Hematologic Malignancies: Treatment Strategies and Future Challenges

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Hematology".

Deadline for manuscript submissions: 26 June 2025 | Viewed by 4661

Special Issue Editor


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Guest Editor
Department of Hematology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu-shi, Chiba, Japan
Interests: hematolygy; lymphoma; hematological malignancies; multiple myeloma

Special Issue Information

Dear Colleagues,

We would appreciate it if you would contribute to the upcoming special issue of the Journal of Clinical Medicine, "Hematologic Malignancies: Treatment Strategies and Future Challenges". Hematologic malignancies are among the most prevalent cancers, and their incidence has increased in recent decades. Despite clinical progress, challenges such as relapse, refractory cases, and drug resistance still remain. The main purpose of this research theme is to introduce current therapeutic strategies and, as future challenges, to explore the future of hematologic malignancies, such as discovery of new targets or biomarkers and epigenetic drugs. It also includes the development of novel drugs in combination with conventional chemotherapeutic agents to reduce side effects and resistance in hematologic malignancies. Authors are encouraged to submit original research papers, reviews. We encourage submissions that provide new insights into underlying proliferation and resistance mechanisms in the treatment of hematological malignancies and discuss the clinical implications of these findings. After submission, all manuscripts are peer-reviewed according to standard journal procedures and policies. We hope that you will accept this invitation and contribute to the success of this special issue. We look forward to working with you.

Dr. Masaaki Noguchi
Guest Editor

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Keywords

  • hematologic malignancies
  • relapse
  • refractory
  • drug resistance
  • therapeutic strategies
  • new target
  • biomarkers
  • new insights

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Published Papers (5 papers)

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Research

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10 pages, 770 KiB  
Article
Inflammatory Markers Significantly Increased in Patients Treated with Obinotuzumab for Lymphoproliferative Diseases
by Krzysztof Gawronski, Nadia Hussein and Piotr Rzepecki
J. Clin. Med. 2024, 13(23), 7146; https://doi.org/10.3390/jcm13237146 - 26 Nov 2024
Viewed by 339
Abstract
Background: The purpose of this study was to analyze the behaviors of inflammatory markers, such as procalcitonin and C-reactive protein (CRP), during treatment with obinotuzumab (an anti-CD20 antibody). Methods: Our non-randomized observational study prospectively evaluated a cohort of 22 adult patients [...] Read more.
Background: The purpose of this study was to analyze the behaviors of inflammatory markers, such as procalcitonin and C-reactive protein (CRP), during treatment with obinotuzumab (an anti-CD20 antibody). Methods: Our non-randomized observational study prospectively evaluated a cohort of 22 adult patients with lymphoproliferative neoplasms, chronic lymphocytic leukemia (CLL), and follicular lymphoma (FL) with indications for obinotuzumab therapy. Results: All patients had their blood drawn to determine blood counts, CRP, and procalcitonin, as well as body temperature measurements and blood cultures performed for bacterial infections on day 0 before administration of the anti-CD20 antibody. Subsequently, on days 1 to 7 after administration, blood was drawn daily at a fixed time of 8:00 a.m. for blood counts and CRP and PCT values, and blood cultures were performed. In addition, on days 1 to 7, body temperature was measured at fixed times (i.e., 8:00 a.m. and 8:00 p.m.). In all of these patients, significant increases in inflammatory markers, such as CRP and procalcitonin, were observed shortly after drug infusion. There was a statistically significant change in the serum PCT concentration (p < 0.0001), which significantly increased on days 1 to 4 compared to the initial measurement 0. Conclusions: The increases in inflammatory markers shortly after obinotuzumab (anti-CD20 antibody) administration can be significantly high but are most often not related to the onset of infection and do not lead to any ill consequences in the treatment of lymphoproliferative disease. Full article
(This article belongs to the Special Issue Hematologic Malignancies: Treatment Strategies and Future Challenges)
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9 pages, 713 KiB  
Article
The Effect of Age on High-Dose Therapy with Autologous Stem Cell Support in Multiple Myeloma: A Single-Center Experience
by Elcin Erdogan Yucel, Ayse Tugce Kirmaz, Merve Kakci, Aylin Fatma Yavuz, Tugce Sencelikel, Inci Alacacioglu and Guner Hayri Ozsan
J. Clin. Med. 2024, 13(14), 4142; https://doi.org/10.3390/jcm13144142 - 16 Jul 2024
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Abstract
Background: This retrospective one-center study demonstrates the complications related to high-dose therapy with autologous stem cell support (HDT) and the survival of multiple myeloma (MM) patients according to age groups. Methods: We categorized the patients into two groups: those who were ≤65 [...] Read more.
Background: This retrospective one-center study demonstrates the complications related to high-dose therapy with autologous stem cell support (HDT) and the survival of multiple myeloma (MM) patients according to age groups. Methods: We categorized the patients into two groups: those who were ≤65 years old (group 1) (N = 115) and those who were >65 years old (group 2) (N = 26). The mean duration of follow-up was 48 (1–125) months. Results: In group 2 patients, the use of a reduced dosage of melphalan (12 [46%] versus 30 [26%]) was more frequent in comparison to group 1 (p = 0.046). There was a statistically significant difference between the two groups regarding the neutrophil engraftment days (p = 0.001) and the median progression-free survival (PFS) (p = 0.02). The PFS was 44 months for group 1 and 30 months for group 2. There was no statistically significant difference between the groups in relation to the median duration of hospitalization, presence of bacteremia, intravenous antibiotic administration, and overall survival (OS). Conclusions: The study’s results indicate that HDT is a reliable method of treatment for older patients with MM, provided that they obtain a suitable conditioning regimen and, furthermore, these patients achieved a comparable OS rate to that of younger patients. Full article
(This article belongs to the Special Issue Hematologic Malignancies: Treatment Strategies and Future Challenges)
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9 pages, 2871 KiB  
Case Report
Primary Bladder Lymphoma with Extravesical Extension: A Case Report and Literature Review on Prognosis and Clinical Characteristics
by Hideshige Seki, Shohei Mizuno, Sakura Saigusa, Yukie Sugita, Yusuke Iida, Saki Shinohara, Kaori Uchino, Tomohiro Horio, Ichiro Hanamura and Akiyoshi Takami
J. Clin. Med. 2024, 13(15), 4340; https://doi.org/10.3390/jcm13154340 - 25 Jul 2024
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Abstract
Background: Primary bladder lymphoma is generally regarded as having a favorable prognosis due to the predominance of low-grade lymphomas confined to the bladder. However, our investigation reveals that cases with extravesical extension, predominantly involving diffuse large B-cell lymphoma (DLBCL), exhibit a distinct clinical [...] Read more.
Background: Primary bladder lymphoma is generally regarded as having a favorable prognosis due to the predominance of low-grade lymphomas confined to the bladder. However, our investigation reveals that cases with extravesical extension, predominantly involving diffuse large B-cell lymphoma (DLBCL), exhibit a distinct clinical course with varied prognostic outcomes. Methods: In this report, we present and analyzed the clinical features and outcomes of 47 patients with primary bladder lymphoma with extravesical extension, including the case that we experienced. Results: An 77-year-old man who experienced fever, anorexia, and general malaise was referred to our hospital. Initial laboratory tests indicated severe renal failure, pyuria, and Escherichia coli bacteremia, accompanied by diffuse thickening of the bladder walls and increased attenuation in the surrounding adipose tissues. Initially misdiagnosed with a severe urinary tract infection leading to sepsis, the patient was treated with antibiotics and hemodialysis. Upon readmission due to abdominal pressure, imaging identified an intra-abdominal mass connected to the bladder wall. A bladder biopsy was performed, resulting in the diagnosis of primary bladder DLBCL with perivesical extension, classified as germinal center B-cell type. Taking inspiration from this case, the review of 46 patients was implemented. As a result, we resolved that primary bladder lymphoma often includes indolent types like Mucosa-associated lymphoid tissue lymphoma, but cases with extravesical expansion are predominantly DLBCL. Conclusions: This case emphasizes the diagnostic complexities of distinguishing primary bladder lymphoma from urinary tract infections and underscores the prognostic implications of extravesical extension. Our comprehensive review of the literature on primary bladder lymphomas with extravesical involvement highlights the clinical characteristics, therapeutic challenges, and need for heightened diagnostic vigilance and tailored treatment strategies for this subset of patients. Full article
(This article belongs to the Special Issue Hematologic Malignancies: Treatment Strategies and Future Challenges)
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17 pages, 3148 KiB  
Case Report
A New Histology-Based Prognostic Index for Aggressive T-Cell lymphoma: Preliminary Results of the “TCL Urayasu Classification”
by Hideaki Nitta, Haruko Takizawa, Toru Mitsumori, Hiroko Iizuka-Honma, Tomonori Ochiai, Chiho Furuya, Yoshihiko Araki, Maki Fujishiro, Shigeki Tomita, Akane Hashizume, Tomohiro Sawada, Kazunori Miyake, Mitsuo Okubo, Yasunobu Sekiguchi, Miki Ando and Masaaki Noguchi
J. Clin. Med. 2024, 13(13), 3870; https://doi.org/10.3390/jcm13133870 - 30 Jun 2024
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Abstract
Background: Aggressive mature T-cell lymphoma (TCL) is a disease that carries a poor prognosis. Methods: We analyzed the expression of 22 tumor cell functional proteins in 16 randomly selected patients with TCL. Immunohistochemistry was performed in paraffin-embedded tumor tissue sections to determine the [...] Read more.
Background: Aggressive mature T-cell lymphoma (TCL) is a disease that carries a poor prognosis. Methods: We analyzed the expression of 22 tumor cell functional proteins in 16 randomly selected patients with TCL. Immunohistochemistry was performed in paraffin-embedded tumor tissue sections to determine the protein expression statuses in tumor cells. Results: Glucose-regulated protein 94 (GRP94), a protein that serves as a pro-survival component under endoplasmic reticulum (ER) stress in the tumor microenvironment, was significantly associated with a shortened survival. Furthermore, significant differences were observed when GRP94 was combined with six other factors. The six factors were (1) programmed cell death-ligand 1 (PD-L1); (2) programmed cell death 1 (PD-1); (3) aldo-keto reductase family 1 member C3 (AKR1C3); (4) P53, a tumor suppressor; (5) glucose-regulated protein 78 (GRP78), an ER stress protein; and (6) thymidine phosphorylase (TP). Based on the combination of GRP94 and the six other factors expressed in the tumors, we propose a new prognostic classification system for TCL (TCL Urayasu classification). Group 1 (relatively good prognosis): GRP94-negative (n = 6; median OS, 88 months; p < 0.01); Group 2 (poor prognosis): GRP94-positive, plus expression of two of the six factors mentioned above (n = 5; median OS, 25 months; p > 0.05); and Group 3 (very poor prognosis): GRP94-positive, plus expression of at least three of the six factors mentioned above (n = 5; median OS, 10 months; p < 0.01). Conclusions: Thus, the TCL Urayasu prognostic classification may be a simple, useful, and innovative classification that also explains the mechanism of resistance to treatment for each functional protein. If validated in a larger number of patients, the TCL Urayasu classification will enable a targeted treatment using selected inhibitors acting on the abnormal protein found in each patient. Full article
(This article belongs to the Special Issue Hematologic Malignancies: Treatment Strategies and Future Challenges)
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16 pages, 682 KiB  
Systematic Review
Evaluating the Impact of Post-Transplant Cyclophosphamide and Anti-Thymocyte Globulin on CMV Reactivation Following Allogeneic Hematopoietic Stem Cell Transplantation: A Systematic Literature Review
by Jarosław Dybko, Ugo Giordano, Justyna Pilch, Jakub Mizera, Artur Borkowski and Izabela Dereń-Wagemann
J. Clin. Med. 2023, 12(24), 7765; https://doi.org/10.3390/jcm12247765 - 18 Dec 2023
Cited by 1 | Viewed by 1436
Abstract
Anti-thymocyte globulin (ATG) and post-transplantation cyclophosphamide (PTCy) are two frequently utilised strategies in graft-versus-host disease (GvHD) prophylaxis following allogeneic hematopoietic cell transplantation (allo-HCT), currently approved for different recipient-donor settings. In addition, being efficacious in preventing GvHD owing to their T-cell depleting capacity, the [...] Read more.
Anti-thymocyte globulin (ATG) and post-transplantation cyclophosphamide (PTCy) are two frequently utilised strategies in graft-versus-host disease (GvHD) prophylaxis following allogeneic hematopoietic cell transplantation (allo-HCT), currently approved for different recipient-donor settings. In addition, being efficacious in preventing GvHD owing to their T-cell depleting capacity, the employment of these two agents increases the risk of infections, including CMV reactivation, which stands as one of the most common and serious infections following allo-HCT. We performed a systematic literature review of articles published until 1 September 2023, through PubMed, MEDLINE, and Scopus, with the main endpoint being CMV reactivation after PTCy or ATG allo-HCT. The majority of the studies included in the analysis provide supporting evidence for a reduced risk of CMV reactivations following the use of PTCy compared to ATG, although not all findings reached statistical significance. Additionally, it appears that utilising a haploidentical donor leads to a higher incidence of CMV infections and clinically significant CMV infections (CS-CMVis) compared to other donor settings in PTCy allo-HCT. This study aims to compare the risk of CMV infections following allo-HCT in patients who have received either ATG or PTCy as GvHD prophylaxis and discuss other factors that could influence the infectious outcomes of patients who have undergone allo-HCT. Full article
(This article belongs to the Special Issue Hematologic Malignancies: Treatment Strategies and Future Challenges)
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