Aditi Vedi, Sarah Maria Leiter, Irum Latif Memon, Arunthethy Mahendrayogam, Elsje Van Rijswijk, Urmila Uparkar, Geoff Shenton, Amelie Trinquand, Katherine Clesham, Vanessa McLelland, Helen Campbell, Katharine Patrick, Lyndsey Thompson, Susan Baird, Philip Connor, Donna Lancaster, Beki James
{"title":"Real-world experience of paediatric acute promyelocytic leukaemia in the United Kingdom and Ireland.","authors":"Aditi Vedi, Sarah Maria Leiter, Irum Latif Memon, Arunthethy Mahendrayogam, Elsje Van Rijswijk, Urmila Uparkar, Geoff Shenton, Amelie Trinquand, Katherine Clesham, Vanessa McLelland, Helen Campbell, Katharine Patrick, Lyndsey Thompson, Susan Baird, Philip Connor, Donna Lancaster, Beki James","doi":"10.1111/bjh.19843","DOIUrl":"https://doi.org/10.1111/bjh.19843","url":null,"abstract":"<p><p>Acute promyelocytic leukaemia (APL), defined by the t(15;17)(q24;q21) translocation, accounts for 5%-10% of paediatric acute myeloid leukaemia cases. All-trans retinoic acid (ATRA) and arsenic trioxide (ATO) are key treatments, though ATO access varies. We evaluated treatment, complications and survival in 50 UK paediatric APL patients diagnosed between 2014 and 2021. All patients received ATRA and most received ATO. Event-free survival was lower in high-risk patients (85% vs. 100%, p = 0.03), and those not receiving ATO at diagnosis. All relapsed patients could be salvaged with ATO. Addressing ATO availability and consistent funding is crucial to ensure timely treatment and improve outcomes.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646095","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}
Hayley Colton, Natalie Barratt, Nigel Temperton, Hailey Hornsby, Adrienn Angyal, Irina Grouneva, Benjamin B Lindsey, Pamela Kearns, Eleanor Barnes, Carl S Goodyear, Alex Richter, David Thomas, Gordon Cook, Iain B McInnes, Michelle Willicombe, Stefan Siebert, Kim Orchard, Rachael Selby, Sarah Bowden, Paul J Collini, Ann Pope, Amanda Kirkham, Barbara Kronsteiner, Susanna J Dunachie, Paul Miller, Jennifer Clay, Erin Hurst, Ram Malladi, Murali Kesavan, Francesca Kinsella, Robin Sanderson, Kwee L Yong, Daniel Rea, Helen Parry, Sean H Lim, John A Snowden, Thushan I de Silva
{"title":"Greater preservation of SARS-CoV-2 neutralising antibody responses following the ChAdOx1-S (AZD1222) vaccine compared with mRNA vaccines in haematopoietic cell transplant recipients.","authors":"Hayley Colton, Natalie Barratt, Nigel Temperton, Hailey Hornsby, Adrienn Angyal, Irina Grouneva, Benjamin B Lindsey, Pamela Kearns, Eleanor Barnes, Carl S Goodyear, Alex Richter, David Thomas, Gordon Cook, Iain B McInnes, Michelle Willicombe, Stefan Siebert, Kim Orchard, Rachael Selby, Sarah Bowden, Paul J Collini, Ann Pope, Amanda Kirkham, Barbara Kronsteiner, Susanna J Dunachie, Paul Miller, Jennifer Clay, Erin Hurst, Ram Malladi, Murali Kesavan, Francesca Kinsella, Robin Sanderson, Kwee L Yong, Daniel Rea, Helen Parry, Sean H Lim, John A Snowden, Thushan I de Silva","doi":"10.1111/bjh.19874","DOIUrl":"https://doi.org/10.1111/bjh.19874","url":null,"abstract":"<p><p>Whilst SARS-CoV-2 mRNA vaccines generate high neutralising antibodies (nAb) in most individuals, haematopoietic stem cell transplant (HSCT) and chimeric antigen receptor T-cell (CAR-T) recipients respond poorly. HSCT/CAR-T treatment ablates existing immune memory, with recipients requiring revaccination analogous to being vaccine naive. An optimal revaccination strategy for this cohort has not been defined. Factors predicting immunogenicity following three ancestral SARS-CoV-2 vaccines were assessed in 198 HSCT/CAR-T recipients and 96 healthcare workers (HCWs) recruited to multicentre studies. Only 25% of HSCT/CAR-T recipients generated nAbs following one dose, with titres 167-fold and 7-fold lower than that in HCWs after the first and second doses, respectively. Lower post-second dose nAb titres were associated with older age, rituximab use, and previous HSCT. ChAdOx1-S recipients were more likely to generate nAbs compared with mRNA vaccines, with titres comparable to HCWs. In contrast, nAbs were significantly lower in HSCT/CAR-T recipients than HCWs after mRNA vaccination. The poor first-dose immunogenicity in HSCT/CAR-T recipients suggests a minimum licensed dosing interval could limit the period of vulnerability following HSCT/CAR-T. The relative preservation of nAbs with ChAdOx1-S vaccination highlights the importance of evaluating alternative platforms to mRNA vaccination within this highly vulnerable clinical cohort.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646077","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}
Varsha Bhat, Alka A Potdar, G Karen Yu, Greg Gibson, Vivien A Sheehan
{"title":"Impact of hydroxycarbamide treatment on the whole-blood transcriptome in sickle cell disease.","authors":"Varsha Bhat, Alka A Potdar, G Karen Yu, Greg Gibson, Vivien A Sheehan","doi":"10.1111/bjh.19839","DOIUrl":"https://doi.org/10.1111/bjh.19839","url":null,"abstract":"<p><p>Hydroxycarbamide (HC) is the most widely used therapeutic for individuals with sickle cell disease (SCD, including sickle cell anemia and other forms of the disease). HC's clinical benefits are primarily associated with its ability to induce foetal haemoglobin (HbF); this limited view of HC's therapeutic potential may lead to its discontinuation when a modest amount of HbF is induced. A better understanding of the HbF-independent effects of HC on genes and pathways relevant to SCD pathophysiology is therefore needed. In this study, we performed bulk RNA-Seq on whole blood samples collected from a cohort of 25 paediatric patients with SCD to identify genes and pathways that are affected by treatment with HC. At the maximum tolerated dose (MTD) of HC, patients showed altered expression levels of several genes and biological pathways. Pathways related to haeme metabolism, interferon-alpha response, and interferon-gamma response were significantly downregulated at HC MTD relative to the matched pre-HC samples. Pathways linked with IL2-STAT5 signalling and TNFα signalling via NF-Kβ were observed to be up-regulated at HC MTD. These results illustrate the range of effects exerted by HC during therapy for SCD and pave the way for an improved understanding of the HbF induction-independent benefits of HC.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646080","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}
Giuseppe Bertuglia, Sara Bringhen, Benedetto Bruno, Giorgia Andrea Impalà, Mattia D'Agostino
{"title":"M-protein-related necrobiotic granuloma in a multiple myeloma patient treated with daratumumab, lenalidomide and dexamethasone.","authors":"Giuseppe Bertuglia, Sara Bringhen, Benedetto Bruno, Giorgia Andrea Impalà, Mattia D'Agostino","doi":"10.1111/bjh.19887","DOIUrl":"https://doi.org/10.1111/bjh.19887","url":null,"abstract":"","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613342","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}
{"title":"Dutcher bodies and Russell bodies in a case of t(11;14) multiple myeloma.","authors":"Jing Wu, Wei Cai, Mi Jiang","doi":"10.1111/bjh.19890","DOIUrl":"10.1111/bjh.19890","url":null,"abstract":"","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613305","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}
{"title":"Dissecting the genomic traits and clinical course of secondary myelodysplastic syndrome following aplastic anaemia: A milestone.","authors":"Carmelo Gurnari, Valeria Visconte","doi":"10.1111/bjh.19898","DOIUrl":"https://doi.org/10.1111/bjh.19898","url":null,"abstract":"<p><p>Dissecting the genomic traits and clinical course of secondary myelodysplastic syndrome following aplastic anaemia is a milestone. The report by Li and colleagues investigates determinants of evolution to myelodysplastic syndrome and acute myeloid leukaemia in patients with aplastic anaemia and paroxysmal nocturnal haemoglobinuria with a specific focus on post-transplant outcomes. Commentary on: Li et al. Clinical and genetic profiles and outcomes of allogeneic haematopoietic stem cell transplantation in secondary myelodysplastic syndrome following aplastic anaemia. Br J Haematol 2024 (Online ahead of print). doi: 10.1111/bjh.19855.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613302","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}
{"title":"Clonal haemopoiesis and venous thromboembolism risk.","authors":"David P Steensma","doi":"10.1111/bjh.19893","DOIUrl":"10.1111/bjh.19893","url":null,"abstract":"<p><p>Many cases of venous thromboembolism (VTE) are idiopathic and clonal haemopoiesis, a risk factor for atherosclerotic vascular disease, may be a contributing factor to VTE. The report by Englisch and colleagues suggests that clonal haemopoiesis is a risk factor for recurrent VTE, especially in people without identifiable thrombotic predisposition. Commentary on: Englisch et al. Association of clonal hematopoiesis with recurrent venous thromboembolism: A case-control study. Br J Haematol 2024 (Online ahead of print). doi: 10.1111/bjh.19871.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613296","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}
{"title":"Clinical and neurophysiological aspects of peripheral neuropathy in patients with myelodysplastic syndromes.","authors":"Michail Papantoniou, Ioanna Stergiou, Stavroula Giannouli, Chrysanthi Bountziouka, Panagiotis Kokotis","doi":"10.1111/bjh.19901","DOIUrl":"https://doi.org/10.1111/bjh.19901","url":null,"abstract":"<p><p>Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal disorders, manifesting multiple clinical autoimmune inflammatory phenomena, including rarely peripheral neuropathy. Twenty-four patients diagnosed with MDS and 29 healthy subjects were enrolled in this prospective study in a 5-year period. Every subject was assessed by symptoms questionnaire and clinical neurological examination followed by nerve conduction studies, quantitative sensory testing and skin biopsy. Peripheral neuropathy was diagnosed in 12 subjects (50%). Our study indicated that peripheral neuropathy involving large and small nerve fibres, with a symmetrical length-dependent pattern, is not uncommon between patients with MDS.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613281","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}
Jun Qi, Tianju Wang, Manni Wang, Pengcheng He, Yuhui Li, Lixia Shang, Le Chen, Xiaofang Wang, Hua Xu, Chaofeng Ma
{"title":"Comparative study of the diversity of amino acids on human leucocyte antigen class II molecules in patients with acquired aplastic anaemia.","authors":"Jun Qi, Tianju Wang, Manni Wang, Pengcheng He, Yuhui Li, Lixia Shang, Le Chen, Xiaofang Wang, Hua Xu, Chaofeng Ma","doi":"10.1111/bjh.19899","DOIUrl":"https://doi.org/10.1111/bjh.19899","url":null,"abstract":"<p><p>Human leucocyte antigen (HLA) class II molecules are critically involved in the pathology of acquired aplastic anaemia (AA) by regulating the immune response and autoreactive T cell-mediated haematopoietic cell death. In the study, amino acid residue variation and molecular structure of HLA class II have been initially investigated in 96 patients with AA. The frequencies of residues 9 and 57 in pocket 9 (P9) in DQB1, and amino acid positions 9, 11, 13, 16, 26, 38, 67 and 71 in the P4, P6 and P9 pockets in DRB1 were more prevalent among AA patients. By applying a multivariate recursive approach, the DRβ-Gln-16 (OR = 3.003, 95% CI = 1.468-6.145, p<sub>c</sub> = 0.003), DRβ-Ala-71 (OR = 1.924, 95% CI = 1.233-3.002, p<sub>c</sub> = 0.004) in P4/P7 and DQβ-Asp-57 (OR = 3.483, 95% CI = 1.079-11.242, p<sub>c</sub> = 0.037) in P9, these critical residues were significantly discovered as risk amino acid residues on the onset of AA, as well as associated with PNH-type cells and pathological somatic or cytogenetic mutations. In silico structural model analysis showed that identified DRβ-Ala-71 and DQβ-Asp-57 within the antigen-binding groove interacting with a more variable antigenic segments, may impact the repertoire of peptides presented, influence the interface HLA-antigen-T-cell receptor β (TCR β). These findings provided light on the immunogenetic pathophysiology of AA aetiology and their potential impact on upcoming immunotherapies.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613299","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}
Jithma P Abeykoon, Ronald S Go, Levi-Dan Azoulay, Julien Haroche
{"title":"Methotrexate and cytarabine in adult LCH: High risk, high reward and maintenance free?","authors":"Jithma P Abeykoon, Ronald S Go, Levi-Dan Azoulay, Julien Haroche","doi":"10.1111/bjh.19903","DOIUrl":"https://doi.org/10.1111/bjh.19903","url":null,"abstract":"<p><p>Lin et al. report the long-term follow-up of a phase II trial involving 95 adult patients with Langerhans cell histiocytosis (LCH), investigating the combination of methotrexate and cytarabine (MA). After a median follow-up of 6.5 years, the study showed high response rates, with 90% overall response; 55% of patients free from an event such as disease progression, poor response or death; and 93% of patients were alive, though nearly half experienced febrile neutropenia. This prospective study helps fill gaps in understanding adult LCH treatment, indicating that fixed-duration chemotherapy can yield durable responses despite its associated risks. It emphasizes the importance of personalized treatment decisions, considering both fixed-duration chemotherapy and continuous targeted agents based on patient and disease-specific factors. Commentary on: Lin et al. Long term follow-up of methotrexate and cytarabine in adult patients with Langerhans cell histiocytosis. Br J Haematol 2024 (Online ahead of print). doi: 10.1111/bjh.19830.</p>","PeriodicalId":135,"journal":{"name":"British Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613315","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}