Issue 16, Volume 127

Cover Figure: Intrinsic CNS tropism of BCP-ALL blasts.  See the article by Williams et al.

WASHINGTON, April 21, 2016 – Welcome to “This Week in Blood,” a weekly snapshot of the hottest studies from each week’s issue of Blood, the official journal of the American Society of Hematology (ASH), hand-picked by Blood Editor-in-Chief Bob Löwenberg, MD, PhD, and Deputy Editor Nancy Berliner, MD.

Reducing the hospital burden of heparin-induced thrombocytopenia: impact of an avoid-heparin program
In this week’s Blood, McGowan and colleagues report the outcomes and cost-effectiveness of a hospital-wide strategy to replace unfractionated heparin (UFH) with low-molecular-weight heparin (LMWH) for prophylactic and therapeutic indications. They report that the use of LMWH markedly reduces the rate of heparin-induced thrombocytopenia (HIT), with a vast cost savings reflecting decreased HIT-related expenditures.

Large B-cell transformation in nodular lymphocyte-predominant Hodgkin lymphoma: 40-year experience from a single institution
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a very rare subtype of HL that is often diagnosed at an older age and tends to follow an indolent course but is associated with late relapse and transformation to diffuse large B-cell lymphoma. In this month’s CME article in Blood, Kenderian and colleagues report on a large cohort of patients with NLPHL from the Mayo Clinic, demonstrating that the risk of transformation is lower than expected and that transformation does not have a negative impact on survival.

The clinical significance of EBV DNA in the plasma and peripheral blood mononuclear cells of patients with or without EBV diseases
Kanakry and colleagues examine the diagnostic power of detection of Epstein-Barr virus (EBV) DNA in plasma versus peripheral blood mononuclear cells to diagnose EBV+ DNA. Reviewing results of over 2000 samples from a largely immunocompromised hospital population, they report that detection of cell-free EBV DNA in plasma is more sensitive and specific for the diagnosis of EBV+ disease.

HIF-1α regulates the interaction of chronic lymphocytic leukemia cells with the tumor microenvironment
Valsecchi and colleagues demonstrate that HIF-1α is an important regulator of the interaction between chronic lymphocytic leukemia (CLL) cells and the tumor microenvironment. Inactivation of HIF1α impairs CLL cell adhesion to stroma and reduces bone marrow and spleen colonization, prolonging survival in a xenograft model. This emphasizes the role of HIF-1α in CLL pathogenesis and elucidates a novel potential therapeutic target for the disease.

Risk factors predictive of occult cancer detection in patients with unprovoked venous thromboembolism
Ihaddadene and colleagues assess the risk of cancer detection in patients with unprovoked venous thromboembolism (VTE). They identify age, prior provoked VTE, and smoking as important predictors of occult cancer in patients with unprovoked VTE; the presence of any of these risk factors was associated with a 4-fold increased risk of a future cancer diagnosis. This may highlight a subset of patients with unprovoked VTE who may benefit from further cancer screening.

Silent cerebral infarcts and cerebral aneurysms are prevalent in adults with sickle cell anemia
Silent cerebral infarcts (SCIs) have been previously reported to occur in up to 39% of children with sickle cell disease (SCD), but little is known about its prevalence in adults. In a letter to Blood, Kassim and colleagues report that the prevalence of SCIs in adults with SCD is as high as 50%, suggesting that cerebral ischemia continues to be an important issue in adults with the disease.


This week's complete table of contents

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Blood (, the most cited peer-reviewed publication in the field of hematology, is available weekly in print and online. Blood is the official journal of the American Society of Hematology (ASH) (, the world’s largest professional society concerned with the causes and treatment of blood disorders.

ASH’s mission is to further the understanding, diagnosis, treatment, and prevention of disorders affecting blood, bone marrow, and the immunologic, hemostatic, and vascular systems by promoting research, clinical care, education, training, and advocacy in hematology.

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