bluuebunny/crossref_metadata_2025_split huggingface dataset:
Allo-Reactable Lymphocytes Collected Early Phase in Cord Boold Transplant Can be Used As Cell Source for Donor Lymphocyte Infusion
Authors: Zong Sa , Bu Chaoke , Liu Nan , Chen Cunming , He Yuelin , Li Chunfu 
Published: December 2024

Background: Approximately 5%-37% of patients develop persistent thrombocytopenia following hematopoietic stem cell transplantation (HSCT). One of therapy is donor lymphocyte infusions (DLI). But in cord blood (CB) transplant (CBT), DLI is difficult because of donor lymphocytes unavailable. We hypothesized peripheral lymphocytes collected early phase (PLCEP) in CBT still retain allo-reaction and may be used as cell source for DLI. Here, we reported the first case with PLCEP-DLI.
Objective: To prove the effect of PLCEP-DLI.
Methods: Lymphocytes were collected in early phase in CBT as DLI cell source, and the DLI was given when the patient has thrombocytopenia.
Case report: A 2 year old boy, with body weigh of14.8kg, was diagnosed with thalassemia major at the age of 8 months, and then, began to receive regular infusion. He received dual HSCT from haploidentical donor combined with matched CB in August 2021, with conditioning regimen comprised of BU+CY+TT+Flu+ATG. CB stably engrafted finally.
At day 685 after HSCT, the patient was re-admitted due to “subcutaneous hemorrhagic spot for 2 weeks”. The routine blood test showed that neutrophils were 5.69*10e9/L, hemoglobin 112g/L, and platelets 2*10e9/L. Cells in peripheral blood (PB) sourced from cord blood in 100%. Anti-platelet and anti-HLA antibodies were positive (4+), with 0.4% red cell fragments and rare platelets on PB smear. Scanning of viruses, such as CMV, EBV, ADV, and B19 was negative. Direct and indirect Coomb's tests were negative.
Immune thrombocytopenia was diagnosed and drugs (IVIg, steroid, Rituximab Eltrombopag, and intravenous TPO) were given. In spite of short respondence and negative anti-platelet and anti-HLA antibodies, platelets were still low (1-8*10e9/L) along with hyperplasia marrow and 110 megakaryocytes on bone marrow smear. On day 700 after transplant, the patient received PLCEP-DLI with CD3+ cells of 4.94*10e6/kg following lymphocyte-depleted therapy of Flu (30mg/ m2 *3d) and CY (200mg/ m2 *1d) and immunosuppressant discontinuation.
On day 6 after DLI, skin rash appeared and disappeared after Ruxolitinib. The platelets recovered to 20, 50 and 123*10e9/L on day 9, 20, and 27, respectively. Up to June 30, 2024 (1048 days after HCT), the platelet was normal.
Summary: The case showed PLCEP-DLI was effect. which could effectively correct the immune thrombocytopenia in post-CBT. Allo-reactable lymphocytes collected early phase in CBT can be used as cell source for post-CBT DLI, however, the result of the case need to be proved in more cases in the future.
Progression of Disease within 24 Months (POD24) Based Prognostic Signature: A New Method for Personalized Risk Assessment in Patients with Mantle Cell Lymphoma
Authors: He Yizi , Wang Caiqin , Li Yajun , Zeng Ruolan , Xia Chen , Li Yixue , Xiao Ling , Zhou Hui 
Published: December 2024

Background
Mantle cell lymphoma (MCL) is an uncommon lymphoproliferative disorder with extremely heterogeneous in both biological and clinical aspects. Its diverse clinical presentations necessitate a personalized prognostic model to stratify patients into subgroups with distinct survival outcomes.
Methods
Recognizing the limitations of existing models in capturing disease complexity, we utilized clinical and molecular data from nine Chinese medical centers to validate the progression of disease within 24 months (POD24) and to develop a novel prognostic risk model to predict the survival outcome of MCL patients.
Results
POD24 was observed in 37.7% of evaluable patients (369/979), with a significantly shorter median overall survival of 21 months compared to 122 months for those without POD24 (P &lt; 0.0001).Patients with POD24 were more likely to present with B symptoms (P = 0.003), elevated lactate dehydrogenase (LDH) levels (P &lt; 0.0001), splenomegaly (P &lt; 0.0001), Ki-67 expression (P &lt; 0.0001), and a poorer performance status (P = 0.005). Additionally, they were more likely to have undergone autologous stem cell transplantation (ASCT) (P = 0.037). The POD24-based risk model （POD24 ,age, LDH level, MIPI score, splenomegaly, Ki67 expression and ASCT）demonstrated the highest sensitivity for predicting survival, with an impressive area under the curve (AUC) for the risk score of 0.869.
Conclusion
Our study confirms the robust predictive power of POD24 and introduces a novel risk model that integrates POD24 with clinical factors. Our new prognostic model might be helpful to effectively classify MCL patients with high-risk groups in terms of survival rate, which may help select high-risk MCL patients for more intensive treatment at time of relapse. This novel developed model greatly improved the prognostic predictive accuracy, which could be used to individualize the survival outcomes of patients and has the potential translation into clinical practice in the future.
Immunoglobulin Light Chain Renal Amyloidosis Patients with t(11;14) Have Much More Possibility to be Present As Nephrotic Syndrome
Authors: Liu Menghan , Geng Chuanying , Gao Wen , Chen Wenming , Yang Guangzhong 
Published: December 2024

Immunoglobulin Light Chain Renal Amyloidosis patients with t(11;14) have much more possibility to be present as nephrotic syndrome
Introduction：Systemic immunoglobulin light chain (AL) amyloidosis is a clonal plasma cell disorder characterized by organ dysfunction secondary to deposition of misfolded light chains. Approximately 70% of patients with AL amyloidosis have renal involvement presented with heavy proteinuria or nephrotic syndrome and can progressed to end-stage renal disease. We sought to explore the clinical characteristics and outcomes between patients presenting with or without nephrotic syndrome.
Methods:
A total of 37 patients of newly diagnosed AL amyloidosis with renal involvement between 2015/9/26 and 2023/11/30 were included in this single-center, retrospective observational study. The diagnosis of AL amyloidosis was confirmed by tissue biopsy. Exclusion criteria included known as prior AL amyloidosis related treatment, multiple myeloma, baseline end-stage renal disease, dialysis or renal transplant. Demographic and clinical characteristics, FISH results, along with outcomes including best hematologic response, renal response and overall survival (OS) were assessed. The definition of both hematological response and renal response was based on the International Myeloma Working Group (IMWG) criteria
Results：
37 participants were included for statistical analyses, including 24（64.9%）patients with nephrotic syndrome (AN group) and 13 patients（35.1%）without nephrotic syndrome (AM group). The two groups share a similar incidence rate of cytogenetic abnormalities, while the prevalence of t(11;14）was significantly higher in AN group than AM group (62.5% vs. 46.2%, p=0.027). Although the small number of patients with renal stage III (n=2) were enrolled, which were all classified in AN group.
Regardless of treatment regimen, there was no difference between the two groups in terms of hematologic remission. Compared with the AN group, a significantly higher proportion of deep renal remission （≥VGPR）were observed in AM group (53.8% vs. 20.8%, p＜0.001). Meanwhile, we classified the patients into four subgroups according to the different treatments, including bortezomib-based, melphalan-based, dara-based and others regimen groups. No statistical significance was found comparing different treatment groups due to the small sample size.
The median follow-up of the patients was 52.3 months. There was a tendency for the AM group to have longer OS compared with the AN group, but no statistical significance was achieved（75% vs. 61.5%，p =0.312），which needed to be confirmed in an cohort with expanded sample sizes.
Conclusions:
Nephrotic syndrome was more likely to be presented in AL amyloidosis patients with t(11;14), leading to a relatively poor organ response to chemotherapy.
Chromosome Abnormality Spectra and Clinical Impact in 1,787 Cases of Acute Leukemia in Koreans
Authors: Son Dong Geun , Jang Ho Cheol , Lee Young Eun , Choi Yong Jun , Park Joo Heon , Baek Hee Jo , Kook Hoon , Kim Mihee , Song Ga-Young , Ahn Seo-Yeon , Jung Sung-Hoon , Yang Deok-Hwan , Lee Je-Jung , Kim Hyeoung-Joon , Ahn Jae-Sook , Shin Myung Geun 
Published: December 2024

In acute leukemia, chromosomal alterations serve as diagnostic and prognostic markers, detectable via various techniques. Our institution previously studied chromosomal abnormalities over two periods of time, noting any differences. This study investigated the frequency of these abnormalities and clinical trends in acute leukemia in Korea across three time periods.
We reviewed data from 1,787 acute leukemia patients (319 children, 1,468 adults) diagnosed between 2006 and 2020. Conventional cytogenetics, fluorescence in situ hybridization (FISH), and multiplex RT-PCR were used for analysis. Patients were grouped into three periods: 2006-2009 (I), 2010-2015 (II), and 2016-2020 (III).
Chromosomal aberrations were identified in 92% of patients using conventional cytogenetics, with PML::RARA being the most frequent. Age-specific patterns showed significant differences in fusion genes between children and adults, with some abnormalities detectable only using specific methods. In adult patients, a significant increase in the median age receiving intensive chemotherapy was observed (median years: 48 vs. 53 vs. 60 in periods I, II, and III, respectively, P &lt;0.001). An improvement in overall survival during period III was particularly evident in patients over 50 years old (P=0.003).
Over the 15-year period, chromosomal aberrations showed minimal changes, with consistent common fusion transcripts. In children, acute lymphoblastic leukemia (ALL) is more prevalent, with significant ETV6::RUNX1 and RUNX1::RUNX1T1 aberrations. In adults, the incidence has increased, with PML::RARA remaining common. Clinically, advances in transplantation and supportive care have allowed for increased intensive chemotherapy administration to older patients, improving survival rates.
Investigating the Impact of an Efficacy-Based Nursing Program Integrated with Nutritional Intervention Strategies on the Outcomes of Multiple Myeloma Patients Experiencing Renal Failure
Authors: Liu Tingting , Jiang Cuiting , Xu Luxiang , Liu Yao 
Published: December 2024

Objective: Assessing the Effectiveness of a Nutritional Intervention Combined with an Efficacy-Grounded Nursing Plan for Patients with Multiple Myeloma (MM) and Renal Failure.
Methods: A prospective selection was conducted on 92 patients with MM complicated with renal failure admitted to our hospital from April 2022 to April 2024. They were randomly divided into a control group (46 cases, receiving routine nursing care) and an observation group (46 cases, receiving a nursing plan based on efficacy theory combined with nutritional intervention). Compare the changes in self-efficacy CDSES score, psychological resilience CD-RISC score, cancer-related fatigue CFS score, and quality of life FLIC score between two groups.
Results: Following the intervention, there was a notable elevation in CDSES and CD-RISC scores for both groups, with the combined observation group exhibiting higher scores than the control group. Additionally, CFS scores reduced in both groups at 1 week, 1 month, and 3 months post-intervention compared to T0, with the combined regimen patients displaying apparently lower scores than the control group (P&lt;0.05). Marked improvements were observed in domains of physical and psychological well-being, cancer-related hardship, and social well-being for both groups, with the combined observation group achieving higher scores than the control. Nausea scores decreased clearly in both groups post-intervention, though the control group experienced a more pronounced decline compared to the combined care patients (P&lt;0.05).
Conclusions: The integration of an efficacy theory-grounded nursing plan with nutritional intervention exhibits beneficial effects on MM patients with renal failure, enhancing their self-efficacy, bolstering psychological resilience, mitigating cancer-related fatigue, and optimizing nutritional status and overall quality of life.
Prophylaxis with Thiotepa and High-Dose Methotrexate Showed Low CNS Relapse Rate in Diffuse Large B-Cell Lymphoma with High Risk of CNS Relapse
Authors: Zeng Ruolan , Ouyang Zhou , Li Yajun , He Yizi , Wang Caiqin , Xia Chen , Wang Zhongtai , Li Yixue , Liu Yinhua , Tang Weiqiang , Ouyang Qianying , Liang Liang , Su Chang , Lu Guige , Zhu Xueting , Hu Qianyu , Xiao Ling , Zhou Hui 
Published: December 2024

Background: Central nervous system (CNS) relapse in patients with diffuse large B-cell lymphoma (DLBCL) results in dismal prognosis. There is controversy over the treatment method and efficacy of CNS prophylaxis in high risk DLBCL. Although methotrexate (MTX) is the most widely used therapy for CNS prophylaxis, results from previous studies investigating the optimal regimen for CNS prophylaxis remains unclear. Therefore, additional strategies for preventing CNS relapse in DLBCL patients are required. We evaluated the efficacy and safety of different prophylactic regimens (thiotepa plus high-dose methotrexate, high-dose methotrexate alone or intrathecal methotrexate and cytarabine) in newly diagnosed DLBCL patients with high-risk for CNS relapse.
Methods: We retrospectively analyzed records of all newly diagnosed DLBCL patients at high risk for CNS relapse treated at Hunan Cancer Hospital between November 2009 and January 2024. Patients received either thiotepa plus high-dose methotrexate (thiotepa 40mg/ m2, methotrexate 3.5g/m2, T-HD-MTX), high-dose methotrexate alone (methotrexate 3.5g/m2, HD-MTX), or intrathecal methotrexate and cytarabine (IT). The primary endpoint was the rate of CNS relapse, and the secondary endpoints included progression-free survival (PFS) and adverse events (AEs).
Results: 232 newly diagnosed DLBCL patients (128 males; median age 59 years, range, 19-76) with high-risk for CNS relapse was included in this study, of whom 170 patients were Ⅲ-Ⅳ stage, 136 patients were non-GCB and 46 patients were CD5 positive. Prophylactic regimens were as follows: IT MTX in 84 patients (36.2%), HD-MTX in 105 patients (45.3%), and T-HD-MTX in 43 patients (18.5%). With a median follow-up of 43 months, CNS relapse rate was 22.6% (19/84) in IT group, 8.6% (9/105) in HD-MTX group, 2.3% (1/43) in T-HD-MTX group (P＜0.001). The most common AEs were leukopenia (56.5%), thrombocytopenia (32.8%), and anemia (37.5%). Grade 3-4 AEs included leukopenia (10.8%), thrombocytopenia (2.2%), and pneumonia (3.4%), and no severe AEs reported.
Conclusion: Thiotepa plus high-dose methotrexate is an effective and well-tolerated CNS prophylactic regimen for high-risk newly diagnosed DLBCL patients.
Intensified Conditioning Containing Decitabine Versus Standard Myeloablative Conditioning for Adult Patients with KMT2A-Rearranged Leukemia: A Multicenter Retrospective Study
Authors: Hu Zhongli , He Hai , Liu Shiqi , Dong Ying , Fan Zhiping , Li Yiqing , Huang Fen , Xu Na , Liu Can , Zeng Yunxin , Zhu Ping , Lin Ren , Jin Hua , Zhang Xiong , Sun Ruijuan , Liu Qifa , Xuan Li 
Published: December 2024

Background: KMT2A-rearranged (KMT2A-r) leukemia has a poor prognosis. Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) is recommended for patients with this disease, but relapse remains high. In addition to disease-associated factors, intensities of conditioning are an essential factor affecting relapse post-transplantation. We aimed to determine whether intensified conditioning containing decitabine (Dec) could reduce relapse compared with standard myeloablative conditioning in adult patients with KMT2A-r leukemia.
Methods: We performed a multicenter retrospective study at six institutions in China. Eligible patients were aged 14 years or older at transplantation, had a diagnosis of KMT2A-r leukemia, and underwent first allo-HSCT. Standard myeloablative conditioning regimens (standard group) included BuCy (busulfan 3.2 mg/kg/day on days -7 to -4; cyclophosphamide 60 mg/kg/day on days -3 to -2) and TBI-Cy (total body irradiation 4.5 Gy/day on days -5 to -4; cyclophosphamide 60 mg/kg/day on days -3 to -2). Intensified conditioning regimens containing Dec (intensified group) consisted of Dec-BuCy (Dec 20 mg/m2/day on days -14 to -10; the same dose of BuCy) and Dec-TBI-Cy (Dec 20 mg/m2/day on days -10 to -6; the same dose of TBI-Cy).
Results: Between April 2009 and December 2019, 218 patients were enrolled including 105 in the intensified group and 113 in the standard group. The 3-year cumulative incidence of relapse was 19.4% and 37.0%, overall survival was 71.3% and 61.0%, disease-free survival was 70.1% and 56.0%, and non-relapse mortality was 13.0% and 11.1% in the intensified and standard groups, respectively (P = 0.001; P = 0.034; P = 0.005; P = 0.850). Subgroup analysis showed the relapse rate of intensified conditioning was lower than that of standard conditioning in multiple subgroups, including different leukemia types and disease status at transplantation, high-risk cytogenetics and busulfan-based regimens. Grade 3 or worse RRT occurred in 11 (10.5%) and 10 (8.8%) patients in the intensified and standard groups, respectively. One (1.0%) patient in the intensified group died of heart toxicity, and one (0.9%) in the standard group died of kidney toxicity. There was no difference in engraftment or graft-versus-host disease between the intensified and standard groups.
Conclusions: These results suggest that intensified conditioning containing Dec might be a better strategy than standard myeloablative conditioning for adult patients with KMT2A-r leukemia undergoing allo-HSCT, which requires further confirmation in prospective, randomized controlled studies.
White Blood Cell Count, Neutrophil to Lymphocyte Ratio and Serum Lactate Dehydrogenase Level Associated with Thrombosis Risk Prediction in Essential Thrombocytosis
Authors: Oh Yu Been , Lee Young Eun , Lim Ha Jin , Kwon Yong Jun , Choi Yong Jun , Park Joo Heon , Choi Hyun-Jung , Choi Hyun-Woo , Kee Seung-Jung , Kim Soo Hyun , Shin Jong Hee , Shin Myung Geun 
Published: December 2024

Risk assessment systems, including International Prognosis Score of thrombosis in Essential Thrombocythemia (IPSET-t), have been developed to predict the risk of thrombosis in essential thrombocythemia (ET) patients. However, these systems have not been extensively validated. This study aims to assess the clinical utility of conventional risk stratification, IPSET-t, and a revised IPSET-t system in Korean ET patients. Additionally, this study identified markers that could predict thrombosis in ET using routine laboratory test results.
A total of 359 ET patients were diagnosed through blood tests, bone marrow tests, genetic tests, and chromosome tests. Markers that predict thrombosis were identified using blood tests and clinical chemistry test results performed at the time of diagnosis. The patients were classified using conventional risk stratification, IPSET-t, and revised IPSET-t systems.
The average age of ET patients was 61.8 years with 52.9% of female patients. Chromosomal abnormalities were observed in 5.1% of patients. Thrombosis-free survival (TFS) analysis revealed statistically significant differences in survival between the low and high-risk groups without showing statistical significance. No differences in progression-free survival (PFS) were observed between groups for the IPSET-t and revised IPSET-t risk prediction systems. White blood cell (WBC) count, neutrophil to lymphocyte ratio (NLR) and lactate dehydrogenase (LDH) levels were significantly associated with risk stratification, with higher values observed in higher-risk categories.
Three risk assessment systems were confirmed to be useful in predicting TFS but showed limitations in predicting PFS. Meanwhile, the WBC count, NLR and LDH levels were useful as blood test markers for predicting the prognosis.
Efficacy and Safety of Rituximab Biosimilar (DRL_RI) Versus Mabthera in Low Tumor Burden Follicular Lymphoma: The Flinter Study
Authors: Maharaj Narendra , Uppada Dharma Rao , Eswaraiah Anand , Kakkattu Ranjith , Reddy Pramod , Kalenik Volha A , Belada David , Oliveira Ana C , Kim Jin Seok , Baranau Yauheni V 
Published: December 2024

Objective: This randomized, double-blind, phase 3 study evaluated the efficacy, safety, and immunogenicity of biosimilar rituximab (DRL_RI) versus rituximab (MabThera®) in patients with low-tumor-burden follicular lymphoma (LTB-FL).
Methods: Previously untreated, stage II-IV, CD20-positive LTB-FL patients (N=317) were randomized (1:1) to receive DRL_RI (n=162) or MabThera® (n=155) as intravenous infusions of 375 mg/m² weekly for 4 weeks (induction period), and thereafter 8 weekly from Week 12 to Week 36 (maintenance treatment) and followed up till Week 52. The primary endpoint was best overall response rate (BORR) up to Week 28 based on blinded independent central review. Efficacy equivalence was demonstrated if the two-sided 90% CI for BORR difference was within the prespecified equivalence margin (±17%). Secondary endpoints included objective and complete responses, duration of response, progression-free survival, overall survival, safety, immunogenicity and exploratory endpoints included mean serum drug concentrations, and pharmacodynamics (PD).
Results: The BORR up to Week 28 was 80.2% vs. 79.4% for DRL_RI vs. MabThera® group; with a difference of 0.89% [90% CI: -6.67-8.48; 95% CI: -8.05-9.93 within the prespecified margin]. Both treatment groups were comparable for all secondary efficacy endpoints. Treatment-emergent adverse events were reported in 68.6% of patients; safety, immunogenicity, and mean serum drug concentrations were similar between groups. Peripheral B-cell counts declined below quantifiable limits in most patients, with a median time to B-cell depletion of 6.9 days vs. 7.0 days for DRL_RI vs. MabThera®.
Conclusion: The study demonstrated efficacy equivalence of DRL_RI to MabThera®; with comparable safety, immunogenicity, serum drug concentrations, and PD between groups.
Clinical Trial Registry Information: This trial was registered at ClinicalTrials.gov identifier: NCT03976102 and EudraCT (2018-004223-36).