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Haematology
15th Jan, 2026
The Lancet
The conduct of thalassaemia-related clinical trials in Lebanon, a nation recently afflicted by armed conflict, reflects the exceptional resilience, ingenuity, and adaptability of its health-care professionals. Despite enduring an escalating threat of armed violence, clinical research in Lebanon has not only survived, but it has also evolved. This Global haematology article outlines how thalassaemia clinical trials were managed under wartime conditions at the Chronic Care Center, a specialised long-term care thalassaemia centre located in Hazmieh, Lebanon, and affiliated with the American University of Beirut in Lebanon.
I was 8 years old when my spleen nearly ruptured. The first sign was not pain but the sudden inability to finish dinner—dangerous ground in a Cypriot immigrant family. My mother rubbed warm olive oil on my abdomen, a home remedy that offered comfort but no cure. Days later we learned my spleen had grown so large it pressed against my stomach, making eating impossible. Despite days in hospital and a transfusion, my greatest relief was being absolved of the cardinal sin of leaving my mother's louví (black eyed peas) unfinished.
“The patient voice, especially when informed and reflective, can illuminate blind spots that data alone cannot,” writes Roanna Maharaj, a patient with β-thalassaemia, emphasising the importance of patients being active participants in decision making, and one of several articles on thalassaemia in this issue of The Lancet Haematology. That there are now multiple treatment options is a testament to the work that has gone into improving outcomes for patients in recent years and is also discussed in a Viewpoint that presents a prioritisation-based matrix for deciding how best to treat transfusion-dependent β-thalassaemia in settings with limited resources.
The development of bispecific antibodies to treat B-cell non-Hodgkin lymphoma has marked a substantial advance that offers new hope for patients. The bispecific T-cell engager epcoritamab joins a growing list of treatments for several lymphoma settings, with encouraging results presented at the American Society of Hematology (ASH) annual meeting. In the EPCORE FL-1 trial, 488 patients with relapsed or refractory follicular lymphoma received lenalidomide and rituximab with and without epcoritamab, with a positive result for the dual primary endpoint of overall response rate and progression-free survival leading to this combination being approved by the US Food and Drug Administration (FDA) on Nov 18, and it joins mosunetuzumab as a bispecific antibody treatment option for this disease setting.
Regional Health – Europe
Stigma from HCPs is a quantifiable contributor of treatment disengagement, representing a direct threat to patient safety and a major contributor to the SUD treatment gap. These findings underscore the urgent need for evidence-based interventions, including training HCPs across all specialties in non-stigmatizing communication, to improve healthcare engagement for this vulnerable population and narrow the substantial treatment gap.
General Medicine
Climate change inflicts substantial economic damage on developing African nations, threatening progress towards the UN Sustainable Development Goals. There are synergies between actions needed to tackle climate change and other ongoing development priorities for Africa, including infectious disease control, facilitating clean energy access, reducing air pollution, tackling malnutrition and food insecurity, and providing universal health coverage. Action to protect human health against climate change needs to be integrated into all systems that are responsible for delivering essential services and implementing policies across all sectors that underpin the attainment of key development priorities for Africa.
Epcoritamab plus R2 resulted in significantly higher response rate and longer progression-free survival versus R2 among participants with follicular lymphoma who had received at least one line of therapy. Epcoritamab plus R2 had more grade 3 or higher adverse events versus R2. Adverse events were manageable and consistent with the established safety profiles of the individual components, with no new safety findings identified. These findings position epcoritamab plus R2 as a new standard of care for second-line or subsequent treatment of follicular lymphoma.
Workowski KA. Zoliflodacin shows benefit as an oral treatment for uncomplicated gonorrhoea. Lancet 2026; 407: 108–109—In the last sentence of the first paragraph in this Comment, the name of the Global Antibiotic Research and Development Partnership has been corrected. In the second paragraph, the 11th sentence has been amended to read: “Microbiological cure rates at the urogenital site were 460 (90·9%, 95% CI 88·1–93·3) of 506 participants for the zoliflodacin group and 229 (96·2%, 92·9–98·3) of 238 participants for the comparator group, with the difference between groups meeting the prespecified non-inferiority margin.” Additionally, the last sentence in the second paragraph has been amended to read: “For the secondary endpoints of microbiological cure at the rectal and pharyngeal sites, 79% of participants in the microbiological intent to treat population and over 90% of participants in the evaluable population in both treatment groups were cured;however, the study was underpowered for extragenital endpoints.” These corrections have been made to the online version as of Jan 8, 2026, and the printed version is correct.
We would like to thank Mustafa Turgut Yildizgören for his Correspondence, which gives us the opportunity to further clarify some of the rationale behind the design choices of the DISTRICTS study and its findings.1 The DISTRICTS trial compared the effectiveness of two treatment strategies for carpal tunnel syndrome: one starting with surgery and one starting with a corticosteroid injection, with the option to receive additional treatments in both strategies if needed.1 We deliberately chose not to impose a strict treatment protocol on participating centres.
We thank Peng Luo and colleagues for their interest in our work and insightful Correspondence regarding our Article on satricabtagene autoleucel (satri-cel).1 Their points on the dynamic nature of claudin-18 isoform 2 (CLDN18.2) expression and the effect of tumour biological heterogeneity are well received and resonated with broader challenges in the field of chimeric antigen receptor (CAR) T-cell therapy in solid tumours.
The Article by Changsong Qi and colleagues,1 on satricabtagene autoleucel (satri-cel), a claudin-18 isoform 2 (CLDN18.2) targeted chimeric antigen receptor (CAR) T-cell therapy, is a crucial milestone in addressing therapeutic stagnation in gastric or gastro-oesophageal junction adenocarcinomas. However, the discussion surrounding biomarker-based patient selection, particularly CLDN18.2 expression, warrants deeper scrutiny.
We thank Guilherme Corrêa de Araújo Moury Fernandes and colleagues for their response to our Seminar,1 and their discussion of the use of platelet-rich plasma for the management of knee osteoarthritis. We agree that not all platelet-rich plasma is equivalent. Platelet-rich plasma is an autologous blood product prepared from patients’ whole blood, comprising platelets, leukocytes, growth factors, and cytokines. Its composition depends on the concentration of the constituents in whole blood, and on the manufacturing procedure, which differs in centrifugation protocol, addition of activators, and other factors.
We read with interest the Seminar by Margreet Kloppenburg and colleagues,1 which provides a comprehensive overview of osteoarthritis. However, we were surprised by the assertion that there is an absence of evidence for the use of platelet-rich plasma for knee osteoarthritis. This conclusion, based primarily on the RESTORE trial,2 overlooks important and recent high-quality data.
Lead poisoning remains one of the world's most significant yet preventable environmental health threats. It accounts for 1·5% of annual global deaths1 and disproportionately affects those in southeast Asia, which has more than 20% of the world's children who are affected by lead.2 In this region, exposure to lead is concentrated in lower-income economies: 1·6% of children in Thailand have blood lead concentrations above the WHO threshold of 5 μg/dL,3 which is similar to high-income countries. By comparison, 79·4% of children in neighbouring Cambodia are estimated to exceed this threshold.
A hospital invoice for a baby's birth in the USA occasionally makes the rounds on social media. For those of us lucky enough to live in the UK with universal health coverage through the National Health Service (NHS), the itemised costings for even a “normal” American delivery seem, frankly, grotesque: the hefty mark-up on a single sanitary pad; dollars for one dose of over-the-counter painkillers; billing for “skin to skin” between mother and baby.
Regional Health – Southeast Asia
Medical Journal
Wiley
Medical News
phys.org
