Background/Objectives: Diffuse large B-cell lymphoma (DLBCL) and high-grade follicular lymphoma (FL) are aggressive B-cell malignancies predominantly affecting older adults. R-CHOP remains the frontline standard of care, with frail and elderly patients requiring attenuated regimens such as R-mini-CHOP. Real-world comparative data in elderly and Hispanic populations remain limited. We aimed to evaluate outcomes of R-mini-CHOP versus R-CHOP in elderly patients and to explore potential differences by ethnicity. Methods: Single-center retrospective analysis of adult patients older than 70 years with DLBCL and high-grade FL, treated between January 2014 and June 2025. Clinical characteristics, treatment responses, and survival outcomes were analyzed. The overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method. Results: A total of 136 patients were included (72 R-mini-CHOP; 64 R-CHOP). Patients receiving R-mini-CHOP were older (median 82 vs. 74 years) and had higher-risk features. Overall response rates were 88.7% and 92.6% in the R-mini-CHOP and R-CHOP groups, respectively. Two-year OS was 79.3% for R-mini-CHOP and 76.7% for R-CHOP. Median OS and PFS were not reached in either group. Elevated lactate dehydrogenase (LDH) was associated with an inferior response. We identified a trend toward better response with R-CHOP in Hispanic patients, although this was not statistically significant. Conclusions: In this real-world cohort, R-mini-CHOP achieved response and survival outcomes comparable to R-CHOP despite worse baseline characteristics. These findings support the use of dose-attenuated therapy in frail and elderly patients and suggest that equitable access to care may mitigate ethnic disparities in outcomes.

Therapy for chronic lymphocytic leukemia (CLL) has evolved dramatically with the introduction of targeted agents, particularly Bruton tyrosine kinase inhibitors (BTKis) and BCL2 inhibitors (BCL2is). This review summarizes contemporary frontline and relapsed/refractory treatment strategies, with an emphasis on molecular risk stratification, combination and triplet regimens, measurable residual disease (MRD)–guided therapy, and time-limited approaches. We further examine how genomic complexity, prior therapies, and sociodemographic factors influence disease progression, treatment resistance, and clinical outcomes.

Background/Objectives: Lymphoma-associated hemophagocytic lymphohistiocytosis (LA-HLH) is a fatal hyperinflammatory syndrome. Non-Hodgkin lymphoma (NHL) is the established primary trigger, while Hodgkin lymphoma (HL) is considered a rare cause. This exploratory study aimed to characterize the features of LA-HLH in a predominantly Hispanic patient population to generate novel pathophysiological hypotheses. Methods: We conducted a retrospective, multicenter analysis of adult patients diagnosed with HLH between 2000 and 2024. Using HLH-2004 criteria, we identified a final cohort of 20 patients with LA-HLH for analysis. Results: In our cohort (70% Hispanic, reflecting the catchment populations of the partic-ipating centers), the most common underlying malignancy was HL (60%), contradicting established literature. Stratification by HIV status suggested two distinct profiles: the HIV-negative group (n=13) was younger and driven almost exclusively by HL (85%), whereas the HIV-positive group (n=7) was older, driven by NHL (86%), and presented with more extreme hyperferritinemia and higher soluble IL-2 receptor (sIL-2R) levels. The overall mortality rate was 57.9%. Conclusions: The unexpected predominance of HL-driven HLH in this cohort suggests a need to re-evaluate the differential diagnosis in specific demographic contexts. Our findings are hypothesis-generating and suggest differing clinicopathological patterns by HIV status and lymphoma subtype; further studies are required to determine whether distinct biological pathways underlie these patterns. Given the retrospective nature and limited sample size, further multicenter studies with uniform laboratory testing and molecular profiling are required to clarify potential biological heterogeneity among LA-HLH presentations.

Background: Accurate identification and classification of white blood cell (WBC) subtypes in peripheral blood smears (PBS) is essential for the diagnosis and monitoring of hematological malignancies, including leukemia. Conventional manual microscopy, although clinically established, is labor-intensive and subject to inter- and intra-observer variability. Deep learning-based object detection offers a route to automation, yet most prior studies are limited by small datasets, restricted cell taxonomies, or single-microscope acquisition. This study evaluates a YOLOv11-large (YOLOv11L) detector for simultaneous localization and classification of 13 leukemia-relevant WBC subtypes plus an artifact class (14 classes total), trained on the large-scale, multi-domain, open-source LeukemiaAttri dataset. Methods: From the LeukemiaAttri dataset, 18,664 annotated images (67,347 objects) acquired at 40× and 100× magnification were partitioned by stratified sampling into training (70%), validation (15%), and test (15%) sets. The training set was expanded to 65,785 images through extensive geometric, photometric, and AugMix augmentation. A YOLOv11L model pretrained on MS COCO was fine-tuned for 250 epochs (640 × 640 input) on a single NVIDIA H200 SXM GPU, using an auto-selected optimizer (momentum 0.9; weight decay 5 × 10⁻⁴), automatic mixed precision (AMP), and mosaic augmentation for the first 240 epochs. Results: On an internal held-out test set, the model achieved an mAP50 of 93.9%, mAP50-95 of 77.9%, precision of 94.1%, recall of 88.8%, and an F1 score of 0.913, with similar performance in the validation and test sets. Class-wise average precision (AP) ranged from 89.3% (monocyte) to 98.2% (monoblast), confirming consistent detection across morphologically diverse subtypes. Conclusions: The YOLOv11L detector achieved high performance across all 14 categories on the internal test set, with metrics exceeding those previously reported for subset-specific baselines. These findings support further evaluation of the model as a decision-support tool for peripheral blood smear analysis. External validation is required to determine its clinical utility and generalizability.