Although chimeric antigen receptor T (CAR-T) cell therapy has been indicated to be effective in treating relapsed or refractory multiple myeloma (R/R MM), severe hematological toxicity (HT) remains an intractable issue. This study enrolled 54 patients with R/R MM following combined infusion of anti-CD19 and anti-BCMA CAR-T cells. The results showed that the rates of severe cytopenia were high, including severe neutropenia (28/54, 52%), severe anemia (15/54, 28%), and severe thrombocytopenia (18/54, 33%). Moreover, the incidence of prolonged HT (PHT) on Day 28 post-infusion was 52% (28/54), including 46% for severe neutropenia, 30% for severe anemia, and 31% for severe thrombocytopenia. Patients with PHT had a poorer median progression-free survival (PFS) and overall survival (OS) than patients without PHT (P=0.011; P=0.007). Furthermore, Cox regression analyses showed that PHT was an independent risk factor for PFS and OS. Univariate analyses showed that IFNγ (OR: 1.046; 95% CI: 1.002-1.093, P=0.042) and severe HT after lymphodepletion chemotherapy (OR: 0.082; 95% CI: 0.017-0.404; P=0.002) were independent risk factors for PHT. In conclusion, these results indicated that PHT was associated with poor outcomes following CAR-T-cell therapy in MM patients. Early detection and management of PHT would be beneficial for the prevention of life-threatening complications and improvement in the survival of patients after CAR-T-cell therapy.Clinical trial registrationThis trial was registered on 1 May 2017 at http://www.chictr.org.cn as ChiCTR-OIC-17011272.

Atopic dermatitis (AD) is one of the most prevalent inflammatory skin diseases. Janus kinase (JAK) inhibitor baricitinib is a promising treatment for AD as shown in recent clinical trials. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) reporting the efficacy and safety of baricitinib. Data analysis was carried out using Cochrane Collaboration Review Manager 5.4 software and performed as risk ratios (RR) with 95% confidence intervals. Six RCTs involving a total of 2595 patients were included in the review. The meta-analysis revealed that patients in the baricitinib group had significantly higher rates achieving EASI75, EASI90, IGA-Response, SCORAD75, and Itch NRS improvement. Pooled analysis also showed no significant differences in treatment of emergent adverse events (TEAEs) between baricitinib and placebo groups. In conclusion, our meta-analysis showed that baricitinib has promising efficacy for moderate-to-severe AD with favourable safety files.

Although chimeric antigen receptor T (CAR-T) cell therapy has proven to be effective in treating relapsed or refractory multiple myeloma (R/R MM), the severity of cytokine release syndrome (CRS) can affect patient survival and the risk factors for CRS remain an intractable issue. We enrolled 54 patients with R/R MM following combined infusion of anti-CD19 and anti-B-cell maturation antigen (BCMA) CAR-T cells. The results showed the overall response rate was 94% (51/54) after CAR-T cell infusion, with a 100% incidence of CRS, including 47 patients with grade 1-2 (mild) CRS and 7 patients with grade 3-5 (severe) CRS. In the mild CRS group, the median progression-free survival (PFS) was 18.2 months (95% CI, 6.5 to 30.1) and the median overall survival (OS) was not reached yet. In the severe CRS group, median PFS and median OS were 1.9 months (95% CI, 0.2 to 3.8). Further analysis demonstrated that severe CRS had a shorter median PFS and OS than mild CRS (p=0.029, p=0.020). Bone marrow tumor burden was found to be independently associated with CRS. The grade of CRS was positively correlated with six serum cytokines levels including G-CSF, IL-6, IL-8, IP-10, MIP-1a and RANTES. In conclusion, early detection and management of CRS are imperative for the prevention of life-threatening complications and improvement in the survival of patients of CAR-T cell therapy.Clinical Trial Registrationwww.chictr.org.cn, identifier ChiCTR-OIC-17011272.

Peripheral T-cell lymphoma accounts for about 10% of all cases of non-Hodgkin’s lymphoma. However, less than 5% of patients with non-Hodgkin’s lymphoma present with hypercalcaemia as the initial symptom, and less than 1% present with primary bone lesions. We herein describe a 76-year-old Chinese man who was diagnosed with primary bone adult T-cell lymphoma with extensive osteolysis, including bone loss in the radius, as the initial manifestation. He had developed severe generalised bone pain and an inability to raise his arms. X-ray examination revealed osteolytic destruction of the forearm with loss of the radial diaphysis. The patient was diagnosed with peripheral T-cell lymphoma based on his immunohistochemical results. He began treatment with the CHOPE chemotherapy regimen, which resulted in significant improvement of his bone pain.

Objective No consensus exists regarding the association between pemphigus and thyroid disease. To explore the relationship between the two conditions by synthesizing the existing data. Methods We performed this review based on PubMed, Embase and Web of Science (from inception to 2022) and used the Newcastle-Ottawa scale for assessing the quality of studies. The outcome was represented by pooled odds ratios (ORs) with 95% confidence intervals (CI). And the publication bias and sensitivity analyses were developed. Results Our analyze finally included six studies containing 17,567 pemphigus patients. Overall, we revealed that pemphigus is significantly associated with hypothyroidism (OR 1.70, 95% CI 1.54–1.87), while not with thyroid cancer (OR 0.93, 95% CI 0.41–2.11) and autoimmune thyroid disease (AITD) (OR 1.64, 95% CI 0.91–2.95). In subgroup analyses, pemphigus was also not associated with Graves’ disease (OR 0.97, 95% CI 0.63–1.49) and Hashimoto’s thyroiditis (OR 1.32, 95% CI 0.88–1.97). Conclusion Our results reveal a significant association between pemphigus and hypothyroidism. Considering other relevant studies, we also speculate that the prevalence of AITD is higher in pemphigus patients than in the general population.