Recently, treatments for chronic hepatitis C virus (HCV) infection have significantly improved by the development of direct‑acting antiviral agents (DAAs) and almost all patients with HCV can complete antiviral treatment without apparent adverse events. Malignant lymphoma, particularly B‑cell non‑Hodgkin's lymphoma, is one of the extrahepatic manifestations associated with chronic HCV infection. The effectiveness of anti‑HCV therapy with DAAs for B‑cell non‑Hodgkin's lymphoma has been demonstrated in recent reports, whereas late‑onset B‑cell non‑Hodgkin's lymphoma after HCV eradication with DAAs has occasionally been reported. In the present study, a 77‑year‑old man with chronic hepatitis C and intermediate liver cancer risk received sofosbuvir‑ledipasvir treatment for 12 weeks. Two months following the end of antiviral therapy, he had achieved sustained virologic response for 8 weeks. However, the patient occasionally found swelling of the right cervical lymph nodes without any subjective symptoms. Lymph node biopsy revealed diffuse large B‑cell lymphoma and whole‑body 18F‑fluorodeoxyglucose (FDG) positron emission tomography with computed tomography showed increased FDG uptake in the right cervical, right submandibular, mediastinal and mesenteric lymph nodes. The patient received six courses of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone chemotherapy and achieved complete response at 8 months after chemotherapy initiation. Thus, the development of lymphoid malignancies may arise, even after HCV eradication with DAAs. Therefore, clinicians should be aware of such risks during and after antiviral treatment with DAAs.

Venetoclax plus azacitidine (VEN + AZA) is widely used in acute myeloid leukemia (AML). This study explored the role of static and dynamic profiles of mutational clonal burden to predict outcomes by analyzing marrow samples from 228 VEN + AZA treated AML cases at “Pre-treatment” (n = 228), “Best-response” (n = 105), and “Relapse” (n = 27) phases using targeted-capture sequencing. In a multivariate model, older age, prior AZA, TP53 mutation with variant allele frequency ≥0.10, and RAS-pathway mutations predicted shorter overall survival (OS), while BCORL1 mutation predicted longer OS. Notably, myelodysplasia-related gene mutations, which constitute adverse factors in ELN 2022, predicted favorable survival. Achieving composite complete remission (CRc) significantly predicted longer OS (P < 0.001) but showed residual mutations in 76.2% of the cases. Among CRc cases, relapse-free survival was stratified by molecular clearance of mutations other than DNMT3A, ASXL1, and TET2 (P = 0.04). In addition, 37% of relapsed cases showed a change of major clones, with 40% having potential targets of molecular-targeting treatment. This study revealed the novel prognostic role of myelodysplasia-related gene mutations and established the importance of molecular response assessment in CRc phase.

The optimal second‐line chemotherapy regimen for relapsed or refractory diffuse large B‐cell lymphoma (R/R DLBCL) remains uncertain. We retrospectively compared efficacy and safety between gemcitabine, carboplatin, dexamethasone, and rituximab (GCD‐R) and cyclophosphamide, high‐dose cytarabine, dexamethasone, etoposide, and rituximab (CHASER) as second‐line treatments for R/R DLBCL. We evaluated 68 R/R DLBCL patients receiving either GCD‐R ( n = 42) or CHASER ( n = 26) as second‐line treatment between 2004 and 2020. The primary endpoint was the complete response rate (CRR). Secondary endpoints included overall response rate (ORR), overall survival (OS), progression‐free survival (PFS), and adverse events. CRR (43% vs. 42%; p = 1.00) and ORR (60% vs. 50%; p = 0.46) were comparable between GCD‐R and CHASER groups. Median OS (GCD‐R 18.6 months, CHASER 11.2 months; p = 0.93) and median PFS (GCD‐R 10.0 months, CHASER 4.6 months; p = 0.47) showed no significant differences between groups. Further, among patients who subsequently underwent autologous stem cell transplantation, OS was also comparable between groups ( p = 0.44). However, febrile neutropenia was significantly less frequent with GCD‐R (33%) than with CHASER (92%; p < 0.001). As GCD‐R predominantly uses peripheral intravenous catheters, whereas CHASER frequently requires central venous access, catheter management was significantly simpler with GCD‐R ( p < 0.001). GCD‐R demonstrated equivalent efficacy to CHASER with significantly reduced toxicity and improved patient management, supporting its use as an effective and well‐tolerated salvage therapy for R/R DLBCL. GCD‐R represents a feasible treatment option not only for elderly patients, but also for patients eligible for subsequent stem cell transplantation.

This study investigated the prognostic impact of vitamin D deficiency and reduced skeletal muscle mass in diffuse large B-cell lymphoma (DLBCL) patients. A retrospective analysis of 186 newly diagnosed DLBCL patients from 2012 to 2022 was conducted, measuring serum 25-hydroxyvitamin D [25(OH)D] levels and the skeletal muscle index (SMI). Decreased vitamin D levels were linked to more severe DLBCL disease, with a median 25(OH)D concentration of 13 (4.0–27) ng/mL. Males in the group with a low SMI had a considerably lower 25(OH)D concentration. The optimal threshold of 25(OH)D levels for overall survival (OS) was 9.6 ng/mL, with lower values associated with a higher likelihood of recurrence and mortality. Multivariable analysis showed hazard ratios for OS of 1.4 [95% CI 0.77–2.5] for a low SMI and 3.2 [95% CI 1.8–5.8] for low 25(OH)D concentration. The combination of a low SMI and low vitamin D concentration resulted in the worst prognosis. Thus, low levels of vitamin D associated with disease progression significantly impact DLBCL prognosis, which can be further stratified by the SMI, providing valuable insights for patient management and potential therapeutic interventions.

Background/Objectives: The objective of this retrospective, multicenter cohort study was to compare the incidence of viral load blips between two-drug and three-drug antiretroviral therapy regimens in human immunodeficiency virus (HIV) patients. Methods: A total of 121 patients were included, with 44 receiving two-drug regimens (e.g., dolutegravir/lamivudine) and 77 receiving three-drug regimens (e.g., bictegravir/tenofovir alafenamide/emtricitabine) at the time of analysis. The primary outcome was the occurrence of viral blips, defined as transient HIV-RNA elevations ≥ 50 copies/mL; a sensitivity analysis used ≥20 copies/mL. Results: Generalized estimating equation models adjusted for clinical covariates showed no significant difference in the odds of blip occurrence comparing three-drug with two-drug regimens, both for blips ≥ 50 (odds ratio [OR]: 2.64; 95% confidence interval [CI]: 0.91–7.70; p = 0.075) and ≥20 (OR: 1.76; 95% CI: 0.76–4.08; p = 0.190). In the two- and three-drug groups, the predicted probabilities of blips were 1.4% and 3.7% (p = 0.075) for blips ≥ 50, and 6.9% and 11.5% (p = 0.190) for ≥20, respectively. No virologic failure was observed. Conclusions: These findings suggest that two-drug regimens provide virologic control comparable to three-drug regimens and may be a viable clinical option due to fewer drug interactions, lower toxicity, and reduced cost.