Current Opinion in Hematology最新文献_第2页

Pregnancy after haematopoietic stem cell transplantation: likelihood, risks, and management. 造血干细胞移植后妊娠：可能性、风险和管理。

IF 2.9 3区医学

Current Opinion in Hematology Pub Date : 2026-11-01 Epub Date: 2026-10-01 DOI: 10.1097/MOH.0000000000000947

Fariya Zaheer, Nadine Shehata, Evangelia Vlachodimitropoulou

{"title":"Pregnancy after haematopoietic stem cell transplantation: likelihood, risks, and management.","authors":"Fariya Zaheer, Nadine Shehata, Evangelia Vlachodimitropoulou","doi":"10.1097/MOH.0000000000000947","DOIUrl":"10.1097/MOH.0000000000000947","url":null,"abstract":"Purpose of review: Advances in haematopoietic stem cell transplantation (HSCT) have improved long-term survival, making fertility and reproductive health increasingly important aspects of survivorship. This review summarizes current evidence regarding fertility after HSCT, fertility preservation, and pregnancy outcomes.Recent findings: Infertility remains common after HSCT, particularly following total body irradiation and myeloablative conditioning, with reproductive outcomes influenced by age at transplantation, conditioning intensity, pretransplant therapy and other related factors. Although fertility remains substantially reduced after HSCT, spontaneous conception and successful pregnancies have been reported. As posttransplant fertility cannot be reliably predicted, early fertility counselling and discussion of fertility-preservation options should be standard components of care before gonadotoxic therapy and HSCT. Most pregnancies following HSCT result in live births but carry increased risks of preterm birth, low birth weight, and placental insufficiency, particularly after total body irradiation. For survivors who conceive, multidisciplinary management is essential to optimize maternal and neonatal outcomes.Summary: Fertility preservation should be routinely discussed before gonadotoxic therapy and HSCT, as posttransplant reproductive recovery cannot be reliably predicted. Multidisciplinary pregnancy care and prospective studies defining regimen-specific reproductive risks are needed to optimize reproductive outcomes.","PeriodicalId":55196,"journal":{"name":"Current Opinion in Hematology","volume":" ","pages":"253-258"},"PeriodicalIF":2.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Second-line and salvage therapies for steroid-refractory acute graft-versus-host disease: an integrated synthesis of current evidence and clinical sequencing. 类固醇难治性急性移植物抗宿主病的二线和救助疗法：当前证据和临床测序的综合综合

IF 2.9 3区医学

Current Opinion in Hematology Pub Date : 2026-11-01 Epub Date: 2026-08-31 DOI: 10.1097/MOH.0000000000000952

Julieta Zuluaga, Alexandros Kanelopoulos, Emmanouil Nikolousis

{"title":"Second-line and salvage therapies for steroid-refractory acute graft-versus-host disease: an integrated synthesis of current evidence and clinical sequencing.","authors":"Julieta Zuluaga, Alexandros Kanelopoulos, Emmanouil Nikolousis","doi":"10.1097/MOH.0000000000000952","DOIUrl":"10.1097/MOH.0000000000000952","url":null,"abstract":"Purpose of review: Acute graft-versus-host disease (aGVHD) remains a principal driver of nonrelapse mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Fifty percent of patients fail to achieve durable responses to first-line corticosteroids, defining steroid-refractory aGVHD (SR-aGVHD) and limited long-term survival. The Janus kinase 1/2 (JAK1/2) inhibitor ruxolitinib became the standard second-line therapy. Nevertheless, primary resistance and secondary loss of response continue to leave a substantial proportion of patients without effective treatment.Recent findings: This review synthesizes evidence available up to June 2026 on second-line and salvage options that complement or follow ruxolitinib, including mesenchymal stromal cells, extracorporeal photopheresis administered alone or in combination with ruxolitinib, mammalian target of rapamycin (mTOR) inhibitors with or without interleukin-2 receptor antagonists (IL-2RAs), the humanized anti-CD25 monoclonal antibody xenopax, antithymocyte globulin as salvage, and investigational agents. We examine 2025 four-RCT meta-analysis supporting mesencymal stem cells (MSCs), the 2025 conditional approval by the Chinese NMPA of umbilical cord-derived MSC product for SR-aGVHD, the REACH2 long-term data, and biomarker-guided risk stratification using suppression of tumorigenicity 2 and regenerating islet-derived 3-alpha (REG3α).Summary: We propose an evidence-based clinical sequencing algorithm that integrates ruxolitinib, MSCs, extracorporeal photopheresis (ECP), mTOR-targeted salvage, ATG, and clinical trial enrollment and supportive-care priorities, including infectious prophylaxis and organ-specific management.","PeriodicalId":55196,"journal":{"name":"Current Opinion in Hematology","volume":" ","pages":"265-270"},"PeriodicalIF":2.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Proteomics in the discovery of biomarkers of major complications after allogeneic hematopoietic cell transplantation. 蛋白质组学在发现异基因造血细胞移植后主要并发症的生物标志物方面的应用。

IF 2.9 3区医学

Current Opinion in Hematology Pub Date : 2026-11-01 Epub Date: 2026-08-31 DOI: 10.1097/MOH.0000000000000951

Fotios V Michelis, Ivan Pasic, Eleftherios P Diamandis

{"title":"Proteomics in the discovery of biomarkers of major complications after allogeneic hematopoietic cell transplantation.","authors":"Fotios V Michelis, Ivan Pasic, Eleftherios P Diamandis","doi":"10.1097/MOH.0000000000000951","DOIUrl":"10.1097/MOH.0000000000000951","url":null,"abstract":"Purpose of review: Allogeneic hematopoietic cell transplantation (allo-HCT) is complicated by life-threatening conditions whose prompt diagnosis is essential yet frequently delayed. This review examines proteomic approaches to biomarker discovery for the most common posttransplant complications, emphasizing methodological reliability and translational status.Recent findings: Proximity extension assay (PEA) and aptamer-based platforms now permit simultaneous quantification of thousands of proteins from microliter plasma volumes. For acute graft-versus-host disease (GVHD), validated plasma panels incorporating ST2 and REG3α have been established as prognostic tools, and a PEA discovery study in patients with acute myeloid leukemia identified a four-marker panel (SLAMF7, IL-1ra, BTN3A2, and DAB2) with an area under the curve of 0.90. For sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD), a PEA study of very severe cases identified multiple candidate proteins at diagnosis and four proteins whose serum levels declined during defibrotide treatment. Proteomic evidence for other complications remains sparse and early in development.Summary: Most proteomic biomarker studies in allo-HCT derive from small single-center discovery cohorts. Multicenter validation, harmonized biobanking, and integration with clinical risk models are required before these biomarkers can enter transplant practice.","PeriodicalId":55196,"journal":{"name":"Current Opinion in Hematology","volume":" ","pages":"236-242"},"PeriodicalIF":2.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bridging TP53-mutated myelodysplastic syndrome/acute myeloid leukemia to transplant: is venetoclax part of the answer? 桥接tp53突变骨髓增生异常综合征/急性髓系白血病移植：venetoclax是答案的一部分吗？

IF 2.9 3区医学

Current Opinion in Hematology Pub Date : 2026-11-01 Epub Date: 2026-08-13 DOI: 10.1097/MOH.0000000000000949

Peter Zhao, Samuel Urrutia

{"title":"Bridging TP53-mutated myelodysplastic syndrome/acute myeloid leukemia to transplant: is venetoclax part of the answer?","authors":"Peter Zhao, Samuel Urrutia","doi":"10.1097/MOH.0000000000000949","DOIUrl":"10.1097/MOH.0000000000000949","url":null,"abstract":"Purpose of review: TP53-mutated myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) remain among the most challenging myeloid malignancies, with poor long-term outcomes despite allogeneic stem cell transplantation (HCT). Venetoclax-based regimens produce encouraging response rates, but their role as optimal pre-transplant therapy for TP53 mutated MDS/AML remains unconfirmed. This review evaluates the rationale and clinical evidence supporting venetoclax as a bridging strategy to HCT.Recent findings: Recent studies have refined risk stratification through TP53 allelic-state characterization, demonstrating poor transplant outcomes. Studies show venetoclax-based therapy may induce deeper and faster remissions. A higher proportion of patients who receive venetoclax successfully transition to transplantation. However, higher response rates do not consistently translate into a survival advantage post-transplant. Efforts to study venetoclax regimens in the pre-transplant setting lack stratification by TP53 allelic state or design focus for this subgroup.Summary: Current evidence supports venetoclax as an acceptable bridging strategy to accelerate response and cytoreduction for TP53-mutated MDS/AML. There is a limited number of studies of venetoclax-containing regimens specific for transplant eligible patients with TP53 mutated MDS/AML. It is important for future studies to incorporate a standardized TP53 allelic-state assessment, molecular measurable residual disease evaluation, and transplant-specific endpoints.","PeriodicalId":55196,"journal":{"name":"Current Opinion in Hematology","volume":" ","pages":"259-264"},"PeriodicalIF":2.9,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The life, function and death of platelets. 血小板的生命、功能和死亡。

IF 2.9 3区医学

Current Opinion in Hematology Pub Date : 2026-09-09 DOI: 10.1097/MOH.0000000000000942

Mariia Naumenko, Dianne E van der Wal, Anastasiia Naumenko, Alexander Moskalensky, Maha Othman

引用次数: 0

Roles of megakaryocytes and platelets in myeloproliferative neoplasms. 巨核细胞和血小板在骨髓增殖性肿瘤中的作用。

IF 2.9 3区医学

Current Opinion in Hematology Pub Date : 2026-09-01 Epub Date: 2026-06-17 DOI: 10.1097/MOH.0000000000000938

Molly Brakhane, Abigail Ajanel, Joshua I Siner

{"title":"Roles of megakaryocytes and platelets in myeloproliferative neoplasms.","authors":"Molly Brakhane, Abigail Ajanel, Joshua I Siner","doi":"10.1097/MOH.0000000000000938","DOIUrl":"10.1097/MOH.0000000000000938","url":null,"abstract":"Purpose of review: The purpose of this review is to describe the activity and function megakaryocytes and platelets in the myeloproliferative neoplasms (MPNs.) Specific attention is paid to how megakaryocytes relate to disease progression and altered hemostasis and how current therapies are beginning to target them.Recent findings: MPN megakaryocytes are hyperproliferative and induce further dysregulation within the niche via inflammatory cytokine secretion, while MPN platelets display a contradictory phenotype of baseline preactivation and functional exhaustion upon stimulation, due in part to mitochondrial dysregulation. Platelet transcriptomic profiling has further revealed disease subtype-specific gene expression and a shared thrombo-inflammatory profile. CALR -mutated MPNs have significantly advanced with the development of mutation-specific interventions in early clinical trials.Summary: Thrombotic and hemorrhagic complications represent the most common cause of morbidity in MPNs, however the mechanisms underlying this pathology remain opaque. Cytoreduction and antithrombotic therapies, the mainstay for treatment of MPNs, inadequately address platelet dysfunction, though emerging therapies targeting the MPN clone are promising. Thus, a deeper understanding of megakaryocyte and platelet biology in MPNs is essential for the development of precise therapeutic strategies to reduce thrombotic complications and improve patient outcomes.","PeriodicalId":55196,"journal":{"name":"Current Opinion in Hematology","volume":" ","pages":"219-225"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introduction. 编辑介绍。

IF 2.9 3区医学

Current Opinion in Hematology Pub Date : 2026-09-01 Epub Date: 2026-07-30 DOI: 10.1097/MOH.0000000000000935

引用次数: 0

Fibrin formation and lysis in hyperglycaemia - molecular and cellular drivers. 高血糖中纤维蛋白的形成和溶解——分子和细胞驱动因素。

IF 2.9 3区医学

Current Opinion in Hematology Pub Date : 2026-09-01 Epub Date: 2026-05-14 DOI: 10.1097/MOH.0000000000000932

Julia S Gauer

{"title":"Fibrin formation and lysis in hyperglycaemia - molecular and cellular drivers.","authors":"Julia S Gauer","doi":"10.1097/MOH.0000000000000932","DOIUrl":"10.1097/MOH.0000000000000932","url":null,"abstract":"Purpose of review: Clot structure is a well established determinant of thrombosis risk. Hyperglycaemia alters clot architecture and function, producing denser, less permeable fibrin networks with reduced susceptibility to lysis. Although several mechanisms contributing to these effects have been reviewed previously, novel findings and growing evidence of cellular bioenergetics' effect on clot structure have not yet been integrated into this context. This review presents new insights and discusses their relevance for future therapeutic development.Recent findings: Recent studies have identified novel glycation sites on fibrin(ogen), that contribute to altered microstructures and play important roles in FXIII cross-linking and plasmin cleavage. Increased level of fibrinolysis inhibitor PAI-1 was shown to precede the development of diabetes. Altered platelet and neutrophil bioenergetics in prediabetes and diabetes were shown to contribute to a procoagulant phenotype through increased oxidative stress and NETosis, respectively. Duration of hyperglycaemia and glycaemic control were shown to be key determinants influencing these cellular behaviours.Summary: Considering the interplay between the molecular and cellular drivers of hyperglycaemia-induced alterations in fibrin formation and lysis has important implications for identifying future therapeutic targets. Further research that encompasses hyperglycaemia duration and variations in glycaemic control may support the development of personalised strategies for thrombosis prevention.","PeriodicalId":55196,"journal":{"name":"Current Opinion in Hematology","volume":" ","pages":"210-218"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The dual role of the brain-derived neurotrophic factor as a regulator of hemostasis and thrombotic risk. 脑源性神经营养因子作为止血和血栓风险调节因子的双重作用。

IF 2.9 3区医学

Current Opinion in Hematology Pub Date : 2026-09-01 Epub Date: 2026-06-09 DOI: 10.1097/MOH.0000000000000936

Charlotte Aubin, Jessica Blais, Yanitsa Petkova, Marie Lordkipanidzé

{"title":"The dual role of the brain-derived neurotrophic factor as a regulator of hemostasis and thrombotic risk.","authors":"Charlotte Aubin, Jessica Blais, Yanitsa Petkova, Marie Lordkipanidzé","doi":"10.1097/MOH.0000000000000936","DOIUrl":"10.1097/MOH.0000000000000936","url":null,"abstract":"Purpose of review: Brain-derived neurotrophic factor (BDNF), a neurotrophin associated with neuronal survival and plasticity, has emerged as a significant player in cardiovascular biology. This review examines the evidence for BDNF as a regulator of hemostasis and thrombosis, integrating experimental, clinical, and genetic data to clarify its role in platelet function and thrombotic disease.Recent findings: Human platelets represent the largest peripheral reservoir of BDNF, releasing it upon activation by classical agonists. Once secreted, BDNF further amplifies platelet activation through a truncated isoform of the TrkB receptor via a kinase-independent signaling pathway. It also modulates clot architecture by promoting thinner, less stable fibrin networks and facilitating fibrinolysis. Paradoxically, lower circulating BDNF levels are consistently associated with greater severity of ischemic stroke and coronary artery disease, suggesting a systemic protective role. Genetic studies offer a more nuanced understanding linking BDNF to endothelial dysfunction and elevated cardiovascular risk.Summary: BDNF is a context-dependent modulator of thrombosis, amplifying platelet activation at sites of injury while exerting protective effects on vascular integrity systemically. Its potential as a cardiovascular biomarker and therapeutic target warrants further investigation.","PeriodicalId":55196,"journal":{"name":"Current Opinion in Hematology","volume":" ","pages":"196-202"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From biomimicry to clinical actionability: rethinking high-shear thrombosis as a mechanobiological system. 从仿生学到临床可操作性：重新思考高剪切血栓形成作为一种机械生物学系统。

IF 2.9 3区医学

Current Opinion in Hematology Pub Date : 2026-09-01 Epub Date: 2026-06-20 DOI: 10.1097/MOH.0000000000000937

Marcus Vinicius Batista da Silva, Christopher A Bresette, Viviana Clavería

{"title":"From biomimicry to clinical actionability: rethinking high-shear thrombosis as a mechanobiological system.","authors":"Marcus Vinicius Batista da Silva, Christopher A Bresette, Viviana Clavería","doi":"10.1097/MOH.0000000000000937","DOIUrl":"10.1097/MOH.0000000000000937","url":null,"abstract":"Purpose of review: Arterial thrombosis remains a leading cause of morbidity and mortality worldwide, while its mechanistic understanding and clinical management remain limited. In this review, we discuss how recent advances in microfluidic thrombosis models, mechanobiology, and microrobotic technologies may enable the development of clinically actionable and personalized thrombosis platforms.Recent findings: Recent findings demonstrate that arterial thrombus formation is strongly regulated by dynamic shear stress, platelet-rich aggregation, and von Willebrand factor (vWF)-mediated interactions. Emerging evidence further shows that shear-induced platelet aggregates, also known as SIPA clots, can form mechanically robust thrombi independently of classical coagulation pathways, highlighting thrombosis as a highly mechanosensitive process. Although microfluidic and flow-based systems have improved the physiological modeling of thrombosis, current platforms still face major limitations in capturing multidimensional shear dynamics, mechanobiological complexity, and patient-specific variability.Summary: Recent progress in vessel-on-a-chip technologies, computational modeling, artificial intelligence, and microrobotic systems suggests a pathway toward integrated and feedback-driven thrombosis management. These approaches may enable not only the measurement and prediction of thrombotic behavior but also its active modulation through targeted interventions. Collectively, this perspective supports a transition from static thrombosis assays toward dynamic and controllable mechanobiological platforms for precision cardiovascular medicine.","PeriodicalId":55196,"journal":{"name":"Current Opinion in Hematology","volume":" ","pages":"203-209"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13566384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0