Meera Mohan, Anushareddy Muddasani, Hayder Alkhalisy, Lisa Rein, Jean Esselman, Binod Dhakal, Anita D’Souza, Sabarinath Venniyil Radhakrishnan, Sharmilan Thanendrarajan, Maurizio Zangari, Frits van Rhee, Aniko Szabo, Carolina Schinke
{"title":"Immune effector cell associated hematotoxicity (ICAHT) with BCMA CAR T cell therapy in the earlier lines","authors":"Meera Mohan, Anushareddy Muddasani, Hayder Alkhalisy, Lisa Rein, Jean Esselman, Binod Dhakal, Anita D’Souza, Sabarinath Venniyil Radhakrishnan, Sharmilan Thanendrarajan, Maurizio Zangari, Frits van Rhee, Aniko Szabo, Carolina Schinke","doi":"10.1038/s41408-026-01611-x","DOIUrl":"https://doi.org/10.1038/s41408-026-01611-x","url":null,"abstract":"B-cell maturation antigen (BCMA)-directed chimeric antigen receptor (CAR) T-cell therapy is highly effective in relapsed/refractory multiple myeloma (MM), but adverse effects such as immune effector cell–associated hematotoxicity (ICAHT) remain a challenging early and long-term toxicity. Most reports on ICAHT originate from CAR T-cell therapies in late-stage MM, with limited data from earlier-line treatment. We conducted a multi-institutional retrospective study of 245 MM patients treated with BCMA CAR T, comparing ICAHT between early-line [early CAR T] (1–3 prior lines; n = 69) and late-line [late CAR T] (≥4 prior lines; n = 176) cohorts. Cytopenias (neutropenia ≤1000/µL, thrombocytopenia ≤50,000/µL, anemia ≤9 g/dL) were assessed at day 21 (D + 21), 3, and 6 months post-CAR T-cell infusion. At D + 21, ICAHT was less frequent with early CAR T versus late CAR T (39% vs 62%; p = 0.002), driven largely by lower thrombocytopenia (17% vs 39%; p = 0.001). At 3 months, ICAHT remained more common with late CAR T (30% vs 12%; p = 0.004), but by 6 months, rates converged (8.9% vs 18%; p = 0.126). Blood counts among patients with ICAHT at D + 21 often remained inferior at 3 and 6 months despite stem cell boosts. ICAHT at D + 21 independently predicted worse overall survival (HR 3.12; p = 0.022). Early-line CAR T-cell therapy was associated with superior 12-month PFS (87.8% vs 65.4%) and OS (96.2% vs 85.9%). These real-world data show that ICAHT occurs even with earlier-line BCMA CAR T-cell therapy, though less severe, and underscore the prognostic importance of early post-infusion cytopenias.","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"25 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148769228","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}
Sarah Matarasso Greenfeld, Rakan Okde, Mark Sorin, Olivia Benguigui, Joseph Tuscano, Maria Sannikova, Eugene Nikitin, Lorenzo Falchi, Sarit Assouline
{"title":"Lenalidomide and rituximab for relapsed/refractory follicular lymphoma: a systematic review and meta-analysis","authors":"Sarah Matarasso Greenfeld, Rakan Okde, Mark Sorin, Olivia Benguigui, Joseph Tuscano, Maria Sannikova, Eugene Nikitin, Lorenzo Falchi, Sarit Assouline","doi":"10.1038/s41408-026-01608-6","DOIUrl":"https://doi.org/10.1038/s41408-026-01608-6","url":null,"abstract":"Lenalidomide (len) and rituximab (R2) is standard second-line therapy for follicular lymphoma (FL), and the backbone and comparator for several new therapies. This systematic review and meta-analysis of R2 or len-anti-CD20 monoclonal antibodies aims to clarify efficacy across trials, and to evaluate the benefit of triplet therapies including R2. Across 24 treatment arms involving 2245 patients, 63% received R2 or len-anti-CD20 and 37% received it with an additional agent. For R2/len-anti-CD20, the overall response rate (ORR) was 75.9% (95% CI 72.1–79.3, p = 0.0092; I2 = 53.5%), and complete response rates (CR), 39.6% (95% CI 32.4–47.3, p < 0.0001, I2 = 73.2%). ORRs were similar whether studies included or excluded rituximab-refractory, but CR appeared lower (28.6% vs. 42.9%). The number of prior lines of therapy did not affect response. Adding a third agent to R2 or len-anti-CD20 resulted in similar ORRs but significantly higher CR and 1- and 2-year progression-free survival appeared longer than that seen with R2. However, triplet regimens were associated with increased grade ≥3 toxicity. These findings reinforce the role of R2 in R/R FL in the modern treatment era. R2 at first relapse is effective across rituximab sensitivity profiles. Triplet combinations built on the R2 backbone improve efficacy but require careful patient selection and monitoring due to higher toxicity risks.","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"35 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148769229","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}
David L Murray, Jonathan Coker, Taxiarchis Kourelis, Angela Dispenzieri, Mindy Kohlhagen, Surendra Dasari, Maria Willrich
{"title":"Persistence of M-proteins detected by mass spectrometry.","authors":"David L Murray, Jonathan Coker, Taxiarchis Kourelis, Angela Dispenzieri, Mindy Kohlhagen, Surendra Dasari, Maria Willrich","doi":"10.1038/s41408-026-01610-y","DOIUrl":"https://doi.org/10.1038/s41408-026-01610-y","url":null,"abstract":"","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"16 1","pages":""},"PeriodicalIF":13.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787934","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}
Alexandra D Dreyfuss, Joachim Yahalom, Sridevi Rajeeve, Alexander M Lesokhin, Gunjan L Shah, Heather J Landau, Maximilian Merz, Michael Scordo, Andriy Derkach, David Nemirovsky, Harper Hubbeling, Gustav Cederquist, Zachary R Moore, Sergio A Giralt, Sham Mailankody, Saad Z Usmani, Brandon S Imber, Hamza Hashmi
{"title":"Lesion-level PET/CT analysis to identify predictors of progression after BCMA CAR T-cell therapy in multiple myeloma.","authors":"Alexandra D Dreyfuss, Joachim Yahalom, Sridevi Rajeeve, Alexander M Lesokhin, Gunjan L Shah, Heather J Landau, Maximilian Merz, Michael Scordo, Andriy Derkach, David Nemirovsky, Harper Hubbeling, Gustav Cederquist, Zachary R Moore, Sergio A Giralt, Sham Mailankody, Saad Z Usmani, Brandon S Imber, Hamza Hashmi","doi":"10.1038/s41408-026-01607-7","DOIUrl":"10.1038/s41408-026-01607-7","url":null,"abstract":"","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"16 1","pages":""},"PeriodicalIF":13.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13490575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788005","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}
Mahnoor Fatima, Sudhesh Kumar, Momna Warraich, Kristen McCullough, Aref Al-Kali, Hassan B Alkhateeb, Kebede H Begna, Abhishek Mangaonkar, Antoine N Saliba, Mark R Litzow, William Hogan, Mithun V Shah, Mrinal M Patnaik, Animesh Pardanani, Talha Badar, James Foran, Jeanne Palmer, Cecilia Arana Yi, Ayalew Tefferi, Naseema Gangat
{"title":"Determinants of survival after failure of frontline venetoclax plus hypomethylating agent therapy in 356 patients with newly diagnosed acute myeloid leukemia.","authors":"Mahnoor Fatima, Sudhesh Kumar, Momna Warraich, Kristen McCullough, Aref Al-Kali, Hassan B Alkhateeb, Kebede H Begna, Abhishek Mangaonkar, Antoine N Saliba, Mark R Litzow, William Hogan, Mithun V Shah, Mrinal M Patnaik, Animesh Pardanani, Talha Badar, James Foran, Jeanne Palmer, Cecilia Arana Yi, Ayalew Tefferi, Naseema Gangat","doi":"10.1038/s41408-026-01612-w","DOIUrl":"https://doi.org/10.1038/s41408-026-01612-w","url":null,"abstract":"","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"16 1","pages":""},"PeriodicalIF":13.8,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13483032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787963","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}
Betty Gration, Cameron Wellard, Elizabeth Moore, Peter Mollee, Anita Shetty, Cecily Forsyth, Jessica Heenan, Ian Kerridge, Zoe McQuilten, Erica Wood, Andrew Spencer, Georgia McCaughan
{"title":"Impact of socioeconomic status on treatment and survival in multiple myeloma in Australia","authors":"Betty Gration, Cameron Wellard, Elizabeth Moore, Peter Mollee, Anita Shetty, Cecily Forsyth, Jessica Heenan, Ian Kerridge, Zoe McQuilten, Erica Wood, Andrew Spencer, Georgia McCaughan","doi":"10.1038/s41408-026-01596-7","DOIUrl":"https://doi.org/10.1038/s41408-026-01596-7","url":null,"abstract":"Outcomes in multiple myeloma (MM) have improved significantly but remain heterogeneous. We assessed the impact of non-biological social determinants of health on treatment and survival outcomes in Australia using data from the Australian and New Zealand Myeloma and Related Diseases Registry. A total of 4405 patients diagnosed with MM between June 2012 and October 2025 across 44 Australian sites were assigned an area-level socioeconomic status (SES) using individual postcodes. Baseline characteristics, treatment and survival outcomes were compared across high (n = 1484), medium (n = 1463), and low (n = 1458) SES tertiles. Lower neighbourhood SES was associated with higher BMI, poorer functional status, more comorbidities (diabetes, cardiac and pulmonary disease), Asian ethnicity and greater remoteness. Independent of these baseline differences, patients from lower SES neighbourhoods were less likely to receive an autologous stem cell transplant (odds ratio = 1.1 medium vs low, p = 0.41; 1.5 high vs low, p < 0.01) and time to reach ASCT following induction was longer (p < 0.001) despite this being standard-of-care therapy with proven survival benefit. Median overall survival was shorter for the low SES group at 78.5 months compared to 92.5 months (HR = 0.85, p = 0.01) and 86.7 months (HR = 0.85, p = 0.01) for the medium and high SES groups respectively. These findings demonstrate significant disparities in treatment and outcomes favouring higher SES, independent of biological factors, within a universal healthcare system. This suggests that non-biological factors continue to influence access to standard-of-care therapy and survival, warranting further research to identify and address barriers to equitable care.","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"16 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148728873","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}
Maria A Malik, Eliana Schach, Yan Leyfman, Andriy Derkach, Francesca Castro, Jorge Arturo Hurtado Martinez, Ana M Sahagun Sanchez Aldana, Patricia Alejandra Flores Perez, Jennifer M Ahlstrom, Jay R Hydren, Saad Z Usmani, Jun J Mao, Susan Chimonas, Urvi A Shah
{"title":"Patterns and perceptions of supplement use among patients with plasma cell disorders.","authors":"Maria A Malik, Eliana Schach, Yan Leyfman, Andriy Derkach, Francesca Castro, Jorge Arturo Hurtado Martinez, Ana M Sahagun Sanchez Aldana, Patricia Alejandra Flores Perez, Jennifer M Ahlstrom, Jay R Hydren, Saad Z Usmani, Jun J Mao, Susan Chimonas, Urvi A Shah","doi":"10.1038/s41408-026-01603-x","DOIUrl":"https://doi.org/10.1038/s41408-026-01603-x","url":null,"abstract":"","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"16 1","pages":""},"PeriodicalIF":13.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763807","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}
{"title":"Infectious complications following bispecific antibody or CAR T therapy in adult patients with hematologic malignancies: a retrospective database analysis","authors":"Mark Michael, Fady Mishriky, Konstantinos Ouranos, Nadine Hassan, Evangelia K. Mylona, Fadi Shehadeh, Tilemachos Koutouratsas, Diana Avila, Siddharth Das, Jenny Petkova, Eleftherios Mylonakis","doi":"10.1038/s41408-026-01599-4","DOIUrl":"https://doi.org/10.1038/s41408-026-01599-4","url":null,"abstract":"T-cell redirection therapies, including bispecific antibodies (BsAbs) and chimeric antigen receptor (CAR) T therapy, have transformed the treatment of relapsed or refractory hematologic malignancies. However, comparative data on infectious complications between these treatments remain limited. We performed a propensity score-matched analysis of adults with hematologic malignancies treated with BsAbs or CAR T using the TriNetX global research network. To mitigate confounding, we utilized 1:1 propensity score matching (caliper 0.1) to balance cohorts on demographics, malignancy type, comorbidities, and prior treatments. The primary outcome was 1-year infection hazard in BsAbs vs. CAR T. We included 2 192 matched patients (1 096/group; mean age 65.8 (11.4) years for BsAbs, 65.4 (10.2) years for CAR T). Multiple myeloma was the most common malignancy (~62%). At 1 year, infection hazard was not statistically different between cohorts (BsAbs: 57% vs. CAR T: 55.9%; HR: 1.07; 95% CI: [0.96–1.20]). Early phase infection hazard (days 1–30) was lower with BsAbs but not statistically significant (HR: 0.87; 95% CI: [0.74–1.02]). However, BsAbs therapy was associated with higher infection hazard during intermediate (days 31–180; HR: 1.27; 95% CI: [1.10–1.46]) and late phases (days 181–365; HR: 1.20; 95% CI: [1.01–1.41]). In the late phase, BsAbs carried higher hazard for fungal (HR: 2.14; 95% CI: [1.26–3.64]) and viral pathogens (HR: 1.32; 95% CI: [1.02–1.73]). Respiratory tract infections were the most frequent complication and were higher with BsAbs across all time windows (1-year: 35.4% vs. 30.4%; HR: 1.32; 95% CI: [1.14–1.53]). In conclusion, among patients captured within TriNetX, the overall observed 1-year infection rate did not differ significantly between BsAbs and CAR T therapy. However, BsAbs therapy was associated with higher coded rates of late-onset infections after extensive adjustment, although residual confounding from disease severity and treatment duration remains possible. Further studies must better define this infection burden and optimize prevention strategies.","PeriodicalId":8989,"journal":{"name":"Blood Cancer Journal","volume":"375 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148728892","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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