ARTICLES IN THREE SENTENCES
Monomorphic epitheliotropic intestinal T-cell lymphoma comprises morphologic and genomic heterogeneity impacting outcome
Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), formerly considered as a variant (type II) of enteropathy-associated T-cell lymphoma, is now recognized as a separate entity based on distinct clinicopathological and epidemiological features, unrelated to celiac disease. Veloza and colleagues performed a comprehensive clinical, pathological and genomic study of 71 European MEITL patients. They found that MEITL is an aggressive disease resistant to conventional therapy, predominantly characterized by driver gene alterations deregulating histone methylation and JAK/STAT signaling, and encompassing genetic and morphologic variants associated with very high clinical risk.
Axicabtagene ciloleucel compared to tisagenlecleucel for the treatment of aggressive B-cell lymphoma
Axicabtagene ciloleucel (axi-cel) and tisagenlecleucel (tisa-cel) are CD19-targeted chimeric antigen receptor (CAR) T cells approved for relapsed/refractory large B-cell lymphoma. There are no randomized trials comparing axi-cel and tisa-cel and significant differences in patients’ inclusion criteria and trial design preclude direct comparisons between the results of trials on the single products. Kwon and colleagues performed a retrospective study to evaluate the safety and efficacy of axi-cel and tisa-cel in a real-world setting that help clinicians in product selection. They showed that patients treated with axi-cel experienced more toxicity but similar non-relapse mortality compared with those receiving tisa-cel, while the efficacy of the two products was similar.
The efficacy of combination treatment with elotuzumab and lenalidomide is dependent on crosstalk between natural killer cells, monocytes and myeloma cells
The ELOQUENT-2 clinical study showed improved objective response rates and improved overall survival in patients with refractory relapsed multiple myeloma treated with the combination of elotuzumab and lenalidomide compared to those treated with elotuzumab alone. However, the mechanisms by which the combination improves disease control have not been resolved. The study by Richardson and colleagues revealed for the first time the mechanisms through which elotuzumab and lenalidomide treatment acts, involving complex interactions between myeloma cells, natural killer cells and monocytes.
Mitigation of gastrointestinal graft-versus-host disease with tocilizumab prophylaxis is accompanied by preservation of microbial diversity and attenuation of enterococcal domination
Graft-versus-host disease (GvHD) of the gastrointestinal (GI) tract is a major driver of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). At the same time alterations in intestinal microbiota composition are reproducibly observed in HSCT with an attendant loss of diversity and a shift from anaerobes to facultative aerobes. Chhabra and colleagues present results of a phase II study in which tocilizumab was administered as adjunctive GvHD prophylaxis to patients at high risk of developing GI-tract disease to assess its effect on transplant outcomes and microbial diversity and composition. They conclude that an extended course of tocilizumab is effective at preventing lower GI-tract GvHD, and that loss of microbial diversity and enterococcal domination is attenuated in tocilizumab-treated recipients.
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