Sarah Dingli, Paul Rothweiler, Moritz Binder, Joselle Cook, Morie A. Gertz, Suzanne Hayman, Prashant Kapoor, Taxiarchis Kourelis, Shaji K. Kumar, Mustaqeem Siddiqui, Rahma Warsame, Yi Lin, Arthur G. Erdman, David Dingli
{"title":"The ratio of brain to liver glucose activity and disease activity in multiple myeloma","authors":"Sarah Dingli, Paul Rothweiler, Moritz Binder, Joselle Cook, Morie A. Gertz, Suzanne Hayman, Prashant Kapoor, Taxiarchis Kourelis, Shaji K. Kumar, Mustaqeem Siddiqui, Rahma Warsame, Yi Lin, Arthur G. Erdman, David Dingli","doi":"10.1038/s41408-025-01280-2","DOIUrl":"https://doi.org/10.1038/s41408-025-01280-2","url":null,"abstract":"<p>Changes in metabolic activity in tumor cells is one of the hallmarks of cancer. Cancer cells exhibit the Warburg effect with high glucose consumption for their energy needs. This provides the basis for imaging using <sup>18</sup>F-2-deoxy-D-glucose for positron emission tomography to assess tumor burden and response to therapy. We postulated that metabolically active tumors may compete with the brain for glucose uptake and evaluated glucose uptake in the brain and liver in patients with multiple myeloma in various states of response and relapse. The ratio of brain to liver glucose activity (B2LR) mirrors disease activity in myeloma, predicts the presence of extramedullary disease and is also predictive of a short response to chimeric antigen receptor T cell therapy. Patients with a low B2LR also have an inferior survival compared to patients with persistently higher B2LR values. Our simple metabolic ratio has prognostic implications in myeloma and other tumors.</p>","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"110 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920169","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":"Momelotinib in JAK2 inhibitor-naïve myelofibrosis: pros and cons.","authors":"Naseema Gangat,Ayalew Tefferi","doi":"10.1038/s41408-025-01302-z","DOIUrl":"https://doi.org/10.1038/s41408-025-01302-z","url":null,"abstract":"","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"76 1","pages":"91"},"PeriodicalIF":12.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921061","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}
Mithun Vinod Shah, Kevin Hung, Anmol Baranwal, Gauri Wechalekar, Aref Al-Kali, Carla R. Toop, Patricia Greipp, Monika M. Kutyna, Aasiya Matin, Dariusz Ladon, Antoine Saliba, Dong Chen, Kebede Begna, Anna Brown, Danielle Rud, Mark R. Litzow, William J. Hogan, Peter Bardy, Talha Badar, Sharad Kumar, David T. Yeung, Mrinal M. Patnaik, James M. Foran, Rong He, Naseema Gangat, Mehrdad Hefazi, Hamish S. Scott, Cecilia Y. Arana Yi, Hassan Alkhateeb, Abhishek A. Mangaonkar, Daniel Thomas, Christopher N. Hahn, Attilio Orazi, Daniel A. Arber, Chung Hoow Kok, Ayalew Tefferi, Devendra Hiwase
{"title":"Validation of the 5th edition of the World Health Organization and International Consensus Classification guidelines for TP53-mutated myeloid neoplasm in an independent international cohort","authors":"Mithun Vinod Shah, Kevin Hung, Anmol Baranwal, Gauri Wechalekar, Aref Al-Kali, Carla R. Toop, Patricia Greipp, Monika M. Kutyna, Aasiya Matin, Dariusz Ladon, Antoine Saliba, Dong Chen, Kebede Begna, Anna Brown, Danielle Rud, Mark R. Litzow, William J. Hogan, Peter Bardy, Talha Badar, Sharad Kumar, David T. Yeung, Mrinal M. Patnaik, James M. Foran, Rong He, Naseema Gangat, Mehrdad Hefazi, Hamish S. Scott, Cecilia Y. Arana Yi, Hassan Alkhateeb, Abhishek A. Mangaonkar, Daniel Thomas, Christopher N. Hahn, Attilio Orazi, Daniel A. Arber, Chung Hoow Kok, Ayalew Tefferi, Devendra Hiwase","doi":"10.1038/s41408-025-01290-0","DOIUrl":"https://doi.org/10.1038/s41408-025-01290-0","url":null,"abstract":"<p>The World Health Organization (WHO-5) and International Consensus Classification (ICC) acknowledge the poor prognosis of <i>TP53</i>-mutated (<i>TP53</i><sup>mut</sup>) myeloid neoplasm (MN). However, there are substantial differences between the two classifications that may lead to under- or overestimation of the prognostic risk. We retrospectively applied WHO-5 and ICC to 603 MN cases harboring <i>TP53</i><sup>mut</sup> (variant allele frequency, VAF ≥ 2%). WHO-5 and ICC would not classify 64% and 20% of these cases as <i>TP53</i><sup>mut</sup> MN, respectively. Moreover, of those classified, 67.5% would be classified discrepantly. Primary drivers of discrepancies included: (i) prognostic importance of <i>TP53</i><sup>mut</sup> acute myeloid leukemia (AML), (ii) interaction of the blast percentage and allelic status, (iii) 17p.13.1 deletion detected by cytogenetics, (iv) complex karyotype (CK) as multi-hit equivalent, and (v) <i>TP53</i><sup>mut</sup> VAF threshold, we analyzed survival outcomes of each of these groups with an aim to provide clarity. <i>TP53</i><sup>mut</sup> AML was associated with significantly poor survival compared to <i>TP53</i>-wild type <i>TP53</i><sup>wt</sup> AML, myelodysplasia-related (AML, MR 4.7 <i>vs</i>. 18.3 months; <i>P</i> < 0.0001), supporting its inclusion within <i>TP53</i><sup>mut</sup> MN as a distinct subentity. Secondly, the survival of <i>TP53</i><sup>mut</sup> with blast 10–19% was poor regardless of the allelic status. Thirdly, for cases with a single <i>TP53</i><sup>mut</sup> with VAF < 50%, 17p13.1 del or CK serve as practical surrogates of biallelic inactivation, obviating the need for an additional copy number analysis. Finally, <i>TP53</i><sup>mut</sup> AML, MDS multi-hit/multi-hit equivalent with VAF < 10% had significantly poorer survival compared to <i>TP53</i><sup>mut</sup> MDS VAF < 10% without CK and 17p del, and were comparable to those with VAF ≥ 10% (14.1 <i>vs</i>. 48.8 <i>vs</i>.7.8 months, <i>P</i> < 0.0001). Collectively, these findings address key areas of contention and provide valuable insights that will guide future revisions of the WHO and ICC classifications.</p>","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"16 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916003","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}
Dmitry Prokopov,Hale Tunbak,Eve Leddy,Bryce Drylie,Francesco Camera,Özgen Deniz
{"title":"Transposable elements as genome regulators in normal and malignant haematopoiesis.","authors":"Dmitry Prokopov,Hale Tunbak,Eve Leddy,Bryce Drylie,Francesco Camera,Özgen Deniz","doi":"10.1038/s41408-025-01295-9","DOIUrl":"https://doi.org/10.1038/s41408-025-01295-9","url":null,"abstract":"Transposable elements (TEs) constitute over half of the human genome and have played a profound role in genome evolution. While most TEs have lost the ability to transpose, many retain functional elements that serve as drivers of genome innovation, including the emergence of novel genes and regulatory elements. Recent advances in experimental and bioinformatic methods have provided new insights into their roles in human biology, both in health and disease. In this review, we discuss the multifaceted roles of TEs in haematopoiesis, highlighting their contributions to both normal and pathological contexts. TEs influence gene regulation by reshaping gene-regulatory networks, modulating transcriptional activity, and creating novel regulatory elements. These activities play key roles in maintaining normal haematopoietic processes and supporting cellular regeneration. However, in haematological malignancies, TE reactivation can disrupt genomic integrity, induce structural variations, and dysregulate transcriptional programmes, thereby driving oncogenesis. By examining the impact of TE activity on genome regulation and variation, we highlight their pivotal roles in both normal haematopoietic processes and haematological cancers.","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"47 1","pages":"87"},"PeriodicalIF":12.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915135","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}
Daniel J Olivieri,Alexis Berridge-Green,Megan Othus,Jerald P Radich,Anjali S Advani,Harry P Erba,Roland B Walter
{"title":"Biobanking and consent to future biospecimen use among adults enrolled in SWOG trials from 2000 to 2024.","authors":"Daniel J Olivieri,Alexis Berridge-Green,Megan Othus,Jerald P Radich,Anjali S Advani,Harry P Erba,Roland B Walter","doi":"10.1038/s41408-025-01294-w","DOIUrl":"https://doi.org/10.1038/s41408-025-01294-w","url":null,"abstract":"","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"20 1","pages":"85"},"PeriodicalIF":12.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915136","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}
Ruoxuan Zhang, Huihong Huang, Yi Zhang, Yi Xia, Jiayu Huang, Chuanhe Jiang, Luxiang Wang, Haiyang Lu, Zengkai Pan, Gaoxiang Wang, Yang Yang, Yilei Ma, Xiaodong Mo, Wei Shi, Xiaoxia Hu, Yang Cao
{"title":"Outcomes of acute myeloid leukemia with KMT2A (MLL) rearrangement: a multicenter study of TROPHY group","authors":"Ruoxuan Zhang, Huihong Huang, Yi Zhang, Yi Xia, Jiayu Huang, Chuanhe Jiang, Luxiang Wang, Haiyang Lu, Zengkai Pan, Gaoxiang Wang, Yang Yang, Yilei Ma, Xiaodong Mo, Wei Shi, Xiaoxia Hu, Yang Cao","doi":"10.1038/s41408-025-01293-x","DOIUrl":"https://doi.org/10.1038/s41408-025-01293-x","url":null,"abstract":"<p>Acute myeloid leukemia (AML) with <i>KMT2A</i> rearrangement (<i>KMT2A</i>-r) is associated with poor prognosis, but the benefit of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for <i>KMT2A</i>-r AML is unclear. We reviewed adult AML patients treated within the TROPHY group and identified 292 cases of <i>KMT2A</i>-r AML, 254 (87.0%) of whom achieved first complete remission (CR1) and 192 (75.6%) of CR1 patients underwent allo-HSCT. We show that allo-HSCT is an independent favorable prognostic factor in CR1 patients for both overall survival (OS) (hazard ratio [HR] = 0.56, 95% confidence interval [CI]: 0.45–0.69, <i>P</i> < 0.001) and cumulative incidence of relapse (CIR) (HR = 0.01, 95% CI: 0.005–0.04, <i>P</i> < 0.001). Among allo-HSCT recipients, survival outcomes were comparable between patients with <i>KMT2A::MLLT3</i> and those with other 11q23/<i>KMT2A</i> rearrangements (3-year OS: 74.3% vs. 77.5%, <i>P</i> = 0.97; 3-year event-free survival [EFS]: 55.2% vs. 62.2%, <i>P</i> = 0.34; 3-year CIR: 24.4% vs. 20.8%, <i>P</i> = 0.32). Both multiparameter flow cytometry-based measurable residual disease (MFC-MRD) and <i>KMT2A</i>-r MRD determined by quantitative PCR prior to allo-HSCT were associated with worse transplant outcomes. Multivariable analysis identified detectable <i>KMT2A</i>-r MRD at allo-HSCT as a significant risk factor for reduced EFS (HR = 2.46, 95% CI: 1.32–4.60, <i>P</i> = 0.005). These findings confirm the survival benefit of allo-HSCT in adult patients with <i>KMT2A</i>-r AML and underscore the prognostic value of <i>KMT2A</i>-r MRD prior to transplantation.</p>","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"8 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901782","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}
Ruben A. L. de Groen, Fleur A. de Groot, Stefan Böhringer, Esther J. Kret, Lorraine M. de Haan, Troy Noordenbos, Susan Blommers, Romée E. W. Jansen, Tom van Wezel, Ronald van Eijk, Richard Raghoo, Dina Ruano, Liane te Boome, Valeska Terpstra, Henriette Levenga, Els Ahsmann, Eduardus F. M. Posthuma, Isabelle Focke-Snieders, Lizan Hardi, Wietske C. E. den Hartog, Anke van den Berg, Pim Mutsaers, King Lam, Marjolein W. M. van der Poel, Myrurgia Abdul Hamid, F. J. Sherida H. Woei-A-Jin, Ann Janssens, Thomas Tousseyn, Judith V. M. G. Bovée, Lianne Koens, Arjan Diepstra, Arjen H. G. Cleven, Marie José Kersten, Patty M. Jansen, Hendrik Veelken, Marcel Nijland, Tim J. A. Dekker, Joost S. P. Vermaat
{"title":"Superior survival in diffuse large B cell lymphoma of the bone with immune rich tumor microenvironment","authors":"Ruben A. L. de Groen, Fleur A. de Groot, Stefan Böhringer, Esther J. Kret, Lorraine M. de Haan, Troy Noordenbos, Susan Blommers, Romée E. W. Jansen, Tom van Wezel, Ronald van Eijk, Richard Raghoo, Dina Ruano, Liane te Boome, Valeska Terpstra, Henriette Levenga, Els Ahsmann, Eduardus F. M. Posthuma, Isabelle Focke-Snieders, Lizan Hardi, Wietske C. E. den Hartog, Anke van den Berg, Pim Mutsaers, King Lam, Marjolein W. M. van der Poel, Myrurgia Abdul Hamid, F. J. Sherida H. Woei-A-Jin, Ann Janssens, Thomas Tousseyn, Judith V. M. G. Bovée, Lianne Koens, Arjan Diepstra, Arjen H. G. Cleven, Marie José Kersten, Patty M. Jansen, Hendrik Veelken, Marcel Nijland, Tim J. A. Dekker, Joost S. P. Vermaat","doi":"10.1038/s41408-025-01291-z","DOIUrl":"https://doi.org/10.1038/s41408-025-01291-z","url":null,"abstract":"<p>With tumor genomic and gene-expression profiling (GEP), this study investigated the immune-molecular signatures of a unique cohort of diffuse large B-cell lymphoma of the bone (bone-DLBCL), including primary bone (PB-DLBCL, <i>n</i> = 52) and polyostotic-DLBCL (<i>n</i> = 20), in comparison to nodal DLBCLs with germinal center B-cell (GCB) phenotype (nodal-DLBCL-GCB, <i>n</i> = 34). PB-DLBCL and polyostotic-DLBCL shared similar genomic profiles and transcriptomic signatures, justifying their collective analysis as bone-DLBCL. Differential incidences of <i>EZH2</i>, <i>HIST1H1E</i>, and <i>MYC</i> aberrations (<i>p</i> < 0.05) confirmed the distinct oncogenic evolution between bone-DLBCL and nodal-DLBCL-GCB. Differentially expressed genes were identified between bone-DLBCL and nodal-DLBCL-GCB (<i>p</i> < 0.001), substantiated by distinct gene-set enrichment analysis (GSEA). In contrast to a more ‘depleted’ phenotype for nodal-DLBCL-GCB, bone-DLBCL primarily exhibited an ‘intermediate/rich’ tumor microenvironment (TME) signature (<i>p</i> = 0.001), as determined by a previously published gene set. Unsupervised clustering defined two distinct groups that aligned with previously reported immune-enriched TME clusters: an ‘immune-rich’ cluster largely consisting of bone-DLBCLs (75%, <i>p</i> = 0.002) with superior survival (<i>p</i> = 0.030), and a poor-prognostic ‘immune-low’ cluster, including mostly nodal-DLBCL-GCB (61%). Single-sample (ss)GSEA showed higher scores for regulatory T cells, immunosuppressive/prolymphoma cytokines, and vascular endothelial cells in immune-rich samples (<i>p</i> < 0.001). Additionally, CIBERSORTx revealed a higher abundance of regulatory T cells and activated mast cells in the immune-rich cluster (<i>p</i> < 0.001). These findings were confirmed at protein level, where CD3 and FOXP3 immunochemistry showed significant overlap with the gene-expression data (<i>p</i> < 0.001). Conclusively, PB-DLBCL and polyostotic-DLBCL share immune-molecular TME characteristics, supporting their classification as a unified bone-DLBCL entity. The distinct immune-rich TME profile of bone-DLBCL associated with superior survival potentially shapes emerging immunomodulatory strategies</p><figure></figure>","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"46 12 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884701","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}
Lixia Sheng, Hailing Liu, Xiaohui Zhang, Kaiyang Ding, Jie Ma, Hongling Peng, Xia Zhao, Mei Sun, Wei Shi, Feiyan Zhang, Jianyong Li, Lei Cao, Lei Fan
{"title":"Prospective phase II trial of first-line rituximab, methotrexate, and orelabrutinib (R-MO) in primary central nervous system lymphoma","authors":"Lixia Sheng, Hailing Liu, Xiaohui Zhang, Kaiyang Ding, Jie Ma, Hongling Peng, Xia Zhao, Mei Sun, Wei Shi, Feiyan Zhang, Jianyong Li, Lei Cao, Lei Fan","doi":"10.1038/s41408-025-01278-w","DOIUrl":"https://doi.org/10.1038/s41408-025-01278-w","url":null,"abstract":"<p>The treatment of primary central nervous system lymphoma (PCNSL) is currently limited by the impermeability of the blood-brain barrier. This study aims to assess the efficacy and safety of the R-MO regimen (rituximab, high-dose methotrexate, and orelabrutinib) in the treatment of patients with newly diagnosed PCNSL. A total of 37 patients were enrolled in this prospective, multi-center phase II trial. The post-induction overall response rate (ORR) was 90.3%, and the complete response rate (CRR) was 87.1%. Throughout the trial, the best ORR was 97.1%, and the best CRR was 94.1%. With a median follow-up of 12.6 months, the median progression-free survival (PFS) was not reached, with a 1-year PFS rate of 83.6%, meeting the primary study endpoint. The 1-year overall survival rate was 89.6%. Notably, there was no significant difference in PFS between transplanted and non-transplanted groups (<i>P</i> = 0.226). The most common adverse events were neutropenia, lymphocytopenia, and infections, each occurring in 45.9% of patients. Overall, the addition of orelabrutinib to high-dose methotrexate and rituximab in newly diagnosed PCNSL patients has demonstrated promising outcomes and favorable safety profiles, advocating for the use of this combination therapy as a potential frontline treatment option for PCNSL.</p>","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"39 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884799","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}