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Current Issue
Volume 4,
Issue 4,
February 25, 2020

Featured Content

Blood Advances Editor-in-Chief Search is Open

The American Society of Hematology is looking for its next Editor-in-Chief of Blood Advances. All members of ASH are encouraged to submit a letter of intent if they are interested in the position or provide the name of a potential candidate. 

Outpatient intensive induction chemotherapy for acute myeloid leukemia and high-risk myelodysplastic syndrome

There is a growing movement to transition care from the inpatient to the outpatient setting. Mabrey et al describe a pilot program in Seattle to deliver intensive induction chemotherapy for acute myeloid leukemia and myelodysplastic syndrome at home. If this can be done safely and effectively, it would represent a major change in care delivery and could keep more patients in the comforts of their home. This manuscript discusses the successful pilot program, the attendant risks, and the type of team required to initiate this new approach to care.

Presentation of BK polyomavirus–associated hemorrhagic cystitis after allogeneic hematopoietic cell transplantation

BK virus can cause significant morbidity after transplant. In this detailed retrospective single-center analysis, Imlay and colleagues investigated the natural history of BK viruria, viremia, and hemorrhagic cystitis after transplant. They found that BK-associated hemorrhagic cystitis was associated with long-lasting and sometimes severe symptoms and that our current management strategies are not sufficient. Data from this study will be important to inform end points for future clinical trials.

Patient-reported long-term quality of life after tisagenlecleucel in relapsed/refractory diffuse large B-cell lymphoma

Chimeric antigen receptor (CAR) T cells have resulted in significant clinical responses in patients with often refractory B-cell malignancies, but they are also associated with a number of important toxicities. Maziarz and colleagues report on the first study focusing on patient-reported quality of life after therapy with tisagenlecleucel for relapsed/refractory diffuse large B-cell lymphoma.

Comparing CAR T-cell toxicity grading systems: application of the ASTCT grading system and implications for management

As chimeric antigen receptor (CAR) T cells become an increasingly common therapy for patients with B-cell malignancies, the importance of uniform toxicity grading that can guide management is of paramount importance to the field. Pennisi et al compared the American Society for Transplantation and Cellular Therapy grading system to other grading scores in patients with B-cell malignancies treated with several different CAR T cells. They found that, while different grading systems agreed on the diagnosis of either cytokine release syndrome or immune effector cell associated neurotoxicity syndrome, the grades applied to patients based on different scoring systems were different, and these resulted in different recommendations for management with either tocilizumab or steroids. These differences could potentially result in either overtreating patients or delaying treatment. This study uncovers a need for unifying this important aspect of CAR T-cell therapy.

A 4-gene leukemic stem cell score can independently predict the prognosis of myelodysplastic syndrome patients

In this manuscript, Wang et al describe the application of a score originally developed for acute leukemia to myelodysplastic syndrome (MDS). They found that the expression of 4 genes related to the stemness of leukemia stem cells, LAPTM4B, NGFRAP1, EMP1, and CPXM1, can also provide risk stratification of MDS genes. This discovery could help guide treatment for MDS patients.

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