Background/Objectives: Methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms may influence folate metabolism and DNA synthesis, potentially affecting disease characteristics and clinical outcomes in hematologic malignancies. This study investigated the associations of MTHFR C677T and A1298C polymorphisms with clinical features and survival outcomes in adult patients with acute lymphoblastic leukemia (ALL) or non-Hodgkin lymphoma (NHL). Methods: A total of 92 adult patients with ALL or NHL treated with standard chemotherapy were retrospectively analyzed. MTHFR C677T and A1298C genotypes were determined using real-time polymerase chain reaction. Associations between genotypes and baseline clinical features, treatment response, toxicity, overall survival (OS), and progression-free survival (PFS) were examined. Results: The C677T heterozygous genotype was significantly associated with the presence of B symptoms (p = 0.027). No significant differences were observed across genotypes with respect to other baseline clinical features, treatment response, or treatment-related toxicity. In the overall cohort (ALL + NHL), OS and PFS did not differ significantly by C677T or A1298C genotypes. However, in the NHL cohort, carriers of the C677T variant demonstrated significantly shorter PFS (p = 0.048) and a non-significant trend toward lower OS. This association was also observed in the DLBCL subgroup for PFS (p = 0.043), with a similar non-significant trend observed for OS. Conclusions: Although MTHFR genotyping appears to have limited value for broad clinical stratification, the observed association between the C677T polymorphism and PFS in NHL—particularly in the DLBCL subgroup—suggests a potential subtype-specific relevance that warrants further validation in larger, disease-specific cohorts.

Objective: As long as immunosuppressive treatments are widely used, careful monitoring of HBVr is essential. We aimed to measure the awareness of Turkish physicians of certain specialties about the risk of hepatitis B virus reactivation (HBVr), HBV screening methods, prophylactic treatment practices and personal experiences in treating patients with biological agents. Methods: An electronic questionnaire link containing 21 questions about demographics and their applications to HBVr was sent to participants working in the various specialties across the country. Results: 227 participants took our survey (Female: 52.4%, n:119, Male: 47.6%, n:108), and consisted of 70 Hematologists, 65 Rheumatologists, 38 Gastroenterologists, 33 Oncologists, and 21 Dermatologists. We obtained extremely different results. It was found that all specialties are aware that the use of biological agents can cause HBVr (97.8%, n:222/227). Biological agents were used in 96% of the participants and HBVr was detected in 53.7% (Hematologist: 74.3%, Rheumatologist: 53.8%, Oncologist: 45.5%, Gastroenterologist: 44.7%, Dermatologist: 14.3%, p< 0.001). The general opinion was that, screening tests should be used (Gastroenterologist: 47.4%, p< 0.001) and 55.1% awared of how to monitor HBVr (Gastroenterologist: 65.8%, p = 0.06). The duration of antiviral prophylaxis was answered correctly in 70.4% (Hematologist: 82.6%, p = 0.01), the parameters of screening tests in 95.2% (Gastroenterologist: 97.4%, p = 0.52) and the highest risk of reactivation in 93% (Rheumatologist: 96.9%, p = 0.15) and the agent with the highest risk of reactivation in 82.8% of participants (Hematologist: 94.3%, p< 0.001). Conclusion: The opinions of different the clinical disciplines vary according to the profile of patients. Gastroenterologists' perspective on HBVr follow-up and treatment differs markedly from that of other clinical disciplines. However, to create general awareness and manage HBVr, guidelines for specific patient groups are definitely needed.