Elizabeth Williams, Roxanne Dyas, Katherine Colman, Suzannah Kinsella, Amanda Gwee, Amy Lovell, Andrew R Gennery, Mary Slatter, Lori Chait-Rubinek, Eileen Van Der Stoep, Arjan Lankester, Hilda Mekelenkamp, Ben Gelbart, Karen Nicholson, Lorna McLeman, Shivanthan Shanthikumar, Vanessa Clifford, Theresa Cole, Gabrielle M Haeusler, Lisa M Ott de Bruin, Tim Prestidge, Adam Nelson, Kanchan Rao, Rachel Conyers
{"title":"Paediatric haematopoietic stem cell transplantation research priorities: Results from an international multi-stakeholder priority setting partnership.","authors":"Elizabeth Williams, Roxanne Dyas, Katherine Colman, Suzannah Kinsella, Amanda Gwee, Amy Lovell, Andrew R Gennery, Mary Slatter, Lori Chait-Rubinek, Eileen Van Der Stoep, Arjan Lankester, Hilda Mekelenkamp, Ben Gelbart, Karen Nicholson, Lorna McLeman, Shivanthan Shanthikumar, Vanessa Clifford, Theresa Cole, Gabrielle M Haeusler, Lisa M Ott de Bruin, Tim Prestidge, Adam Nelson, Kanchan Rao, Rachel Conyers","doi":"10.1111/bjh.70901","DOIUrl":"https://doi.org/10.1111/bjh.70901","url":null,"abstract":"<p><p>Co-designed research in paediatric HSCT is limited. We sought to determine research priorities which represent the shared priorities of patients, parents, carers and healthcare professionals (HCP) within Australia, New Zealand, the Netherlands and the United Kingdom. An international, multiphase priority-setting methodology was implemented in partnership with the James Lind Alliance and delivered over an 18-month period. Part 1: an international scoping survey asked respondents to submit their research uncertainties related to paediatric HSCT. Part 2: summarising and evidence-checking the submitted uncertainties. Part 3: interim prioritisation survey. Part 4: consensus workshop. In the first international scoping survey, 667 topic ideas were suggested (45% by consumers, 55% by HCP), which were categorised into 80 summary questions. After systematic literature review, 35 summary questions were judged to be true uncertainties (i.e. not answered by existing evidence). These 35 uncertainties were included in a second interim prioritisation survey and completed by 224 participants. From those, a shortlist of 19 questions was drawn. After a multistakeholder workshop, consensus was reached on the top 10 priorities. The PSP identified important research gaps in the management of paediatric HSCT. Priority areas included: implementing personalised medicine approaches, improving immune recovery and adjunct interventions such as exercise, nutrition and microbiome-directed strategies.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Astrid Pavlovsky, Lorena Fiad, Isolda Fernández, Virginia Prates, Nicolas Kurgansky, Amalia Cerutti, Federico Sackmann, Florencia Negri, Pedro Negri, Guillermina Remaggi, Luciana Ferrari, Luciana Guanchiale, Romina Mariano, Franco Giuliani, Juan Maradei, Gonzalo Bentolila, Fernando Warley, Maximiliano Riddick, Santiago Pavlovsky
{"title":"Long-term follow-up of PET/CT-adapted therapy after three cycles of ABVD for all stages of classic Hodgkin lymphoma: Results of the GATLA LH-05 trial","authors":"Astrid Pavlovsky, Lorena Fiad, Isolda Fernández, Virginia Prates, Nicolas Kurgansky, Amalia Cerutti, Federico Sackmann, Florencia Negri, Pedro Negri, Guillermina Remaggi, Luciana Ferrari, Luciana Guanchiale, Romina Mariano, Franco Giuliani, Juan Maradei, Gonzalo Bentolila, Fernando Warley, Maximiliano Riddick, Santiago Pavlovsky","doi":"10.1111/bjh.70721","DOIUrl":"10.1111/bjh.70721","url":null,"abstract":"<div>\u0000 \u0000 <p>The Grupo Argentino de Tratamiento de la Leucemia Aguda (GATLA) LH-05 trial evaluated positron emission tomography-computed tomography (PET-CT)-guided ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) in patients with stage I–IV classic Hodgkin lymphoma (cHL). A total of 563 patients with cHL stages I–IV were included in the prospective, non-randomized GATLA LH-05 trial. Patients received three cycles of ABVD followed by PET-CT (PET3). Patients with PET3 Deauville score (DS) 1–2 discontinued treatment, DS 3–4 completed six ABVD with involved-field radiotherapy (IFRT) and DS 5 received salvage chemotherapy. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method. Prognostic factors for PFS were assessed using Cox regression. After a median follow-up of 93.5 months Interquartile Range (IQR) 54–139, 5- and 10-year PFS for the whole cohort were 78.9% 95% Confidence Interval (CI) 75.5–82.6 and 76.2% (95% CI 72.4–80.2) respectively. Five- and 10-year OS were 95.2% (95% CI 93.3–97.0) and 93.7% (95% CI 91.5–96.0). All PET3-negative patients achieved 10-year PFS of 84.4%. PET3 was the strongest predictor of PFS, while disease stage had no independent prognostic significance. With extended follow-up, PET-CT-adapted therapy after three cycles of ABVD provides durable disease control while reducing exposure to chemotherapy and radiotherapy. These results support PET-CT-guided treatment discontinuation in PET3-negative patients across all stages of cHL.</p>\u0000 </div>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":"209 4","pages":"1610-1618"},"PeriodicalIF":3.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cecilie Velsoe Maeng, Pei Meng, Mathias Heldbo, Olafur Davidsson, Morten Munk Johansen, Sigrún Thorsteinsdóttir, Jojo Biel-Nielsen Dietz, Ragnar Pétur Kristjansson, Ole Birger Vesterager Pedersen, Erik Sørensen, Christian Erikstrup, Christina Mikkelsen, Nanna Brøns, Henrik Ullum, Bitten Aagaard, Mie Topholm Bruun, Estrid Høgdall, DBDS Research Consortium, CHB Research Consortium, Bo Porse, Simon Husby, Sisse R. Ostrowski, Henrik Hjalgrim, Kirsten Grønbæk
{"title":"Mosaic chromosomal alterations and relation to haematological cancer in two large Danish cohorts","authors":"Cecilie Velsoe Maeng, Pei Meng, Mathias Heldbo, Olafur Davidsson, Morten Munk Johansen, Sigrún Thorsteinsdóttir, Jojo Biel-Nielsen Dietz, Ragnar Pétur Kristjansson, Ole Birger Vesterager Pedersen, Erik Sørensen, Christian Erikstrup, Christina Mikkelsen, Nanna Brøns, Henrik Ullum, Bitten Aagaard, Mie Topholm Bruun, Estrid Høgdall, DBDS Research Consortium, CHB Research Consortium, Bo Porse, Simon Husby, Sisse R. Ostrowski, Henrik Hjalgrim, Kirsten Grønbæk","doi":"10.1111/bjh.70688","DOIUrl":"10.1111/bjh.70688","url":null,"abstract":"<p>Mosaic chromosomal alterations (mCAs) are large somatic gains, losses and copy-neutral loss of heterozygosity identified in the peripheral blood, which represent a relatively unexplored spectrum of clonal haematopoiesis. We aimed to describe mCAs in two large Danish cohorts with extensive long-term registry-based follow-up and examine associations with haematological malignancy. We analysed genotype data from 97 752 participants from the Danish Blood Donor Study and 86 301 patients from the Copenhagen Hospital Biobank using the MoChA software. Association to haematological cancers was modelled with competing-risk methods and Cox regression, or logistic regression, via nationwide register linkage. Among 184 053 individuals, 15 459 (8%) carried autosomal mCAs and 14 322 females (17%) had loss of X, with prevalence increasing with age. In samples before or after diagnosis of haematological cancer, autosomal mCAs were detectable in 21%–62% of individuals depending on cancer subtype. Overall, the risk of haematological cancer was increased for individuals carrying autosomal mCA (hazard ratio [HR] 4.1 (95% confidence interval [CI] 3.1–5.5)), but not for individuals carrying loss of X chromosome (HR 1.1 [95% CI 0.7–1.6]). The level of malignancy risk was highly variable between different chromosomal aberrations, and cancer gene–related mCAs conveyed highest risk. Autosomal mCAs, especially those overlapping cancer gene loci, identify individuals at increased risk of haematological malignancy and may assist improvement of risk stratification and early detection.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":"209 4","pages":"1549-1561"},"PeriodicalIF":3.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjh.70688","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elena Vuelta, Alessandro Liquori, Matias Morín, Lucia Soletto, Miguel Ángel Marugal, Marta Santiago-Balsera, Miguel Gallardo, Miguel Ángel Moreno-Pelayo, José Cervera, Alejandra Sanjuan-Pla
{"title":"Functional assessment of inherited myeloid neoplasm-associated SAMD9L germline variants via Monoallelic CRISPR modelling","authors":"Elena Vuelta, Alessandro Liquori, Matias Morín, Lucia Soletto, Miguel Ángel Marugal, Marta Santiago-Balsera, Miguel Gallardo, Miguel Ángel Moreno-Pelayo, José Cervera, Alejandra Sanjuan-Pla","doi":"10.1111/bjh.70799","DOIUrl":"10.1111/bjh.70799","url":null,"abstract":"<p>While the majority of myeloid neoplasms are sporadic, the increasing application of germline genetic testing has led the World Health Organization to designate ‘<i>Myeloid malignancies with germline predisposition’</i> as a distinct clinical entity, carrying major implications for clinical care and research. Germline variants in the Sterile alpha motif domain-containing 9-like (<i>SAMD9L)</i> gene are specifically associated with an increased risk for these malignancies. In this study, we functionally modelled two novel <i>SAMD9L</i> variants—p.N697Y and p.K1294*—alongside two previously reported variants (p.T233N and p.H880Q). We generated heterozygous knock-in cellular models in the Human leukemia (HL-60 myeloid cell line) for each variant using homology-directed repair-based Clustered regularly interspaced short palindromic repeats and CRISPR-associated protein 9 (CRISPR/Cas9) gene editing. Functional assays, focused on proliferation and protein translation, confirmed that the p.T233N, p.N697Y and p.K1294* variants all caused a decreased rate of protein translation. These results provide functional evidence to fine-tune the classification of these <i>SAMD9L</i> variants and significantly advance our understanding of the molecular mechanisms by which <i>SAMD9L</i> variants drive inherited myeloid neoplasms.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":"209 4","pages":"1538-1548"},"PeriodicalIF":3.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjh.70799","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yaddanapudi Ravindranath, Douglas B. Craig, Prahlad Parajuli, Shruti Bagla, Ali Saad, Daniela Cukovic, Markku Heikinheimo, Jonna Salonen, Katherine Regling, Alan Dombkowski, Tony DeFalco, James J. Bieker
{"title":"Interplay between fibroblast growth factor 9 (FGF9) and CD44 underlies 46,XY disorders of sex development in Kruppel-like factor 1 (KLF-1)-E325K-associated congenital dyserythropoietic anaemia (CDA-IV)","authors":"Yaddanapudi Ravindranath, Douglas B. Craig, Prahlad Parajuli, Shruti Bagla, Ali Saad, Daniela Cukovic, Markku Heikinheimo, Jonna Salonen, Katherine Regling, Alan Dombkowski, Tony DeFalco, James J. Bieker","doi":"10.1111/bjh.70760","DOIUrl":"10.1111/bjh.70760","url":null,"abstract":"<div>\u0000 \u0000 <p>A heterozygous Kruppel-like factor 1 (KLF1) E325K mutation causes a severe form of congenital dyserythropoietic anaemia (CDA), designated CDA-IV (Online Mendelian Inheritence in Man, OMIM 613673), a rare disease with only 15 cases known. In addition to haemolytic anaemia, manifest often at birth, four of seven (57%) of 46,XY children with KLF1 E325K mutation exhibit a range of dysmorphic external genitalia including 46,XY complete sex reversal (2/7 or 28.5%). No genital abnormalities were reported in a boy with double heterozygous <i>KLF1</i> null mutations, suggesting that the KLF1 E325K variant causes, in addition to its negative impacts on erythroid differentiation, disruptions in male sex differentiation. Our studies suggest a role for a cooperative effect of concurrent ‘non-pathogenic’ polymorphisms in multiple genes associated with disorders of sex differentiation (DSD), notably <i>fibroblast growth factor 9</i> (<i>FGF9</i>), whose expression was decreased in the gonads and peripheral blood in the case described here. We propose that the combined loss of FGF9 and CD44 (a target for CDA-IV KLF1) resulted FGF9 signalling loss and likely caused 46,XY sex reversal. Our studies also suggest that whole-blood gene expression studies in the proband/parent triad may provide critical clues in evaluating children with DSD, the cause of which remains undiagnosed in many cases.</p>\u0000 </div>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":"209 4","pages":"1574-1585"},"PeriodicalIF":3.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas Peberdy, Melvin Joy, Christine J Harrison, Sujith Samarasinghe, Amir Enshaei, Anthony V Moorman
{"title":"Sex ratio of children and young people with acute lymphoblastic leukaemia is age-dependent and varies by biological subgroup.","authors":"Thomas Peberdy, Melvin Joy, Christine J Harrison, Sujith Samarasinghe, Amir Enshaei, Anthony V Moorman","doi":"10.1111/bjh.70896","DOIUrl":"https://doi.org/10.1111/bjh.70896","url":null,"abstract":"","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer Tam, Barbara De la Salle, Patience Kapuya, Christopher Reilly-Stitt, Tracey Smith-Straney, Tony Cambridge, Deepa J. Arachchillage, Wayne Thomas
{"title":"Point-of-care testing in general haematology: An update to the British Society for Haematology good practice paper","authors":"Jennifer Tam, Barbara De la Salle, Patience Kapuya, Christopher Reilly-Stitt, Tracey Smith-Straney, Tony Cambridge, Deepa J. Arachchillage, Wayne Thomas","doi":"10.1111/bjh.70758","DOIUrl":"10.1111/bjh.70758","url":null,"abstract":"<p>This guideline update was compiled according to the British Society of Haematology (BSH) process at https://b-s-h.org.uk/media/or2db2zv/2024-08-20-bsh-guidelines-development-process.pdf?cf=638372962768270000. Levels of evidence and the strength of recommendations were evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE) nomenclature (http://www.gradeworkinggroup.org).</p><p>This good practice paper updates the BSH Guideline on point-of-care testing (POCT) published in 2019<span><sup>1</sup></span> and reflects the evolution of POCT.</p><p>POCT describes diagnostic testing outside the hospital laboratory, in close proximity to the patient, where results are available rapidly enough to influence immediate clinical management.<span><sup>2, 3</sup></span> Recently, POCT delivery has been shaped by the confluence of innovation, strengthened frameworks, digital integration and connectivity.</p><p>Ongoing technological development has given rise to portable, user-friendly POCT platforms and assays with improved rapidity, reliability and analytical performance. POCT in diagnosis and monitoring can directly impact on clinical decision-making, translating to faster patient turnaround times (TATs). Moreover, POCT has become widely embedded across various healthcare settings, including acute hospital care, primary care and community pharmacies.</p><p>The International Organization for Standardization (ISO) standard, ISO 15189:2022, specifies quality, governance and risk assessment in medical laboratories.<span><sup>4</sup></span> Importantly, ISO 15189:2022 incorporates POCT requirements previously covered under ISO 22870:2016 (which is now superseded, although a few organisations may still hold accreditation to ISO 22870:2016).<span><sup>3, 4</sup></span></p><p>The coronavirus disease 2019 (COVID-19) pandemic accelerated decentralisation of testing and reinforced the value of rapid, accurate, near-patient diagnostics. Increasingly, devices are connected to laboratory information systems and electronic health records (EHRs), enabling data transfer and remote monitoring.</p><p>This good practice paper provides an overview of current POCT assays and sets out a framework for high-quality POCT in secondary care. POCT in community settings is outside the scope of this paper and will be addressed separately.</p><p>Hospitals must balance safe, timely patient turnaround with quality of care. Rapid, accurate results afforded by POCT can facilitate patient flow and inform immediate treatment administration in life-threatening clinical settings.<span><sup>1, 5</sup></span> POCT may be implemented within a wider strategy for operational efficiency, alongside effective management plans and waiting time targets, with the approval of a POCT committee.</p><p>Table 1 summarises commonly available POCT assays and platforms in haematology and is not intended to be exhaustive. Description of assays does not constitute endorsement or promo","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":"209 4","pages":"1489-1504"},"PeriodicalIF":3.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjh.70758","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Koji Jimbo, Aileen G Rowan, Momoko Usui, Kako Suzuki, Makoto Yamagishi, Junya Makiyama, Lucy B M Cook, Yoshihisa Yamano, Kaoru Uchimaru, Yasuhito Nannya, Shigeo Fuji
{"title":"Flow cytometric assessment of T-cell receptor β-chain constant region 1/2 skewing as a surrogate marker for clonality in human T-cell leukaemia virus type-1-infected cells.","authors":"Koji Jimbo, Aileen G Rowan, Momoko Usui, Kako Suzuki, Makoto Yamagishi, Junya Makiyama, Lucy B M Cook, Yoshihisa Yamano, Kaoru Uchimaru, Yasuhito Nannya, Shigeo Fuji","doi":"10.1111/bjh.70889","DOIUrl":"https://doi.org/10.1111/bjh.70889","url":null,"abstract":"<p><p>Estimating T-cell clonality within human T-cell leukaemia virus type 1 (HTLV-1)-infected cell populations may aid risk assessment and diagnosis of adult T-cell leukaemia/lymphoma (ATL). However, direct assessment of HTLV-1 integration-site clonality requires genetic analyses that are costly and labour-intensive. We developed a simple flow cytometric surrogate assay by combining the HTLV-1 analysis system by flow cytometry (HAS-Flow) method, which efficiently identifies HTLV-1-infected cells, with T-cell receptor β-chain constant region (TRBC1/2) staining. We analysed 53 HTLV-1-infected individuals, including asymptomatic carriers (n = 25), patients with HTLV-1-associated myelopathy (n = 4) and patients with ATL (n = 24). TRBC1/2 skewing was quantified using the dominant TRBC ratio. The dominant TRBC ratio was significantly higher in ATL than in non-ATL cases and effectively discriminated ATL from non-ATL cases (Area under the receiver operating characteristic curve [AUC], 0.913; 95% confidence interval, 0.803-1.000; p < 0.0001). It correlated with established markers of disease progression, including abnormal lymphocyte burden, proviral load and soluble interleukin-2 receptor levels, as well as clonality assessed by two independent HTLV-1 integration-site-based methods (viral integration site and RAISING-CLOVA). These findings indicate that assessment of TRBC1/2 skewing in HTLV-1-infected cells (HAS-TRBC method) is a simple, cost-effective surrogate for estimating T-cell clonality within HTLV-1-infected cell populations, with potential clinical utility.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}