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Objectives: Impaired B‐cell reconstitution after allogeneic hematopoietic cell transplantation (allo‐HCT) contributes to the pathogenesis of chronic graft‐versus‐host disease (cGVHD). Therefore, methods to consistently achieve effective B cell lymphogenesis are required. We assessed the long‐term effects of posttransplantation cyclophosphamide (PTCy) use on immune reconstitution in clinical settings, an emerging strategy to suppress allogeneic immunological inflammation early after allo‐HCT and prevent subsequent GVHD. Methods: We comprehensively analyzed peripheral immune cell subsets and measured serum immunoglobulin G (IgG) or cytokine levels in 39 patients who survived for >1 year after allo‐HCT. Results: The absolute counts of B1 and IgM memory B cells were significantly lower in patients with severe cGVHD than in those without. The absolute count and percentage (among total CD19+ B cells) of switched memory B cells and serum IgG levels were significantly higher in patients transplanted with PTCy than in those transplanted with conventional GVHD prophylaxis. Interestingly, increased percentages of switched memory B cells and serum IgG levels were observed only in patients transplanted with PTCy and not in those transplanted with umbilical cord blood. Conclusions: PTCy administration can mediate favorable memory B‐cell reconstitution long after allo‐HCT and may therefore suppress cGVHD. [ABSTRACT FROM AUTHOR]

Low‐dose imatinib with monitoring of drug concentrations in blood may successfully control Philadelphia chromosome‐positive mixed phenotype acute leukemia (Ph+MPAL), particularly in elderly patients with comorbidities. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We examined the prognostic factors to validate previous prognostic models for survival and thrombosis with large‐scale data on Japanese patients with essential thrombocythemia (ET). Method: We conducted a study in 352 patients with ET to validate previous prognostic models and search for new prognostic factors. Results: The International Prognostic Score for essential thrombocythemia (IPSET), the conventional risk classification and the International Prognostic Score for thrombosis in essential thrombocythemia (IPSET‐T) were confirmed to be reproducible in Japanese patients. However, no significant difference was observed between the low‐risk and intermediate‐risk categories according to the revised IPSET‐T, which does not allow direct comparison of the four risk groups. We reevaluated the risk using a modified revised IPSET‐T, which was derived from the revised IPSET‐T by scoring the factors as follows: one point for age > 60 years, two points for past history of thrombosis, two points for JAK2 gene mutation‐positive; total points of 0 = very low risk, 1 =  low risk, 2 =  intermediate risk, 3 and above = high risk, with significantly different thrombosis‐free survival. Conclusion: The modified revised IPSET‐T has been useful for 4‐group stratification to predict a population that requires therapeutic intervention, irrespective of the treatment regimens. [ABSTRACT FROM AUTHOR]

Background: The treatment strategy for diffuse large B-cell lymphoma (DLBCL) in elderly patients is problematic. Although several researchers have reported the effectiveness of comprehensive geriatric assessment (CGA) and the futility of curative treatment in 'unfit' patients with DLBCL, these propositions are not firmly established. Patients and methods: We conducted a retrospective analysis using a database. Patients with DLBCL were eligible if ≧ 60 yr old. CGA stratification was performed using medical records. Results: One hundred and 35 patients were identified. Anthracycline-based chemotherapy with curative intent was performed in 115 (85%) patients. According to CGA, 82 (61%) patients were classified as 'fit'. Their 1-yr overall survival (OS) was significantly better than that of 'unfit' patients [91.3% vs. 53.8%, P < 0.001]. Patients classified as 'unfit' treated with curative intent had a significantly better 1-yr OS when compared with those receiving palliative measures [66.1% vs. 19.0%, P < 0.001]. Conclusions: CGA is an effective tool for predicting outcomes in older patients with DLBCL. The patients treated with curative intent had significantly better outcomes compared with those receiving palliation, irrespective of CGA stratification. Curative treatment should be considered even for 'unfit' patients. [ABSTRACT FROM AUTHOR]