To evaluate the predictive value of peripheral blood CD4⁺/CD8⁺ ratio immediately prior to chimeric antigen receptor T-cell (CAR-T) infusion (Day 0) for treatment efficacy in patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL).

A retrospective analysis was conducted on data from 49 R/R DLBCL patients who received CAR-T therapy at The First Affiliated Hospital of Soochow University between January 2017 and June 2024. The relationship between the Day 0 peripheral blood CD4⁺/CD8⁺ ratio and treatment efficacy was evaluated.

At 3 months post-CAR-T infusion, the objective response rate of the 49 patients was 75.5% (37/49), comprising a complete response rate of 55.1% (27/49) and a partial response rate of 20.4% (10/49). Patients with a Day 0 peripheral blood CD4⁺/CD8⁺ ratio ≥1 had a significantly higher 90-day response rate than those with a ratio <1 (88.2% vs. 46.7%, P =0.002). Multivariate analysis showed that the Day 0 peripheral blood CD4⁺/CD8⁺ ratio was an independent predictor of both progression-free survival (PFS) and overall survival (OS) (P =0.025； P =0.037). Patients with a ratio ≥1 had significantly longer median PFS (11.0 vs. 3.0 months, P =0.011) and median OS (32.1 vs. 8.5 months, P =0.003) compared to those with a ratio <1.

Peripheral blood CD4⁺/CD8⁺ ratio ≥1 immediately prior to CAR-T infusion can predict a higher CAR-T treatment response rate and superior survival outcomes in R/R DLBCL patients.

To summarize the clinicopathological characteristics and survival outcomes of pediatric non-Hodgkin lymphoma (NHL) in Fujian Province.

Clinical data of 294 newly diagnosed pediatric NHL patients treated at multiple centers in Fujian Province from January 2011 to December 2023 were collected. The characteristics of different pathological subtypes were summarized, Kaplan-Meier survival analysis were performed and Cox proportional hazards regression model was used for prognostic analysis.

A total of 294 pediatric NHL patients were included in this study, with a male-to-female ratio of 3.03∶1 and a median age of 7 years (range, 0.9-14 years). The most common subtype was mature B-cell lymphoma, accounting for 59.2% of cases. The majority of patients were diagnosed at stage III/IV (86.2%), with 32 cases (10.9%) involving central nervous system (CNS) infiltration and 89 cases (30.3%) showing bone marrow involvement. The rate of voluntary abandonment significantly decreased after 2018 (abandonment rates before and after 2018: 6/110 (5.45%) vs. 1/184 (0.54%), P =0.012). Furthermore, excluding cases of voluntary abandonment, the 5-year EFS and OS of newly diagnosed pediatric NHL patients from 2018 to 2023 were still significantly higher than those diagnosed from 2011 to 2017 (EFS: 79.3%±3.7% vs. 70.2%±4.5%, P =0.032; OS: 87.7%±2.6% vs. 70.2%±4.5%, P < 0.001). OS improvements after 2018 were significant in patients with BL and LBL (BL: 89.3%±3.6% vs. 73.5%±7.6%, P =0.033; LBL: 89.3%±5.3% vs. 56.5%±10.3%, P =0.001). However, there were no statistically significant differences in EFS or OS for patients with ALCL or DLBCL (all P >0.05). Multivariate survival analysis identified concurrent hemophagocytic lymphohistiocytosis syndrome was an independent risk factors for both EFS and OS in pediatric NHL patients.

Over the past six years, OS and EFS in children with NHL in Fujian Province have improved markedly, with more pronounced gains in BL and LBL. This trend may be related to the combined effects of reduced voluntary treatment abandonment, more standardized diagnostic and therapeutic pathways, treatment optimization, and updated protocols. HLH at initial diagnosis is an independent risk factor for poor prognosis in pediatric NHL, while remission after two chemotherapy cycles suggests a favorable outcome.

To explore the infection characteristics and survival status of lymphoma patients who received intravenous immunoglobulin (IVIG) after autologous hematopoietic stem cell transplantation (AHSCT).

The clinical data of 121 lymphoma patients who underwent AHSCT from September 2019 to September 2023 were retrospectively analyzed. A Cox proportional hazards model was used to identify risk factors for post-transplant infection-free survival. The patients were divided into IVIG and non-IVIG group according to whether they received IVIG after transplantation, and their infection and survival outcomes were compared.

Within 1 year after transplantation, bacterial, viral, and fungal infections occurred in 37 (30.58%), 18 (14.88%), and 3 (2.48%) of the 121 lymphoma patients, respectively. The 1-year overall infection rate after transplantation was 38.1% in the IVIG group (42 patients) and 44.3% in the non-IVIG group (79 patients). In the IVIG group, median infection time was +55 (9-233) days, with 7 cases of early infection, 5 cases of blood stream infection, and 6 cases of respiratory tract infection. In the non-IVIG group, median infection time was +8 (4-122) days, with 27 cases of early infection, 20 cases of bloodstream infection, and 4 cases of respiratory tract infection. IVIG group had fewer early and bloodstream infections, more respiratory tract infections, and a delayed median infection time compared to non-IVIG group. Multivariate Cox regression analysis indicated that pre-transplant serum IgG< 7 g/L, graft MNC< 8.1×10⁸/kg and CD34⁺ cells≤2.8×10⁶/kg served as independent risk factors for infection-free duration in AHSCT-treated lymphoma patients. The 3-year progression-free survival rates of the IVIG group and non-IVIG group were 52.3% and 48.4%, respectively, and 3-year overall survival rates were 79.4% and 83.0%. At 1 month post-transplant, 69 patients showed a decline in immunoglobulin levels, and 12 patients developed severe hypogamaglobulinemia (HG) (IgG< 4 g/L), with 4 cases (15.4%) in IVIG group and 8 cases (18.6%) in non-IVIG group. One month after transplantation, patients with serum IgG< 4 g/L had a significantly lower survival rate than those with IgG≥4 g/L (55.0% vs. 83.0%).

In lymphoma patients, post-AHSCT early stage sees mainly bacterial infections. Some develop severe HG. The utilization of IVIG is capable of reducing the incidence of early post-transplant infections and severe HG.

To analyze the clinical characteristics and prognosis of adult T-cell leukemia/lymphoma (ATLL) patients.

The clinical data of 32 newly diagnosed ATLL patients admitted to our hospital from January 1, 2014, to October 1, 2021 were retrospectively analyzed. The efficacy and the incidence of complications of different chemotherapy regimens were explored, and the factors that may affect patients' prognosis were analyzed.

Among the 32 enrolled ATLL patients, the male-to-female ratio was 1.3:1, and the median age was 53 (range 24-79) years. Of these patients, 21 were of the acute type, 9 of the lymphoma type, and 2 of the chronic type. The main initial manifestations included lymph node enlargement, pulmonary infection, abdominal pain, and rash. Additionally, 28 patients had elevated lactate dehydrogenase (LDH), 14 had hypercalcemia, 20 had bone marrow invasion, and 5 had bone marrow chromosomal abnormalities. 29 patients underwent at least one cycle of chemotherapy, among whom 23 were assessable for efficacy. Of these 23 patients, 9 achieved complete remission (CR) and 4 achieved partial remission (PR), with an objective response rate (ORR) of 56.5%. 4 patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) after chemotherapy. By the end of follow-up, 19 cases had died, 11 cases were lost to follow-up, and 2 cases were alive, with a median survival time (MST) of 10.0 (95%CI: 0.0-20.2) months. Multivariate analysis indicated that sex, age, and white blood cell count (WBC) were independent influencing factors for OS in ATLL patients.

ATLL patients often present with lymph node enlargement, elevated WBC, and elevated LDH at initial diagnosis. Age ≥60 years, and WBC≥10×10⁹/L at initial diagnosis are independent risk factors affecting patient prognosis, while male sex serves as a protective factor for prognosis.

To explore the clinical characteristics and prognosis of second primary cancers (SPC) in patients with hematologic malignancies. Additionally, it aims to characterize hematologic malignancies that develop as SPC following prior solid tumors.

A retrospective analysis was conducted on the clinical data of patients with hematologic malignancies treated at Wuxi People's Hospital affiliated to Nanjing Medical University from January 2018 to December 2024. Patients with hematological tumors combined with other tumors were screened, and their clinical characteristics and prognosis were evaluated.

A total of 236 patients with hematologic malignancies were included in this study. Among them, 116 cases were complicated with SPC, including 26 cases with hematologic malignancies as the first primary cancer(FPC), which were classified as the FPC group of hematological tumors; and 90 cases diagnosed with hematological tumors after suffering from other malignant tumors in the past, which were classified as the SPC group of hematological tumors. The remaining 120 patients had only hematologic malignancies without other cancers (the single hematologic system tumor group). The rate of prior exposure to chemotherapy and/or radiotherapy for the FPC was significantly higher in the hematologic FPC group compared to the solid SPC group (80.8% vs. 34.4%, P < 0.001). Multivariable logistic regression analysis demonstrated that concomitant chronic diseases (OR =1.803, 95%CI :1.035-3.141, P =0.037) and increasing age at diagnosis of hematologic malignancies (OR =1.033, 95%CI :1.009-1.057, P =0.006) were identified as independent risk factors for SPC development. The median OS in the hematologic system tumor with SPC group was lower than that in the single hematologic system tumor group (32 months vs. 49 months), with a statistically significant difference (P < 0.05). Cox proportional hazards model analysis showed that a diagnostic interval of less than 60 months between the two cancers independently predicted inferior overall survival (HR=2.099, 95%CI :1.207-3.650, P =0.009).

The development of SPC in patients with hematologic malignancies is closely associated with advanced age, chronic comorbidities, and prior exposure to chemotherapy and/or radiotherapy. Patients with both hematologic malignancies and SPC have significantly worse overall survival than those with hematologic malignancies alone. A diagnostic interval of less than 60 months between the two cancers is an independent adverse prognostic factor and may serve as a simple prognostic indicator. Therefore, intensified surveillance and long-term follow-up are warranted for high-risk patients.

To explore the genetic characteristics and clinical efficacy of pediatric acute myeloid leukemia (AML) with NUP98∷KDM5A fusion gene positive.

The laboratory and clinical characteristics of 10 NUP98∷KDM5A-positive pediatric AML patients identified by transcriptome sequencing (RNA-seq) were retrospectively analyzed during the period from March 2018 to March 2024 at Hebei Yanda Ludaopei Hospital and Beijing Ludaopei Hospital. Survival curves were plotted using the Kaplan-Meier method, and the 1-year overall survival and cumulative recurrence rates were calculated.

The median onset age of the 10 patients was 2(1-4) years, with a male to female ratio of 3∶7. All patients presented with thrombocytopenia, skin ecchymosis, and/or scattered petechiae as the main clinical manifestations. According to the FAB classification, 7 cases were diagnosed as AML-M7, 2 as AML-M5, and 1 as AML-M2. Cytogenetic analysis showed that 8 pediatric patients exhibited structural abnormalities involving chromosome 13 at initial diagnosis, relapse, or post-transplant relapse, and mainly manifested as del(13q). RNA-seq results showed that 9 patients had a fusion of NUP98 exon 13 with KDM5A exon 27, and 1 patient had a fusion of NUP98 exon 13 with KDM5A exon 25. Expression levels of MECOM and PRDM16 genes in the patient group were significantly higher than in the normal control group (P <0.05). Among co-occurring genetic mutations, JAK2 gene mutations exhibited the highest frequency of occurrence (40%). All patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT), with 7 in complete remission (CR) and 3 in partial remission (PR)/non-remission (NR) before transplantation. The median follow-up time was 5.8 (2.5-23.7) months. During the follow-up period, 3 patients survived and 7 died, among which 6 died from relapse and 1 died from acute graft-versus-host disease of the gut post-transplantation. The median survival time post-transplantation was 7.8 months (95%CI : 0.8-14.8 months), the median relapse time was 5.5 months (95%CI : 0-11.7 months), the 1-year overall survival rate was 34.3%, and cumulative relapse rate was 55%.

Pediatric AML with the NUP98∷KDM5A fusion gene is more common in the M7 subtype, predominantly in females, and is often associated with chromosome 13 abnormalities and a higher rate of JAK2 mutations. Allo-HSCT can partially improve the prognosis of pediatric AML positive for NUP98∷KDM5A, but the relapse rate is high, and relapse is a significant factor affecting patient survival.

To investigate the expression and methylation alterations of ARHGAP10 in AML and to further explore its clinical significance.

ARHGAP10 expression was measured by RT-qPCR in 18 controls and 68 AML patients. ARHGAP10 methylation was assessed using targeted sulfite sequencing in 25 controls and 102 AML patients. The clinical significance of ARHGAP10 expression and methylation changes in AML was further analyzed.

Analysis of publicly available datasets identified increased expression of ARHGAP10 in AML patients, which was further validated in our hospital cohort. Among the FAB subtypes, ARHGAP10 expression was significantly higher in the M2 and M5 subgroups compared to the control group. ROC curve analysis indicated that ARHGAP10 expression could be a potential diagnostic biomarker for AML. Kaplan-Meier analysis showed that high ARHGAP10expression and ARHGAP10 hypomethylation were associated with shorter overall survival. Furthermore, ARHGAP10 hypomethylation was observed in AML patients, and further analysis revealed a negative correlation between ARHGAP10 methylation level and expression level.

ARHGAP10 exhibits high expression and hypomethylation changes in AML, and these alterations may serve as potential indicators of poor prognosis in AML patients.

India witnessed a significant step forward in cervical cancer prevention and human papillomavirus (HPV) vaccine coverage with the rollout of a nationwide free HPV vaccination drive aimed at vaccinating 14‑y‑old girls. However, the campaign's success rate can be significantly reduced if timely measures to tackle vaccine hesitancy and related misinformation are not taken into account. This commentary article discusses the effects of HPV vaccine misinformation, identifies global vaccine hesitancy factors, and highlights behavioral determinants affecting HPV vaccine hesitancy and its coverage in India. It identifies low awareness, misconceptions, sociocultural beliefs, stigma, safety concerns, weak injunctive norms, parental resistance, urban-rural disparities, and health system barriers as key challenges associated with vaccine hesitancy and low vaccine uptake among adolescents in India. Using an integrated Health Belief Model (HBM) and COM-B theoretical framework, it proposes a culturally sensitive, evidence-based multifactorial communication strategy focused on raising awareness, building trust, countering misinformation, capacity building of healthcare providers, and enhancing opportunities for the adoption of HPV preventive behavior. The commentary highlights the need to actively engage parents, adolescents, healthcare providers, educators, influencers, media, and community members to strengthen vaccine confidence, social norms, and support India's broader cervical cancer prevention goals in alignment with WHO's 90-70-90 targets by 2030.

Introduction/ObjectivesCancer nutrition education supports cancer prevention and survivorship, yet African American/Black (AA/B) women continue to experience nutrition-related inequities across the cancer continuum. This review examined how qualitative studies describe these inequities and assign responsibility within the literature.MethodsPubMed and Scopus were searched in December 2024 and updated in January 2026. Eligible studies involved AA/B women in the United States, addressed cancer-related nutrition experiences, used qualitative methods, and examined nutrition-related inequities across the cancer care continuum. SPIDER-informed criteria guided eligibility, data were synthesized using inductive thematic analysis guided by intersectionality, and study quality was appraised using CASP.ResultsFourteen qualitative studies were included. Responsibility for nutrition-related inequities was located within programmatic, institutional, and structural conditions. Five themes were identified: Universal Nutrition Standards, Feasible Nutrition Guidance, Access and Choices, Concordance and Cultural Relevance, and Community-Driven Co-Design. Participants described adapting nutrition guidance to caregiving demands, cultural food practices, survivorship challenges, and access barriers. Race, gender, caregiving, cultural identity, geography, and socioeconomic conditions were reported across studies.ConclusionsThe literature frames inequities in cancer nutrition education as consequences of programmatic, institutional, and structural conditions. Improving cancer nutrition equity for AA/B women may require culturally relevant, feasible, community-informed approaches and stronger attention to nutrition delivery contexts.

This study aimed to evaluate the efficacy and safety of selinexor combined with bortezomib, lenalidomide, and dexamethasone (the XVRd regimen) for newly diagnosed multiple myeloma (NDMM) patients with high-risk features.

This single-arm, open-label, prospective observational study recruited patients between August 2022 and November 2024. The study consisted of an induction phase (21-day cycles) and a maintenance phase (28-day cycles). During induction, all enrolled patients aged ≥18 years received the XVRd regimen containing oral selinexor 60 mg weekly. After induction, patients transitioned to maintenance therapy with selinexor plus lenalidomide. The primary endpoints were the overall response rate (ORR) and minimal residual disease (MRD) negative rate. Secondary endpoints included progression-free survival (PFS), treatment safety, and tolerability.

A total of 30 patients were enrolled, with a median age of 62.1 years (range, 47-73 years). Twenty-four patients (80%) presented with extramedullary plasmacytoma or plasma cell leukemia (PCL). The ORR across the entire cohort was 93.3% (28/30), including 5 patients with stringent complete response (sCR), 9 with complete response (CR), 4 with very good partial response (VGPR), and 10 with partial response (PR). Five patients (16.7%) achieved MRD negativity after induction treatment. Survival analysis demonstrated a median PFS of 16.2 months (95% CI, 14.6-NA), a 1-year PFS rate of 89% (95% CI, 0.78-1), and unreached median overall survival (OS). The overall safety profile was manageable.

The XVRd regimen may yield promising efficacy with a tolerable safety profile in NDMM patients with extramedullary disease (EMD) and/or high-risk cytogenetic abnormalities.

Chinese Clinical Trial Registry, registration number: ChiCTR2200062860.