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©2019 by the American Society of Hematology

ISSN 1520-4391
eISSN 1520-4383

Hematology, the ASH Education Program, is published annually by the American Society of Hematology (ASH) in one volume per year.

All business correspondence and purchase and reprint requests should be addressed to the American Society of Hematology, 2021 L Street, NW, Suite 900, Washington, DC 20036, USA; phone: 202-776-0544; fax: 202-776-0545; e-mail:

© 2019 by the American Society of Hematology. All rights reserved. Copyright is not claimed in any works of the United States Government. Except as expressly permitted in this statement, no part of this publication may be used (as here in after defined) in any form or by any means now or hereafter known, electronic or mechanical, without permission in writing from the Publisher, the American Society of Hematology. For purposes of this notice, the term “use” includes but is not limited to reproduction, photocopying, storage in a retrieval system, translation, and transmittal. The Publisher hereby consents to the use of this publication or any part hereof for any noncommercial educational purpose within the health field such as classroom instruction and clinical and residency training. This publication or any part thereof may be used for educational purposes at conferences, continuing education courses, and other educational activity, provided no fee or other compensation is charged therefor. All materials so used must acknowledge the Publisher’s copyright therein as “© 2019 by the American Society of Hematology.”

Hematology Rights and Permission 
To request permission to reprint or reuse Hematology articles, figures, or tables, please visit the Hematology page at the Copyright Clearance Center (

Article Citations

Cite articles in this volume by listing Author(s), Title, Hematology Am Soc Hematol Educ Program. 2019;2019:beginning page number-ending page number.

The publisher disclaims responsibility for opinions expressed by the authors.


Adam Cuker, MD, MS
Executive Editor, Hematology 2019
Associate Professor of Medicine
Perelman School of Medicine
University of Pennsylvania
Philadelphia, PA

Mario Cazzola, MD
Deputy Editor, Hematology 2019
Research Group Leader on Myeloid Neoplasms
Fondazione IRCCS Policlinico San Matteo and University of Pavia
Pavia, Italy

Ann LaCasce, MD, MMSc
Deputy Editor, Hematology 2019
Associate Professor of Medicine
Dana-Farber Cancer Institute
Boston, MA

Stella Chou, MD
Deputy Editor, Hematology 2019
Associate Professor of Pediatrics
The Children's Hospital of Philadelphia
University of Pennsylvania
Philadelphia, PA

David Garcia, MD
Special Section Editor, Hematology 2019
Professor of Medicine
University of Washington
Seattle, WA

Committee on Educational Affairs
Michael L. Linenberger, MD (’19) (Chair)
Marc J. Kahn, MD, MBA (’19) (Vice Chair)
Anjali Advani, MD (’18)
Jennifer R. Brown, MD, PhD (’21)
Eldad Dann, MD (’21)
James Foran, MD (’18)
Heidi Klepin, MD (’18)
Casey L. O’Connell, MD (’19)
Heather A. O’Leary, PhD (’19)
Miguel-Angel Perales, MD (’20)
Adriana Seber, MD (’21)
B. Douglas Smith, MD (’19)
Julie Stakiw, MD, FRCPC (’19)
Andrew D. Zelenetz, MD, PhD (’21)

Roy L. Silverstein, MD (President-Elect)
Stephanie J. Lee, MD, MPH (Vice President)
Martin S. Tallman, MD (’21) (Vice President

Adam Cuker, MD, MS (Executive Editor, Hematology, and Senior Executive Editor, ASH-SAP7)
Jessica Altman, MD (Junior Editor, ASH-SAP7)
Elisabeth Battinelli, MD, PhD (2019 Education Program Co-Chair)
Jason Gotlib, MD, MS (2019 Education Program Co-Chair)
Robert A. Brodsky, MD (Secretary)
Molly Weidner Mandernach, MD, MPH (Member, Committee on Practice)


Cover: T cells and brain cancer cell. The image is a composite colored scanning electron micrograph of T cells and an apoptotic brain cancer cell. T cells are a component of the body’s immune system. Chimeric antigen receptor (CAR) T-cell therapy takes T cells from a cancer patient’s blood and modifies them to recognize a specific protein found on the patient’s tumor cells. When reintroduced into the patient, the T cells find and destroy the tumor cells. The newest form of CAR T-cell therapy, now in clinical trials, uses “memory” T cells, which remain in the body after attacking the cancer. The hope is that memory T cells may provide an active reservoir of cancer-killing cells capable of stopping further tumors. Magnification 36000 at 10 cm wide. Source: Steve Gschmeissner/Science Photo Library.

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