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BLOOD COMMENTARIES

PLENARY PAPER

In a Plenary Paper, Young et al describe impressive favorable outcomes of emicizumab prophylaxis in children with hemophilia A and factor VIII inhibitors, reporting a 99% reduction in annualized bleeding, with 77% of patients having no treated bleeding events.

REVIEW ARTICLE

Koyama and Hill review the role of the gut microbiome interaction with pretransplant conditioning injury in stimulating graft-versus-host disease.

IMMUNOBIOLOGY AND IMMUNOTHERAPY

Gardner et al report that early intervention with tocilizumab and steroids at the first signs of mild cytokine release syndrome (CRS) following CD19 chimeric antigen receptor (CAR) T-cell infusion for B-cell acute lymphocytic leukemia reduces the development of life-threatening severe CRS without having a negative impact on antileukemic effect.

LYMPHOID NEOPLASIA

One-third of peripheral T-cell lymphomas are “not otherwise specified” (PTCL-NOS), but they have been subdivided into 2 subgroups based on gene expression profiling. Amador and colleagues generated an immunohistochemical algorithm that parallels the molecular separation of PTCL-NOS and provides useful prognostic information.

MYELOID NEOPLASIA

There is increasing evidence that the metabolic regulation of acute myeloid leukemia (AML) cell growth interacts with epigenetic pathways of gene expression and differentiation. Jiang et al link inhibition of glucose metabolism to epigenetic changes and altered transcriptional pathways in leukemic cells and demonstrate synergy between simultaneously targeting metabolism and chromatin modifiers in suppression of AML.

Cohesin mutations are common in myeloid malignancy. Sasca et al elucidate the potential role of cohesin loss in myelodysplastic syndrome and acute myeloid leukemia (MDS/AML). They demonstrate that cohesin binding is critical for erythroid-specific gene expression and that reduction in cohesin impairs terminal erythroid maturation and promotes myeloid malignancy.

THROMBOSIS AND HEMOSTASIS

Prevel and colleagues examined the natural history of thrombotic thrombocytopenic purpura (TTP) in older adults, reporting that the geriatric TTP population experiences delayed diagnosis and more severe neurologic and renal impairment. Older patients also have greater short- and long-term mortality.

LETTERS TO BLOOD

BLOOD WORK

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