Background: An increasing number of studies have validated the prognostic significance of the controlling nutritional status (CONUT) score in patients with solid tumors. However, the extent of the correlation between the CONUT score and clinical outcomes of patients with hematologic malignancies is unclear.Objective: This study aimed to investigate the prognostic role of the CONUT score in patients with hematologic malignancies.Methods: All relevant articles published up to November 15, 2021, were identified by systematically searching PubMed, Embase, Web of Science, and Cochrane Library. Pooled hazard ratios (HRs) and 95% confidence intervals were used to quantitatively analyze the association between the CONUT scores and clinical outcomes of patients with hematologic malignancies. Subgroup and sensitivity analyses were performed. Funnel plots as well as Begg’s and Egger’s tests were used to assess publication bias.Results: Six studies with 1811 patients were included in the meta-analysis. The results showed that a high CONUT score was associated with worse overall survival (OS) (HR=1.34, 95%CI 1.14-1.59, P < 0.001) and progression-free survival (PFS) (HR=1.20, 95%CI 1.10-1.32, P < 0.001).Conclusions: The CONUT score is an independent prognostic factor in patients with hematologic malignancies.Systematic review registration: http://www.crd.york.ac.uk/prospero/, identifier CRD42021292621.

Rituximab has been frequently used as a second-line treatment for patients with immune thrombocytopenia (ITP). Recently, several studies have proposed low-dose (100 mg or 100mg/m² per week for 4 weeks) rituximab instead of the standard dose of 375mg/m² per week for 4 weeks to treat ITP patients. The aim of this review was to systematically evaluate the efficacy and safety of low-dose rituximab for patients with ITP. Pubmed, Web of Science, Cochrane Library and Embase were searched to identify the clinical studies published in full text or abstract that met the predefined inclusion criteria. Efficacy analysis was restricted to the studies enrolling five or more patients. While safety analysis was evaluated based on all the studies reported adverse events. Nine studies (329 patients) were included for effect assessment of low-dose rituximab treatment on the patients with ITP. The pooled overall response rate was 63% (95% CI, 0.54–0.71) while the pooled complete response was 44% (95% CI, 0.33–0.55). Thirty-one patients were reported to experience adverse effects associated with rituximab, among them 30 cases suffered mild to moderate side-effects (grade1-2). Only one patient developed into interstitial pneumonia (grade3). No death was reported. Low-dose rituximab exhibited a satisfactory efficacy and safety profile, indicating that this regimen is a promising therapy for ITP, and should be further investigated through randomized clinical trials with standard-dose rituximab.

Objective: This study was conducted in order to study the clinical characteristics, prognostic factors, and treatment outcomes in patients with primary central nervous system lymphoma (PCNSL).Materials and Methods: The data of a total of 5,166 PCNSL patients diagnosed between 2000 and 2018 from the Surveillance, Epidemiology, and End Results (SEER) database were obtained.Results: The mean age was 63.1 ± 14.9 years, with a male to female ratio of 1.1:1.0. The most common histologic subtype was diffuse large B-cell lymphoma (DLBCL) (84.6%). The 1-, 3-, and 5-year overall survival (OS) rates were 50.1%, 36.0%, and 27.2%, respectively, and the corresponding disease-specific survival (DSS) rates were 54.4%, 41.3%, and 33.5%, respectively. Multivariate analysis with Cox regression showed that race, sex, age, marital status, surgical resection, and chemotherapy were independent prognostic factors for OS and DSS, but radiotherapy was only for OS. Nomograms specially for DLBCL were established to predict the possibility of OS and DSS. The concordance index (C-index) values of OS and DSS were 0.704 (95% CI 0.687–0.721) and 0.698 (95% CI 0.679–0.717), suggesting the high discrimination ability of the nomograms.Conclusion: Surgical resection and/or chemotherapy was favorably associated with better OS and DSS. However, radiotherapy was not beneficial for OS and DSS in the long term. A new predictive nomogram and a web-based survival rate calculator we developed showed favorable applicability and accuracy to predict the long-term OS for DLBCL patients specifically.

Retinoic acid receptor gamma (RARG) belongs to the nuclear receptor superfamily and has 90% homology to RAR alpha (RARA) and RAR beta. The promyelocytic leukemia (PML)–RARA fusion gene has been implicated in acute promyelocytic leukemia (APL). RARG gene rearrangement has been identified in a rare subtype of acute myeloid leukemia (AML) that resembles APL. To date, only 10 cases of gene rearrangements involving RARG (nucleoporin [NUP] 98–RARG, promyelocytic leukemia protein–RARG, cleavage and polyadenylation-specific factor 6–RARG, or nucleophosmin [NPM] 1–RARG–NPM1) have been reported. These patients show characteristics similar to APL, including bone marrow morphology, coagulation abnormality, and immunophenotype; however, they are resistant to all-trans retinoic acid and arsenic trioxide treatment. Moreover, there is no optimal therapeutic regimen for this subtype of AML. In this study, we report the clinical presentation and experimental findings of a case of AML with NUP98–RARG gene fusion similar to APL and review other cases of RARG gene rearrangement described in the literature.

Objectives: It is common of chronic phase chronic myeloid leukemia (CML-CP) patients coexisting anemia at diagnosis, but the role of anemia on the prognosis is not clear. This study aims to explore impact of anemia on outcomes of CML-CP patients in TKI era. Methods: In the retrospective study, 258 newly diagnosed CML patients treated with TKIs were enrolled. Patients with moderate anemia (Hb ≤ 90 g/L) and non-moderate anemia (Hb > 90 g/L) were compared. Results: The incidence of moderate anemia at the time of CML diagnosis was 34.8%. Compared with patients with non-moderate anemia, patients with moderate anemia had higher proportion of intermediate-high Sokal risks and more aggressive characteristics such as higher WBC counts, higher percent of myeloblasts and basophils. However, there were no statistical differences in terms of optimal response rates, 5-year PFS and OS between the two groups. Conclusion: Moderate anemia is a common concomitant symptom in CML-CP patients and is associated with high-risk CML, but its occurrence does not affect the survival of CML-CP patients in TKI era.

Background: It has been reported that inflammatory bowel disease (IBD) is associated with an increased risk of malignancies, including lymphoma. A number of large observational studies have been devoted to exploring the causal link between IBD and malignant lymphoma. However, no consensus exists on whether there is a causal relationship between IBD and malignant lymphoma.Methods: The summary dataset of the IBD and lymphoma genome-wide association studies (GWAS) was obtained from the OPEN GWAS website. Single-nucleotide polymorphisms (SNPs) were selected as genetic instrumental variants (IVs) for fulling P < 5 × 10^-8 and linkage disequilibrium (LD) of r² = 0.001 in the IBD GWAS. The proxy SNPs with LD of r² > 0.8 were identified. Palindromic SNPs and outlier SNPs were excluded. The assessments of sensitivity employed the Cochran’s Q test, Mendelian randomization (MR)-Egger intercept test, and leave-one-out analysis.Results: The MR analysis results proved the causality of IBD on diffuse large B-cell lymphoma (DLBCL). The risk of developing DLBCL is increased by 28.6% in patients with IBD [odds ratio (OR)_IVW = 1.286, 95% confidence interval (CI) 1.066–1.552, P = 0.009]. The results of the subgroup analysis showed that Crohn’s disease (OR_IVW = 1.218, 95% CI 1.030–1.441, P = 0.021) rather than ulcerative colitis (OR_IVW = 1.206, 95% CI 0.984–1.478, P = 0.072) had a causal effect on DLBCL. No horizontal and directional pleiotropy was observed in the MR studies.Conclusions: The above MR study concluded that IBD itself is causally responsible for DLBCL, especially Crohn’s disease. Further investigations are needed to elucidate the mechanism underlying this direct causal link.