Elias J. Jabbour, Hagop M. Kantarjian, Nicola Goekbuget, Bijal D. Shah, Sabina Chiaretti, Jae H. Park, Anita W. Rijneveld, Lia Gore, Shaun Fleming, Aaron C. Logan, Josep M. Ribera, Tobias F. Menne, Khalid Mezzi, Faraz Zaman, Kelly Velasco, Nicolas Boissel
{"title":"Frontline Ph-negative B-cell precursor acute lymphoblastic leukemia treatment and the emerging role of blinatumomab","authors":"Elias J. Jabbour, Hagop M. Kantarjian, Nicola Goekbuget, Bijal D. Shah, Sabina Chiaretti, Jae H. Park, Anita W. Rijneveld, Lia Gore, Shaun Fleming, Aaron C. Logan, Josep M. Ribera, Tobias F. Menne, Khalid Mezzi, Faraz Zaman, Kelly Velasco, Nicolas Boissel","doi":"10.1038/s41408-024-01179-4","DOIUrl":"https://doi.org/10.1038/s41408-024-01179-4","url":null,"abstract":"<p>This narrative review seeks to summarize chemotherapeutic regimens commonly used for patients with newly diagnosed Philadelphia (Ph) chromosome–negative B-cell precursor acute lymphoblastic leukemia (BCP-ALL) in the frontline setting and to describe the latest clinical research using the bispecific T-cell–engaging immunotherapy blinatumomab in the first-line treatment setting. Current standard-of-care chemotherapeutic backbones for newly diagnosed Ph-negative BCP-ALL are based on the same overarching treatment principle: to reduce disease burden to undetectable levels and maintain lasting remission. The adult treatment landscape has progressively evolved following the adoption of pediatric-inspired regimens. However, these intense regimens are not tolerated by all, and high-risk patients still have inferior outcomes. Therefore, designing more effective and less toxic strategies remains key to further improving efficacy and safety outcomes. Overall, the treatment landscape is evolving in the frontline, and integration of blinatumomab into different standard frontline regimens may improve overall outcomes with a favorable safety profile.</p>","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"38 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670896","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}
Moazzam Shahzad, Muhammad Kashif Amin, Naval G. Daver, Mithun Vinod Shah, Devendra Hiwase, Daniel A. Arber, Mohamed A. Kharfan-Dabaja, Talha Badar
{"title":"What have we learned about TP53-mutated acute myeloid leukemia?","authors":"Moazzam Shahzad, Muhammad Kashif Amin, Naval G. Daver, Mithun Vinod Shah, Devendra Hiwase, Daniel A. Arber, Mohamed A. Kharfan-Dabaja, Talha Badar","doi":"10.1038/s41408-024-01186-5","DOIUrl":"https://doi.org/10.1038/s41408-024-01186-5","url":null,"abstract":"<p><i>TP53</i> is a tumor suppressor gene frequently mutated in human cancers and is generally associated with poor outcomes. <i>TP53</i> mutations are found in approximately 5% to 10% of patients with de novo acute myeloid leukemia (AML), more frequently observed in elderly patients and those with therapy-related AML. Despite recent advances in molecular profiling and the emergence of targeted therapies, <i>TP53</i>-mutated AML remains a challenge to treat. Current treatment strategies, including conventional chemotherapy, hypomethylating agents, and venetoclax-based therapies, have shown limited efficacy in <i>TP53</i>-mutated AML, with low response rates and poor overall survival. Allogeneic hematopoietic stem cell transplantation is a potentially curative option; however, its efficacy in <i>TP53</i>-mutated AML depends on comorbid conditions and disease status at transplantation. Novel therapeutic modalities, including immune-based therapies, did show promise in early-phase studies but did not translate into effective therapies in randomized controlled trials. This review provides a comprehensive overview of <i>TP53</i> mutations in AML, outcomes based on allelic burden, clinical implications, and therapeutic challenges.</p>","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"18 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670897","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}
Jinha Hwang, Ha Nui Kim, Jung Ah Kwon, Soo-Young Yoon, Min Ji Jeon, Eun Sang Yu, Dae Sik Kim, Chul Won Choi, Jung Yoon
{"title":"Impact of TP53 mutation on genetic and cellular hierarchy profile in complex karyotype AML/MDS with increased blasts","authors":"Jinha Hwang, Ha Nui Kim, Jung Ah Kwon, Soo-Young Yoon, Min Ji Jeon, Eun Sang Yu, Dae Sik Kim, Chul Won Choi, Jung Yoon","doi":"10.1038/s41408-024-01188-3","DOIUrl":"https://doi.org/10.1038/s41408-024-01188-3","url":null,"abstract":"","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"11 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142637179","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}
Sikander Ailawadhi, Hans C. Lee, James Omel, Kathleen Toomey, James W. Hardin, Cristina J. Gasparetto, Sundar Jagannath, Robert M. Rifkin, Brian G. M. Durie, Mohit Narang, Howard R. Terebelo, Prashant Joshi, Ying-Ming Jou, Jorge Mouro, Edward Yu, Rafat Abonour
{"title":"Impact of lenalidomide-bortezomib-dexamethasone induction on patients with newly diagnosed multiple myeloma and renal impairment: Results from the Connect® MM Registry","authors":"Sikander Ailawadhi, Hans C. Lee, James Omel, Kathleen Toomey, James W. Hardin, Cristina J. Gasparetto, Sundar Jagannath, Robert M. Rifkin, Brian G. M. Durie, Mohit Narang, Howard R. Terebelo, Prashant Joshi, Ying-Ming Jou, Jorge Mouro, Edward Yu, Rafat Abonour","doi":"10.1038/s41408-024-01177-6","DOIUrl":"https://doi.org/10.1038/s41408-024-01177-6","url":null,"abstract":"<p>Limited data exist on the effects of induction treatment in patients with newly diagnosed multiple myeloma (NDMM) and renal impairment (RI), who may also be ineligible for autologous stem cell transplant. This analysis investigated the impact of lenalidomide-bortezomib-dexamethasone (RVd) induction on renal function in patients from the Connect® MM Registry based on transplant status. Eligible patients were aged ≥18 years with symptomatic MM diagnosed ≤2 months before enrollment. Patients in this analysis received front-line RVd for ≥3 cycles and were grouped by transplant status and baseline renal function. As of August 4, 2021, 344 transplanted and 289 non-transplanted patients had received RVd for ≥3 cycles at induction. Improved renal function was observed at 3, 6, and 12 months in patients with all severities of RI at baseline. In patients with >60 and ≤60 creatinine clearance mL/min at baseline, median progression-free survival was 49.4 months and 47.6 months in transplanted patients and 35.7 months and 29.1 months in non-transplanted patients, respectively. These results provide real-world evidence that patients with NDMM and RI who receive front-line RVd for ≥3 cycles may have improved renal function regardless of transplant status, with renal function no longer affecting the long-term outcome. Clinical trial information: NCT01081028.</p>","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"10 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598040","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}
Matteo Giaccherini, Alyssa I Clay-Gilmour, Romano Liotti, Angelica Macauda, Manuel Gentiluomo, Elizabeth E Brown, Mitchell J Machiela, Stephen J Chanock, Michelle A T Hildebrandt, Aaron D Norman, Elisabet Manasanch, S Vincent Rajkumar, Jonathan N Hofmann, Sonja I Berndt, Parveen Bhatti, Graham G Giles, Elad Ziv, Shaji K Kumar, Nicola J Camp, Wendy Cozen, Susan L Slager, Federico Canzian, Federica Gemignani, Celine M Vachon, Daniele Campa
{"title":"Genetically determined telomere length in monoclonal gammopathy of undetermined significance, multiple myeloma risk and outcome.","authors":"Matteo Giaccherini, Alyssa I Clay-Gilmour, Romano Liotti, Angelica Macauda, Manuel Gentiluomo, Elizabeth E Brown, Mitchell J Machiela, Stephen J Chanock, Michelle A T Hildebrandt, Aaron D Norman, Elisabet Manasanch, S Vincent Rajkumar, Jonathan N Hofmann, Sonja I Berndt, Parveen Bhatti, Graham G Giles, Elad Ziv, Shaji K Kumar, Nicola J Camp, Wendy Cozen, Susan L Slager, Federico Canzian, Federica Gemignani, Celine M Vachon, Daniele Campa","doi":"10.1038/s41408-024-01181-w","DOIUrl":"10.1038/s41408-024-01181-w","url":null,"abstract":"","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"14 1","pages":"200"},"PeriodicalIF":12.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rossana Di Staso, Beatrice Casadei, Frederick L. Locke, Michael Jain, Timothy J. Voorhees, Adam S. Kittai, Mariana Bastos-Oreiro, Antonio Gutiérrez, Alejandro Martin Garcia-Sancho, Maria Jose Terol, Monica Mead, Michael J. Maranzano, Gloria Iacoboni, Pere Barba, Mi Kwon, Rebeca Bailen, Juan Luis Reguera-Ortega, Agrima Mian, Brian Hill, Emmanuel Bachy, Franck Morschhauser, Roch Houot, Catherine Thieblemont, Steven Le Gouill, Riccardo Masetti, Davide Gori, Alessandro Broccoli, Pier Luigi Zinzani, Lisa Argnani
{"title":"Is CAR T a drug or a therapeutic pathway? Intention to treat versus per protocol analysis of real world studies of CAR-T cell therapy in relapsed refractory diffuse large B cell lymphoma","authors":"Rossana Di Staso, Beatrice Casadei, Frederick L. Locke, Michael Jain, Timothy J. Voorhees, Adam S. Kittai, Mariana Bastos-Oreiro, Antonio Gutiérrez, Alejandro Martin Garcia-Sancho, Maria Jose Terol, Monica Mead, Michael J. Maranzano, Gloria Iacoboni, Pere Barba, Mi Kwon, Rebeca Bailen, Juan Luis Reguera-Ortega, Agrima Mian, Brian Hill, Emmanuel Bachy, Franck Morschhauser, Roch Houot, Catherine Thieblemont, Steven Le Gouill, Riccardo Masetti, Davide Gori, Alessandro Broccoli, Pier Luigi Zinzani, Lisa Argnani","doi":"10.1038/s41408-024-01183-8","DOIUrl":"https://doi.org/10.1038/s41408-024-01183-8","url":null,"abstract":"","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"243 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142594814","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":"Proteasome inhibitors related thrombotic microangiopathy: a systematic and comprehensive review","authors":"Can Chen, Yiwei Li, Pengfei Shi, Shenxian Qian","doi":"10.1038/s41408-024-01182-9","DOIUrl":"https://doi.org/10.1038/s41408-024-01182-9","url":null,"abstract":"<p>Proteasome inhibitors (PIs) are crucial in treating multiple myeloma but carry a risk of thrombotic microangiopathy (TMA), especially with carfilzomib use. This systematic review includes 44 studies with 115 cases of PI-induced TMA, where carfilzomib was implicated in 101 cases. Treatment approaches varied: 28 patients received supportive care, 43 underwent therapeutic plasma exchange (TPE), 9 were treated exclusively with eculizumab (ECU), and 13 received both TPE and ECU. Notably, eculizumab significantly improved outcomes for patients unresponsive to initial TPE, achieving complete remission in seven cases. The need for dialysis emerged as a significant predictor of outcomes, often indicating a poor prognosis. For patients suspected of having PI-TMA, it is advisable to discontinue the offending medication promptly, even without definitive laboratory confirmation. In cases where diagnosis is challenging, kidney biopsy may assist if conditions permit. Comprehensive evaluation of the complement system, including genetic mutations, function, and associated complement inhibitory factor antibodies, should be included in the assessment of PI-TMA. Early administration of eculizumab may be beneficial in cases of suspected complement abnormalities or suboptimal response to initial treatments.</p>","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"20 4 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142594911","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}
Tiziano Barbui, Alessandra Carobbio, Arianna Ghirardi, Francesca Fenili, Maria Chiara Finazzi, Marta Castelli, Alessandro M. Vannucchi, Paola Guglielmelli, Alessandro Rambaldi, Naseema Gangat, Ayalew Tefferi
{"title":"Neutrophil-to-lymphocyte ratio as a prognostic indicator of mortality in Polycythemia Vera: insights from a prospective cohort analysis","authors":"Tiziano Barbui, Alessandra Carobbio, Arianna Ghirardi, Francesca Fenili, Maria Chiara Finazzi, Marta Castelli, Alessandro M. Vannucchi, Paola Guglielmelli, Alessandro Rambaldi, Naseema Gangat, Ayalew Tefferi","doi":"10.1038/s41408-024-01176-7","DOIUrl":"https://doi.org/10.1038/s41408-024-01176-7","url":null,"abstract":"<p>We analyzed the neutrophil-to-lymphocyte ratio (NLR) in 1508 patients with PV and found that those with an NLR ≥ 5 were generally older, had a longer disease history, and had higher cardiovascular risk factors, more arterial thrombosis, and more aggressive blood counts, indicating a more proliferative disease. NLR was an accurate predictor of mortality, with patients with NLR ≥ 5 having significantly worse overall survival and more than twice the mortality rate compared to those with NLR < 5. Multivariable models confirmed that increasing age, previous venous thrombosis and NLR ≥ 5 were strong predictors of death, further influenced by cardiovascular risk factors. We examined the interaction between NLR and the number of cardiovascular risk factors and found a progressive trend of increased mortality risk for NLR values ≥ 5 in addition to the presence of more than one risk factor. In conclusion, patients with NLR ≥ 5 require careful monitoring and management of cardiovascular risk factors because they increase mortality when associated with progressive levels of NLR.</p>","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"6 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142588767","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}
Yan Cheng, Fumou Sun, Daisy V. Alapat, Visanu Wanchai, David Mery, Eric R. Siegel, Hongwei Xu, Sarah Johnson, Wancheng Guo, Clyde Bailey, Cody Ashby, Michael Anton Bauer, Samer Al Hadidi, Carolina Schinke, Sharmilan Thanendrarajan, Maurizio Zangari, Frits van Rhee, Guido Tricot, John D. Shaughnessy, Fenghuang Zhan
{"title":"Multi-omics reveal immune microenvironment alterations in multiple myeloma and its precursor stages","authors":"Yan Cheng, Fumou Sun, Daisy V. Alapat, Visanu Wanchai, David Mery, Eric R. Siegel, Hongwei Xu, Sarah Johnson, Wancheng Guo, Clyde Bailey, Cody Ashby, Michael Anton Bauer, Samer Al Hadidi, Carolina Schinke, Sharmilan Thanendrarajan, Maurizio Zangari, Frits van Rhee, Guido Tricot, John D. Shaughnessy, Fenghuang Zhan","doi":"10.1038/s41408-024-01172-x","DOIUrl":"https://doi.org/10.1038/s41408-024-01172-x","url":null,"abstract":"<p>Tumor immune microenvironmental alterations occur early in multiple myeloma (MM) development. In this study, we aim to systematically characterize the tumor immune microenvironment (TME) and the tumor-immune interactions from precursor stages, i.e., monoclonal gammopathy of undetermined significance (MGUS) and smoldering MM (SMM), to newly diagnosed MM, comparing these to healthy donors. Using CIBERSORT, mass cytometry (CyTOF), and single-cell RNA sequencing (scRNA-Seq), we examined innate and adaptive immune changes across these stages. We found a decrease in granulocytes in the TME predicts MM outcomes. HLA-DR is reduced in CD16<sup>+</sup> monocytes and plasmacytoid dendritic cells, while myeloid dendritic cells show decreased expression of stress and immune-response genes. NK cells and CD8<sup>+</sup> T cells shift from a GZMK<sup>+</sup> to a GZMB<sup>+</sup> cytotoxic phenotype in the TME, with increased inhibitory markers TIM3 and TIGIT. In paired samples, the proportion and gene expression pattern in patient-specific GZMB<sup>+</sup>CD8<sup>+</sup> T cells remain largely unchanged despite MM progression. Our findings provide a comprehensive immune landscape of MM and its precursors, offering insights into therapeutic strategies. Enhancing neutrophil and NK cell cytotoxicity, tumor antigen presentation, and CD8<sup>+</sup> T cell versatility in precursor stages may prevent MM progression.</p>","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"31 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142588768","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}
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