HaematologicaPub Date : 2025-10-09DOI: 10.3324/haematol.2025.288058
Kristin C Marr,Terry Tang,Jonathan Simkin,Jewon Kim,Andrea C Lo,Diego Villa,Alina S Gerrie,Greg Hapgood,David W Scott,Laurie H Sehn,Ryan R Woods,Kerry J Savage
{"title":"Long-term cardiac morbidity in adolescent and young adult survivors of classical Hodgkin lymphoma: the British Columbia experience.","authors":"Kristin C Marr,Terry Tang,Jonathan Simkin,Jewon Kim,Andrea C Lo,Diego Villa,Alina S Gerrie,Greg Hapgood,David W Scott,Laurie H Sehn,Ryan R Woods,Kerry J Savage","doi":"10.3324/haematol.2025.288058","DOIUrl":"https://doi.org/10.3324/haematol.2025.288058","url":null,"abstract":"Adolescents and young adults (AYA) with classic Hodgkin lymphoma (cHL) have excellent survival outcomes, however the late effects of treatment, including cardiovascular disease (CVD), can impact long-term disease-free morbidity and mortality. Using population-level administrative data, we evaluated rates of CVD in 2-year AYA survivors of cHL, aged 16-39 years, treated with ABVD or equivalent chemotherapy, with or without radiotherapy (RT). With a median follow up of 17 years (range 2.3-29 years), risk of CVD was 2.9-fold higher relative to controls, with a 5.2-fold risk of heart failure (HF) and 2.4-fold risk of ischemic heart disease (IHD). Risk of HF was associated with anthracycline-containing chemotherapy regimens alone or with combined modality therapy; whereas higher IHD risk was identified only in those treated with RT. At 20 years after the most recent cHL diagnosis or relapse, the cumulative incidence (CI) of HF was 4.3% in cases vs 0.8% in controls; and for IHD was 8.3% in cases vs 2.8% in controls. Treatment after 2005 using a PET scan guided approach reduced the overall use of RT (56.0% < 2005 vs 14.9% > 2005), and was associated with a lower 15-year CI of IHD (< 2005: 3.4% (95% CI 1.8-5.1%), > 2005: 0.7% (95% CI 0-1.7%) with the latter era comparable to controls; (1.6% (95% CI 1.3-1.9%)). cHL survivors had increased 20-year cumulative mortality above that of age-matched controls (5.0% vs 2.0%). These results can inform surveillance strategies, screening guidelines, and recommendations for risk factor modification for AYA cHL survivors.","PeriodicalId":12964,"journal":{"name":"Haematologica","volume":"22 1","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Platelets-driven monocyte activation promotes hypoxic thromboinflammation through the HIF-1α-NLRP3-EGR-1 axis.","authors":"Shankar Chanchal,Kashika Singh,Raishal Safdar,Syed Mohd,Tashi Thinlas,Sayeed Ahmad,Tathagata Chatterjee,Mohammad Zahid Ashraf","doi":"10.3324/haematol.2025.287317","DOIUrl":"https://doi.org/10.3324/haematol.2025.287317","url":null,"abstract":"Hypoxia exacerbates thromboembolism and sterile inflammation through NLRP3 inflammasome, which is directly activated by HIF-1α that plays a pivotal role in potentiating deep vein thrombosis (DVT). One of the clinical manifestations of thromboinflammation is DVT, characterized by formation and propagation of clot in the lower extremity of the body. The underlying inflammatory milieu promotes immune cell recruitment and platelet hyperactivation, further promoting a prothrombotic state. However, the intricate relationship between hypoxia, thromboembolism, and sterile inflammation is not fully understood. To address this knowledge gap, we integrated in vitro cell lines, ex vivo human primary blood mononuclear cells (hPBMCs), in vivo animal models, and human patient-based studies to uncover the role of cellular interactions in driving hypoxia-induced thrombosis. We identified the early mechanistic insights and subsequently tested the translational potential in human samples who developed DVT at high altitudes (altitude >11,000 feet). Our investigation revealed that hypoxia increased monocyte adhesion to endothelial surface, mediated through CD11a/CD18 (β2 integrin) and F11R (Junctional adhesion molecule-1; JAM-1). We identified the significance of the HIF-1α- NLRP3-Egr1-TF/FVII axis in inflammation-induced coagulation under sterile conditions operating through NLRP3 elevating Egr-1, which subsequently augments tissue factor. This axis increases platelet hyperactivation and platelets' association amplifying thromboinflammation. Human patients who developed high altitude thrombosis revealed enhanced HIF-1α, NLRP3, Egr1, and TF/FVII levels, confirming clinical relevance. Finally, abrogating these molecules either with pharmacological inhibitors or siRNAs have demonstrated a potential to reverse these pathophysiological processes. These finding identify the HIF-1α-NLRP3-Egr1-TF/FVII axis as a potential therapeutic target for mitigating hypoxia induced thromboinflammation.","PeriodicalId":12964,"journal":{"name":"Haematologica","volume":"7 1","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HaematologicaPub Date : 2025-10-09DOI: 10.3324/haematol.2025.289205
Jayastu Senapati,Naval G Daver
{"title":"Response to Comment on: Clinical interrogation of TP53 aberrations and its impact on survival in patients with myeloid neoplasms.","authors":"Jayastu Senapati,Naval G Daver","doi":"10.3324/haematol.2025.289205","DOIUrl":"https://doi.org/10.3324/haematol.2025.289205","url":null,"abstract":"Not available.","PeriodicalId":12964,"journal":{"name":"Haematologica","volume":"8 1","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HaematologicaPub Date : 2025-10-09DOI: 10.3324/haematol.2025.288479
Hamza Sajid
{"title":"Comment on: Clinical interrogation of TP53 aberrations and its impact on survival in patients with myeloid neoplasms.","authors":"Hamza Sajid","doi":"10.3324/haematol.2025.288479","DOIUrl":"https://doi.org/10.3324/haematol.2025.288479","url":null,"abstract":"<p><p>Not available.</p>","PeriodicalId":12964,"journal":{"name":"Haematologica","volume":" ","pages":""},"PeriodicalIF":7.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HaematologicaPub Date : 2025-10-09DOI: 10.3324/haematol.2025.287793
Adi Sherban,Ofir Wolach
{"title":"Acute leukemia of ambiguous lineage: the known and the uncertain.","authors":"Adi Sherban,Ofir Wolach","doi":"10.3324/haematol.2025.287793","DOIUrl":"https://doi.org/10.3324/haematol.2025.287793","url":null,"abstract":"Acute leukemia of ambiguous lineage (ALAL) is a rare, high-risk form of acute leukemia. It is characterized by the inability to assign a single lineage of differentiation to the leukemia and can manifest with more than one lineage-defining marker, called mixed phenotype acute leukemia (MPAL), or the complete absence of such markers, defined as acute undifferentiated leukemia (AUL). Recent genetic, epigenetic and metabolic insights refine diagnostic frameworks, inform classification and risk-stratification, and expose potential targetable vulnerabilities. However, the rarity and heterogeneous manifestations of ALAL result in ongoing diagnostic and therapeutic uncertainty. The most recent World Health Organization (WHO) and International Consensus Classification (ICC) manuscripts provide a pragmatic framework integrating immunophenotypic and genetic criteria for classification, with recognition of specific somatic genetic alterations that define disease biology. These include rearrangements involving BCR::ABL1, KMT2A, ZNF384, and BCL11B activation. Current evidence supports the use of ALL-type induction regimens (with the addition of tyrosine kinase inhibitors (TKI) for Philadelphia-positive MPAL) over AML or hybrid approaches. For AUL the optimal therapeutic approach is uncertain. Incorporation of targeted therapies in combination with intensive, and lower-intensity chemotherapy backbones based on the specific biological and genetic characteristics of ALAL is an appealing approach and is increasingly reported. The use of lineage-specific targeted approaches may result in therapeutic pressure and lineage switch in patients with acute leukaemia with multi-phenotypic potential. The role and optimal platform for minimal residual disease surveillance in ALAL to guide therapy, and inform transplantation is unclear, given the paucity of prospective controlled data.","PeriodicalId":12964,"journal":{"name":"Haematologica","volume":"11 1","pages":""},"PeriodicalIF":10.1,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}