Cancer Research and Treatment

Original Articles

Role of Autologous Stem Cell Transplantation in Transplant-Eligible Dialysis-Dependent Multiple Myeloma Patients: Myungwon Lee, Chang-Ki Min, Ho-Young Yhim, Dok Hyun Yoon, Sang Min Lee, Ho-jin Shin, Jae-Cheol Jo, Jongheon Jung, Yundeok Kim, Jae Hoon Lee, Ji Hyun Lee, Sunghyun Kim, Sung-Hoon Jung, Kihyun Kim; Received May 29, 2026 Accepted August 12, 2026 Published online August 13, 2026; DOI: https://doi.org/10.4143/crt.2026.0585 [Accepted]

Abstract PDF: Purpose
The role of autologous stem cell transplantation (ASCT) in transplant-eligible patients with dialysis-dependent multiple myeloma (DDMM) remains unclear. We compared outcomes between ASCT and non-ASCT approaches in newly diagnosed DDMM.
Materials and Methods
In this multicenter retrospective study, 117 patients with newly diagnosed DDMM who remained dialysis-dependent throughout induction therapy were included. Patients who achieved dialysis independence during induction were excluded. In the ASCT group, patients also remained dialysis-dependent at transplantation.
Results
Post-induction overall response and ≥VGPR rates were comparable between groups. In the ASCT group, responses deepened significantly after transplantation. Among 53 paired-evaluable patients, ≥CR increased from 18.9% before ASCT to 60.4% after ASCT, while ≥VGPR from 52.8% to 83.0%; 67.9% experienced response deepening. In diagnosis-anchored analyses, ASCT was associated with significantly longer progression-free survival (PFS) (median, 39.4 vs. 12.1 months; p<0.001) and overall survival (OS) (median, 71.4 vs. 40.3 months; p=0.020); however, when ASCT was modeled as a time-dependent covariate and adjusted for baseline covariates, neither PFS (HR, 0.63; p=0.122) nor OS (HR, 0.78; p=0.463) remained statistically significant, indicating that the apparent survival advantage should be regarded as hypothesis-generating. Early post-transplant mortality was 5.5%, and non-relapse mortality was 3.6%. Durable dialysis discontinuation occurred in 16.4% and 12.9% of the ASCT and non-ASCT groups, respectively (p=0.611).
Conclusion
In transplant-eligible patients with DDMM, ASCT was feasible and was associated with substantial deepening of response. After accounting for immortal time bias, the apparent survival advantage was attenuated and should be regarded as hypothesis-generating, warranting confirmation in prospective studies.

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A Phase II Study of Bendamustine Plus Rituximab in Patients with Relapsed or Progressive Marginal Zone Lymphoma: KCSG LY14-09: Jeong-Ok Lee, Jinny Park, Hye Jin Kang, Shin Young Hyun, Gyeong-Won Lee, Ho-Young Yhim, Hyo Jung Kim, Jong Seok Lee, Dae Seog Heo, Tae Min Kim; Received August 1, 2025 Accepted December 2, 2025 Published online December 3, 2025; DOI: https://doi.org/10.4143/crt.2025.815 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Purpose
This multicenter, phase II study examined the efficacy and safety of bendamustine plus rituximab in patients with relapsed or progressive marginal zone lymphoma (MZL).
Materials and Methods
Patients received six cycles of bendamustine 90 mg/m² intravenously on day 1 and 2, rituximab 375 mg/m² intravenously in cycle 1, and 1,400 mg subcutaneously in cycles 2-8 on day 1 every 4 weeks. Bendamustine dose reduction to 60 mg/m² (level –1) and 40 mg/m² (level –2) was allowed based on prespecified toxicity criteria. The primary endpoint was overall response rate (ORR) and the secondary endpoints included progression-free survival (PFS), overall survival (OS), and safety.
Results
Among the 26 evaluable patients, 81.8% achieved an ORR, while 40.7% had a complete response. The median PFS was 46.06 months, and the estimated 3-year OS rate was 92.3%. Hematological toxicities, primarily neutropenia (grade 3/4, 48.1%), were the most common adverse events, resulting in both reduction and interruption of bendamustine doses, accounting for 18 (75%) of 24 dose-reduced cycles and 7 (41%) of 17 missed cycles, respectively. Nonhematologic toxicities were generally mild, with nausea and fatigue identified as the most frequently reported toxicities. The mean relative dose intensities were 76.9% (range, 31.5–100) for bendamustine and 91.3% (range, 72.7–100) for rituximab.
Conclusion
Bendamustine plus rituximab is a highly effective and tolerable treatment for patients with relapsed or progressive MZL, providing durable disease control.

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Prognostic Factors for Relapse and the Role of Maintenance Therapy in Acute Promyelocytic Leukemia: A Real-World Multicenter Study in Korea: Kunye Kwak, Mihee Kim, Dongjin Shin, Changgon Kim, Yoon Seok Choi, Ka-Won Kang, Byung Soo Kim, Min Ji Jeon, Eun Sang Yu, Dae Sik Kim, Chul Won Choi, Byung-Hyun Lee, Se Ryeon Lee, Hwa Jung Sung, Chang-Hoon Lee, Seo-Yeon Ahn, Ho-Young Yhim, Jae-Sook Ahn, Yong Park; Received August 26, 2025 Accepted November 6, 2025 Published online November 10, 2025; DOI: https://doi.org/10.4143/crt.2025.929 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub

Purpose
Acute promyelocytic leukemia (APL) is curable, but relapse remains a concern, particularly in patients treated with all-trans retinoic acid (ATRA) and chemotherapy-based regimens. The identification of prognostic factors for relapse is important for enhanced survival outcomes.
Materials and Methods
This retrospective multicenter study analyzed the clinical outcomes and prognostic factors for relapse in 286 Korean patients treated with ATRA and idarubicin-based chemotherapy protocols between 2002 and 2024.
Results
Propensity score-matched analysis revealed key prognostic factors, such as post-consolidation measurable residual disease (MRD) (hazard ratio [HR], 20.16, p < 0.001) and male sex (HR, 5.96; p=0.016). No significant benefit of ATRA-based maintenance therapy was observed in relapse-free survival, compared with observation alone. We also found that FLT3–internal tandem duplication mutations were associated with an increased risk of relapse.
Conclusion
These findings highlight prognostic factors for relapse and the importance of individualized therapeutic strategies for high-risk patients. Moreover, our findings indicate that post-consolidation MRD is the most significant predictor of relapse, emphasizing the need for molecular profiling and longitudinal monitoring. Future prospective studies should validate these prognostic markers and refine personalized therapeutic approaches for APL.

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Induction-phase blood arsenic concentration and relapse risk in pediatric acute promyelocytic leukemia treated with arsenic and all-trans retinoic acid
Qingyuan Xu, Linya Wang, Ning Liao, Mincui Zheng, Yunpeng Dai, Diying Shen, Shaoyan Hu, Li Wang, Qun Hu, Xin Tian, Xiaohuan Wang, Yuanyuan Zhang, Pengli Huang, Jiaole Yu, Ying Wu, Wei Lin, Peijing Qi, Jia Fan, Ruidong Zhang, Yaguang Peng, Huyong Zheng, Hu
Leukemia.2026;[Epub] CrossRef

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Impact of Cell-of-Origin and MYC/BCL2 Status on the Risk of Central Nervous System Relapse in Primary Breast Diffuse Large B-Cell Lymphoma: Chang-Hoon Lee, Ga-Young Song, Ho-Young Yhim, Dok Hyun Yoon, Kyu Yun Jang, Sang Eun Yoon, Jin Seok Kim, Jeong-Ok Lee, Hyeon-Seok Eom, Hyewon Lee, Kyoung Ha Kim, Ka-Won Kang, Young Rok Do, Soon Il Lee, Han Sang Lee, Hyo Jung Kim, Ae Ri Ahn, Deok-Hwan Yang, Won Seog Kim, Jae-Yong Kwak; Received August 5, 2025 Accepted November 3, 2025 Published online November 5, 2025; DOI: https://doi.org/10.4143/crt.2025.836 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Purpose
Primary breast diffuse large B-cell lymphoma (DLBCL) is a rare entity with a distinct relapse pattern involving the central nervous system (CNS). However, data regarding predictors of CNS relapse in this population remain limited.
Materials and Methods
CNS relapse was retrospectively analyzed in two multicenter cohorts comprising 53 patients with newly diagnosed primary breast DLBCL, including a prospective trial and real-world cohort, all treated with rituximab-based immunochemotherapy. The impact of baseline clinical parameters, cell-of-origin, and MYC/BCL2 dual expression (DE) status on CNS relapse was assessed using a multivariate Cox regression model, separately conducted for the overall study set (n=53) and the immunohistochemical study set (n=36).
Results
By the CNS-International Prognostic Index (CNS-IPI), most patients were classified as low or intermediate risk; no patients were classified as high risk. With a median follow-up of 58.8 months, the 4-year risk of CNS relapse was 15.6% in the overall study set and 14.2% in the immunohistochemical set. MYC/BCL2 DE was identified in 14 patients (38.9%) and was significantly associated with increased risk of CNS relapse (4-year risk, 30.7% vs. 0%, p=0.001). Patients with non-germinal center B-cell–like subtype had a numerically higher risk of CNS relapse. However, in multivariate analysis, only MYC/BCL2 DE status was associated with CNS relapse. Synchronous bilateral involvement was also an independent predictor of CNS relapse in both study sets. CNS-IPI was not discriminatory for CNS relapse.
Conclusion
MYC/BCL2 DE and synchronous bilateral breast involvement may help identify patients at higher risk for CNS relapse. Further studies are warranted.

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Hematologic malignancy

Real-World Efficacy and Safety of Teclistamab for Patients with Relapsed or Refractory Multiple Myeloma: Nationwide Retrospective Analysis of the Named Patient Program in Korea: Jun Ho Yi, Jae Hoon Lee, Sung‑Hoon Jung, Ji Hyun Lee, Ji Yun Lee, Kihyun Kim, Sung‑Soo Park, Chang‑Ki Min, Yoon Seok Choi, Min Kyoung Kim, Ho-Young Yhim, Dok Hyun Yoon; Cancer Res Treat. 2026;58(3):971-978. Published online July 30, 2025; DOI: https://doi.org/10.4143/crt.2025.399

Abstract PDF Supplementary Material PubReader ePub

Purpose
The prognosis for heavily pretreated patients with relapsed or refractory multiple myeloma (RRMM) remains poor. Teclistamab, a bispecific antibody targeting B-cell maturation antigen and CD3, has demonstrated deep and durable responses in triple-class–exposed RRMM patients in the MajesTEC-1 trial. To further evaluate the efficacy and safety of teclistamab in Korean patients, we conducted a nationwide retrospective analysis.
Materials and Methods
In August 2022, a Named Patient Program for teclistamab was initiated in Korea. The inclusion and exclusion criteria, dosage, treatment schedule, and dose modification protocols were largely consistent with those of the MajesTEC-1 trial. Retrospective data were collected for 42 patients who participated in the program.
Results
The median age was 67 years (range, 48 to 84 years), and the median number of prior lines of therapy was 6 (range, 3 to 10). Triple- and penta-class refractoriness were observed in 40.5% and 19.0% of patients, respectively. The overall response rate was 66.7% (28/42); 17 patients (40.5%) achieved a complete or deeper response. With a median follow-up of 16.4 months, the median progression-free survival (PFS) was 14.1 months. Patients with revised International Staging System stage III exhibited significantly shorter PFS (3.1 months vs. not reached, p=0.041). The 12-month overall survival rate was 61.7%; disease progression and infection were the most common causes of death. Only one patient experienced grade ≥ 3 cytokine release syndrome (CRS), and no cases of immune effector cell-associated neurotoxicity syndrome were reported. Grade ≥ 3 infections occurred in 42.9% (n=18) of patients and frequently led to treatment interruption (n=18).
Conclusion
Efficacy outcomes including rapid responses, a high response rate, and prolonged survival duration as well as safety profiles, including the incidence of infections, CRS were comparable to those observed in the MajesTEC-1 trial. Given the historically poor outcomes observed in patients with triple-class–exposed RRMM, teclistamab treatment should be strongly considered for these patients.

Citations

Citations to this article as recorded by

Bispecific Antibodies: Strategies Available to Optimize Their Safe Delivery in Patients with Multiple Myeloma
Hannah Victoria Giles, Bhuvan Kishore
Antibodies.2026; 15(1): 5. CrossRef
Real-world incidence of severe infections in multiple myeloma patients receiving bispecific antibodies: a meta-analysis
Federico Spataro, Vanessa Desantis, Hermann Einsele, Franco Dammacco, Angelo Vacca, Roberto Ria, Antonio Giovanni Solimando
Annals of Hematology.2026;[Epub] CrossRef
Efficacy and safety of BCMA- or GPRC5D-directed CD3 bispecific antibodies in relapsed/refractory multiple myeloma: a systematic review and meta-analysis of prospective clinical trials and real-world studies
Jiashun Li, Ainikaer Abulaiti, Deyu Li, Yan Zhao, Paerhati Wahafu, Maerdan Maimaitiming, Shi Qiu, Yuxiang Zhang, Yaqin An, Wenxing Wang, Liangquan Shi, Maihemuti Yakufu, Li Shu, Guohua Li, Zhen Liu
Frontiers in Immunology.2026;[Epub] CrossRef
Infectious toxicities associated with bispecific antibodies and CAR-T Cells in multiple myeloma: a systematic review
Magdalena Benda, Patrick Reimann, Wolfgang Willenbacher, Eberhard Gunsilius, Katja Weisel, Irene Strassl, Maria Theresa Krauth, Stefan Knop, Thomas Winder, Normann Steiner
Annals of Hematology.2026;[Epub] CrossRef

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Validating the Korean Geriatric Assessment Tool in Elderly Multiple Myeloma Patients: A Multicenter Study: Ji Yun Lee, Sang-A Kim, Youngil Koh, Ho-Young Yhim, Gyeong-Won Lee, Chang-Ki Min, Young Rok Do, Hyo Jung Kim, Sung Hwa Bae, Hyeon-Seok Eom, Sung-Hoon Jung, Hyunkyung Park, Seung-Hyun Nam, Ji Hyun Lee, Sung-Hyun Kim, Hyun Jung Lee, Young Seob Park, Soo-Mee Bang; Cancer Res Treat. 2026;58(1):311-319. Published online February 21, 2025; DOI: https://doi.org/10.4143/crt.2025.066

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study evaluates the Korean Cancer Study Group Geriatric Score-7 (KG-7) frailty screening tool’s effectiveness in elderly multiple myeloma (MM) patients to prevent under and overtreatment.
Materials and Methods
This prospective pilot cohort study included 100 elderly patients aged 70 and older with newly diagnosed MM who had not undergone transplantation from August 2020 to January 2022.
Results
The median age was 77 years, and 73.0% of patients were classified at International Staging System stages 2 or 3. Using a 5-point cutoff on the KG-7 index (non-frail, score ≥ 5; frail, score < 5), 31% were categorized as frail. After a median follow-up of 26.8 months, the 3-year overall survival rate was 73.0%. There was no statistically significant association between any frailty index and the risk of death. However, frail patients defined by the simplified frailty index (hazard ratio [HR], 2.49; 95% confidence interval [CI], 1.09 to 5.95; p=0.030) and by KG-7 (HR, 2.43; 95% CI, 1.03 to 5.86; p=0.043) had a significantly higher risk of grade 3-4 non-hematologic toxicity, whereas the International Myeloma Working Group definition did not. Over a 24-month tracking period, vulnerability as measured by KG-7 either improved or deteriorated.
Conclusion
The pilot study, which had a limited number of participants, did not demonstrate KG-7’s effectiveness in predicting survival; however, it successfully predicted severe non-hematologic toxicities. We plan to conduct larger studies in elderly MM patients to determine whether KG-7 can help tailor their treatment regimens.

Citations

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Advances in the application of frailty scoring in the diagnosis and management of elderly patients with multiple myeloma (Review)
Junlun Liu, Danyu Li, Chao Li, Zhuoren Chen
Oncology Reports.2026; 55(5): 1. CrossRef

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Assessing the Efficacy of Bortezomib and Dexamethasone for Induction and Maintenance Therapy in Relapsed/Refractory Cutaneous T-Cell Lymphoma: A Phase II CISL1701/BIC Study: Yoon Seok Choi, Joonho Shim, Ka-Won Kang, Sang Eun Yoon, Jun Sik Hong, Sung Nam Lim, Ho-Young Yhim, Jung Hye Kwon, Gyeong-Won Lee, Deok-Hwan Yang, Sung Yong Oh, Ho-Jin Shin, Hyeon-Seok Eom, Dok Hyun Yoon, Hong Ghi Lee, Seong Hyun Jeong, Won Seog Kim, Seok Jin Kim; Cancer Res Treat. 2025;57(1):267-279. Published online July 16, 2024; DOI: https://doi.org/10.4143/crt.2024.479

Abstract PDF Supplementary Material PubReader ePub

Purpose
This multicenter, open-label, phase II trial evaluated the efficacy and safety of bortezomib combined with dexamethasone for the treatment of relapsed/refractory cutaneous T-cell lymphoma (CTCL) in previously treated patients across 14 institutions in South Korea.
Materials and Methods
Between September 2017 and July 2020, 29 patients with histologically confirmed CTCL received treatment, consisting of eight 4-week cycles of induction therapy followed by maintenance therapy, contingent upon response, for up to one year. The primary endpoint was the proportion of patients achieving an objective global response.
Results
Thirteen of the 29 patients (44.8%) achieved an objective global response, including two complete responses. The median progression-free survival (PFS) was 5.8 months, with responders showing a median PFS of 14.0 months. Treatment-emergent adverse events were generally mild, with a low incidence of peripheral neuropathy and hematologic toxicities. Despite the trend toward shorter PFS in patients with higher mutation burdens, genomic profiling before and after treatment showed no significant emergence of new mutations indicative of disease progression.
Conclusion
This study supports the use of bortezomib and dexamethasone as a viable and safe treatment option for previously treated CTCL, demonstrating substantial efficacy and manageability in adverse effects. Further research with a larger cohort is suggested to validate these findings and explore the prognostic value of mutation profiles.

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Resminostat for maintenance treatment in patients with advanced-stage mycosis fungoides or Sézary syndrome: a multicentre, double-blind, randomised, placebo-controlled, phase 2 trial
Rudolf Stadler, Pietro Quaglino, F J Sherida H Woei-A-Jin, Reinhard Dummer, Christina Mitteldorf, Evangelia Papadavid, Pablo L Ortiz Romero, Emmanuella Guenova, Riichiro Abe, Richard Cowan, Martine Bagot, Stéphane Dalle, Taku Fujimura, Thilo Gambichler, S
The Lancet Haematology.2026; 13(2): e98. CrossRef
Emerging Therapeutic Strategies in Cutaneous T-Cell Lymphoma: A Comprehensive Review of Clinical Trials
Yoni Sacknovitz, Rachel Ma, Christina M. Bear, Maggie H. Zhou, Joshua A. Kent, Larisa J. Geskin
American Journal of Clinical Dermatology.2026; 27(3): 537. CrossRef
A rare collision tumor of lymphoepithelioma-like carcinoma and t-cell lymphoma: a case report
Mengping Zhu, Junyu Zhang
Frontiers in Oncology.2026;[Epub] CrossRef
Influence of Hypoxia on Tumor Heterogeneity, DNA Repair, and Cancer Therapy: From Molecular Insights to Therapeutic Strategies
Dominika Kunachowicz, Paulina Tomecka, Mikołaj Sędzik, Jarosław Kalinin, Jacek Kuźnicki, Nina Rembiałkowska
Cells.2025; 14(14): 1057. CrossRef

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Treatment Outcomes of Rituximab Plus Hyper-CVAD in Korean Patients with Sporadic Burkitt or Burkitt-like Lymphoma: Results of a Multicenter Analysis: Junshik Hong, Seok Jin Kim, Jae-Sook Ahn, Moo Kon Song, Yu Ri Kim, Ho Sup Lee, Ho-Young Yhim, Dok Hyun Yoon, Min Kyoung Kim, Sung Yong Oh, Yong Park, Yeung-Chul Mun, Young Rok Do, Hun-Mo Ryoo, Je-Jung Lee, Jae Hoon Lee, Won Seog Kim, Cheolwon Suh; Cancer Res Treat. 2015;47(2):173-181. Published online October 28, 2014; DOI: https://doi.org/10.4143/crt.2014.055

Abstract PDF PubReader ePub

Purpose
This study was conducted to evaluate outcomes in adult patients with Burkitt lymphoma (BL) or Burkitt-like lymphoma treated with an rituximab plus hyper-CVAD (R-hyper-CVAD) regimen by focusing on tolerability and actual delivered relative dose intensity (RDI).
Materials and Methods
Patients ≥ 20 years of age and pathologically diagnosed with BL or Burkitt-like lymphoma were treated with at least one cycle of R-hyper-CVAD as the first-line treatment in this study. Eligible patients’ case report forms were requested from their physicians to obtain clinical and laboratory data for this retrospective study.
Results
Forty-three patients (median age, 51 years) from 14 medical centers in Korea were analyzed, none of which were infected with human immunodeficiency virus. The majority of patients had advanced diseases, and 24 patients achieved a complete response (75.0%). After a median follow-up period of 20.0 months, 2-year event-free and overall survival rates were 70.9% and 81.4%, respectively. Eleven patients (25.6%) were unable to complete the R-hyper-CVAD regimen, including six patients due to early death. The RDIs of adriamycin, vincristine, methotrexate, and cytarabine were between 60% and 65%, which means less than 25% of patients received greater than 80% of the planned dose of each drug. Poor performance status was related to the lower RDIs of doxorubicin and methotrexate.
Conclusion
R-hyper-CVAD showed excellent treatment outcomes in patients who were suitable for dose-intense chemotherapy. However, management of patients who are intolerant to a dose-intense regimen remains problematic due to the frequent occurrence of treatmentrelated complications.

Citations

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Comparison of chemotherapy regimens plus rituximab in adult Burkitt lymphoma: A single-arm meta-analysis
Xiaoxuan Lu, Yu Liu, Ruyu Liu, Jiaxin Liu, Xiaojing Yan, Liren Qian
Frontiers in Oncology.2022;[Epub] CrossRef
Trends in survival of patients with stage I/II Burkitt lymphoma in the United States: A SEER database analysis
Ze‐Long Liu, Pan‐Pan Liu, Xi‐Wen Bi, De‐Xin Lei, Yu Wang, Zhi‐Ming Li, Wen‐Qi Jiang, Yi Xia
Cancer Medicine.2019; 8(3): 874. CrossRef
ERK-dependent IL-6 positive feedback loop mediates resistance against a combined treatment using danusertib and BKM120 in Burkitt lymphoma cell lines
Jun Liu, Junshik Hong, Kwang-Sung Ahn, Junhyeok Go, Heejoo Han, Jihyun Park, Dongchan Kim, Hyejoo Park, Youngil Koh, Dong-Yeop Shin, Sung-Soo Yoon
Leukemia & Lymphoma.2019; 60(10): 2532. CrossRef
Lymphoma epidemiology in Korea and the real clinical field including the Consortium for Improving Survival of Lymphoma (CISL) trial
Kwai Han Yoo, Hyewon Lee, Cheolwon Suh
International Journal of Hematology.2018; 107(4): 395. CrossRef
Recent advances in treating extra-ocular lymphomas
Lauge Hjorth Mikkelsen, Natacha Storm Würtz, Steffen Heegaard
Expert Review of Ophthalmology.2018; 13(4): 205. CrossRef
The Consortium for Improving Survival of Lymphoma (CISL): recent achievements and future perspective
Cheolwon Suh, Byeong-Bae Park, Won Seog Kim
Blood Research.2017; 52(1): 3. CrossRef
Primary lymphomas in the gastrointestinal tract
Jiang Chen Peng, Lu Zhong, Zhi Hua Ran
Journal of Digestive Diseases.2015; 16(4): 169. CrossRef

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