Spotlight Review Article
ARTICLES IN THREE SENTENCES
Intestinal IgA-positive plasma cells are highly sensitive indicators of alloreaction early after allogeneic transplantation and associate with both graft-versus-host disease and relapse-related mortality
Intestinal immunoglobulin A (IgA) is strongly involved in microbiota homeostasis, and microbiota disruption is a major risk factor of acute graft-versus-host disease (GvHD) after allogeneic stem cell transplantation (allo-SCT). Scheidler and colleagues analyzed intestinal IgA+ plasma cells in a series of 430 biopsies obtained from 115 patients after allo-SCT for different hematologic disorders. Results showed a prolonged suppression and deficiency of IgA+ plasma cells in patients with GvHD and revealed an association of increased IgA+ plasma cells with a highly increased relapse-related mortality, suggesting plasma cells are a sensitive target of alloreaction involved in graft-versus-leukemia even beyond overt GvHD.
TET2 mutational status affects myelodysplastic syndrome evolution to chronic myelomonocytic leukemia
A large number of patients with myelodysplastic syndrome (MDS) develop genuine chronic myelomonocytic leukemia (CMML), raising the question of a “pre-CMML” state. Tran Quang and colleagues performed a longitudinal study using a combination of phenotypic, genomic, and functional analyses with the aim of identifying robust predictors of MDS evolution to “overt” CMML. They identified a subset of MDS patients who may eventually develop CMML, revisiting the boundaries between MDS and MDS/MPN, and potentially defining a subgroup of patients with the poorest outcome.
Platelet concentrates are currently stored at room temperature (RT), with increased risk of bacterial contamination, post-transfusion septic reaction, and platelet storage lesions. In this context, alternative storage solutions, like cold storage, have been considered; however, the cold-stored platelets have poorer recovery and survival compared to those stored at RT. In their study, Marini and colleagues analyze apoptotic intracellular mechanisms, and suggest that the combination of cold storage and apoptosis inhibition might be a promising strategy to prolong storage time without impairing hemostatic functions or survival of refrigerated platelets.
Consolidative radiotherapy for residual fluorodeoxyglucose activity on day +30 post CAR T-cell therapy in non-Hodgkin lymphoma
Sustained CAR T efficacy in B-cell non-Hodgkin lymphoma (NHL) is limited, and up to 30% of patients have residual fluorodeoxyglucose (FDG) activity on day +30 post-CAR T; most of them experience disease progression. This study is the first to report on the role of consolidative radio therapy (RT) for residual FDG activity on day +30 post-CAR T in B-cell NHL. Saif and colleagues showed that RT appears to alter the pattern of relapse and improve local recurrence-free survival and progression-free survival, resulting in promising overall survival outcomes.
TAKE ADVANTAGE FROM HAEMATOLOGICA