Issue Archive

Structure and function are the 2 critical knowledge elements that must be combined for complex systems such as occlusive thrombus formation to be understood. Edited by Associate Editor Thomas L. Ortel, this review series focuses on recent advances in resolving macro and molecular structures that have driven the field forward. Covering multiple contributions to thrombosis, eg, platelets, factor XIII, and the contact system, the series also looks to put this new knowledge into the context of future advances in diagnostic and therapeutic tools to enhance normal hemostasis while preventing and treating unwanted thrombosis.

Structure and function are the 2 critical knowledge elements that must be combined for complex systems such as occlusive thrombus formation to be understood. Edited by Associate Editor Thomas L. Ortel, this review series focuses on recent advances in resolving macro and molecular structures that have driven the field forward. Covering multiple contributions to thrombosis, eg, platelets, factor XIII, and the contact system, the series also looks to put this new knowledge into the context of future advances in diagnostic and therapeutic tools to enhance normal hemostasis while preventing and treating unwanted thrombosis.

Structure and function are the 2 critical knowledge elements that must be combined for complex systems such as occlusive thrombus formation to be understood. Edited by Associate Editor Thomas L. Ortel, this review series focuses on recent advances in resolving macro and molecular structures that have driven the field forward. Covering multiple contributions to thrombosis, eg, platelets, factor XIII, and the contact system, the series also looks to put this new knowledge into the context of future advances in diagnostic and therapeutic tools to enhance normal hemostasis while preventing and treating unwanted thrombosis.

Structure and function are the 2 critical knowledge elements that must be combined for complex systems such as occlusive thrombus formation to be understood. Edited by Associate Editor Thomas L. Ortel, this review series focuses on recent advances in resolving macro and molecular structures that have driven the field forward. Covering multiple contributions to thrombosis, eg, platelets, factor XIII, and the contact system, the series also looks to put this new knowledge into the context of future advances in diagnostic and therapeutic tools to enhance normal hemostasis while preventing and treating unwanted thrombosis.

Structure and function are the 2 critical knowledge elements that must be combined for complex systems such as occlusive thrombus formation to be understood. Edited by Associate Editor Thomas L. Ortel, this review series focuses on recent advances in resolving macro and molecular structures that have driven the field forward. Covering multiple contributions to thrombosis, eg, platelets, factor XIII, and the contact system, the series also looks to put this new knowledge into the context of future advances in diagnostic and therapeutic tools to enhance normal hemostasis while preventing and treating unwanted thrombosis.

Structure and function are the 2 critical knowledge elements that must be combined for complex systems such as occlusive thrombus formation to be understood. Edited by Associate Editor Thomas L. Ortel, this review series focuses on recent advances in resolving macro and molecular structures that have driven the field forward. Covering multiple contributions to thrombosis, eg, platelets, factor XIII, and the contact system, the series also looks to put this new knowledge into the context of future advances in diagnostic and therapeutic tools to enhance normal hemostasis while preventing and treating unwanted thrombosis.

Adult T-cell leukemia/lymphoma (ATLL) is an aggressive mature T-cell lymphoid malignancy caused by human T-lymphotropic virus 1. In a phase 2 study, Yoshimitsu et al report that the addition of 2 cycles of the anti-CCR4 antibody mogamulizumab to the standard CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) regimen improves outcomes over historical controls and delivers a 65% complete response rate. Progression-free survival after 1 year was 36%, however, highlighting the ongoing challenge in identifying effective regimens for ATLL, especially for patients who are ineligible for allogeneic transplantation.

There is currently no standard therapy for patients with the recently described VEXAS syndrome (an acronym for vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic). Jachiet and colleagues retrospectively describe their multicenter experience with azacitidine therapy for 88 patients with genetically confirmed VEXAS syndrome, finding that improvements in inflammatory disease, blood counts, or both are achievable in more than 60% of patients and that the median duration of benefit exceeds 5 years with ongoing therapy. These data and the correlative findings of association between reduction in clone size and clinical response provide the most robust evidence to date to guide clinical practice.

Amyloid light chain (AL) amyloidosis arises from a typically small plasma cell clone that produces unstable, toxic light chains, prone to misfolding and aggregation, that form amyloid fibrils. Utilizing single cell multiomics, Gort-Freitas and colleagues reveal that clonal amyloidogenic plasma cells are transcriptionally distinct from either nonmalignant or multiple myeloma plasma cells. They show that the pathogenic cells experience protein production–related toxic stress and provide a description of interactions with cells in the bone marrow microenvironment that drive associated inflammation.

TP53 mutations are common in acute myeloid leukemia (AML) with an erythroid immunophenotype and associated inflammatory state, but mutations in typical AML driver genes are not. Taking a candidate approach and exploiting animal models, Andricovich et al found that compound loss of BAP1, a deubiquitinase, and TP53 enables transformation of a heterogeneous population of erythroid-primed multipotent progenitors and triggers inflammation, mimicking clinical disease. BAP1-deficient erythroleukemia is dependent on BCL-xL expression and sensitive to specific inhibitors, suggesting a potential new therapy for clinical investigation.

For patients at high risk (eg, those with hemoglobinopathies), matching beyond ABO and the D antigens is not readily available, despite its being a proven way to limit alloimmunization and improve patient outcomes. In this month’s CME article, Gleadall et al report the performance of an automated, high-throughput genotyping array to support matching of blood products in an international collaboration covering very ancestrally distinct populations. Their Universal Blood Donor Typing array achieves very high accuracy and reproducibility for extended blood typing across diverse populations, providing a suitable platform for routine application.