanation for this rare phenomenon is missing. However, the clonal haematopoiesis mostly present in these patients may work as a seeding soil for a second neoplastic disease. Molecular results from this case study reporting a secondary Acute Lymphoblastic Leukemia presenting after Essential Thrombocythemia support this hypothesis. In this contest secondary Acute Lymphoblastic Leukemia should not be considered as real blast crisis, but rather as a second cancer determined by a different clonal route. Given the unique features of this case, a review of the published cases of MPN transforming to Acute Lymphoblastic Leukemia available in literature is provided in the article.</p>","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of graft-versus-host disease on outcomes of cord blood transplantation according to HLA disparity and its prophylaxis type.","authors":"Hisayuki Yokoyama, Shigeo Fuji, Makoto Murata, Masahiro Hirayama, Atsushi Wake, Naoyuki Uchida, Masatsugu Tanaka, Makoto Onizuka, Satoshi Takahashi, Noriko Doki, Yumiko Maruyama, Kazuya Ishiwata, Yasufumi Uehara, Tetsuya Nishida, Masashi Sawa, Toshiro Kawakita, Tetsuya Eto, Fumihiko Ishimaru, Koji Kato, Tatsuo Ichinohe, Yoshiko Atsuta, Seitaro Terakura, Satoko Morishima","doi":"10.1007/s00277-025-06415-w","DOIUrl":"https://doi.org/10.1007/s00277-025-06415-w","url":null,"abstract":"<p><p>This study evaluated the impact of acute graft-versus-host disease (aGVHD) on cord blood transplantation (CBT) outcomes based on human leukocyte antigen (HLA) disparity and GVHD prophylaxis type. Data from 4,196 adult patients with acute myeloid leukemia, acute lymphoblastic leukemia, or myelodysplastic syndrome were analyzed. Patients were classified by HLA mismatch (8/8-6/8, 5/8, and 4/8-2/8) and further by GVHD prophylaxis type (methotrexate [MTX] or mycophenolate mofetil [MMF]). The impact of aGVHD was assessed using a time-dependent Cox model. Grade I-II aGVHD improved overall survival (OS) in all groups, regardless of HLA mismatches or prophylaxis type. However, grade III-IV aGVHD worsened OS across MMF groups, while in MTX groups, it was unfavorable only in the HLA 8/8-6/8-matched group (HR 1.6, P = 0.01). Grade III-IV aGVHD increased non-relapse mortality (NRM) across all groups but was more pronounced in HLA 4/8-2/8-matched patients receiving MMF. Notably, relapse risk decreased in HLA 4/8-2/8-matched patients with MTX prophylaxis, partially offsetting the negative impact of grade III-IV aGVHD on NRM. These findings suggest that the impact of aGVHD varies with HLA mismatches and prophylaxis type. MTX prophylaxis may mitigate the adverse effects of severe aGVHD in highly mismatched cases, unlike MMF prophylaxis. Careful donor selection considering HLA mismatches is essential when using MMF prophylaxis to manage severe aGVHD and reduce NRM risk.</p>","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life in patients with aggressive non-Hodgkin lymphoma: results from the PETAL trial.","authors":"Ulrich Dührsen, Gabriele Prange-Krex, Regina Moeller, Harald Held, Gerhard Heil, Andreas Schwarzer, Stefan Mahlmann, Ariane Dienst, Matthias Sandmann, Georg Maschmeyer, Jochen Schütte, Dennis Hahn, Michael Heike, Michael Nonnemacher, Christine Hanoun, Andreas Hüttmann","doi":"10.1007/s00277-025-06402-1","DOIUrl":"https://doi.org/10.1007/s00277-025-06402-1","url":null,"abstract":"<p><p>When different therapies provide similar cure rates, health-related quality of life (HRQoL) may become crucial for the choice of treatment. In the Positron Emission Tomography-guided Therapy of Aggressive non-Hodgkin Lymphomas (PETAL) trial, we compared six cycles of R-CHOP with or without two extra doses of rituximab in prognostically favorable interim PET (iPET)-negative patients, while eight cycles of R-CHOP were compared with two R-CHOP cycles followed by six cycles of a more intensive protocol in prognostically unfavorable iPET-positive patients. As reported previously, treatment intensification did not improve outcome. HRQoL was assessed using the EORTC QLQ-C30 questionnaire. Pretreatment questionnaires were obtained from 558 out of the 862 participants (64.7%). Pretreatment HRQoL was significantly worse than in the general population. It was associated with age, gender, B symptoms, International Prognostic Index (IPI) and total metabolic tumor volume (TMTV). Physical and cognitive functioning predicted survival independent of IPI or TMTV. During treatment, some domains remained stable (e.g., cognitive functioning, nausea/vomiting), while others improved (e.g., emotional functioning, pain) or deteriorated (e.g., physical functioning, role functioning, fatigue). At the end of treatment, HRQoL was better in patients with controlled disease than in patients with progressive disease and better for iPET-negative patients than for iPET-positive patients. During follow-up, all HRQoL domains returned to levels similar to those reported for the general population. Differences between randomized treatment arms were not observed. The longitudinal data need to be interpreted with caution, because decreasing participation resulted in a selection of patients with increasingly good outcomes. ClinicalTrials.gov no. NCT00554164 (registered 11/5/2007).</p>","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}