1.Treatment challenges and optimal management of classical Hodgkin’s lymphoma
Jianqing MI ; Yu FANG ; Wenyan YU ; Qingqing CAI
Chinese Journal of Hematology 2025;46(4):364-371
The cure rate of patients with classical Hodgkin’s lymphoma (cHL) has significantly improved and the mortality rate has decreased with the advancement of chemotherapy and radiotherapy, especially the application of combined radio-chemotherapy. However, some patients still face relapse or refractory issues, as well as the risk of death due to treatment-related adverse reaction. Treatment has fully entered the era of targeted therapy in recent years, with the deepening research on cHL. Novel drugs, represented by targeted CD30 antibody-drug conjugates and immune checkpoint inhibitors, have further improved the prognosis of patients with newly diagnosed and relapsed/refractory cHL. This study aims to determine the mechanism of achieving comprehensive optimization management of cHL in the new era of drugs, improve patient prognosis, enhance therapeutic efficacy, and reduce the occurence of adverse reactions.
2.Research progress on targeted delivery of proteasome inhibitor nanoparticles for the treatment of multiple myeloma
Yuxin LIN ; Duohui JING ; Jianqing MI
Chinese Journal of Hematology 2025;46(8):779-784
In recent years, proteasome inhibitors have been widely applied in the treatment of multiple myeloma (MM), demonstrating significant therapeutic value. However, these drugs face numerous clinical challenges, such as short circulation half-life, poor water solubility, patient resistance, and severe adverse events. Nanoparticles for targeted drug delivery, with unique advantages, have shown promise as an effective solution to these issues. This paper reviews the mechanisms of nanotargeted drug delivery for proteasome inhibitors and the progress of their use in MM treatment both domestically and internationally, aiming to provide a reference for researchers in related fields.
3.Clinical characteristics and prognosis of 18 patients with plasmablastic lymphoma
Shanshan WENG ; Qing SHI ; Weili ZHAO ; Jianqing MI ; Li WANG
Chinese Journal of Hematology 2025;46(9):865-869
Plasmablastic lymphoma (PBL) is a rare, highly aggressive non-Hodgkin lymphoma subtype for which no standardized therapeutic regimen has been established in clinical practice. This study retrospectively analyzed 18 PBL cases at Shanghai Ruijin Hospital from July 2012 to June 2024. Participants comprised 12 males and 6 females, with a median age of 59 (39–77) years. Twelve (66.7% ) cases presented at stage Ⅲ/Ⅳ, nine (50% ) have cytopenia, 12 (66.7% ) have increased lactate dehydrogenase level, and four (22.2% ) had a Ki-67 index of ≥90%. The tumor cells highly expressed CD38 (15/17, 88.2% ) /CD138 (12/17, 70.6% ), whereas the B-cell marker CD20 was rarely detected (1/17, 5.9% ). Of the 11 cases that underwent genetic sequencing, common mutations included TP53 (27.3% ), KMT2D (18.2% ), and TET2 (18.2% ). After excluding one patient with positive HIV who died without treatment, 17 patients received first-line therapy, achieving a complete response in 10 (58.8% ) and a partial response in 5 (29.4% ) cases. With the median follow-up time of 4.33 (0.17–12.17) years, Kaplan-Meier analysis indicated that the 2-year progression-free survival rate and overall survival rate were (68.5±11.2) % and (75.5±10.1) %, respectively.
4.Development, reliability, and validity of a treatment-related quality of life scale for Chinese patients with multiple myeloma
Chunyan SUN ; Zhen CAI ; Bing CHEN ; Lijuan CHEN ; Wenming CHEN ; Kaiyang DING ; Juan DU ; Rong FU ; Chengcheng FU ; Da GAO ; Guangxun GAO ; Yanjuan HE ; Jian HOU ; Ming JIANG ; Fei LI ; Jian LI ; Juan LI ; Zhenyu LI ; Aijun LIAO ; Jing LIU ; Jun LUO ; Jianmin LUO ; Yanping MA ; Jianqing MI ; Ting NIU ; Hongling PENG ; Yongping SONG ; Luqun WANG ; Rong ZHAN ; Xi ZHANG ; Yu HU
Chinese Journal of Hematology 2025;46(8):713-721
Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.
5.Efficacy analysis in elderly and frail newly diagnosed multiple myeloma patients with dose-reduced lenalidomide/melphalan/prednisone acetate regimens
Xingli ZHANG ; Jie TIAN ; Jing LUO ; Qian LIU ; Wanyan OUYANG ; Hongchun QIU ; Yan WANG ; Jianqing MI
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(7):815-822
Objective·To investigate the efficacy and safety of a dose-reduced,all-oral lenalidomide/melphalan/prednisone acetate(RMP)regimen in elderly and frail patients with newly diagnosed multiple myeloma(NDMM).Methods·Elderly and frail NDMM patients who visited the Department of Hematology of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,and the Third People's Hospital of Kunshan from April 2018 to March 2024 were retrospectively included.Clinical data and laboratory indicators were collected,and all patients were treated with the RMP regimen.SPSS 27.0 and R software were used for statistical analysis.Independent t-test was applied to normally distributed quantitative data,Mann-Whitney U test to non-normally distributed quantitative data,and x2 test and Fisher's exact probability method to qualitative data.Kaplan-Meier survival curves and Log-rank test were used for survival analysis.Results·Among the 22 elderly and frail NDMM patients treated with RMP,the median age was 76.3(68.4,95.0)years,and the median follow-up time was 25.5 months.The overall response rate(ORR)was 68.2%,and the rate of≥very good partial response(VGPR)was 36.4%.The median progression-free survival(PFS)was 20.53 months.The median PFS in the≤75-year-old group was 25.23(95%CI 12.95?37.52)months,while in the>75-year-old group it was 18.23(95%CI 14.86?21.61)months.There was no significant difference between the two groups.The median PFS in the≥partial response(PR)group was 20.67(95%CI 13.57?27.76)months,and in the
6.Effect of plasma exchange combined with classical chemotherapy on renal function in patients with multiple myeloma
Tong LIN ; Yi TAO ; Shiwei JIN ; Miao SUN ; Jianqing MI
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(7):823-828
Objective·To investigate the effect of plasma exchange combined with classical chemotherapy on renal function in patients with multiple myeloma(MM).Methods·A retrospective analysis was conducted on data from patients newly diagnosed with MM in the Department of Hematology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,between October 2021 and September 2023.Sixty-eight MM patients admitted from October 2021 to September 2022 served as the control group,and 41 patients admitted from October 2022 to September 2023 comprised the experimental group.The control group received classical chemotherapy for MM[PAD(bortezomib+adriamycin+dexamethasone)or PCD(bortezomib+cyclophosphamide+dexamethasone)],and the experimental group underwent plasma exchange before classic chemotherapy.The frequency of plasma exchange was determined according to the clearance rate of M-protein in patients,with the criterion being a reduction of more than 40%in plasma M-protein levels after exchange,and the total number of exchanges ranged from 1 to 3 sessions.After 2 chemotherapy courses,the free light chain difference(dFLC),serum creatinine(Scr),and other renal function indexes were compared between the two groups.Results·Compared with the control group,the experimental group showed no statistically significant difference in dFLC levels.The Scr level decreased[67.00(54.00,75.00)μmol/L vs 77.50(63.00,94.00)μmol/L,P=0.011],and the estimated glomerular filtration rate(eGFR)increased[97.80(92.80,101.30)mL/(min·1.73 m2)vs 85.80(61.35,95.35)mL/(min·1.73 m2),P<0.001]after treatment.Before treatment,the numbers of patients with MM-related severe renal injury[eGFR<50 mL/(min·1.73 m2)]were 41 in the control group and 28 in the experimental group.After treatment,8 patients(19.51%)in the control group achieved complete renal response[eGFR≥60 mL/(min·1.73 m2)],while 12 patients(42.86%)in the experimental group achieved the same,with the difference being statistically significant(P=0.036).After two courses of treatment,the overall response rates(ORR)of the control group and the experimental group were 76.47%and 92.68%,respectively,and the difference in overall therapeutic efficacy was statistically significant(P=0.031).Conclusion·Plasma exchange combined with classical chemotherapy can significantly reduce the Scr levels and increase eGFR in MM patients within a short period,ameliorating the MM-related renal impairment to some extent and improving clinical treatment outcomes.
7.Efficacy analysis in elderly and frail newly diagnosed multiple myeloma patients with dose-reduced lenalidomide/melphalan/prednisone acetate regimens
Xingli ZHANG ; Jie TIAN ; Jing LUO ; Qian LIU ; Wanyan OUYANG ; Hongchun QIU ; Yan WANG ; Jianqing MI
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(7):815-822
Objective·To investigate the efficacy and safety of a dose-reduced,all-oral lenalidomide/melphalan/prednisone acetate(RMP)regimen in elderly and frail patients with newly diagnosed multiple myeloma(NDMM).Methods·Elderly and frail NDMM patients who visited the Department of Hematology of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,and the Third People's Hospital of Kunshan from April 2018 to March 2024 were retrospectively included.Clinical data and laboratory indicators were collected,and all patients were treated with the RMP regimen.SPSS 27.0 and R software were used for statistical analysis.Independent t-test was applied to normally distributed quantitative data,Mann-Whitney U test to non-normally distributed quantitative data,and x2 test and Fisher's exact probability method to qualitative data.Kaplan-Meier survival curves and Log-rank test were used for survival analysis.Results·Among the 22 elderly and frail NDMM patients treated with RMP,the median age was 76.3(68.4,95.0)years,and the median follow-up time was 25.5 months.The overall response rate(ORR)was 68.2%,and the rate of≥very good partial response(VGPR)was 36.4%.The median progression-free survival(PFS)was 20.53 months.The median PFS in the≤75-year-old group was 25.23(95%CI 12.95?37.52)months,while in the>75-year-old group it was 18.23(95%CI 14.86?21.61)months.There was no significant difference between the two groups.The median PFS in the≥partial response(PR)group was 20.67(95%CI 13.57?27.76)months,and in the
8.Effect of plasma exchange combined with classical chemotherapy on renal function in patients with multiple myeloma
Tong LIN ; Yi TAO ; Shiwei JIN ; Miao SUN ; Jianqing MI
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(7):823-828
Objective·To investigate the effect of plasma exchange combined with classical chemotherapy on renal function in patients with multiple myeloma(MM).Methods·A retrospective analysis was conducted on data from patients newly diagnosed with MM in the Department of Hematology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,between October 2021 and September 2023.Sixty-eight MM patients admitted from October 2021 to September 2022 served as the control group,and 41 patients admitted from October 2022 to September 2023 comprised the experimental group.The control group received classical chemotherapy for MM[PAD(bortezomib+adriamycin+dexamethasone)or PCD(bortezomib+cyclophosphamide+dexamethasone)],and the experimental group underwent plasma exchange before classic chemotherapy.The frequency of plasma exchange was determined according to the clearance rate of M-protein in patients,with the criterion being a reduction of more than 40%in plasma M-protein levels after exchange,and the total number of exchanges ranged from 1 to 3 sessions.After 2 chemotherapy courses,the free light chain difference(dFLC),serum creatinine(Scr),and other renal function indexes were compared between the two groups.Results·Compared with the control group,the experimental group showed no statistically significant difference in dFLC levels.The Scr level decreased[67.00(54.00,75.00)μmol/L vs 77.50(63.00,94.00)μmol/L,P=0.011],and the estimated glomerular filtration rate(eGFR)increased[97.80(92.80,101.30)mL/(min·1.73 m2)vs 85.80(61.35,95.35)mL/(min·1.73 m2),P<0.001]after treatment.Before treatment,the numbers of patients with MM-related severe renal injury[eGFR<50 mL/(min·1.73 m2)]were 41 in the control group and 28 in the experimental group.After treatment,8 patients(19.51%)in the control group achieved complete renal response[eGFR≥60 mL/(min·1.73 m2)],while 12 patients(42.86%)in the experimental group achieved the same,with the difference being statistically significant(P=0.036).After two courses of treatment,the overall response rates(ORR)of the control group and the experimental group were 76.47%and 92.68%,respectively,and the difference in overall therapeutic efficacy was statistically significant(P=0.031).Conclusion·Plasma exchange combined with classical chemotherapy can significantly reduce the Scr levels and increase eGFR in MM patients within a short period,ameliorating the MM-related renal impairment to some extent and improving clinical treatment outcomes.
9.Treatment challenges and optimal management of classical Hodgkin’s lymphoma
Jianqing MI ; Yu FANG ; Wenyan YU ; Qingqing CAI
Chinese Journal of Hematology 2025;46(4):364-371
The cure rate of patients with classical Hodgkin’s lymphoma (cHL) has significantly improved and the mortality rate has decreased with the advancement of chemotherapy and radiotherapy, especially the application of combined radio-chemotherapy. However, some patients still face relapse or refractory issues, as well as the risk of death due to treatment-related adverse reaction. Treatment has fully entered the era of targeted therapy in recent years, with the deepening research on cHL. Novel drugs, represented by targeted CD30 antibody-drug conjugates and immune checkpoint inhibitors, have further improved the prognosis of patients with newly diagnosed and relapsed/refractory cHL. This study aims to determine the mechanism of achieving comprehensive optimization management of cHL in the new era of drugs, improve patient prognosis, enhance therapeutic efficacy, and reduce the occurence of adverse reactions.
10.Research progress on targeted delivery of proteasome inhibitor nanoparticles for the treatment of multiple myeloma
Yuxin LIN ; Duohui JING ; Jianqing MI
Chinese Journal of Hematology 2025;46(8):779-784
In recent years, proteasome inhibitors have been widely applied in the treatment of multiple myeloma (MM), demonstrating significant therapeutic value. However, these drugs face numerous clinical challenges, such as short circulation half-life, poor water solubility, patient resistance, and severe adverse events. Nanoparticles for targeted drug delivery, with unique advantages, have shown promise as an effective solution to these issues. This paper reviews the mechanisms of nanotargeted drug delivery for proteasome inhibitors and the progress of their use in MM treatment both domestically and internationally, aiming to provide a reference for researchers in related fields.

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