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BLOOD COMMENTARIES

PLENARY PAPER

Malaria gametocytes develop in the bone marrow, as only mature parasites circulate and can infect mosquitoes. In a Plenary Paper, the authors elegantly delineate novel aspects of the process of maturation of gametocytes, demonstrating that they infect erythroblasts in the bone marrow niche and delay their maturation to allow for full parasite development.

BLOOD SPOTLIGHT

Vitamin C is a cofactor for TET family enzymes, and loss-of-function mutations are prevalent in hematologic malignancy. In a Blood Spotlight, Yue and Rao review the current understanding of the potential role of vitamin C and TET proteins in clonal hematopoiesis and hematologic malignancy.

CLINICAL TRIALS AND OBSERVATIONS

Arginine, the substrate for nitric oxide production, is deficient in patients with sickle cell vaso-occlusive crisis. Morris et al report improved markers of oxidant stress and mitochondrial stress in platelet-rich plasma from 12 patients treated with intravenous arginine, suggesting that arginine may offer a potential therapeutic intervention for sickle crisis.

IMMUNOBIOLOGY AND IMMUNOTHERAPY

Knockout of the endogenous T-cell receptor (TCR) offers the potential for HLA-mismatched “off-the-shelf” chimeric antigen receptor (CAR) T cells without risking GVHD. Stenger et al show that TCR-negative CAR T cells have strong antitumor activity without GVHD in mice. However, they have reduced persistence, increasing susceptibility to relapse.

LYMPHOID NEOPLASIA

Mantle cell lymphoma (MCL) is characterized by 2 major molecular subtypes, conventional and leukemic nonnodal MCL. In this month’s CME article, Nadeu et al investigate the genomic and epigenomic landscape of MCL to elucidate its complex genetic structure and characterize alterations that help to distinguish MCL subtypes.

THROMBOSIS AND HEMOSTASIS

In a meta-analysis of trials including over 2600 patients, the authors concluded that direct oral anticoagulants are an effective treatment for cancer-associated venous thromboembolism.

TRANSPLANTATION

Acute graft-versus-host-disease (GVHD) is associated with decreased intestinal stem cells (ISCs) and Paneth cells (PCs) following allogeneic hematopoietic cell transplant. In mouse models, treatment with teduglutide, a glucagon-like peptide-2 agonist, improves regeneration of ISCs and PCs and decreases GVHD, providing support for clinical trials of teduglutide for prevention of GVHD.

LETTERS TO BLOOD

BLOOD WORK

ERRATUM

CONTINUING MEDICAL EDUCATION (CME) QUESTIONS

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