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Table of Contents

BLOOD COMMENTARIES

HOW I TREAT

In this How I Treat article, Wierda and Tambaro discuss the rationale for use of venetoclax in patients with chronic lymphocytic leukemia (CLL) in both the first-line and relapsed and refractory treatment settings. They provide practical guidance for the use of this novel agent that targets BCL2.

CLINICAL TRIALS AND OBSERVATIONS

Rowan and colleagues investigated biomarkers in a prospective multicenter cohort study of nonrelapse mortality after allogeneic stem cell transplantation, identifying plasma levels of stimulation-2 (ST2) prior to transplant as prognostic, independent of significant clinical covariates.

In an international effort examining large prospective data sets, Enshaei et al demonstrate that by using a continuous variable analytical approach, a limited set of well-established prognostic factors in childhood acute lymphoblastic leukemia can improve prediction of outcomes compared to current risk stratification approaches.

Human herpesvirus 6B (HHV-6B) frequently reactivates after allogeneic hematopoietic cell transplantation (HCT). In a post hoc analysis of a randomized trial of cytomegalovirus prophylaxis, Hill et al found that brincidofovir prophylaxis reduces HHV-6B reactivation after allogeneic HCT.

IMMUNOBIOLOGY AND IMMUNOTHERAPY

Common variable immunodeficiency is usually considered to be an intrinsic disorder of B-cell development. Troilo and colleagues convincingly show that, in some patients, the defect lies within the bone marrow niche and causes defective B-cell development.

LYMPHOID NEOPLASIA

Treating pediatric acute lymphoblastic leukemia is a challenge in resource-limited countries. Pedrosa and colleagues describe the success of an approach that identifies patients at very low risk of relapse and employs a low-intensity chemotherapy regimen for these patients, achieving excellent efficacy and minimal toxicity.

Yoshida and colleagues report identification of recurrent fusion genes involving CD28 in more than one-third of young Japanese patients with adult T-cell leukemia/lymphoma (ATLL). They suggest that CTLA4-CD28 fusion may be a pathway amenable to therapeutic targeting with CTLA4 blockade.

MYELOID NEOPLASIA

Long and colleagues demonstrate that histone deacetylase 8 (HDAC8) upregulation is an important mechanism through which FLT3-ITD+ acute myeloid leukemia cells can persist during tyrosine kinase inhibitor (TKI) therapy. Their data suggest that combining HDAC8 inhibition with TKI treatment could be a promising strategy to treat tyrosine kinase mutation–harboring leukemias.

THROMBOSIS AND HEMOSTASIS

Seth Chhabra et al describe a new factor VIII (FVIII) variant created through protein engineering that has similar functional activity to recombinant or plasma-derived FVIII but with considerably enhanced pharmacokinetic properties. This may enable convenient scheduling to achieve protection against bleeding in conditions of severe hemostatic challenge.

LETTERS TO BLOOD

BLOOD WORK

ERRATUM

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