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Grand RoundsWeekly Evidence Brief

Hematology

Edition

30-Second Takeaway

  • Venetoclax-based lower-intensity therapy deepens remissions and increases HSCT rates in therapy-related AML, especially with VEN-sensitizing mutations.
  • Standard CHOP-based induction leaves most systemic PTCL patients with poor long-term outcomes, especially non-ALCL subtypes.
  • Pre-emptive daratumumab at asymptomatic biochemical myeloma relapse markedly prolongs event-free and overall survival versus observation.

Week ending February 21, 2026

Targeted and cellular therapies in high-risk hematologic disease: efficacy gains, toxicity signals, and emerging preventive clues

VEN-based lower-intensity therapy enhances remission and HSCT in therapy-related AML

HEMASPHEREFeb 16, 2026

Among 317 adults with therapy-related AML, lower-intensity therapy plus venetoclax achieved higher composite CR than lower-intensity therapy alone (58% vs 40%). Allogeneic HSCT rates were higher with venetoclax, both for lower-intensity regimens (22% vs 7%) and intensive chemotherapy (64% vs 39%). Median OS for the cohort was 8.4 months; lower-intensity venetoclax recipients had median OS 9.0 months. ELN2024 favorable-risk patients on lower-intensity venetoclax reached median OS 25.4 months, with notable survival in NPM1- or IDH-mutated disease.

Prospective LEO-MER cohort exposes CHOP-era limitations in systemic PTCL

BLOOD ADVANCESFeb 18, 2026

In 720 systemic PTCL patients, first-line regimens were CHOP-based in 70%, with autologous HSCT consolidation in only 14%. Higher IPI and PIT scores in nodal PTCL were strongly associated with inferior EFS and OS, reinforcing the prognostic value of these indices. Non-ALCL subtypes had substantially worse EFS and OS than ALCL, with hazard ratios near 3 for both endpoints. Within the contemporary LEO cohort, adding etoposide to CHOP improved OS in ALK-negative ALCL; BV-CHP showed a non-significant favorable OS trend in ALCL.

PREDATOR-BR: daratumumab at biochemical myeloma relapse improves EFS and OS

BRITISH JOURNAL OF HAEMATOLOGYFeb 18, 2026

The randomized PREDATOR-BR trial enrolled 92 myeloma patients with asymptomatic biochemical progression short of significant paraprotein relapse. Daratumumab monotherapy extended median event-free survival to 28.9 months versus 4.0 months with observation (HR 0.25; 95% CI 0.14-0.43). Response rates were 61.0% on daratumumab and 6.8% with observation, indicating substantial biochemical disease control. Twenty-four–month overall survival was 100% with daratumumab versus 70.5% with observation (HR 0.04; 95% CI 0.00-0.34).

US RETRO/PROSPECT registries confirm voxelotor benefits without pain-crisis signal

BLOOD ADVANCESFeb 17, 2026

RETRO and PROSPECT registries captured pre- and post-initiation data in 216 and 265 US sickle cell disease patients receiving voxelotor. Mean hemoglobin rose by about 0.6–0.8 g/dL in RETRO and up to 0.7 g/dL over 54 months in PROSPECT. Reticulocyte counts and bilirubin generally decreased post-voxelotor, indicating reduced hemolysis in routine practice. Annualized acute pain crisis rates were similar pre- and post-voxelotor in RETRO and numerically lower post-voxelotor in PROSPECT.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Genomic selection and HSCT integration meaningfully modify risk in therapy-related AML treated with venetoclax-based lower-intensity regimens.
  • Contemporary PTCL cohorts underscore that non-ALCL disease remains poorly served by CHOP; ALCL gains from etoposide or BV-CHP intensification.
  • Early daratumumab at biochemical myeloma relapse extends disease control without quality-of-life loss, challenging the wait-for-symptoms paradigm.