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B-cell acute lymphoblastic leukemia (B-ALL) is an aggressive hematological malignancy that primarily affects children but can also occur in adults, progressing rapidly and requiring urgent clinical intervention. Late-stage diagnosis often results in reduced survival rates and typically depends on costly, time-intensive diagnostic procedures. Peripheral blood smear (PBS) imaging plays a central role in the preliminary screening of B-ALL and provides an accessible foundation for computer-assisted diagnosis. To support early and efficient classification, this study proposes a lightweight convolutional neural network (CNN) designed to classify B-ALL subtypes directly from PBS images without the need for pre-segmentation. The model is computationally efficient, comprising only 986,126 trainable parameters, and integrates Squeeze-and-Excitation (SE) modules within Inverted Residual Blocks to strengthen feature representation. Experimental results demonstrated excellent classification performance, achieving 100 % accuracy, precision, sensitivity, specificity, F1-score, and Matthews correlation coefficient (MCC). To further assess generalizability, cross-dataset validation was performed on the independent Blood Cells Cancer (ALL) dataset without retraining or fine-tuning, yielding a robust accuracy of 99.85 %. Model interpretability was performed using Gradient-weighted Class Activation Mapping (Grad-CAM) and Local Interpretable Model-agnostic Explanations (LIME), which provided visual explanations and highlighted key discriminative cellular features, respectively. Taken together, these results demonstrate that the proposed framework delivers a highly accurate, resource-efficient, and interpretable solution for B-ALL classification, underscoring its strong potential for integration into real-world clinical practice. Additionally, the implementation code for this study is publicly available at: https://github.com/awazabbas/Efficient-Lightweight-CNN-for-Automated-Classification-of-B-cell-Acute-Lymphoblastic-Leukemia-.
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http://dx.doi.org/10.1016/j.compbiolchem.2025.108645 | DOI Listing |
Leukemia
September 2025
University Children's Hospital Zurich, Pediatric Oncology and Children's Research Center, Zurich, Switzerland.
Acute lymphoblastic leukemia (ALL) preferentially localizes in the bone marrow (BM) and displays recurrent patterns of medullary and extra-medullary involvement. Leukemic cells exploit their niche for propagation and survive selective pressure by chemotherapy in the BM microenvironment, suggesting the existence of protective mechanisms. Here, we established a three-dimensional (3D) BM mimic with human mesenchymal stromal cells and endothelial cells that resemble vasculature-like structures to explore the interdependence of leukemic cells with their microenvironment.
View Article and Find Full Text PDFCurr Med Sci
September 2025
Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Objective: To develop a novel prognostic scoring system for severe cytokine release syndrome (CRS) in patients with B-cell acute lymphoblastic leukemia (B-ALL) treated with anti-CD19 chimeric antigen receptor (CAR)-T-cell therapy, aiming to optimize risk mitigation strategies and improve clinical management.
Methods: This single-center retrospective cohort study included 125 B-ALL patients who received anti-CD19 CAR-T-cell therapy from January 2017 to October 2023. These cases were selected from a cohort of over 500 treated patients on the basis of the availability of comprehensive baseline data, documented CRS grading, and at least 3 months of follow-up.
Eur J Case Rep Intern Med
August 2025
Division of Hematology and Oncology, UNM Comprehensive Cancer Center, Albuquerque, USA.
Background: Blinatumomab and inotuzumab ozogamicin (InO) are B-cell targeted agents used in the frontline and relapsed/refractory treatment of B-cell acute lymphoblastic leukaemia (B-ALL). Blinatumomab, a bispecific T-cell engager that targets CD19 and CD3, and InO, an antibody-drug conjugate targeting CD22, have both shown efficacy. However, recent reports have noted lineage conversion as a complication when these agents are used individually or sequentially.
View Article and Find Full Text PDFAm J Hematol
September 2025
Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, California, USA.
Blinatumomab is approved for the treatment of relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL). Studies have correlated pre-blinatumomab high disease burden (HDB) [> 50% bone marrow blasts (BMB)] with lower response rates and increased risk for toxicities, including cytokine release syndrome (CRS) and neurotoxicity (NT). While the administration of pre-blinatumomab cytoreductive therapy is an appealing approach, larger studies validating the beneficial effect of this strategy in patients with HDB are lacking.
View Article and Find Full Text PDFHum Pathol
September 2025
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
We report 35 patients who had a leukemic phase of diffuse large B-cell lymphoma/high-grade B-cell lymphoma with MYC and BCL2 rearrangements, also known as double-hit lymphoma (DHL). There were 23 men and 12 women with a median age of 57 years (range, 29-82). Eight patients had an established DHL diagnosis and later developed a leukemic phase of disease and 27 presented with DHL and a leukemic phase of disease at initial diagnosis.
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