Objective: The aim of this study was to analyze the clinical characteristics and prognosis of Epstein Barr virus-positive diffuse large B-cell lymphoma (EBV+DLBCL) in a Chinese cohort. Methods: A total of 57 patients diagnosed with EBV+DLBCL from January 1, 2013 to December 31, 2020 were included, and 228 concurrent patients with EBV-DLCBL served as control. The differences between the two groups were compared and the prognosis factors were identified by univariate and multivariate analysis. Results: There were 38 man in the EBV+DLBCL group, with a median age of 56 years (rang, 18 to 88). Tumor cells originated from GCB in 15 patients (26.3%), and from non-GCB in 40 patients (70.2%). There were 34 patients (59.6%) with Epstein Barr virus infection. Compared with EBV-DLCBL patients, patients with EBV+DLBCL had B symptoms, hypoalbuminemia, anemia and extranodal involvement>1 more frequently, as well as higher LDH and β2-Microglobulin levels (P < 0.05 foe all). The most common extranodal sites involved were digestive tract, especially, the stomach, nasopharynx, bone marrow and bone. Immunohistochemical staining showed 24 patients (42.1%) in the EBV+DLBCL group were CD30 positive, compared with xxx in patients with EBV﹣DLCBL (P < 0.001). After treatment with rituximab combined with chemotherapy, the EBV+DLBCL patients had a complete response rate and a overall response rate of 55.5% (30/54) and 83.3% (45/54), respectively. With a median follow-up time of 28 months, 22.2% (10/45) patients relapsed. The overall response rate and recurrent rate were similar between the two groups. In multivariate analysis, increased β2-Microglobulin level and bone marrow invasion were independent risk factors for PFS, while increased β2-Microglobulin level and decreased HB were independent risk factors for OS in patients with EBV+DLBCL. Conclusion: The majority of EBV+DLBCL patients were non-GCB.β2-Microglobulin level and bone marrow invasion were independent risk factors for PFS in patients with EBV+DLBCL, while β2-Microglobulin and HB were independent risk factors for OS in patients with EBV+DLBCL. The therapeutical potentials of targeted medicines, such as CD30 inhibitors and PD-1 inhibitors, deserve to be explored in the future. Keywords：Epstein Barr virus, diffuse large B-cell lymphoma, prognostic factors

OBJECTIVES:To develop an individualized nomogram for predicting disease progression risk in systemic anaplastic large cell lymphoma (sALCL). METHODS:Independent predictors of progression-free survival (PFS) were identified using Cox regression in a multicenter retrospective cohort of 109 sALCL patients (2010-2022). These were incorporated into a three-factor nomogram, evaluated via bootstrapped internal validation (1000 resamples), ROC analysis, C-index, decision curve analysis (DCA), and clinical impact curve (CIC). RESULTS:A total of 29 PFS events occurred during a median follow-up of 31 months. Multivariable modelling selected serum β2-microglobulin elevation, extranodal disease, and front-line chemotherapy choice (CHOP versus CHOPE or BV+CHP) as autonomous progression drivers. Upon internal bootstrap validation, the nomogram yielded strong prognostic accuracy, achieving AUCs of 0.81, 0.85 and 0.87 for 1-, 3- and 5-year progression-free survival, alongside a corrected C-index of 0.779 (95% CI: 0.699 - 0.861). Calibration plots showed close agreement between predicted and observed outcomes, while DCA confirmed superior net clinical benefit versus conventional IPI or Ann Arbor stratification across multiple decision thresholds. CONCLUSION:This first sALCL-specific nomogram integrates clinical and treatment variables to provide personalized PFS risk estimation. While internally validated, this exploratory, observation-based tool requires external validation and recalibration in prospective cohorts before clinical implementation.

This multicenter retrospective study evaluated first-line treatment patterns, maintenance therapy outcomes, and prognostic factors in 171 newly diagnosed marginal zone lymphoma (MZL) patients treated across multiple centers in Fujian Province, China (2019-2024). The MALT subtype predominated (79.0%), with the gastrointestinal tract and lung being the most common primary sites. The first-line overall response rate was 91.1%, with 67.3% of patients achieving complete remission. Five-year progression-free survival (PFS) and overall survival (OS) were 82.6% and 94.7%, respectively. Maintenance therapy, received by 66.1% of patients, was associated with superior 5-year OS (100% vs. 87.5%, P=0.0104). Multivariate analysis identified Ki-67 >20% (HR=3.208, P=0.024) and high tumor burden (HR=4.670, P=0.003) as independent negative predictors for PFS, while high tumor burden (HR=4.493, P=0.004) and B symptoms (HR=3.324, P=0.030) predicted worse OS. Chinese MZL patients demonstrated favorable outcomes, and maintenance therapy conferred a significant OS benefit. Ki-67, tumor burden, and B symptoms serve as practical prognostic indicators to inform risk stratification and personalized treatment planning.

BACKGROUND:Thromboembolism (TE) is a serious complication in lymphoma, driving excess morbidity and mortality. Existing prediction tools perform suboptimally in lymphoma-specific settings. METHODS:We retrospectively analysed 790 newly diagnosed lymphoma patients (January 2019-December 2021). Patients were randomly split 7:3 into development and internal-validation cohorts. Forty-eight candidate predictors were screened with LASSO, followed by multivariable Cox modelling to construct a nomogram. Discrimination and calibration were assessed at 6, 12 and 24 months using time-dependent ROC analysis and bootstrap calibration. RESULTS:TE occurred in 77/790 patients (9.8%). Independent predictors were ECOG performance status, prior venous thromboembolism (VTE), coronary artery disease, central venous catheterisation, and APTT category. The nomogram showed good discrimination: AUCs were 0.813, 0.818 and 0.733 at 0.5, 1.0 and 2.0 years in the development cohort, and 0.724, 0.731 and 0.659 in the validation cohort. Conventional scores performed poorly in this population (e.g., at 1 year ThroLy 0.587 vs. Khorana 0.527). Calibration plots indicated close agreement between predicted and observed risks. Patients who experienced TE had poorer overall survival, with the greatest divergence in survival curves occurring within the first six months after diagnosis. CONCLUSIONS:This lymphoma-specific model improves TE risk stratification and can inform individualised prophylaxis and early monitoring. External, multi-centre validation is warranted to confirm generalisability.

The data about the clinical features and outcomes of Chinese patients with peripheral T-cell lymphomas (PTCLs) are limited. This retrospective study included 1031 patients of PTCL from January 2014 to March 2022 at 21 centers in China. The clinical features, treatment patterns, and survival outcomes of the Chinese PTCL population were reported. Among the 1031 patients, 937 patients had mature T or NK cell lymphoma (91.2

Background: To evaluate the potential clinical value of cerebrospinal fluid (CSF) circulating tumor DNA (ctDNA) in the diagnosis and monitors the central nervous system (CNS) lymphomas. Methods: This was a prospective study of 17 consecutive patients with B-cell lymphoma: 10 patients with CNS lymphomas and 7 patients with B-cell lymphomas at high clinical risk of CNS relapse. Genomic profiles were performed on the CSF and plasma samples of patients by next-generation sequencing. Results: In patients with CNS lymphomas, ctDNA was detected in 70.0% of CSF and 60.0% of plasma. The detection rate and gene mutation abundance of CSF were higher than plasma ( p = 0.016). CSF had a unique genetic profile. Furthermore, we newly found that gene mutations consistent with plasma or lymphoma-related were also detected in the CSF of the high-risk group without CNS involvement. Analysis of paired plasma and CSF samples from three patients at different time points, changes of CSF ctDNA abundance occurred at the same time or earlier than clinical disease changes, which could timely monitor the therapeutic response and relapse trend. Conclusion: The detection rate of ctDNA in CSF is higher than that in plasma. The dynamic monitoring of ctDNA in CSF has hint significance for therapeutic response of CNS lymphoma patients.

BACKGROUND:Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of aggressive non-Hodgkin's lymphoma with distinct clinical and molecular heterogeneity. DLBCL that arises in extranodal organs is particularly linked to poor prognosis. This study aimed to determine the clinical and molecular characteristics of extranodal involvement (ENI) in DLBCL and assess the actual survival status of the patients. METHODS:In this population-based cohort study, we investigated the clinical features of 5,023 patients newly diagnosed with DLBCL. Their clinical conditions, eligibility criteria, and sociodemographic details were recorded and analyzed. Gene panel sequencing was performed on 1,050 patients to discern molecular patterns according to ENI. RESULTS:The 2-year overall survival (OS) rate was 76.2% [95% confidence interval (CI), 74.0%-78.2%], and the 5-year OS rate was 67.9% (95% CI, 65.2%-70.4%). The primary treatment was immunochemotherapy with rituximab. Specific lymphoma involvement sites, especially the bones, bone marrow, and central nervous system, were identified as independent adverse prognostic factors. A high prevalence of non-germinal center B-cell (non-GCB) phenotype and myeloid differentiation primary response 88 (MYD88)/CD79B mutations were noted in lymphomas affecting the breasts, skin, uterus, and immune-privileged sites. Conversely, the thyroid and gastrointestinal tract showed a low occurrence of non-GCB phenotype. Remarkably, patients with multiple ENIs exhibited a high frequency of MYD88, tet methylcytosine dioxygenase 2 (TET2), CREB binding protein (CREBBP) mutations, increased MYD88L265P and CD79B mutation (MCD)-like subtypes, and poor prognosis. Genetic subtype-guided immunochemotherapy showed good efficacy in subgroup analyses after propensity score matching with 5-year OS and progression-free survival rates of 85.0% (95% CI, 80.6%-89.5%) and 72.1% (95% CI, 67.3%-76.7%). CONCLUSIONS:In the rituximab era, this large-scale retrospective analysis from Asia confirmed the poor prognosis of DLBCL with multiple ENIs and underscored the efficacy of genetic subtype-guided immunochemotherapy in treating extranodal DLBCL.

ABSTRACT Early T‐cell precursor acute lymphoblastic leukemia (ETP‐ALL) is an aggressive subtype of T‐ALL. Once refractory or relapsed, it is associated with a poor prognosis, with a complete remission (CR) rate of 36%–46% following re‐induction therapy. Previously, we reported a synergistic effect of venetoclax (VEN) and homoharringtonine (HHT) in ETP‐ALL, which potentially elicits notable clinical responses. Herein, we investigated the efficacy and safety of the V‐HAG regimen (VEN, HHT, cytarabine, and granulocyte colony‐stimulating factor [G‐CSF]) in patients with refractory/relapsed ETP‐ALL through a prospective, multicenter, single‐arm, open‐label, phase 2 clinical trial. A total of 18 patients were enrolled, and 100% of these patients achieved CR or CR with incomplete hematological recovery (CRi) after 1 cycle of the V‐HAG regimen as re‐induction therapy. As a follow‐up, both the relapse rate and mortality rate were 33.3%. The 1‐year overall survival and relapse‐free survival were 76.7% (95% confidence interval [CI]: 53.2%‐100.0%) and 55.7% (95% CI: 28.8%–82.6%), respectively. The most common grade 3–4 adverse events were neutropenia (100%), anemia (88.9%), and thrombocytopenia (100%). Notably, the VEN‐ and HHT‐based therapy, V‐HAG regimen, exhibits an extremely high efficacy in the treatment of patients with refractory/relapsed ETP‐ALL with good tolerance, and it provides a promising therapeutic strategy for improving their outcomes.

Epstein-Barr virus-encoded small RNA (EBER), a hallmark of EBV infection, is a poor prognostic factor in peripheral T-cell lymphoma (PTCL). Current clinical-based prognostic scores inadequately identify high-risk EBER-positive patients or guide therapy, underscoring the need for improved risk-stratification and treatment strategies. This multicenter cohort study, encompassing 167 PTCL patients, systematically analyzed the impact of EBER status on patient survival and treatment response. Utilizing LASSO-penalized Cox regression, a novel prognostic risk scoring system was developed incorporating EBER status and clinical indicators. With a median follow-up of 22.1 months, 63 patients (38

e19001 Background: DLBCL comprises 38% of all non-Hodgkin lymphoma (NHL) in China. Outcomes for R/R DLBCL remain poor despite treatment (tx) advances including CAR T-cell therapy, for which access can be limited. Thus, an unmet need in China remains, especially for chemorefractory R/R DLBCL. Subcutaneous (SC) epcor is a CD3xCD20 bispecific antibody approved globally, including the US, for R/R DLBCL and follicular lymphoma (FL). Here we present first efficacy and safety data from R/R DLBCL Chinese pts treated with epcor monotherapy in the pivotal EPCORE NHL-4 (NCT5201248) trial. Methods: Pts had R/R NHL with ≥2 lines of prior systemic tx and were administered 48 mg epcor SC in 28-day cycles (C): QW, C1-3; Q2W, C4-9; Q4W, C10+ until disease progression or unacceptable toxicity. In C1, step-up dosing (day [D] 1, 0.16 mg; D8, 0.8 mg; D15, D22, 48 mg) and prophylactic corticosteroids were used to prevent cytokine release syndrome (CRS). Key endpoints included tx-emergent adverse events (TEAEs), response rates (overall response rate [ORR]/complete response rate [CRR]) and progression-free survival (PFS) by independent review committee (IRC), and duration of response (DoR/DoCR) by IRC. Results: As of June 19, 2024, 42 pts were enrolled (3 DLBCL, 2 FL in safety run-in; 37 DLBCL in dose expansion). In dose expansion, median age was 57.0 y and pts received ≥1 epcor dose; median follow-up was 18.5 mo. In dose expansion, 73% of pts had advanced disease (Ann Arbor Stage III–IV), 89% had primary refractory disease, and 65% were refractory to the last line of anti-CD20 tx. Median prior lines of tx was 3 (range, 2–7). Most pts (97%) had ≥1 Grade (G) 3/4 TEAE, most commonly lymphopenia (89%), neutropenia (57%), leukopenia (35%), and thrombocytopenia (22%). CRS was reported in 84% of pts: G1 51%, G2 32%, and no G≥3. Most CRS events occurred after the first full dose (C1D15), with median time to onset of 16 D (range, 2–29). All CRS events resolved and no pts discontinued epcor due to CRS. No pts had immune effector cell-associated neurotoxicity syndrome, and 1 pt (3%) had G3 clinical tumor lysis syndrome that resolved without dose interruption. Three fatal TEAEs were all due to progressive disease and unrelated to epcor. ORR was 65% and CRR was 38%; median DoR, DoCR, and OS were not reached (NR; Table). Conclusions: Epcor monotherapy showed favorable outcomes in Chinese pts with refractory and heavily pretreated R/R DLBCL.High ORR and CRR were achieved early and safety was manageable. CRS was low grade with predictable timing. Our results are consistent with the pivotal EPCORE NHL-1 and NHL-3 trials and support further development of epcor in China. Clinical trial information: NCT05201248 . Efficacy by IRC. Dose Expansion (n=37) ORR, % 64.9 CR 37.8 PR 27.0 Median time to response, mo (range) 1.4 (1.1–2.8) Time to CR 2.2 (1.1–5.4) Median DoR, mo (95% CI) NR (1.5–NR) DoCR NR (3.9–NR) Median PFS, mo (95% CI) 4.5 (2.7–NR) Median OS, mo (95% CI) NR (6.5–NR)

This open-label, single-arm phase II study assessed the safety and efficacy of sequential hypofractionated radiotherapy (RT) followed by zimberelimab and R-GemOx (rituximab, gemcitabine, oxaliplatin) in patients with primary refractory diffuse large B-cell lymphoma (DLBCL). Fourteen patients were enrolled between June 2022 and December 2023, with 13 included in the analysis. RT doses of 36 and 24 Gy were delivered to the gross and target volumes in 12 fractions, followed by zimberelimab and R-GemOx. The overall response rate within the irradiated field was 92.3%, and a complete response (CR) was achieved by 61.5% of patients; however, 38.5% experienced disease progression. Treatment-related toxicities were manageable, primarily comprising mild leukocytopenia. Digital spatial profiling revealed 53 differentially expressed genes in CD20-rich lymphoma regions and 93 in CD3-rich T cell regions in non-CR patients. Reactome analysis identified key immune system pathways. T cell infiltration correlated with treatment efficacy, and multiplex immunohistochemistry validated immune pathways as potential therapeutic targets. This study demonstrated the promising role of RT combined with immunochemotherapy in refractory DLBCL and suggests immune pathways as critical targets to improve treatment outcomes.

Perianal abscess (PA) is a complication of infection in patients with hematologic malignancies. However, the simultaneous occurrence of neutropenia and increased susceptibility to bleeding pose significant challenges for surgical intervention in perianal abscesses. In this retrospective study, we sought to evaluate and compare the efficacy of pharmacological therapy and surgical intervention in the management of PA in patients with hematologic malignancies, bwtween 2015 and 2022 at the Fujian Medical University Union Hospital. In total, 53 patients were enrolled in this study, including 19 cases with surgical intervention, and 34 cases with conservative treatment. During the 60-day follow-up period, a significant improvement of symptoms or complete resolution was observed in 48 patients (90.5

Background: Although advanced stage follicular lymphoma (FL) is incurable, a majority of newly diagnosed patients achieve long-term, durable remissions with immunochemotherapy. However, the toxicity burden of immunochemotherapy is inevitable. Zanubrutinib plus Obinutuzumab, a novel “chemo-free regimen”, showed promising efficacy and a reasonable safety profile in relapsed/refractory (R/R) follicular lymphoma (FL) (Zinzani PL et al, JCO 2023). Given non-overlapping toxicities and motivation to spare patients from conventional chemotherapy, we conducted a phase II study of Zanubrutinib plus Obinutuzumab as first-line systemic therapy for patients with advanced stage FL. Here, we report initial safety and efficacy data from this ongoing Phase II study (NCT06553352). Methods: Patients with previously untreated FL 1-3a, advanced disease (stage III or IV, or stage II with non-contiguous disease), Eastern Cooperative Oncology Group performance status 0 to 2, and high tumor burden according to Groupe d'Étude des Lymphomes Folliculaires (GELF) criteria will be enrolled. All subjects received Zanubrutinib 160mg BID on days 1-28 of a 28-day cycle for 12 cycles or until disease progression or withdrawal from the trial. Obinutuzumab was received at a dose of 1000 mg on days 1, 8, and 15 of cycle 1 and on day 1 of 2-6 cycles, followed by Obinutuzumab maintenance therapy every 2 months for 2 years. The primary endpoint was complete remission (CR) rate at 12 months, and the secondary endpoint were PFS and OS at 2 years, objective response rate (ORR) and toxicity. Results: As of September 10, 2024, 26 pts had been enrolled. Median age of all pts was 56 (range: 29-73) years, 46% (12/26) were male, 88% (23/26) had Ann Arbor stage III/IV disease, and 58% (15/26) had a FLIPI score ≥2 at study entry. Median follow-up was 4.9 months (range: 1.2-11.1). All patients underwent safety assessment, with 15% (4/26) Grade 1-2 infusion-related reactions (IRRs）related to Obinutuzumab. Serious AEs were gr 2 pneumonitis (n=1), gr 2 thrombocytopenia (n=1), and intestinal obstruction which was unrelated to treatment (n=1). Ten patients received more than 6 cycles and underwent at least one post-baseline tumor assessment after Cycle 6, with 100% (10/10) achieving an objective response, including 80% (8/10) who achieved CR. Six pts who achieved CR underwent ctDNA assessment at baseline and after Cycle 6, with 67% (4/6) achieved MRD negative. Conclusion: Zanubrutinib plus Obinutuzumab is well-tolerated and induces high CR rates in pts with previously untreated FL.

High-grade B-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements constitutes a distinct clinicopathological entity characterized by aggressive behavior, inherent resistance to conventional immunochemotherapy, and suboptimal clinical outcomes. Within our cohort, MYC/BCL2 rearrangements defined double-hit lymphoma (DHL), MYC/BCL6 as DHL-BCL6, and concurrent MYC/BCL2/BCL6 as triple-hit lymphoma (THL). Here, we delineated the clinical characteristics and genetic aberrations of 112 DHL/THL patients to investigate the factors influencing lymphoma relapse and optimize treatment strategies. Compared to 80 DHL-BCL6 patients, DHL/THL manifested distinct features, including an increased prevalence of the germinal center B-cell-like subtype and co-expression of MYC/BCL2, and demonstrated significant associations with abbreviated progression-free and overall survival. Univariate and multivariate analyses identified Ann Arbor stage and serum lactate dehydrogenase elevation as independent prognostic determinants. Therapeutic intensification employing R-DA-EDOCH was correlated with enhanced survival outcomes, while consolidative autologous stem cell transplantation significantly improved prognosis in patients who achieved remission after first-line immunochemotherapy. Regarding genetic aberrations, oncogenic mutations were detected in 102 evaluable patients. EZH2 mutation occurred more frequently in DHL/THL, while TNFRSF14 mutation exhibited greater prevalence in THL. The EZB genotype was predominantly observed in DHL/THL patients, and those with TP53 abnormalities exhibited a further diminished prognosis. In terms of the immune microenvironment, the depleted lymphoma microenvironment (LME-DP) subtype, characterized by diminished immune cell infiltration, demonstrated a propensity for increased frequency in DHL/THL patients. Collectively, these findings advance the comprehensive understanding of DHL/THL pathobiology, underscoring the imperative for novel targeted agents and therapeutic approaches.

Objective:​​ To investigate the clinicopathological characteristics, genomic mutational profiles, prognostic determinants, survival outcomes, and current diagnostic/therapeutic landscape of thyroid diffuse large B-cell lymphoma (TDLBCL), distinguishing primary from secondary subtypes. Methods:​​​ A multi-center retrospective analysis was conducted on 190 TDLBCL patients (123 primary, 67 secondary) treated across 22 Chinese institutions between November 2003 and November 2024. Clinicopathological data, treatment modalities, and survival outcomes were analyzed. Targeted sequencing of 55 lymphoma-associated genes was performed on 49 tumor samples to characterize mutational patterns. Results:​​​ Primary TDLBCL patients exhibited significantly higher proportions (P<0.05) of the following favorable features compared to secondary cases: ECOG performance status ≤1(P=0.005), Ann Arbor stage I–II(P< 0.001), ≤1 extranodal involvement site(P< 0.001), normal lactate dehydrogenase (LDH) (P< 0.001), combined surgical resection and chemotherapy(P< 0.001), concurrent Hashimoto's thyroiditis (HT) (P=0.005), neck mass as initial presentation(P< 0.001), localized compressive symptoms(P< 0.001), absence of B symptoms(P=0.002), thyroid dysfunction(P=0.021), and maximum tumor diameter <6 cm(P=0.018). Among 175 evaluable patients, primary TDLBCL (91.0%，101/111) achieved superior objective response rates (ORR) versus secondary disease (73.4%，47/64) (P=0.002). For 108 patients receiving first-line rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)-based therapy, primary TDLBCL demonstrated significantly improved 5-year progression-free survival (PFS) (66.9% vs. 52.4%; P=0.018).Prognostic Factors:​​Univariate analysis of R-CHOP-treated patients identified extranodal involvement ≥2 sites(HR=2.185, 95%CI 1.011‒4.720), ECOG performance status ≥2(HR=2.378, 95%CI 1.039‒5.441), Ann Arbor stage III–IV(HR=2.262, 95%CI 1.046‒4.891), and elevated LDH (HR=2.690, 95%CI 1.178‒6.142) as significant adverse prognostic factors for progression-free survival (PFS), while maximum tumor diameter ≥6 cm (HR=5.788, 95%CI 1.436‒23.338) and double-expressor (DE) (HR=5.585, 95%CI 1.001‒31.150)（P=0.05） subtype detrimentally impacted overall survival (OS) (P<0.05); Multivariate analysis: Elevated LDH independently predicted inferior progression-free survival (HR = 2.690, 95% CI: 1.178–6.142, P = 0.019), while maximum tumor diameter emerged as an independent predictor for overall survival (model χ² = 8.587, P = 0.014), with tumors <6 cm conferring significantly reduced mortality risk (HR = 0.348, 95% CI: 0.159–0.759, P = 0.008). furthermore, genomic profiling revealed recurrent mutations in TP53 (30.6%), TET2 (30.6%), and KMT2D (26.5%), with TET2 mutational frequency differing significantly between primary and secondary TDLBCL subtypes (P=0.032), though none of these mutations demonstrated a statistically significant association with survival outcomes. Conclusion:​​ Primary TDLBCL demonstrates superior survival outcomes and enhanced response to first-line therapy compared to secondary TDLBCL. Adverse prognostic factors significantly impacting patient survival include Ann Arbor stage III–IV, elevated serum LDH, extranodal involvement ≥2 sites, maximum tumor diameter ≥6 cm, and the DE phenotype.Serum LDH levels and tumor diameter serve as ​independent predictors​ for PFS and OS, respectively, underscoring their critical role in prognostication.Genomic profiling identified TET2, TP53, and KMT2D as the most recurrently mutated genes in TDLBCL; however, none of these genetic alterations exhibited a statistically significant association with prognosis.

This study evaluates the diagnostic performance of staging 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for detecting bone marrow involvement (BMI) in low-grade follicular lymphoma (FL) and its impact on the clinical necessity of bone marrow biopsy (BMB). We retrospectively analyzed patients newly diagnosed with low-grade (grade 1–2) FL who underwent both 18F-FDG PET/CT and BMB from 2010 to 2022 at two Chinese institutions. PET/CT’s diagnostic accuracy for BMI was assessed using BMB as gold standard. Clinical and imaging data were analyzed to identify risk factors for BMI. Among 171 patients, 27 had positive BMB results. PET/CT demonstrated 86.5

BackgroundThis study aimed to elucidate the treatment outcomes and prognosis of angioimmunoblastic T-cell lymphoma (AITL) patients in a real-world setting.ObjectivesThe clinical efficacy of new drug applications was evaluated, alongside the predictive accuracy of prognostic models, to inform future research.MethodsIn this study, 82.9% of patients received a CHOP-like regimen, while 36.4% also received chidamide. We assessed the prognostic models’ predictive power using the Cox proportional hazards model and concordance index (C-index).ResultsThe median age of the patients in this study was 62.0 years, with 2-year progression-free survival (PFS) and overall survival (OS) rates of 36.1% and 60.3%, respectively. Complete response (CR) rates in first-line treatments were 21.6% for the chidamide-containing group and 28.1% for the chidamide-free group. The AITL scores, PIAI scores, and Chinese AITL scores demonstrated superior C-index values, with the Chinese AITL score providing the most distinct risk stratification. Advanced age (over 70 years), bone marrow involvement, and CD7 negativity were identified as significant prognostic factors associated with poorer PFS in both univariate and multivariate analyses. A novel prognostic model, the South China AITL Score, was constructed by combining these three factors, stratifying patients into low-risk and high-risk groups, with 5-year PFS rates of 81.5% and 34.6%, respectively. This model was successfully validated in an independent cohort.ConclusionsThe prognosis of AITL in real-world settings is poor, and the addition of chidamide did not show improvement in remission rates or survival. Our novel prognostic model, along with the Chinese AITL score, may enhance the identification of Chinese patients at varying risks for chemotherapy. Furthermore, the pathological marker CD7 is anticipated to emerge as a significant biomarker for the prognostic evaluation of AITL.

Background Bone marrow biopsy (BMB) is a cornerstone in the staging of aggressive lymphomas, yet its relevance in indolent lymphomas remains under scrutiny. This study assessed the utility of BMB in positron emission tomography/computed tomography (PET/CT) staging for low-grade follicular lymphomas (FL). Methods This retrospective study analyzed the records of patients newly diagnosed with low-grade (grade 1–2) FL who underwent initial staging with both PET/CT and BMB at two Chinese institutions from 2010 to 2022. Data for a cohort of 171 patients were analyzed, 27 had positive BMB results. Results Using BMB as the benchmark for diagnostic accuracy, PET/CT demonstrated an overall accuracy of 86.5% in detecting BM involvement. BMB led to the reclassification of 13 patients to stage IV disease who were initially evaluated as stage III via PET/CT. In patients with advanced-stage disease, positive BMB results correlated with extramedullary tumor burden. Patients were stratified as low-, intermediate-, and high-risk using four independent BMB-positive risk factors: sex, Eastern Cooperative Oncology Group performance score > 1, elevated beta2 micro-globulin levels, and involvement of more than four lymph node regions. The BMB-positive rates for the risk categories were 5.6%, 40.7%, and 68.8%, respectively. Over a median follow-up period of 34 months, there was no observed survival difference between BMB-positive and BMB-negative patients. Conclusions Baseline PET/CT can safely and effectively substitute for BMB in the staging of early-stage, low-grade FL. However, in patients with advanced-stage disease, routine BMB provides additional diagnostic value over PET/CT. The rate of BMB positivity is strongly linked to tumor burden.

Background Radiotherapy (RT) is an effective and available local treatment for patients with refractory or relapsed (R/R) aggressive B-cell lymphomas. However, the value of hypofractionated RT in this setting has not been confirmed. Methods We retrospectively analyzed patients with R/R aggressive B-cell lymphoma who received hypofractionated RT between January 2020 and August 2022 at a single institution. The objective response rate (ORR), overall survival (OS), progression-free survival (PFS) and acute side effects were analyzed. Results A total of 30 patients were included. The median dose for residual disease was 36 Gy, at a dose per fraction of 2.3–5 Gy. After RT, the ORR and complete response (CR) rates were 90% and 80%, respectively. With a median follow-up of 10 months (range, 2–27 months), 10 patients (33.3%) experienced disease progression and three died. The 1-year OS and PFS rates for all patients were 81.8% and 66.3%, respectively. The majority (8/10) of post-RT progressions involved out-of-field relapses. Patients with relapsed diseases, no response to systemic therapy, multiple lesions at the time of RT, and no response to RT were associated with out-of-field relapses. PFS was associated with response to RT ( P = 0.001) and numbers of residual sites ( P < 0.001). No serious non-hematological adverse effects (≥ grade 3) associated with RT were reported. Conclusion These data suggest that hypofractionated RT was effective and tolerable for patients with R/R aggressive B-cell lymphoma, especially for those that exhibited localized residual disease.