{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:03:28Z","timestamp":1793916208673,"version":"4.8.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000054","name":"U.S. Department of Health & Human Services | NIH | National Cancer Institute","doi-asserted-by":"publisher","award":["CA235026"],"award-info":[{"award-number":["CA235026"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"U.S. Department of Health & Human Services | NIH | National Cancer Institute","doi-asserted-by":"publisher","award":["CA258465"],"award-info":[{"award-number":["CA258465"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"U.S. Department of Health & Human Services | NIH | National Institute on Aging","doi-asserted-by":"publisher","award":["AG58266"],"award-info":[{"award-number":["AG58266"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Blood Cancer J."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Monoclonal B-cell lymphocytosis (MBL) and clonal hematopoiesis of indeterminate potential (CHIP) are prevalent clonal precursors associated with increased risk of lymphoid malignancies. However, the relationship between MBL and CHIP and their combined impact on lymphoid malignancy risk remains poorly understood. We screened participants from the Mayo Clinic Biobank to identify MBL using eight-color flow cytometry; CHIP was detected using whole-exome sequencing of whole-blood DNA in 291 genes related to myeloid or lymphoid malignancies. Incident myeloid or lymphoid hematological malignancies were identified using ICD codes and confirmed via medical record review. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI). Cox regression was used to estimate hazard ratios (HR). Analyses were adjusted for age and sex. In 10,067 participants, 15% had MBL, and 9% had CHIP. No evidence of an association between MBL and CHIP (OR\u2009=\u20091.00; 95% CI: 0.82\u20131.20) was observed. With a median follow-up of 5.4 years, 138 participants developed hematological malignancies (94 lymphoid). MBL (HR\u2009=\u20093.48; 95% CI: 2.27\u20135.34;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001) and CHIP (HR\u2009=\u20091.89; 95% CI: 1.10\u20133.27;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.022) were each associated with incident lymphoid malignancy. Compared to individuals with no precursors, the combined presence of MBL and CHIP significantly amplified lymphoma risk (HR\u2009=\u20097.18; 95% CI: 3.33\u201315.47;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001), more than doubling the risk among individuals with MBL alone (HR\u2009=\u20093.30; 95% CI: 2.06\u20135.30;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). In contrast, the risk associated with CHIP alone was attenuated and no longer statistically significant (HR\u2009=\u20091.63; 95% CI: 0.77\u20133.47;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.20). MBL and CHIP are independent hematological precursor conditions. While their combined presence amplifies the risk of lymphoid malignancy, CHIP alone may not be a strong independent risk factor.\n                  <\/jats:p>","DOI":"10.1038\/s41408-025-01385-8","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T15:28:00Z","timestamp":1762442880000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["CHIP amplifies the risk of lymphoid malignancies in individuals with monoclonal B-cell lymphocytosis (MBL)"],"prefix":"10.1038","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6784-2072","authenticated-orcid":false,"given":"Nicholas J.","family":"Boddicker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tait D.","family":"Shanafelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3221-7314","authenticated-orcid":false,"given":"Sameer A.","family":"Parikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7313-1875","authenticated-orcid":false,"given":"Kari G.","family":"Rabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5721-3727","authenticated-orcid":false,"given":"Rosalie","family":"Griffin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4208-2708","authenticated-orcid":false,"given":"Aaron D.","family":"Norman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shulan","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R.","family":"O\u2019Brien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan A.","family":"Vallejo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingma S.","family":"Hoel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey J.","family":"Lehman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4944-7789","authenticated-orcid":false,"given":"Janet E.","family":"Olson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1292-3024","authenticated-orcid":false,"given":"Paul J.","family":"Hampel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3860-4830","authenticated-orcid":false,"given":"Esteban","family":"Braggio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6998-662X","authenticated-orcid":false,"given":"Mrinal M.","family":"Patnaik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7482-178X","authenticated-orcid":false,"given":"James R.","family":"Cerhan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1962-9322","authenticated-orcid":false,"given":"Celine M.","family":"Vachon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis A.","family":"Hanson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5173-4712","authenticated-orcid":false,"given":"Susan L.","family":"Slager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"1385_CR1","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1056\/NEJMoa0806122","volume":"360","author":"O Landgren","year":"2009","unstructured":"Landgren O, Albitar M, Ma W, Abbasi F, Hayes RB, Ghia P, et al. B-cell clones as early markers for chronic lymphocytic leukemia. N Engl J Med. 2009;360:659\u201367.","journal-title":"N Engl J Med"},{"key":"1385_CR2","doi-asserted-by":"publisher","first-page":"2046","DOI":"10.1182\/blood.2020006322","volume":"137","author":"SL Slager","year":"2021","unstructured":"Slager SL, Lanasa MC, Marti GE, Achenbach SJ, Camp NJ, Abbasi F, et al. Natural history of monoclonal B-cell lymphocytosis among relatives in CLL families. Blood. 2021;137:2046\u201356.","journal-title":"Blood"},{"key":"1385_CR3","doi-asserted-by":"publisher","first-page":"1557","DOI":"10.1182\/blood.2021012890","volume":"139","author":"PM Kolijn","year":"2022","unstructured":"Kolijn PM, Hosnijeh FS, Spath F, Hengeveld PJ, Agathangelidis A, Saleh M, et al. High-risk subtypes of chronic lymphocytic leukemia are detectable as early as 16 years prior to diagnosis. Blood. 2022;139:1557\u201363.","journal-title":"Blood"},{"key":"1385_CR4","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1111\/j.1365-2141.2005.05550.x","volume":"130","author":"GE Marti","year":"2005","unstructured":"Marti GE, Rawstron AC, Ghia P, Hillmen P, Houlston RS, Kay N, et al. Diagnostic criteria for monoclonal B-cell lymphocytosis. Br J Haematol. 2005;130:325\u201332.","journal-title":"Br J Haematol"},{"key":"1385_CR5","doi-asserted-by":"publisher","first-page":"2745","DOI":"10.1182\/blood-2017-09-806398","volume":"131","author":"M Hallek","year":"2018","unstructured":"Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Dohner H, et al. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood. 2018;131:2745\u201360.","journal-title":"Blood"},{"key":"1385_CR6","doi-asserted-by":"publisher","first-page":"1720","DOI":"10.1038\/s41375-022-01620-2","volume":"36","author":"R Alaggio","year":"2022","unstructured":"Alaggio R, Amador C, Anagnostopoulos I, Attygalle AD, Araujo IBO, Berti E, et al. The 5th edition of the World Health Organization Classification of Haematolymphoid Tumours: lymphoid neoplasms. Leukemia. 2022;36:1720\u201348.","journal-title":"Leukemia"},{"key":"1385_CR7","doi-asserted-by":"publisher","first-page":"2337","DOI":"10.1182\/blood-2003-09-3277","volume":"103","author":"P Ghia","year":"2004","unstructured":"Ghia P, Prato G, Scielzo C, Stella S, Geuna M, Guida G, et al. Monoclonal CD5+ and CD5- B-lymphocyte expansions are frequent in the peripheral blood of the elderly. Blood. 2004;103:2337\u201342.","journal-title":"Blood"},{"key":"1385_CR8","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1182\/blood-2013-08-523704","volume":"123","author":"YK Shim","year":"2014","unstructured":"Shim YK, Rachel JM, Ghia P, Boren J, Abbasi F, Dagklis A, et al. Monoclonal B-cell lymphocytosis in healthy blood donors: an unexpectedly common finding. Blood. 2014;123:1319\u201326.","journal-title":"Blood"},{"key":"1385_CR9","doi-asserted-by":"publisher","first-page":"1702","DOI":"10.1182\/blood.2022016279","volume":"140","author":"SL Slager","year":"2022","unstructured":"Slager SL, Parikh SA, Achenbach SJ, Norman AD, Rabe KG, Boddicker NJ, et al. Progression and survival of MBL: a screening study of 10 139 individuals. Blood. 2022;140:1702\u20139.","journal-title":"Blood"},{"key":"1385_CR10","doi-asserted-by":"publisher","first-page":"2477","DOI":"10.1056\/NEJMoa1409405","volume":"371","author":"G Genovese","year":"2014","unstructured":"Genovese G, Kahler AK, Handsaker RE, Lindberg J, Rose SA, Bakhoum SF, et al. Clonal hematopoiesis and blood-cancer risk inferred from blood DNA sequence. N Engl J Med. 2014;371:2477\u201387.","journal-title":"N Engl J Med"},{"key":"1385_CR11","doi-asserted-by":"publisher","first-page":"2488","DOI":"10.1056\/NEJMoa1408617","volume":"371","author":"S Jaiswal","year":"2014","unstructured":"Jaiswal S, Fontanillas P, Flannick J, Manning A, Grauman PV, Mar BG, et al. Age-related clonal hematopoiesis associated with adverse outcomes. N Engl J Med. 2014;371:2488\u201398.","journal-title":"N Engl J Med"},{"key":"1385_CR12","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.ajhg.2015.01.011","volume":"96","author":"MJ Machiela","year":"2015","unstructured":"Machiela MJ, Zhou W, Sampson JN, Dean MC, Jacobs KB, Black A, et al. Characterization of large structural genetic mosaicism in human autosomes. Am J Hum Genet. 2015;96:487\u201397.","journal-title":"Am J Hum Genet"},{"key":"1385_CR13","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1182\/blood-2015-03-631747","volume":"126","author":"DP Steensma","year":"2015","unstructured":"Steensma DP, Bejar R, Jaiswal S, Lindsley RC, Sekeres MA, Hasserjian RP, et al. Clonal hematopoiesis of indeterminate potential and its distinction from myelodysplastic syndromes. Blood. 2015;126:9\u201316.","journal-title":"Blood"},{"key":"1385_CR14","doi-asserted-by":"publisher","first-page":"1472","DOI":"10.1038\/nm.3733","volume":"20","author":"M Xie","year":"2014","unstructured":"Xie M, Lu C, Wang J, McLellan MD, Johnson KJ, Wendl MC, et al. Age-related mutations associated with clonal hematopoietic expansion and malignancies. Nat Med. 2014;20:1472\u20138.","journal-title":"Nat Med"},{"key":"1385_CR15","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1038\/s41586-018-0317-6","volume":"559","author":"S Abelson","year":"2018","unstructured":"Abelson S, Collord G, Ng SWK, Weissbrod O, Mendelson Cohen N, Niemeyer E, et al. Prediction of acute myeloid leukaemia risk in healthy individuals. Nature. 2018;559:400\u20134.","journal-title":"Nature"},{"key":"1385_CR16","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1038\/s41591-018-0081-z","volume":"24","author":"P Desai","year":"2018","unstructured":"Desai P, Mencia-Trinchant N, Savenkov O, Simon MS, Cheang G, Lee S, et al. Somatic mutations precede acute myeloid leukemia years before diagnosis. Nat Med. 2018;24:1015\u201323.","journal-title":"Nat Med"},{"key":"1385_CR17","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1038\/s41591-021-01521-4","volume":"27","author":"A Niroula","year":"2021","unstructured":"Niroula A, Sekar A, Murakami MA, Trinder M, Agrawal M, Wong WJ, et al. Distinction of lymphoid and myeloid clonal hematopoiesis. Nat Med. 2021;27:1921\u20137.","journal-title":"Nat Med"},{"key":"1385_CR18","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1038\/s41586-022-05448-9","volume":"612","author":"MD Kessler","year":"2022","unstructured":"Kessler MD, Damask A, O\u2019Keeffe S, Banerjee N, Li D, Watanabe K, et al. Common and rare variant associations with clonal haematopoiesis phenotypes. Nature. 2022;612:301\u20139.","journal-title":"Nature"},{"key":"1385_CR19","doi-asserted-by":"crossref","unstructured":"Olson JE, Ryu E, Hathcock MA, Gupta R, Bublitz JT, Takahashi PY, et al. Characteristics and utilisation of the Mayo Clinic Biobank, a clinic-based prospective collection in the USA: cohort profile. BMJ Open 2019;9.","DOI":"10.1136\/bmjopen-2019-032707"},{"key":"1385_CR20","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1038\/s41375-020-0799-8","volume":"35","author":"TD Shanafelt","year":"2021","unstructured":"Shanafelt TD, Kay NE, Parikh SA, Achenbach SJ, Lesnick CE, Hanson CA, et al. Risk of serious infection among individuals with and without low count monoclonal B-cell lymphocytosis (MBL). Leukemia. 2021;35:239\u201344.","journal-title":"Leukemia"},{"key":"1385_CR21","doi-asserted-by":"publisher","DOI":"10.1038\/s41408-022-00754-x","volume":"12","author":"SA Parikh","year":"2022","unstructured":"Parikh SA, Achenbach SJ, Rabe KG, Norman AD, Boddicker NJ, Olson JE, et al. The risk of coronavirus disease 2019 (COVID-19) among individuals with monoclonal B cell lymphocytosis. Blood Cancer J. 2022;12:159.","journal-title":"Blood Cancer J"},{"key":"1385_CR22","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1038\/s41375-022-01514-3","volume":"36","author":"NJ Boddicker","year":"2022","unstructured":"Boddicker NJ, Achenbach SJ, Parikh SA, Kleinstern G, Braggio E, Norman AD, et al. Associations of history of vaccination and hospitalization due to infection with risk of monoclonal B-cell lymphocytosis. Leukemia. 2022;36:1404\u20137.","journal-title":"Leukemia"},{"key":"1385_CR23","doi-asserted-by":"publisher","first-page":"4153","DOI":"10.1200\/JCO.24.00332","volume":"42","author":"BA Vallejo","year":"2024","unstructured":"Vallejo BA, Ansari A, Parikh SA, Achenbach SJ, Rabe KG, Norman AD, et al. Risk of incident melanoma among individuals with low-count monoclonal B-cell lymphocytosis. J Clin Oncol. 2024;42:4153\u201362.","journal-title":"J Clin Oncol"},{"key":"1385_CR24","doi-asserted-by":"publisher","first-page":"4188","DOI":"10.1182\/blood-2008-09-176149","volume":"113","author":"TD Shanafelt","year":"2009","unstructured":"Shanafelt TD, Kay NE, Jenkins G, Call TG, Zent CS, Jelinek DF, et al. B-cell count and survival: differentiating chronic lymphocytic leukemia from monoclonal B-cell lymphocytosis based on clinical outcome. Blood. 2009;113:4188\u201396.","journal-title":"Blood"},{"key":"1385_CR25","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1038\/nature15395","volume":"526","author":"DA Landau","year":"2015","unstructured":"Landau DA, Tausch E, Taylor-Weiner AN, Stewart C, Reiter JG, Bahlo J, et al. Mutations driving CLL and their evolution in progression and relapse. Nature. 2015;526:525\u201330.","journal-title":"Nature"},{"key":"1385_CR26","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1038\/nature14666","volume":"526","author":"XS Puente","year":"2015","unstructured":"Puente XS, Bea S, Valdes-Mas R, Villamor N, Gutierrez-Abril J, Martin-Subero JI, et al. Non-coding recurrent mutations in chronic lymphocytic leukaemia. Nature. 2015;526:519\u201324.","journal-title":"Nature"},{"key":"1385_CR27","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1002\/ajh.25831","volume":"95","author":"G Kleinstern","year":"2020","unstructured":"Kleinstern G, O\u2019Brien DR, Li X, Tian S, Kabat BF, Rabe KG, et al. Tumor mutational load predicts time to first treatment in chronic lymphocytic leukemia (CLL) and monoclonal B-cell lymphocytosis beyond the CLL international prognostic index. Am J Hematol. 2020;95:906\u201317.","journal-title":"Am J Hematol"},{"key":"1385_CR28","doi-asserted-by":"publisher","first-page":"2118","DOI":"10.1182\/bloodadvances.2023012242","volume":"8","author":"G Kleinstern","year":"2024","unstructured":"Kleinstern G, Boddicker NJ, O\u2019Brien DR, Allmer C, Rabe KG, Norman AD, et al. Tumor mutational load is prognostic for progression to therapy among high-count monoclonal B-cell lymphocytosis. Blood Adv. 2024;8:2118\u201329.","journal-title":"Blood Adv"},{"key":"1385_CR29","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1093\/aje\/kwq482","volume":"173","author":"JL St Sauver","year":"2011","unstructured":"St Sauver JL, Grossardt BR, Yawn BP, Melton LJ 3rd, Rocca WA. Use of a medical records linkage system to enumerate a dynamic population over time: the Rochester epidemiology project. Am J Epidemiol. 2011;173:1059\u201368.","journal-title":"Am J Epidemiol"},{"key":"1385_CR30","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1093\/ije\/dyx268","volume":"47","author":"WA Rocca","year":"2018","unstructured":"Rocca WA, Grossardt BR, Brue SM, Bock-Goodner CM, Chamberlain AM, Wilson PM, et al. Data Resource Profile: expansion of the Rochester Epidemiology Project medical records-linkage system (E-REP). Int J Epidemiol. 2018;47:368\u2013368j.","journal-title":"Int J Epidemiol"},{"key":"1385_CR31","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1038\/s41375-023-01914-z","volume":"37","author":"NJ Boddicker","year":"2023","unstructured":"Boddicker NJ, Parikh SA, Norman AD, Rabe KG, Griffin R, Call TG, et al. Relationship among three common hematological premalignant conditions. Leukemia. 2023;37:1719\u201322.","journal-title":"Leukemia"}],"container-title":["Blood Cancer Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41408-025-01385-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-025-01385-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41408-025-01385-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T15:28:00Z","timestamp":1762442880000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41408-025-01385-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,6]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1385"],"URL":"https:\/\/doi.org\/10.1038\/s41408-025-01385-8","relation":{},"ISSN":["2044-5385"],"issn-type":[{"value":"2044-5385","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,6]]},"assertion":[{"value":"15 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 September 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 September 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 November 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"SAP: Research funding has been provided to the institution from Janssen, AstraZeneca, Merck, and Genentech for clinical studies in which Sameer A. Parikh is a principal investigator. Honoraria have been provided to the institution from Pharmacyclics, Merck, AstraZeneca, Janssen, BeiGene, Genentech, Amgen, MingSight Pharmaceuticals, TG Therapeutics, Novalgen Limited, Kite Pharma, and AbbVie for Sameer A. Parikh\u2019s participation in consulting activities\/advisory board meetings. PJH: Research funding has been provided to the institution from AstraZeneca and BeiGene for clinical studies in which PJH is a principal investigator. Honoraria have been provided to the institution from AbbVie For PJH participation in consulting activities\/advisory board meetings. TDS: Reports receiving grant support from Pharmacyclics, AbbVie, Genentech, and holding a patent (US14\/292,075) on green tea extract epigallocatechin gallate in combination with chemotherapy for chronic lymphocytic leukemia. MP: Research funding from Kura Oncology, Stem Line Pharmaceuticals, Polaris, Epigenetic, and Solutherapeutics. Serves on the advisory board for SOBI, AstraZeneca, and GSK.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"195"}}