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Issue 8, Volume 127

Cover Figure: IL-7 increases CD4 T cells in idiopathic CD4 lymphocytopenia.See the article by Sheikh et al.

WASHINGTON, February 25, 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.

The genetic fingerprint of susceptibility for transplant-associated thrombotic microangiopathy
In this week's Blood, Jodele and colleagues demonstrate that transplant-associated thrombotic microangiopathy (TMA) is likely a complement-mediated process. They analyze 17 candidate genes known to play a role in complement activation in 77 patients, of whom 34 had TMA. Gene variants are strongly associated with TMA, and nonwhites have more variants than whites. This may help explain racial disparities in transplant-related mortality; further, it may offer the opportunity to identify patients at high risk of TMA who might benefit from complement inhibition.

Whole-exome sequencing in relapsing chronic lymphocytic leukemia: clinical impact of recurrent RPS15 mutations
In this week's Blood, Ljungström and colleagues present the results of whole-exome sequencing of sequential samples from patients who relapsed following therapy with fludarabine, cyclophosphamide, and rituximab. They report the somewhat unexpected finding that many patients have mutations in the ribosomal subunit gene RPS15. These mutations confer poor prognosis, occur early, and are associated with p53 mutations in about one-third of patients.

Mechanical prophylaxis is a heparin-independent risk for anti-platelet factor 4/heparin antibody formation after orthopedic surgery
There have been reports that spontaneous "heparin-induced thrombocytopenia" can occur, albeit rarely, in patients who have not been exposed to heparin. In this issue of Blood, Bito and colleagues report the results of a prospective seroconversion study of over 2000 patients undergoing total knee arthroplasty, which yields the surprising observation that dynamic mechanical prophylaxis increases the rate of anti-platelet factor 4/heparin antibodies, even in the absence of heparin administration.

Umbilical cord blood-derived T regulatory cells to prevent GVHD: kinetics, toxicity profile, and clinical effect
In this issue, Brunstein and colleagues report on the impact of infusion of ex vivo expanded umbilical cord Tregs on graft-versus-host disease (GVHD). Although the numbers were small (11 patients), there was a striking decrease in grade 2-5 acute GVHD, and no patients developed chronic GVHD. These compelling results reflect successful modification of expansion procedures and lay the groundwork for a more comprehensive study of this intervention that could have a major impact on transplant outcomes.

How I treat extramedullary myeloma
In this week's issue, Touzeau and Moreau discuss the approach to the treatment of extramedullary myeloma. Extramedullary myeloma affects up to 15% of multiple myeloma patients. Using a case-and-comment structure, the authors describe their approach to this challenging and poor-prognosis category of patients with multiple myeloma.

This week's complete table of contents

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Blood (www.bloodjournal.org), 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) (www.hematology.org), 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.

blood® is a registered trademark of the American Society of Hematology.