As more biomedical journals around the world institute Web-based electronic submission and publication systems, the dissemination of scientific information worldwide has less respect for national borders. Blood aims to be a venue for the publication of the very best basic and clinical research in hematology from around the world, with no mandate—official or unofficial—to publish more papers emanating from the United States and North America, even though it is owned and published by the American Society of Hematology (ASH). We have strong participation from the international community of hematologists as authors and reviewers and are a truly global publication. Still, some confusion seems to remain. It has stimulated this editorial, in the hope that Blood's submission, editorial, and publication processes will become more transparent to our worldwide community of hematologists.

I would like to emphasize that anyone can submit a paper to Blood. There is no requirement that the corresponding author, or any author, be an ASH member, and there is no need for an ASH member to sponsor a submitted paper. Although ASH owns the journal, the editorial process, peer review, and final decisions are completely independent from the Society, as are our editorial policies. The submission fee for an article is the same for ASH members and nonmembers.

Blood's burgeoning submission rate, in combination with economic and practical limitations on page numbers, means that over the past 5 years a lower percentage of submitted articles were published in comparison to previous acceptance rates. As a result, some unhappy authors of rejected papers, in particular international authors, may be questioning whether their papers were given the same consideration as papers submitted from the United States. I would like to assure the readers that Blood's processes and policies ensure impartiality and fairness.

In 2007, there were 5236 initial article submissions to Blood (including review articles, perspectives, and letters to the editor), of which 1544 were accepted for publication, for an overall acceptance rate of 29%. The number of submissions has increased every year this decade, more than doubling since 1997. More than half (57%) of submitted papers come from outside North America, and 48% of published papers are from outside North America.

The acceptance rate for papers submitted from North America is indeed higher (38% vs 23% for those from outside North America). The decisions are based primarily on recommendations from reviewers, and our statistics show that 58% of reviewers were from outside North America in 2007, exactly the same percentage as the origin of submitted papers during the same time period. Our 100-member editorial board currently has 23 non–North American members. Because the editorial board members are chosen based almost entirely on a record of accepted review requests and on the quality of their reviews, the easiest way to get nominated to this board is to accept review requests and to communicate to the Associate Editor handling your area of expertise your willingness to review papers for Blood.

After 10 years as an Associate Editor and now several months of screening and assigning papers as Editor-in-Chief, I can offer some guidance and suggestions on how international authors can improve their acceptance rate in the future.

First, a proportionally higher number of papers submitted to Blood from outside the United States and North America are clearly outside the scope of the journal, with almost no relevance to clinical or research hematology. Almost daily, the journal receives papers that focus on atherosclerosis, diabetes, inflammatory bowel disease, lupus, or other multisystem autoimmune disorders, cardiac physiology, and a host of other topics. I cannot be sure why these nonhematologic papers more frequently originate from outside North America; perhaps it is because the authors are less familiar with the journal or focus more intensely on the impact factor in choice of submission venue, because Blood has such a high impact factor compared with most other subspecialty biomedical journals. I would recommend carefully checking the Author Guide (especially the sections on scope and on article types) before submission.

Second, we receive many single or small-series case reports from outside North America, in particular from the developing world. Blood cannot accommodate clinical reports that do not offer definitive new insights into disease biology or treatment. It is commendable that authors from institutions with limited resources wish to contribute to the international literature, and in rejecting these types of papers, I make sure to explain Blood's position and encourage the authors to resubmit to more appropriate venues, often with suggestions for improvement of the paper, to increase their chances for successful publication in a more specialized journal.

Third, a minority of papers submitted are written in such poor English that they are literally incomprehensible. In the rejection letter we strongly suggest that the authors obtain professional assistance before possible resubmission to Blood or any other English-language journal. In fact, Blood provides links to multiple language services for non–English-speaking authors to make this process easier.

Papers deemed inappropriate based on any of these 3 factors are immediately rejected by the Editors without a full external peer review, saving the authors time and allowing rapid resubmission to a more appropriate journal. Review of statistics over the past 2 years indicates that the difference in the acceptance rate for North American versus non–North American papers completely disappears if only papers undergoing full peer review are considered.

Feel free to send a presubmission inquiry e-mail to Include the abstract and a brief narrative about the work. Please title your message “Presubmission query to Editor.” Taking advantage of this presubmission process could save time and effort of submitting the article to Blood only to find that the topic is outside our areas of interest, or clearly not novel or high-priority enough to be considered for publication. Presubmission communication is also strongly encouraged for review articles, “Perspectives,” and “How I Treat” submissions, because relevance to readership, lack of overlap with invited or already submitted articles, and timing of submission are particularly critical for successful publication in these categories.

I hope that this message will help prospective authors understand Blood's objectives and the processes leading to publication in the journal. Hematologists and scientists and scientists worldwide are welcome to participate fully in Blood as authors, reviewers, and readers. Only with the help and contributions from the international scientific community can Blood continue its mission to remain a global platform for the exchange of the best scientific research in the field of hematology.