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Issue 3, Volume 128

Cover Figure: Persisting long-lived plasma cells after CAR T-cell therapy. See the article by Bhoj et al.

WASHINGTON, July 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.

Clinical and prognostic significance of serum levels of von Willebrand factor and ADAMTS-13 antigens in AL amyloidosis
The authors report that serum von Willebrand factor antigen and ADAMTS-13 levels define an ultrahigh-risk group of patients with immunoglobulin light-chain (AL) amyloidosis.

Complex karyotypes and KRAS and POT1 mutations impact outcome in CLL after chlorambucil-based chemotherapy or chemoimmunotherapy
Herling et al present the first large, prospective clinical trial that integrates cytogenetic, next-generation sequencing (NGS), clinical, and laboratory data into a prognostic analysis in chronic lymphocytic leukemia (CLL). They show that mutations in KRAS or POT1 affect treatment outcome. Their results furnish a strong rationale for incorporating cytogenetic and NGS analyses in clinical practice.

Daratumumab depletes CD38+ immune regulatory cells, promotes T-cell expansion, and skews T-cell repertoire in multiple myeloma
Krejcik and colleagues provide the first clinical data demonstrating unexpected immune-stimulatory activity of the monoclonal antibody daratumumab. The prospect of triggering long-term memory antimyeloma immunity in patients at early stages of the disease offers encouraging potential for prolonged survival and possibly cure.

Persistence of long-lived plasma cells and humoral immunity in individuals responding to CD19-directed CAR T-cell therapy
Despite a maximum half-life for immunoglobulin G of about 1 month, the humoral protection can last for the entire lifetime of the host. Bhoj et al present their findings on longevity of plasma cells and humoral immunity in the absence of B cells in subjects experiencing B-cell aplasia after CD19-directed chimeric antigen receptor (CAR) therapy.

Speed bumps on the road to a chemotherapy-free world for lymphoma patients
With the increasing number of targeted agents for the treatment of patients with lymphoid malignancies comes the promise of safe and effective chemotherapy-free treatment strategies, but there are obstacles on the way.

Idelalisib in the management of lymphoma
Inhibition of the phosphatidylinositol-3-kinase (PI3K) pathway as an anticancer therapeutic strategy has become a reality with the approval of the orally bioavailable small molecule PI3Kδ inhibitor idelalisib. This Blood Spotlight highlights the rationale for targeting the pathway in lymphomas, and the authors describe the preclinical experience with this agent and some of its idiosyncratic toxicities.

Clonal hematopoiesis in acquired aplastic anemia
In a review, Ogawa summarizes recent advances in the current understanding of clonal hematopoiesis and its evolution in aplastic anemia. He further discusses the diagnostic and therapeutic implications of clonal hematopoiesis in aplastic anemia in relation to other clonal hematopoietic diseases.

How I treat patients with a history of heparin-induced thrombocytopenia
Warkentin and Anderson discuss the challenges in the clinical management of patients with a history of heparin-induced thrombocytopenia and offer therapeutic guidance. They present real-life examples of how patients are managed, and they discuss the risks influencing clinical decision making.

Treosulfan-based conditioning for allogeneic HSCT in children with chronic granulomatous disease: a multicenter experience
Morillo-Gutierrez et al report findings from the largest multicenter retrospective study of the use of treosulfan as the primary conditioning agent for hematopoietic stem cell transplantation (HSCT) in children with chronic granulomatous disease. The fact that treosulfan, a low-toxicity alkylating agent, can be used effectively indicates a breakthrough in the treatment of these high-risk patients.

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.

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