Multiple myeloma (MM) is a heterogeneous cancer that remains incurable. After treatment, the presence of residual myeloma clonal cells, or minimal residual disease (MRD), leads to tumor recurrence (relapse) and treatment failure (refractory disease). Strong clinical evidence indicates MRD is a surrogate marker of survival in patients with MM and is of important prognostic value in disease management. MRD status is dynamic and longitudinal changes in MRD status have different clinical implications. For example, sustained MRD negativity (undetectable MRD) has been associated with greatly improved survival outcomes, whereas the loss of MRD negativity is associated with disease progression. Although research on the prognostic impact of MRD dynamics in real world clinical practice is ongoing, several major concerns remain to be addressed before implementing the monitoring of MRD dynamics and MRD-guided therapeutic decision making in everyday clinical practice in the management of MM. In this review, we discuss the prognostic and clinical value of MRD dynamics, the evidence from literature for MRD-guided clinical decision making, and the challenges around implementing monitoring of MRD dynamics into clinical practice.

Anemia, a global health concern, significantly impacts children and adolescents, impairing their physical and cognitive development. While nutritional deficiencies are primary contributors, oxidative stress has emerged as a key factor in anemia pathogenesis. Flavonoids, known for their antioxidant properties, may play a protective role, but their relationship with anemia in pediatric populations remains underexplored. Using data from the National Health and Nutrition Examination Survey (NHANES) cycles (2007–2008, 2009–2010, and 2017–2018), we analyzed 6815 participants aged ≤20 years to investigate the association between dietary flavonoid intake and anemia risk. Flavonoid intake was assessed via two 24 h dietary recalls, and anemia was defined using WHO hemoglobin thresholds. Multivariable logistic regression and restricted cubic spline (RCS) models were employed, adjusting for sociodemographic, dietary, and lifestyle factors. The results showed that lower dietary flavonoid intake was significantly associated with increased anemia risk. High-intake groups of total flavonoids and flavan-3-ols were linked to a reduced anemia prevalence compared to low-intake groups, with odds ratios (ORs) of OR = 0.641 (95% CI: 0.439, 0.935) and 0.612 (95% CI: 0.406, 0.921), respectively. This study highlights the potential protective role of dietary flavonoids, particularly flavan-3-ols, in reducing the anemia risk among children and adolescents, underscoring the importance of flavonoid-rich diets in anemia prevention.

Background: This umbrella review summarizes evidence from systematic reviews and meta‐analyses on the efficacy and safety of immune checkpoint inhibitors (ICIs) in hematologic malignancies. To our knowledge, this is the first umbrella review to comprehensively evaluate ICIs across multiple hematologic cancers. The goal is to clarify their therapeutic potential, highlight major safety issues, and provide evidence‐based guidance for future clinical and research applications. Methods: A comprehensive search was conducted across PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews up to May 2025. Systematic reviews and meta‐analyses investigating ICIs in hematologic malignancies were included. The AMSTAR tool was used to assess methodological quality, and the GRADE system was employed to evaluate the quality of evidence for each outcome. Results: A total of 24 meta‐analyses met the inclusion criteria, covering 39 unique interventions. ICIs demonstrated significant efficacy in multiple myeloma (MM), relapsed/refractory natural killer T‐cell lymphoma (R/R NKT), relapsed/refractory chronic lymphocytic leukemia (R/R CLL), and relapsed/refractory primary mediastinal B‐cell lymphoma (R/R PMBCL). Pembrolizumab combined with lenalidomide and dexamethasone (PLD) significantly improved overall survival (OS) in MM (HR: 0.51, 95% CI: 0.32 to 0.82, high quality). In R/R NKT, sintilimab and other ICIs showed moderate overall response rates (ORR) with favorable safety profiles. Pembrolizumab also demonstrated moderate efficacy in R/R CLL and R/R PMBCL, with low rates of severe adverse events. However, the studies exhibited significant heterogeneity, and publication bias was detected in certain outcomes, highlighting the need for cautious interpretation. Conclusions: ICIs show promising therapeutic potential in several hematologic malignancies, particularly R/R NKT, MM, R/R CLL, and R/R PMBCL. While safety profiles are generally favorable, certain regimens are associated with manageable toxicities. Future research should focus on optimizing combination therapies, refining patient selection criteria, and addressing study heterogeneity to enhance the clinical application of ICIs in hematologic cancers.

While polyethylene (PE), polystyrene (PS), and polyvinyl chloride (PVC) polymers and their environmental degradation products have been implicated in the pathogenesis of various diseases, their specific roles in multiple myeloma (MM) remain poorly understood. This study aims to identify candidate genes associated with polymer degradation product-related signatures and to evaluate their prognostic value in MM. The analysis is based on the overlap between MM-related genes and computationally predicted polymer targets; it does not directly demonstrate exposure or causality. First, differential expression analysis and WGCNA were undertaken in the GSE39754 dataset to acquire differentially expressed genes (DEGs) and WGCNA genes. Second, PE, PS, and PVC target genes were acquired from public databases. Subsequently, intersection of 3 gene sets was taken to acquire candidate genes. Prognostic genes were further recognized through univariate Cox regression analysis and machine learning, and risk model was constructed. Additionally, molecular regulatory networks, molecular docking, and molecular dynamics (MD) simulations were undertaken. Finally, potential biological mechanisms of MM were explored at the single-cell level. The expression levels of prognostic genes were detected using reverse transcription quantitative PCR (RT-qPCR) technology. PTGS1, CA1, and SYK were recognized as prognostic genes. Risk model exhibited robust predictive performance. Additionally, 225 and 138 pathways were associated with LRC and HRC, respectively. CA1 presented a strong positive correlation with type 17 T helper cells. Computational prediction suggested that NEAT1 and SNHG6 might regulate CA1 through hsa-miR-944. Molecular docking predicted weak-to-moderate binding affinity between representative degradation products/monomers of PE, PS, and PVC and the prognostic genes, and MD simulation explored the stability of the predicted PTGS1–PS complex. These in silico results are hypothesis-generating and require experimental validation. Finally, single-cell analysis identified macrophages as a key MM-associated cell population, and SYK displayed dynamic expression trends in pseudotime analysis. These findings are exploratory and do not directly link macrophages to polymer exposure. PCR results revealed that the mRNA expression levels of CA1 and PTGS1 in the MM group were significantly downregulated, whereas SYK showed no significant difference (P < 0.05 for CA1 and PTGS1). In vitro, exposure to PE/PVC microspheres (1 μm) altered PTGS1 mRNA expression but increased CA1 and SYK mRNA expression in MM cell lines; CA1 silencing attenuated polymer-induced cell death and improved cell viability. The direction of PTGS1 change was consistent between clinical samples and cell lines, whereas CA1 was downregulated in clinical samples but upregulated after acute polymer exposure. These cell-line findings suggest a potential role for CA1 in polymer-induced cytotoxicity, but they do not establish a causal link to MM progression. This study provides candidate genes and a prognostic framework for further investigation of potential links between polymer degradation products and MM. It does not establish a causal role for PE, PS, or PVC in MM pathogenesis.