Anticoagulation in pediatric cancer–associated venous thromboembolism: a subgroup analysis of EINSTEIN-Jr
There is a paucity of information about the safety and efficacy of anticoagulation treatment in pediatric patients with cancer. In this report, Palumbo et al leverage the EINSTEIN-Jr randomized study to examine the incidence of venous thromboembolism (VTE) in anticoagulated pediatric patients with cancer. The authors found that anticoagulation is safe and associated with reduced clot burden in most children with cancer-associated VTE, including patients who had anticoagulant treatment interruptions. The results may help guide decisions in this pediatric cancer population.
Efficacy comparison of tisagenlecleucel vs usual care in patients with relapsed or refractory follicular lymphoma
Salles et al address an indirect comparison of the outcomes of patients with follicular lymphoma treated with the CD19 CAR T product tisa-cel (in the setting of a clinical trial) with a real-life cohort of patients. The findings support an advantage for tisa-cel. This is the first publication that indirectly compares the outcomes of patients with follicular lymphoma treated with CAR T cells vs patients receiving standard care.
In this study, Han and colleagues utilize an unbiased CRISPR screen combined with preclinical functional data to show that the CD58-CD2 axis contributes to the resistance of CAR T therapy that occurs in some patients. Specifically, the authors found that disruption of CD58 in tumor cells triggered the formation of a suboptimal immunological synapse that impaired CAR T cells, which was characterized by decreased cell expansion, degranulation, cytokine secretion, and toxicity. This mode of tumor-intrinsic resistance provides a mechanism for the development of therapeutic strategies focused on overcoming resistance to CAR T-cell therapy in B-cell malignancies.
Characterizing the role of the immune microenvironment in multiple myeloma progression at a single-cell level
Schinke et al investigate the alterations within the bone marrow microenvironment that contribute to the progression of multiple myeloma (MM) from its precursor stages. By performing scRNA-seq in bone marrow cells obtained from 8 patients with monoclonal gammopathy of undetermined significance (MGUS), 7 with smoldering MM, and 4 with newly diagnosed MM (NDMM), the authors identified changes in immune populations as the disease progressed...
Dabigatran in the treatment and secondary prophylaxis of venous thromboembolism in children with thrombophilia
The use of direct oral anticoagulants in pediatrics is a very important topic, especially in children with thrombophilia. Here, Brandão et al compare children with thrombophilia vs those without, or an unknown thrombophilia status in a subgroup analysis of pediatric studies where dabigatran was used for the treatment of acute venous thromboembolism (VTE) and the prevention of prolonged secondary VTE. Their findings suggest dabigatran could be an appropriate long-term anticoagulant for children with thrombophilia.
This retrospective study by Cheng and colleagues describes the Vancouver group's experience of older patients with Hodgkin lymphoma over a 51-year period. The cohort is 744 patients. Understanding that much has changed in diagnosis, staging, and treatment during this long period, this article largely focuses on 327 patients treated with curative intent since 2000, many of whom are in the 60-69 age bracket.