bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology and Survival Outcomes of Acute Promyelocytic Leukemia in Adults: A SEER Database Analysis
Authors: Ali Hassan , Durugu Satya R , Agrawal Shubham , Sinha Shrishti , Santhi Jaison Lawrence Alexander , Bodrova Elizaveta , Ahmed Aftab , Bajwa Shammas , Bajwa Umair , Faisal Muhammad Salman , Thirumaran Rajesh 
Published: December 2024

Background:
Acute Promyelocytic Leukemia (APL) is a relatively uncommon and highly aggressive variant of Acute Myeloid Leukemia, also known as AML-M3. Characterized by the classic translocation t(15;17) and hence retinoic acid receptor (RAR) disruption, APL leads to accumulation of numerous immature blasts in the bone marrow. APL is notorious for causing distinctive and fatal coagulopathy due to the presence of Auer Rods. Pancytopenias with associated sequelae are frequently present. With the advent of all-trans retinoic acid (ATRA), APL has transformed from highly lethal disease to a curable neoplasm with a remission rate of over 90%. ATRA in combination with anthracycline-based chemotherapy is widely used. Newer trails with ATRA/ATO (arsenic trioxide) combination have also shown promising results. We aim to determine survival outcomes for APL based on various demographic factors.
Method:
We extracted 5403 cases of acute promyelocytic leukemia diagnosed after the age of 18 years, using the ICD Code 9866/3, from Surveillance, Epidemiology and End Result database Research Plus Data, 17 Registries, Nov 2023 Sub (2000-2021). Data was stratified based on age, gender, race, median household income inflation adjusted to 2022 and chemotherapy-based treatment regimen. Results were compared using Log-Rank test (GraphPad Prism).
Results:
Of the reported cases, APL was equally distributed among males and females. The median age of diagnosis was 51 years. Most of the cases were reported in Caucasians (57.34%), followed by Hispanics (22.75%), Blacks (10.6%), Asian/Pacific Islanders (8.4%), Alaskan/Native Americans (0.54%) and non-Hispanics of unknown race (0.4%). The Median of survival (MoS) calculated for females was 240 and males was 219 (p 0.0045). Survival based on age showed drastic decline as the age advanced (p &lt;0.0001). Survival obtained for race was undefined for Asian/Pacific Islanders and Hispanics likely for insignificant numbers of death events, while 203 months for White (p &lt;0.0001). Analysis based on chemotherapy showed statistically significant improvement in survival (p &lt;0.0001). Comparison of the curves with reference to median household income revealed higher MoS with increasing income bracket (p 0.0183).
Conclusion:
Acute Promyelocytic Leukemia is a rare and belligerent subtype of AML. Distribution is gender unbiased, but frequently affects Caucasians and Hispanics. Female gender, younger age, Asian/Pacific Islander/Hispanic race, chemotherapy and higher income bracket (&gt;100K) are associated with improved outcomes. The rarity of this neoplasm requires more research and analysis to better understand its nature.
Analysis of High-Risk Factors and Establishment of an Early Warning Model for Thromboembolism in Lymphoma Patients
Authors: Lin Wenzheng , Pan Lili , Guo Jiangrui , Liu Tingbo , Shen Jianzhen , Li Xiaofan 
Published: December 2024

Abstract
Background and Objectives:
Thromboembolism (TE) is a common and serious complication in patients with malignancies, including those with lymphoma, who are at high risk of TE. The incidence of TE in lymphoma patients ranges from 5% to 59.5%. This study aims to investigate the clinical characteristics and high-risk factors of thrombosis in lymphoma patients and to develop a nomogram model for early warning of thromboembolism events.
Materials and Methods:
Clinical data from 790 newly diagnosed lymphoma patients (January 2019 to December 2021) were analyzed, dividing them into thrombus and no thrombus groups. Key clinical features, lab indicators, and lymphoma characteristics were compared. TE risk factors were assessed using multifactor analysis. A nomogram model for predicting lymphoma-related TE was developed using R version 4.3.0, rms, and ggplot packages, and validated with Bootstrap resampling. Model performance was evaluated with ROC and calibration curves.
Results: Clinical Features: TE occurred in 9.75% of patients(77/790), with common sites being upper limb deep veins(58.44%), superficial veins(22.08%), and lower limb deep veins(20.78%).Median age of TE patients was 58 years, with TE occurring a median of 4 months post-diagnosis. Survival Outcomes: TE patients had lower survival rates compared to non-TE patients at 6 months, 1 year, and 2 years.TE complications led to death in 6.50% of TE patients, while disease progression caused 16.88% of deaths.Additionally, 2 patients (2.60%) experienced lower limb functional impairment due to TE, and 1 patient (1.30%) with intracranial TE had cognitive dysfunction. Risk Factor Analysis: Significant risk factors included high ECOG scores, previous venous thromboembolism, coronary artery disease, and central venous catheterization. Prediction Model: The nomogram model showed good predictive accuracy, with ROC AUC values exceeding 0.7 for 0.5, 1, and 2-year predictions.Validation showed consistent predictive performance with an average AUC of 0.705.
Conclusion:
The study identifies key risk factors for TE in lymphoma patients and presents a validated nomogram model for early prediction of TE, which can aid in clinical decision-making and improve patient outcomes.
Incidence, Risk Factors, Microbiology and Outcomes of Bloodstream Infection during Conditioning before Allogeneic Hematopoietic Stem Cell Transplantation
Authors: Pan Ling , Jia Li , Feng Xiaomeng , Jiang Erlie , Feng Sizhou 
Published: December 2024

Objectives : Bloodstream infection (BSI) represents a substantial and recurrent complication that often arises during allogeneic hematopoietic stem cell transplantation (allo-HSCT). Despite its considerable occurrence, there has been a conspicuous absence of focused research delving into BSI specifically during the conditioning phase before HSCT.
Method: A single-center cohort study, comprising 2395 consecutive patients who underwent allo-HSCT from 2013 to 2023 was conducted. We examined the characteristics of BSI during the conditioning phase, risk factors and its prognosis on patients.
Results: The cumulative incidence of BSI during conditioning was 7.7%, with a median onset on day 8 post-agitation of the conditioning regimen. The most frequently isolated pathogens included Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and coagulase-negative staphylococci. A multivariate analysis identified several variables associated with BSI during conditioning, including neutropenia lasting ≥ 7 days before conditioning, a hematopoietic cell transplantation-comorbidity index ≥ 1, and in vivo T-cell depletion using antithymocyte globulin (ATG). Furthermore, the analysis indicated that BSI caused by carbapenem-resistant Enterobacteriaceae significantly increased the risk of all-cause mortality within 90 days following BSI (odd ratio = 7.492; 95% confidence interval: 1.389, 40.429; P = .019).
Conclusions: Reducing the incidence of BSI during conditioning phase can significantly improve early transplantation outcomes in haematological patients. In patients with prolonged neutropenia, comorbidities, or the inclusion of ATG in the conditioning regimen, particularly among those with multiple risk factors, the likelihood of developing BSI is significantly elevated. Therefore, it is imperative to promptly initiate blood cultures and administer timely and appropriate empiric antibiotic therapy.
TP53 Mutation Heterogeneity Reveals Distinct Prognoses in Mantle Cell Lymphoma
Authors: Liu Shuozi , Zhou Shaowei , Zhang Weilong , Wang Jing , Wang Lingli , Li Chunyuan , Chen Yingtong , Qi Wenxin , Yang Ping , Jing Hongmei 
Published: December 2024

Background: Mantle cell lymphoma (MCL) is an uncommon and aggressive type of B-cell non-Hodgkin lymphoma, wherein TP53 mutations play a critical role. This study analyzed the effect of different TP53 mutations on the clinical characteristics and prognosis of patients with MCL.
Methods: TP53 sequencing data and clinical and prognostic information were collected from 215 patients with MCL treated at Peking University Third Hospital between August 2017 and December 2022. Furthermore, descriptive and Cox regression analyses were also performed.
Results: Our findings revealed the association between TP53 mutations and higher Ki67 levels (p = 0.008), elevated combined MCL International Prognostic Index (MIPI-c; p = 0.032), and blastoid/pleomorphic subtypes (p = 0.028). Missense mutations (75.6%; G:C &gt; A:T [48.31%]) were the predominant mutation type, occurring within the DNA-binding domain (DBD; 92.41%) and concentrated in exons 5-8 (82.05%). The extent of the impact on prognosis was dependent on the location of the mutations. G245/R273 mutations were associated with the highest risk. Mutations at zinc-binding motifs and DBD were associated with intermediate risk. Non-DBD and non-TP53 mutations were associated with the lowest risks. Three TP53 mutation groups were defined for further analysis. Notably, these groups exhibited significant differences in OS (p = 0.015) and PFS (p = 0.026).
PET Radiomics Discriminate Among Different Lymphoma Sub-Types
Authors: Chauvie Stephane , Kostakoglu Shields Lale , Guerra Luca , Versari Annibale , Fallanca Federico , Gregianin Michele , Bergesio Fabrizio , Bergalla Enrica , De Maggi Adriano , Sahin Denis , Durmo Rexhep , Vitolo Umberto , Federico Massimo , Gallamini Andrea , Rambaldi Alessandro , Luminari Stefano 
Published: December 2024

Despite numerous studies, the predictive role of radiomics extracted from 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (PET/CT) in lymphoma remains uncertain. In several solid cancers radiomics, and in particular the Haralick heterogeneity metrics (HM), have shown the ability to describe the phenotypes of tumors. This study investigates whether HM can differentiate between various lymphoma subtypes.
We conducted an extensive analysis of a large cohorts of patients with diffuse large B-cell lymphoma (DLBCL) from the GOYA (NCT01287741), Hodgkin lymphoma (HL) from the HD0607 (NCT00795613), and follicular lymphoma (FL) from the FOLL12 (NCT02063685) clinical trials in which baseline PET was acquired and analysed per-protocol.
Metabolic tumor volumes (MTVs) were semi-automatically delineated using a fixed SUV threshold of 4, as recommended in 2023 Menton meeting. Only MTVs larger than 50 ml, corresponding to a lesion radius of approximately 2 cm, were included in the analysis. HM were automatically extracted in Cuneo corelab. HM with a correlation coefficient lower than 0.90 and a variance higher than 0.95 were included in the analysis. Different artificial intelligence (AI) models were applied to training and test populations (70-30%).
Data were available for 746 DLBCL, 285 HL, and 276 FL. The total number of lesions analysed were 1,918 for DLBCL, 607 for HL, and for 804 FL. The median MTV were 252, 81, and 90 ml, for DLBCL, HL, and FL, respectively.
Among the AI, Random Forest (RF) showed the highest accuracy, 0.79 (95% CI: 0.76-0.81), on the test dataset. Sensitivity in identifying DLBCL, HL and FL were 0.93, 0.38 and 0.78. Specificity in identifying DLBCL, HL and FL were 0.86, 0.86 and 0.93.
Radiomics has the potential to classify different lymphoma subtypes, when calculated on lesions large enough to mitigate the technical limitations of PET scanners. The discrimination is particularly high for DLBCL and FL. We anticipate that PET images acquired using new digital PET technology with dedicated reconstruction algorithms could further enhance the classification of lymphoma subtypes, thereby paving the way for their use also in patients prognosis definition.
Long-Term Outcomes of Bronchus-Associated Lymphoid Tissue Lymphoma Based on Lung Involvement Status: A Single-Center Real-World Data Analysis in Korea
Authors: Kim Changgon , Kim Seok Jin , Kim Won Seog , Yoon SangEun 
Published: December 2024

BackgroundThe occurrence of primary lymphoma in the lung is exceedingly uncommon, with the majority of these cases representing marginal zone lymphoma originating from bronchus-associated lymphoid tissue (BALT). BALT lymphoma (BALToma) is a rare and indolent type of lymphoma. Given the limited number of cases and the necessity for prolonged observation, treatment options based on lung disease status remain uncertain.
Methods This retrospective study aimed to investigate the characteristics and survival outcomes of patients with marginal zone lymphoma (MZL) involving the lung at Samsung Medical Center diagnosed between 2003 and 2019. The disease status was classified as unilateral lung disease, bilateral lung disease, or lung disease with other site involvement. The treatment methods were classified into four categories: observation and waiting, surgical intervention, chemotherapy, and a combination of surgery and chemotherapy, followed by radiotherapy. Progression-free survival (PFS) and overall survival (OS) were subsequently compared using Kaplan-Meier survival analysis.
Results A total of 40 patients were analyzed, and the median OS was not reached, with a median PFS of 156 months. The 10-year OS rate was 89.1%, and the 10-year PFS rate was 55.1%. Of the 40 patients, 14 had unilateral stage 1 disease and 26 had stage 4 disease. Of these, 12 patients exhibited bilateral lung disease, while 14 patients demonstrated involvement of other sites. In patients with unilateral lung disease, the median PFS for those who underwent surgery was not reached and was significantly improved compared to those who did not undergo surgery, with a median PFS of 37.4 months (p-value = 0.00465). In patients with bilateral lung disease, the median PFS was not reached in the chemotherapy group, in comparison to 26.3 months in the non-chemotherapy group. This represents a significant increase (p-value = 0.00684). In a multivariate analysis based on clinical information, significant decreases in PFS were observed in patients with involvement of other sites, those with air-bronchogram presentation on CT scan compared to patch or nodular lesions, and those aged 70 years or older. No factors were identified that significantly increased OS.
Conclusion In patients with BALToma, the tailoring of treatment strategies based on the disease status of the lung may result in an increased PFS. Surgery plays a pivotal role in the treatment of this condition, particularly in cases of unilateral lung disease, whereas chemotherapy is an effective treatment for bilateral lung disease.
Preliminary Results from a Phase II Study of Chidamide in Combination with CHOP in Previously Untreated Peripheral T-Cell Lymphoma with T Follicular Helper Phenotype (SWIFT study)
Authors: Cai Qingqing , Xia Yi , Zeng Dongfeng , Li Xi , Fang Xiaojie , Nie Man , Tian Xiaopeng , Li Lirong , Liu Yingxian 
Published: December 2024

Background: Peripheral T-Cell Lymphoma with T-follicular helper phenotype (PTCL-TFH), which mainly includes angioimmunoblastic T-cell lymphoma (AITL), is characterized by recurrent mutations affecting epigenetic regulators. Chidamide is an oral, subtype-selective histone deacetylase (HDAC) inhibitor that targets HDAC subtypes 1, 2, 3, and 10. It has been approved for relapsed or refractory (R/R) PTCL, advanced breast cancer, R/R adult T-cell leukemia-lymphoma, and previously untreated diffuse large B-cell lymphoma with double expression of MYC and BCL2. Single-agent chidamide has shown safety and efficacy in R/R PTCL-TFH. This study aimed to assess the efficacy and safety of chidamide in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) in previously untreated PTCL-TFH.
Methods: This multicenter, open-label, single-arm phase II study was conducted in China (NCT05572983). Previously untreated PTCL-TFH patients received chidamide combined with CHOP for up to 6 cycles in the induction therapy phase. Patients achieving complete response (CR) received chidamide 20 mg biweekly as maintenance therapy. The primary endpoint was CR rate at the end of treatment, with secondary endpoints including overall response rate (ORR), progression-free survival (PFS), overall survival (OS), and safety profiles.
Results: Between May 2023 and May 2024, 17 previously untreated PTCL-TFH patients were enrolled in this study. The median age was 62 years (range: 38-73); 80% were male, and all had AITL subtype. Among the 14 evaluable patients, the ORR was 85.7%, with a CR rate of 71.4%. Follow-up is ongoing for PFS results. A total of 17 patients were included in the safety analysis. Common grade 3 or 4 adverse events (AE) included neutropenia (64.7%), leukopenia (52.9%), and thrombocytopenia (23.5%), respectively. The majority of AEs were reversible and clinically manageable.
Conclusions: This study demonstrated that chidamide plus CHOP is safe, well tolerated, and effective in previously untreated PTCL-TFH patients. Further randomized controlled studies are warranted to assess this promising combination.
Effect Analysis of 33 Patients with Corticosteroids Resistant Grade III/IV Acute Liver Graft-Versus-Host Disease Treated with Sequential Low-Dose Cyclophosphamide and Anti-Thymocyte Globulin Following Plasma Exchange
Authors: Wang Juan , Zu Yingling , Gui Ruirui , Li Zhen , Zhang Wenli , Xin Xiangke , Zhang Yanli , Lu Wenyi , Fu Yuewen , Zhou Keshu , Zhou Jian 
Published: December 2024

Background
Acute graft-versus-host disease (aGVHD) represents a significant complication and leading cause of mortality in allo-HSCT. The response rate to corticosteroids is approximately 50%, with poor long-term survival observed in individuals with steroid-resistant (SR) aGVHD. Plasma exchange stands as the primary treatment for patients experiencing acute liver failure. Cyclophosphamide and anti-thymocyte globulin (ATG) function to inhibit lymphocyte activity in vivo. Currently, there are no clinical studies validating the efficacy of plasma exchange followed by low-dose cyclophosphamide and ATG for the treatment of liver Grade III/IV SR aGVHD.
Methods
A retrospective analysis was performed on 33 hematological patients who developed liver grade III/IV aGVHD after allo-HSCT in Henan Cancer Hospital from October 2020 to March 2024 and were treated with sequential low-dose cyclophosphamide and anti-thymocyte globulin after plasma exchange. Cyclophosphamide dose: 400 mg/ time for adults and children weighing ≥35 kg, 200mg/ time for children weighing &lt; 35 kg, immediately after the end of plasma exchange. Anti-thymocyte globulin dose: adults and children weighing ≥35 kg 50mg/ time, children weighing &lt; 35 kg 25mg/ time, immediately after the end of cyclophosphamide. Efficacy was evaluated 28 days after the first plasmapheresis.
Results
Among the 33 patients, 19 were males (57.6%) and 14 were females (42.4%). The median age was 29 (5-57) years.There were 9 cases (27.3%) of typical aGVHD and 24 cases (72.7%) of delayed aGVHD. There were 27 patients (81.8%) with grade III liver aGVHD and 6 patients (18.2%) with grade IV liver aGVHD. 15 patients (45.5%) achieved complete response (CR), 9 patients (27.3%) achieved partial response (PR), and 9 patients (27.3%) achieved no response (NR). The overall response rate (ORR) was 72.7% (24/33). After a median follow-up of 100 (6-1344) days, the overall survival (OS) rate of the 33 patients at 6 months after treatment was 42.8% (95%CI 25.4%-60.2%), and the OS rate at 1 year after treatment was 35.9% (95%CI 18.8%-53.0%). The OS rates of CR group, PR group and NR group at 6 months after treatment were 69.2% (95% CI 36.1%-86.3%) ,44.4% and 0, respectively. One year after treatment, the OS rates were 52.7% (95%CI 25.1%-80.3%), 44.4% (95%CI 11.9%-76.9%), 0, respectively, and the difference was statistically significant among the three groups (χ2 = 4.474, P &lt; 0.001).
Conclusions
Sequential low-dose cyclophosphamide and anti-thymocyte globulin after plasma exchange may be an effective treatment for patients with corticosteroids resistant liver grade III/IV aGVHD.
Dynamic Changes of Genetic Mutations in AML Patients from Diagnosis to Complete Remission and Relapse
Authors: Yan Xin , Song Chunhua , Ge Zheng 
Published: December 2024

Background
Acute myeloid leukemia(AML)is an aggressive hematopoietic malignancy and accumulation of genetic alterations is a common mechanism in the clonal evolution of AML. Some mutations(DNMT3A, ASXL1, TET2)often persist during remission and disease progression, while relapse can either be driven by the acquisition of mutations in the founder clone or by the selection of resistant subclones (Blood,2021,137:3093-3104). However, the relationship between complete remission(CR)/relapse and the critical dynamic changes in genetic mutations is still not well covered. This study aimed to explore the dynamic changes of genetic mutations in AML patients from diagnosis to CR and relapse.
Methods
A total of ninety-seven AML patients with sequential serial samples were sequenced by our reported targeted exome-seq for human leukemia driver genes (Blood Cancer J,2022;12:145) from 28 May, 2019 to 7 June, 2024. Sixty-six Patients were sequenced at diagnosis and CR, twenty-four patients were sequenced at diagnosis, CR and relapse, while seven patients were sequenced at diagnosis and relapse.
Results
Ninety-three de novo AML patients and four secondary AML patients were analyzed with a median age of 60(15~86) years, including 53 males and 44 females. The median interval time between diagnosis to CR was 2(1~5) months, the median interval time from CR to relapse was 5(1~16) months, as well as the interval time from diagnosis to relapse was 8(2~28) months.
The median number of mutations detected at CR was significantly less than the mutations detected at diagnosis( 1 vs. 3, P&lt;0.001), moreover, 40 patients(44.5%)lost all of the mutations detected at diagnosis and had no mutations at CR. Although the other patients still had mutations detected at diagnosis, the variant allele frequency of these mutations significantly decreased. Furthermore, we found that patients who still had mutations detected at diagnosis had worse relapse-free survival than patients who lost all of the mutations detected at diagnosis (5 vs 11 months, P =0.042 ).
Then, to explore the critical mutations that may promote relapse in AML patients, we found the median number of mutations detected at relapse had no difference than at the diagnosis(3 vs. 3, P= 0.401 ). However, most (20/31,64.5%)patients had newly acquired mutations at relapse, the median number of newly acquired mutations at relapse was 1(0~5).The most frequent newly acquired mutations were RAS(NRAS,KRAS,PTPN11,CBL,NF1)pathway(n=5 ,16.1 %),NPM1(n=4,12.9%) and FLT3(n= 3,9.7%) mutations.
Conclusion
The study clarified the dynamic changes of genetic mutation in AML patients from diagnosis to CR and relapse. Sweeping away and decreasing the genetic mutations detected at diagnosis promotes patients to CR. Newly acquired mutations and Reappeared mutations detected at the diagnosis lead to relapse. Newly acquired RAS pathway, NPM1 and FLT3 mutations may promote patients to relapse and should be targeted as potential intervention points.