Blood Podcast Analysis of IELSG37 Trial Results and PF4 in Stem Cell Aging
Dec 4, 2025
In this discussion, Emanuele Zucca, an oncologist and lymphoma expert, delves into the IELSG37 trial, revealing that the standard R-CHOP21 regimen for primary mediastinal B-cell lymphoma may be less effective than hoped. Sen Zhang, a researcher in pharmacology, explores platelet factor 4's critical role in stem cell aging, highlighting how PF4 deficiency accelerates aging traits in stem cells. Both experts emphasize translational implications for improving therapies and rejuvenating aged hematopoietic stem cells, sparking new hope in regenerative medicine.
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CHOP21 Shows Inferior Metabolic Responses
- CHOP21 produced significantly higher rates of residual PET positivity (Deauville score 5) versus CHOP14 and DA-EPOCH-R in PMBCL patients.
- Emanuele Zucca concludes CHOP21 is likely suboptimal and should be avoided when possible in this young population.
Prefer Accelerated Or Dose-Adjusted Regimens
- Avoid CHOP21 for frontline therapy in primary mediastinal B-cell lymphoma when alternatives are available.
- Prefer CHOP14 or DA-EPOCH-R to reduce need for additional treatment and late sequelae in young patients.
PET+ Might Overcall True Treatment Failure
- PET Deauville scores overcall some treatment failures; about half with score 5 can still be cured with additional therapy.
- Emanuele Zucca plans to use ctDNA to distinguish true failures from false PET positives in future studies.