Issue Archive

Merz and Achebe argue persuasively for abandoning the term “benign ethnic neutropenia” to describe the normal neutrophil counts in selected populations with origins in Africa and the Arabian Peninsula. To describe the normal neutrophil count in certain populations as “neutropenia” applies a pathologic label to a normal phenomenon and reflects patterns of systemic racism within our health care system.

Two papers in this issue document the changing landscape of multiple myeloma in the wake of improved therapies. In the first, investigators from the PETHEMA group report on minimal residual disease (MRD) in multiple myeloma. Although MRD negativity is achieved in a higher percentage of standard-risk than high-risk patients, MRD negativity in both groups is associated with equivalent relapse-free and overall survival. Residual MRD-positive myeloma cells show divergent mutational patterns in high- and low-risk patients, potentially explaining the worse prognosis in the latter group. In a timely Blood Spotlight review, Corre et al discuss how observations like these demand a revision of the evaluation of disease risk in myeloma.

The excellent long-term outcomes of children with low-risk acute lymphoblastic leukemia have led investigators to try to decrease therapy in order to reduce long-term toxicity. The authors present data on 200 children with postinduction MRD of <0.01% who were treated with reduced-intensity therapy, documenting excellent outcomes, especially in those patients with MRD of <0.001%.

Integrin engagement is critical to the process of leukocyte trafficking to sites of infection. The authors demonstrate that kindlin-3 recruitment precedes and is necessary for high-affinity β₂-integrin binding enabling neutrophil arrest.

Bobillo et al performed a retrospective analysis of early-stage diffuse large B-cell lymphoma (DLBCL) in the rituximab era. Although overall outcomes are excellent, extranodal DLBCL has inferior survival, and patients benefit from radiotherapy in the setting of positive positron emission tomography findings after chemoimmunotherapy.

Two papers in this issue document the changing landscape of multiple myeloma in the wake of improved therapies. In the first, investigators from the PETHEMA group report on minimal residual disease (MRD) in multiple myeloma. Although MRD negativity is achieved in a higher percentage of standard-risk than high-risk patients, MRD negativity in both groups is associated with equivalent relapse-free and overall survival. Residual MRD-positive myeloma cells show divergent mutational patterns in high- and low-risk patients, potentially explaining the worse prognosis in the latter group. In a timely Blood Spotlight review, Corre et al discuss how observations like these demand a revision of the evaluation of disease risk in myeloma.

Through a series of studies in mice, Yoshino and colleagues elucidate the interaction of Trib1 and Hoxa9 in leukemogenesis. They demonstrate that Trib1 induces leukemia through degradation of the transcription factor C/EBPα and modification of Hoxa9-associated superenhancers, suggesting Trib1 inhibition as a potential targeted therapy for acute myeloid leukemia.

Ansell et al report the characteristics of a novel anticoagulant reversal agent, ciraparantag, which binds noncovalently to heparin, low-molecular-weight heparin, and direct oral anticoagulants. This “universal” anticoagulant reversal agent has a rapid onset of action and a short half-life, but in animals and normal volunteers it durably reverses anticoagulation, with normal whole-blood clotting times documented for 24 hours.

Graft-versus-host disease (GVHD) continues to be a leading cause of morbidity and mortality complicating allogeneic hematopoietic stem cell transplantation, and definitive diagnosis often requires invasive tissue sampling. Assmann et al demonstrate the value of in vivo imaging of glycolysis for detection of activated T-cell trafficking to target organs, offering potential for noninvasive diagnosis of GVHD.