Blood advancesPub Date : 2025-10-06DOI: 10.1182/bloodadvances.2025017526
Yannis K Valtis, Chenyu Lin, David Nemirovsky, Sean M Devlin, Kai Rejeski, Kevin J Curran, Xiuyan Wang, Nirali N Shah, Nikeshan Jeyakumar, Katharine Miller, Amy Zhang, Vamsi K Kota, Ali Al Darobi, Ibrahim N Muhsen, Joshua P Sasine, Ibrahim Aldoss, Anjali S Advani, Ran Reshef, Evan C Chen, Noam E Kopmar, Stephanie B Tsai, Talal Hilal, Bijal D Shah, Rawan G Faramand, Melhem M Solh, Virginia Tan, Evandro D Bezerra, Minoo Battiwalla, Aravind Ramakrishnan, John Mathews, Paul J Shaughnessy, Luke Mountjoy, Rasmus T Hoeg, Kaitlyn C Dykes, Aaron C Logan, Muthu Kumaran, Marc S Schwartz, Sean I Tracy, Jozal Moore, Silvina Odstrcil Bobillo, Noelle V Frey, Matthew P Connor, Abdullah Ladha, Bhagirathbhai Dholaria, Katherine C Sutherland, Gregory W Roloff, Lori S Muffly, Jae H Park
{"title":"CAR HEMATOTOX independently predicts outcomes after CD19 CAR-T therapy for acute lymphoblastic leukemia.","authors":"Yannis K Valtis, Chenyu Lin, David Nemirovsky, Sean M Devlin, Kai Rejeski, Kevin J Curran, Xiuyan Wang, Nirali N Shah, Nikeshan Jeyakumar, Katharine Miller, Amy Zhang, Vamsi K Kota, Ali Al Darobi, Ibrahim N Muhsen, Joshua P Sasine, Ibrahim Aldoss, Anjali S Advani, Ran Reshef, Evan C Chen, Noam E Kopmar, Stephanie B Tsai, Talal Hilal, Bijal D Shah, Rawan G Faramand, Melhem M Solh, Virginia Tan, Evandro D Bezerra, Minoo Battiwalla, Aravind Ramakrishnan, John Mathews, Paul J Shaughnessy, Luke Mountjoy, Rasmus T Hoeg, Kaitlyn C Dykes, Aaron C Logan, Muthu Kumaran, Marc S Schwartz, Sean I Tracy, Jozal Moore, Silvina Odstrcil Bobillo, Noelle V Frey, Matthew P Connor, Abdullah Ladha, Bhagirathbhai Dholaria, Katherine C Sutherland, Gregory W Roloff, Lori S Muffly, Jae H Park","doi":"10.1182/bloodadvances.2025017526","DOIUrl":"https://doi.org/10.1182/bloodadvances.2025017526","url":null,"abstract":"<p><p>CAR-T treatment for B-cell acute lymphoblastic leukemia (ALL) induces high initial response rates, but most patients relapse. Low disease burden (often defined as < 5% blasts in the bone marrow) is associated with better outcomes. CAR-HEMATOTOX (HT) is a score using pre-lymphodepletion hematologic and inflammatory parameters to predict outcomes in lymphoma. Here, we assess its prognostic utility in a large multicenter adult B-ALL cohort. Patients who received brexucabtagene autoleucel across 33 centers in North America were included as part of the ROCCA consortium. An independent cohort of 61 ALL patients treated with an investigational CD19 CAR-T at one center was also described. Among 199 ROCCA patients, the 43 (22%) HTlow patients had lower rates of delayed neutrophil recovery than HThigh (26% vs. 52%, p = 0.002) and fewer severe infections (2.5% vs. 18.8%, p = 0.011). They had higher response rates, overall survival (OS) and event free survival (EFS), as well as lower non-relapse mortality and cumulative incidence of relapse (CIR). The survival differences remained significant after multivariable adjustment for disease burden and other covariates. In the investigational cohort of 61 patients, HTlow patients had improved OS and EFS, as well as higher peak CAR-T expansion. In summary, CAR HT is a prognostic factor independent of disease burden in adult ALL. HTlow score is associated with superior outcomes post CD19 CAR and higher CAR expansion in a single-center cohort. NCT01044069 and NCT01860937.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237845","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}
Blood advancesPub Date : 2025-10-01DOI: 10.1182/bloodadvances.2024015610
Cody A Despins, Nicholas Jp Viegas, Robert A Holt
{"title":"Applying principles of vaccine development to oncomicrobial vaccines.","authors":"Cody A Despins, Nicholas Jp Viegas, Robert A Holt","doi":"10.1182/bloodadvances.2024015610","DOIUrl":"https://doi.org/10.1182/bloodadvances.2024015610","url":null,"abstract":"<p><p>Considerable global cancer burden is attributable to infectious agents, or oncomicrobes, which provides an opportunity to limit cancer by vaccination. HBV and HPV vaccines exemplify this strategy, by significantly reducing liver and cervical cancer cases, respectively, and highlight the potential of extending this approach to other oncomicrobe targets. However, to date, effective vaccines against other well-established oncomicrobes have not been developed, and novel oncomicrobes continue to emerge. In this review we provide an overview of vaccination and vaccine design with an emphasis on the key factors (vaccine type, antigen selection, administration route, vaccination timing) to consider when developing oncomicrobial vaccines, and we summarize the current state and future directions of vaccination for several established and emerging oncomicrobes.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198418","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}
Blood advancesPub Date : 2025-09-30DOI: 10.1182/bloodadvances.2025017220
Alfonso Rodriguez Espada, Amelia Haj, Sean Joseph Jurgens, Harish Eswaran, Linda Sundler Björkman, Justine Ryu, Sharjeel Chaudhry, Satoshi Koyama, Xin Wang, Seung Hoan Choi, Simone Sanna-Cherchi, Aleena Banerji, Joel T Rämö, Patrick T Ellinor, Steven P Grover, Pavan K Bendapudi
{"title":"Population-scale Analysis Reveals Germline Loss of SERPING1 (C1-Inhibitor) is a Polyphenotypic Thrombotic Disorder.","authors":"Alfonso Rodriguez Espada, Amelia Haj, Sean Joseph Jurgens, Harish Eswaran, Linda Sundler Björkman, Justine Ryu, Sharjeel Chaudhry, Satoshi Koyama, Xin Wang, Seung Hoan Choi, Simone Sanna-Cherchi, Aleena Banerji, Joel T Rämö, Patrick T Ellinor, Steven P Grover, Pavan K Bendapudi","doi":"10.1182/bloodadvances.2025017220","DOIUrl":"https://doi.org/10.1182/bloodadvances.2025017220","url":null,"abstract":"<p><p>Deficiency in C1 inhibitor (C1INH, SERPING1) is canonically associated with hereditary angioedema (HAE-C1INH) but not thrombosis. To determine the thrombosis risk conferred by loss of C1INH in the general population, we studied genetically-defined C1INH deficiency across 635,823 participants. Functionally deleterious germline coding variation in SERPING1 was rare (~1:10,000), indicating strong genetic constraint. SERPING1 variant carriers had significantly lower plasma C1INH levels than non-carriers as determined by Olink® proteomics (P=0.005) and confirmed by ELISA in an independent cohort (P<0.001). After adjustment for age, sex, and ancestry, SERPING1 haploinsufficiency was associated with a significantly increased risk of venous thromboembolism (HR=4.64, 95% CI: 2.08-10.34, P=0.0002), non-cardioembolic ischemic stroke (HR=3.29, 95% CI: 1.06-10.19, P=0.039), and peripheral artery disease (HR=3.10, 95% CI: 1.29-7.45, P=0.011), with a trend towards association with myocardial infarction (HR=2.77, 95% CI: 0.89-8.61, P=0.077). Effect size estimates for all four thrombosis phenotypes increased when analysis was restricted to only the most functionally deleterious variants. Furthermore, the lifetime attributable risks of thrombosis and HAE-C1INH were similar among SERPING1 variant carriers. Taken together, our data suggest that SERPING1 haploinsufficiency represents a polyphenotypic thrombotic disorder and that thrombosis is as likely as HAE-C1INH to be a manifestation of C1INH deficiency. These findings highlight the potential of population-scale datasets to address fundamental questions related to thrombosis risk.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198366","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}
Blood advancesPub Date : 2025-09-30DOI: 10.1182/bloodadvances.2025017770
Malte Roerden, Luca Hensen, Britta Besemer, Friederike Schwartz, Kristina Reuss, Alisha Weiss-Haug, Lennart Harland, Franziska Ginsberg, Christoph Faul, Wolfgang Andreas Bethge, Claudia Lengerke
{"title":"Dual Anti-CD19/22 and Anti-BCMA CAR-T cell therapy in a patient with multiple myeloma and secondary B-ALL.","authors":"Malte Roerden, Luca Hensen, Britta Besemer, Friederike Schwartz, Kristina Reuss, Alisha Weiss-Haug, Lennart Harland, Franziska Ginsberg, Christoph Faul, Wolfgang Andreas Bethge, Claudia Lengerke","doi":"10.1182/bloodadvances.2025017770","DOIUrl":"https://doi.org/10.1182/bloodadvances.2025017770","url":null,"abstract":"","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198379","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}
Blood advancesPub Date : 2025-09-30DOI: 10.1182/bloodadvances.2025017254
Alexandra Power-Hays, Kathryn E McElhinney, Thomas N Williams, George Mochamah, Peter Olupot-Olupot, George Paasi, Marvin E Reid, Angela E Rankine-Mullings, Robert O Opoka, Chandy C John, Patrick T McGann, Charles T Quinn, Nieko C Punt, Luke R Smart, Susan E Stuber, Teresa S Latham, Alexander A Vinks, Russell E Ware
{"title":"Hydroxyurea pharmacokinetics in children with sickle cell anemia across different global populations.","authors":"Alexandra Power-Hays, Kathryn E McElhinney, Thomas N Williams, George Mochamah, Peter Olupot-Olupot, George Paasi, Marvin E Reid, Angela E Rankine-Mullings, Robert O Opoka, Chandy C John, Patrick T McGann, Charles T Quinn, Nieko C Punt, Luke R Smart, Susan E Stuber, Teresa S Latham, Alexander A Vinks, Russell E Ware","doi":"10.1182/bloodadvances.2025017254","DOIUrl":"https://doi.org/10.1182/bloodadvances.2025017254","url":null,"abstract":"<p><p>Hydroxyurea provides effective disease-modifying treatment for people with sickle cell anemia (SCA), especially when escalated to maximum tolerated dose (MTD), but has wide interpatient dosing variability due to pharmacokinetic (PK) differences. Whether hydroxyurea PK parameters differ among children with SCA in different global regions is unknown. We compared hydroxyurea PK parameters among children with SCA from five clinical trials: HUSTLE (USA, NCT00305175), TREAT (USA, NCT02286154), NOHARM (Uganda, NCT01976416), REACH (Uganda and Kenya, NCT01966731), and EXTEND (Jamaica, NCT02556099). Key hydroxyurea PK parameters were determined using HdxSim™, a validated hydroxyurea PK-software program. The results were compared across regions by one way analysis of variance. The influence of laboratory and clinical variables on PK-guided doses were evaluated by linear regression. PK profiles from 451 children with SCA were included: 146 from the USA, 265 from Africa, and 40 from the Caribbean. Children from Africa had slightly lower volumes of distribution (p<0.001), but absorption rate (p=0.07) and clearance (p=0.2) were similar across regions. The PK-recommended doses to achieve MTD were statistically different but clinically similar: 26.6 ± 5.9, 27.6 ± 6.5, and 25.2 ± 4.7 mg/kg/day, respectively (p=0.04). In multivariable regression, younger age and increased reticulocyte counts were associated with higher PK-recommended doses. Hydroxyurea PK parameters in children with SCA differ minimally across global populations, predicting clinically similar doses to achieve MTD. Individualized hydroxyurea dosing based on a PK-population model derived from American children with SCA can be used broadly to maximize the benefits of this critical medication in other global populations.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198392","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}
Blood advancesPub Date : 2025-09-30DOI: 10.1182/bloodadvances.2025017234
Marion Aymard, Morgane Cheminant, Roch Houot, Anne Cuozzo, Elodie Gat, Catherine Thieblemont, Laure Ricard, Louise Roulin, Krimo Bouabdallah, Violaine Safar, Stephanie Guidez, Amandine Fayard, Gabriel Brisou, Loic Ysebaert, Olivier Hermine, Benoit Tessoulin, Charles Herbaux, Steven Le Gouill, Clémentine Sarkozy
{"title":"Outcome of Patients with Mantle Cell Lymphoma after Failure of Anti-CD19 CAR-T Cell Therapy: A Descar-T Study By Lysa Group.","authors":"Marion Aymard, Morgane Cheminant, Roch Houot, Anne Cuozzo, Elodie Gat, Catherine Thieblemont, Laure Ricard, Louise Roulin, Krimo Bouabdallah, Violaine Safar, Stephanie Guidez, Amandine Fayard, Gabriel Brisou, Loic Ysebaert, Olivier Hermine, Benoit Tessoulin, Charles Herbaux, Steven Le Gouill, Clémentine Sarkozy","doi":"10.1182/bloodadvances.2025017234","DOIUrl":"https://doi.org/10.1182/bloodadvances.2025017234","url":null,"abstract":"<p><p>Brexucabtagene autoleucel (brexu-cel) is the anti-CD19 CAR-T therapy approved for the treatment of relapse/refractory (RR) mantle cell lymphoma (MCL). Our study, conducted in the scope of the french DESCAR-T registry, aimed to analyze outcomes of MCL post-brexu-cel failure. In the DESCAR-T registry, 178 RR MCL received brexu-cel. After a median follow-up (FU) of 14.5 months, 61 experienced failures. This study analyzes post CAR-T failure progression-free (PFS2) and overall survival (OS2), according to clinical characteristics and salvage treatments. At infusion, 36% of the 61 patients had a high MIPI score, 76.2% a Ki-67 index ≥ 30%, 30.2% a TP53 mutation, and 31.6% a blastoid variant. After a median FU of 15 months post-failure, median OS2 and PFS2 were 5.8 and 1.8 months, respectively. Patients experiencing early failure (<3 months) had a median OS2 of 1.8 months, compared to 6.7 and 9 months for those relapsing within 3-6 and after 6 months. Forty-nine patients received salvage therapy: 16 lenalidomide ± rituximab (Len/R2), 13 immunochemotherapy (ICT), 8 Bruton tyrosine kinase inhibitor ± venetoclax (BTKi/Ven), 7 a bispecific T-cell engager (TCE), 3 another targeted therapy, and 2 radiations. Overall, post-salvage response rate was 20% (9 CR, 1 PR). 1-year OS2 was 36% for patients treated with Len/R2 and ICT, 57% for TCE and 0% for others type of salvage. Notably, none of the TCE responders have relapsed to date (DOR of 100%). Our series highlights the poor outcomes of MCL patients following CAR-T failure and suggest a potential benefit of bispecific antibodies in this population.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198435","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}
Blood advancesPub Date : 2025-09-30DOI: 10.1182/bloodadvances.2025017012
Lauren Elizabeth Appell, Christina Baggott, Khanh Nguyen, Snehit Prabhu, Holly L Pacenta, Samuel John, Vanessa A Fabrizio, Christine L Phillips, Jenna Rossoff, Julie-An M Talano, Amy Moskop, Rachel Phelan, Susanne H C Baumeister, Michael R Verneris, Erin M Hall, Gary Douglas Myers, Nicole A Karras, Stacy Cooper, Muna Qayed, Sunil Sudhir Raikar, Lena E Winestone, Michelle L Hermiston, Prakash Satwani, Christa Krupski, Amy Keating, Danielle Novetsky Friedman, Kevin J Curran, Alex Hoover, Margaret L MacMillan, Christen L Ebens, Archana Ramgopal, April L Rahrig, Crystal L Mackall, Theodore W Laetsch, Liora M Schultz
{"title":"Liberalizing Hospital Proximity Requirements for Children/Young Adults with Low Burden B-ALL Receiving Tisagenlecleucel.","authors":"Lauren Elizabeth Appell, Christina Baggott, Khanh Nguyen, Snehit Prabhu, Holly L Pacenta, Samuel John, Vanessa A Fabrizio, Christine L Phillips, Jenna Rossoff, Julie-An M Talano, Amy Moskop, Rachel Phelan, Susanne H C Baumeister, Michael R Verneris, Erin M Hall, Gary Douglas Myers, Nicole A Karras, Stacy Cooper, Muna Qayed, Sunil Sudhir Raikar, Lena E Winestone, Michelle L Hermiston, Prakash Satwani, Christa Krupski, Amy Keating, Danielle Novetsky Friedman, Kevin J Curran, Alex Hoover, Margaret L MacMillan, Christen L Ebens, Archana Ramgopal, April L Rahrig, Crystal L Mackall, Theodore W Laetsch, Liora M Schultz","doi":"10.1182/bloodadvances.2025017012","DOIUrl":"https://doi.org/10.1182/bloodadvances.2025017012","url":null,"abstract":"","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198445","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}
Blood advancesPub Date : 2025-09-30DOI: 10.1182/bloodadvances.2025017118
Zuguang Xia, Jiazhen Cao, Yingzhu Li, Jianing Wu, Jun Ren, Weiqi Sheng, Chengxun Li, Shengjie Li
{"title":"Antibody-DNA nanostructure conjugates integrate doxorubicin and rituximab to enhance therapeutic efficacy for DLBCL.","authors":"Zuguang Xia, Jiazhen Cao, Yingzhu Li, Jianing Wu, Jun Ren, Weiqi Sheng, Chengxun Li, Shengjie Li","doi":"10.1182/bloodadvances.2025017118","DOIUrl":"https://doi.org/10.1182/bloodadvances.2025017118","url":null,"abstract":"<p><p>The primary clinical approach for diffuse large B-cell lymphoma (DLBCL) in recent decades has predominantly relied on chemotherapy with R-CHOP as the cornerstone. However, given the highly heterogeneous nature of DLBCL, more than 30% of patients are prone to relapse and may even exhibit resistance to treatment. Antibody-drug conjugate (ADC) therapies have demonstrated significant advancements in clinical trials targeting DLBCL, thereby indicating a promising direction for its management. By leveraging the inherent modifiability of DNA nanostructures and the affinity of doxorubicin for DNA, we employed a combination of rituximab-based R-CHOP scheme and DNA tetrahedra to fabricate antibody-DNA nanostructure conjugate (ADNC). The RTD (Rituximab-Tetrahedron-Doxorubicin conjugate) studied in our research has been validated through in vitro cellular experiments and subcutaneous tumor models. The RTD demonstrated a robust anti-tumor effect in vitro, significantly exceeding the combined effects of rituximab and doxorubicin by more than fifty-fold. Furthermore, confirmation from a subcutaneous tumor model substantiated the potent anti-tumor efficacy of RTD while successfully mitigating cardiotoxicity and hematotoxicity associated with doxorubicin. Antibody-DNA nanostructure conjugate effectively facilitates the binding of rituximab and doxorubicin in the R-CHOP regimen, offering novel prospects for the development of next-generation ADC drugs.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198376","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}
Blood advancesPub Date : 2025-09-30DOI: 10.1182/bloodadvances.2025017244
Nigel H Russell, Jad Othman, Oliver Sebastian Cumming, Abin Thomas, Aditya Tedjaseputra, Nicola Potter, Jelena Jovanovic, Amanda Frances Gilkes, Leona Batten, Joanna Canham, Emily L Hinson, Manohursingh Runglall, Phoebe Aucken, Panagiotis Kottaridis, James Durrell Cavenagh, Claire Arnold, Sylvie D Freeman, Mike Dennis, Steven Knapper, Richard James Dillon
{"title":"Safety and Efficacy of Combining Midostaurin and Gemtuzumab Ozogamicin with Induction Chemotherapy in FLT3 mutated AML.","authors":"Nigel H Russell, Jad Othman, Oliver Sebastian Cumming, Abin Thomas, Aditya Tedjaseputra, Nicola Potter, Jelena Jovanovic, Amanda Frances Gilkes, Leona Batten, Joanna Canham, Emily L Hinson, Manohursingh Runglall, Phoebe Aucken, Panagiotis Kottaridis, James Durrell Cavenagh, Claire Arnold, Sylvie D Freeman, Mike Dennis, Steven Knapper, Richard James Dillon","doi":"10.1182/bloodadvances.2025017244","DOIUrl":"https://doi.org/10.1182/bloodadvances.2025017244","url":null,"abstract":"<p><p>Despite the use of FLT3 inhibitors, outcomes for patients with FLT3 mutated (FLT3mut) AML remain suboptimal because of high rates of relapse. We evaluated the safety and efficacy of the combination of daunorubicin, cytarabine (DA), gemtuzumab ozogamicin (GO) and midostaurin (DAGO+m) for younger patients with newly diagnosed FLT3mut AML in the UK NCRI AML19 trial. 195 patients were randomised to receive DA with either one or two doses of GO (DAGO1 and DAGO2). 77 had a FLT3 mutation (60 had FLT3-ITD) and received midostaurin for two weeks after each chemotherapy course and then as maintainance for one year unless transplanted. 39 patients received midostaurin with DAGO1 (DAGO1+m) and 38 with DAGO2 (DAGO2+m). Their median age was 51y (range 20-74) and 16 (20%) were aged >60y. The overall response rate (CR + CRi) was 91%. Day 30 and day 60 mortality was 0% with no increase in toxicity compared to patients treated contemporaneously with DAGO1 and DAGO2 without midostaurin. 2y overall survival was 77%. 2y event-free survival and cumulative incidence of relapse were 62% and 31% respectively. MRD clearance was enhanced compared to patients with FLT3-mutated AML treated with DAGO1 and DAGO2 without midostaurin. 81% of evaluable patients were NPM1 MRD negative by RT-qPCR in the peripheral blood after course 2 (76% with DAGO1+m and 86% with DAGO2+m), 79% were MRD negative in the bone marrow by FLT3-ITD NGS, and all patients had FLT3-MRD levels below 0.01%. DAGO+m appears safe and effective . DAGO2+m will now be evaluated in a randomised study (OPTIMISE-FLT3, ISRCTN 34016918). Trial: ISRCTN78449203.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198454","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}
Blood advancesPub Date : 2025-09-24DOI: 10.1182/bloodadvances.2025016797
Keri Toner, Lindsay A Renfro, Hema Dave, Gloria Pezzella, Qinglin Pei, Lisa Giulino-Roth, Terzah M Horton, Frank G Keller, Kara M Kelly, Sharon M Castellino, Catherine M Bollard
{"title":"Tumor-Specific Immune Responses and Biomarkers in pediatric High-Risk Hodgkin Lymphoma Patients.","authors":"Keri Toner, Lindsay A Renfro, Hema Dave, Gloria Pezzella, Qinglin Pei, Lisa Giulino-Roth, Terzah M Horton, Frank G Keller, Kara M Kelly, Sharon M Castellino, Catherine M Bollard","doi":"10.1182/bloodadvances.2025016797","DOIUrl":"https://doi.org/10.1182/bloodadvances.2025016797","url":null,"abstract":"<p><p>There is an unmet need to examine anti-tumor immune responses and predictive biomarkers in the peripheral blood to guide effective combination immunotherapies in classical Hodgkin Lymphoma (cHL). We sought to evaluate T cell specific immune responses as well as cytokine and chemokine profiles including levels of sCD30, sCD163 and TARC in relation to event-free survival (EFS) in patients with cHL. The Children's Oncology Group clinical trial AHOD1331 (NCT02166463) was a randomized phase III trial for patients with newly diagnosed high risk cHL ages 2 to 21 years which compared standard chemotherapy with doxorubicin, bleomycin, vincristine, etoposide, prednisone and cyclophosphamide (ABVE-PC) to brentuximab vedotin (Bv) + AVE-PC with response adapted radiation. Our results demonstrate that chemotherapy with or without addition of anti-CD30 antibody drug conjugate brentuximab vedotin (Bv) is associated with a favorable cytokine environment for cellular and immunotherapies. Treatment of cHL on both arms increased tumor antigen-specific T cell responses and resulted in decreased levels of sCD30, sCD163 and TARC. We demonstrate that treatment of cHL on COG AHOD1331 produced an environment that favors anti-tumor immune response, which may aid in application of further cellular and immunotherapies targeting cHL.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130008","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}