Blood ReviewsPub Date : 2025-05-21DOI: 10.1016/j.blre.2025.101304
Yesim Dargaud, Sebastien Lobet, Nathalie Roussel, Leonard A Valentino
{"title":"Unmet needs in hemophilic arthropathy.","authors":"Yesim Dargaud, Sebastien Lobet, Nathalie Roussel, Leonard A Valentino","doi":"10.1016/j.blre.2025.101304","DOIUrl":"https://doi.org/10.1016/j.blre.2025.101304","url":null,"abstract":"<p><p>Hemophilia A and B are rare X-linked bleeding disorders caused by coagulation factor deficiencies, leading to joint bleeding, synovial hypertrophy and chronic hemophilic arthropathy marked by progressive cartilage and bone damage. Musculoskeletal issues remain the primary source of morbidity in people with hemophilia (PwH). Despite significant advances in prophylactic therapies, joint pain, functional limitations, and deterioration persist. The long-term impact of novel treatments on joint health and physical activity levels remains incompletely understood. Early detection and prevention of damage is challenging, highlighting the need for highly sensitive diagnostic tools to identify subclinical changes before irreversible damage occurs. Pain management, currently adapted from other conditions, does not fully meet the unique needs of PwH. Research into targeted pain relief, synovial hypertrophy management, and cartilage regeneration is crucial. Addressing unmet needs in diagnosis, treatment, and management requires collaboration between clinical and research communities to improve care effectiveness and enhance the quality of life for PwH.</p>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":" ","pages":"101304"},"PeriodicalIF":6.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144599","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}
Blood ReviewsPub Date : 2025-05-20DOI: 10.1016/j.blre.2025.101303
Tobias Dittrich, Lina Weinert, Anita D'Souza
{"title":"Patient-reported outcomes - the missing link to advancing light chain (AL) amyloidosis clinical research.","authors":"Tobias Dittrich, Lina Weinert, Anita D'Souza","doi":"10.1016/j.blre.2025.101303","DOIUrl":"https://doi.org/10.1016/j.blre.2025.101303","url":null,"abstract":"<p><p>Systemic light chain (AL) amyloidosis often results in multi-organ dysfunction and significant morbidity. Clinical assessments may not capture the full impact of disease and treatment on patients. Patient-reported outcomes (PROs) can help fill this gap. Although evidence suggests that the use of PROs provides additional predictive value beyond established cardiac staging systems, their integration into standard AL amyloidosis management remains limited. Our review examines the prognostic and therapeutic value of PROs and their current use as endpoints in clinical trials. We also discuss practical considerations, including instrument selection and administration, data interpretation, and reporting. Finally, we present a roadmap for integrating PROs into routine AL amyloidosis management, focusing on the selection of appropriate ePRO platforms and implementation strategies. We advocate a framework for data sharing and a coordinated research agenda. By addressing evidence gaps and prioritizing the patient perspective, PROs have the potential to advance AL amyloidosis care and research.</p>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":" ","pages":"101303"},"PeriodicalIF":6.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144584","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}
Blood ReviewsPub Date : 2025-05-14DOI: 10.1016/j.blre.2025.101302
Shuang Liu, Yan Shen, Jiayi Chen, Zheng Ruan, Li Hua, Kankan Wang, Xiaodong Xi, Jianhua Mao
{"title":"The critical role of platelets in venous thromboembolism: Pathogenesis, clinical status, and emerging therapeutic strategies.","authors":"Shuang Liu, Yan Shen, Jiayi Chen, Zheng Ruan, Li Hua, Kankan Wang, Xiaodong Xi, Jianhua Mao","doi":"10.1016/j.blre.2025.101302","DOIUrl":"https://doi.org/10.1016/j.blre.2025.101302","url":null,"abstract":"<p><p>Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a complex vascular disorder with high morbidity and mortality, driven by Virchow's Triad: blood stasis, hypercoagulability, and endothelial injury. VTE is now recognized as an inflammatory process involving multiple components. Platelets are involved in the process of VTE, contributing to thrombosis initiation, progression, resolution and recurrence through coagulation activation, and interactions with immune and endothelial cells. Anticoagulation remains the cornerstone of VTE treatment; however, antiplatelet agents like aspirin have demonstrated therapeutic potential, particularly following major orthopedic surgeries. Furthermore, emerging platelet-targeted therapies and biomarkers offer new opportunities for improving VTE diagnosis and treatment. This review explores the evolving role of platelets in VTE pathophysiology, assesses current antiplatelet strategies, and highlights novel therapeutic approaches. Advancing platelet research in VTE may lead to safer, more effective interventions, optimizing outcomes for patients with this life-threatening condition.</p>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":" ","pages":"101302"},"PeriodicalIF":6.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096012","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}
Blood ReviewsPub Date : 2025-05-14DOI: 10.1016/j.blre.2025.101301
Alain Mina, Yazan Madanat, Yasmin Abaza, Amer M Zeidan
{"title":"Navigating the dynamic landscape of lower-risk MDS: Advances and emerging insights.","authors":"Alain Mina, Yazan Madanat, Yasmin Abaza, Amer M Zeidan","doi":"10.1016/j.blre.2025.101301","DOIUrl":"https://doi.org/10.1016/j.blre.2025.101301","url":null,"abstract":"<p><p>Myelodysplastic syndromes/neoplasms (MDS) are a group of clonal myeloid malignancies characterized by ineffective hematopoiesis, cytopenias, and an increased risk of transformation to acute myeloid leukemia (AML). In lower-risk (LR) MDS, as defined by the revised and molecular international prognostic scoring systems (IPSS-R and IPSS-M), anemia is often the predominant clinical manifestation. Treatment strategies have traditionally focused on supportive care, including transfusion support and erythropoiesis stimulating agents (ESAs). While allogeneic hematopoietic stem cell transplantation remains the only potentially curative option for select patients, LR-MDS remain otherwise incurable with current therapies. With the exception of lenalidomide which was approved in 2005 in USA, therapeutic advancements in LR-MDS have stalled for almost 15 years. Progress has been limited by the disease's inherent complexity, indolent nature, and significant heterogeneity, as well as challenges in clinical trial design and execution. Recent advances in gene sequencing and molecular analyses have significantly increased our understanding of disease biology. These insights, coupled with collaborative efforts across the academic community, have led to meaningful shifts in classification, prognostication, and response assessment paradigms in LR-MDS. This evolution has led to a number of approvals, including luspatercept approved in 2020, and imetelstat, which was approved in 2024 in USA. As the therapeutic landscape of LR-MDS continues to evolve, there is growing optimism that these recent milestones will pave the way for further advancements and improved patient outcomes. Next set of studies should focus on the optimal sequencing and combinations of existing agents, as well as moving forward novel effective agents.</p>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":" ","pages":"101301"},"PeriodicalIF":6.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227776","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}
Blood ReviewsPub Date : 2025-05-09DOI: 10.1016/j.blre.2025.101300
Tomás José González-López, Drew Provan
{"title":"The new era of primary immune thrombocytopenia management in adults: A narrative review of current and emerging treatments.","authors":"Tomás José González-López, Drew Provan","doi":"10.1016/j.blre.2025.101300","DOIUrl":"https://doi.org/10.1016/j.blre.2025.101300","url":null,"abstract":"<p><p>The purpose of this review is to highlight the treatments currently available and those under- going evaluation in clinical trials for the treatment of ITP in order to achieve optimal use of the various existing ITP treatments. Specifically, we point out the indications for use of the various therapies available: corticosteroids, intravenous immunoglobulins (IVIG), thrombo- poietic agents (TPO-RAs), Syk inhibitors: Fostamatinib, antiCD20 monoclonal antibodies i.e. rituximab and the use of splenectomy in ITP. A review of the use of new drugs in ITP is also included in our manuscript: Neonatal Fc receptor (FcRn) antagonists; Bruton tyrosine kinase (BTK) inhibition; B-cell activating factor (BAFF) pathway inhibition; plasma cell depletion (an- tiCD38 monoclonal antibodies); new Syk inhibitors and complement inhibition. We believe that a reader with little knowledge of ITP can gain a clear understanding of the current treatment of ITP and its more or less immediate treatment prospects.</p>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":" ","pages":"101300"},"PeriodicalIF":6.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082283","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}
Blood ReviewsPub Date : 2025-05-09DOI: 10.1016/j.blre.2025.101299
Anam Ashfaque, Yara Shatnawi, Shahzad Raza, Diana Basali, Jack Khouri, Louis Williams, Sandra Mazzoni, Christy Samaras, Hamza Hassan, Utkarsh Acharya, Chakra Chaulagain, Faiz Anwer
{"title":"Suppression to removal, an emerging therapeutic approach for AL amyloidosis: A comprehensive review with early human data and pharmacokinetics of CAEL-101 antibody.","authors":"Anam Ashfaque, Yara Shatnawi, Shahzad Raza, Diana Basali, Jack Khouri, Louis Williams, Sandra Mazzoni, Christy Samaras, Hamza Hassan, Utkarsh Acharya, Chakra Chaulagain, Faiz Anwer","doi":"10.1016/j.blre.2025.101299","DOIUrl":"https://doi.org/10.1016/j.blre.2025.101299","url":null,"abstract":"<p><p>Light chain (AL amyloidosis) is a rare disorder characterized by the deposition of misfolded light chains in various organs, causing progressive organ damage. Current therapeutic agents do not remove amyloid aggregates already present in the organs, which are the major determinants of morbidity and mortality. Therefore, drugs targeting amyloid fibrils are currently being investigated. This article provides a comprehensive review of a novel, fibril-directed antibody, CAEL-101 (Anselamimab), which removes fibrillary aggregates from the organs, restoring organ function. Overall, CAEL-101 has demonstrated a favorable toxicity profile and improved organ responses, with faster treatment response time than current therapies in phase I/II trials, and is expected to have promising outcomes in the ongoing phase III studies. Combining anti-plasma cell dyscrasia (suppression) and fibril-directed agents (removal) is a novel therapeutic approach, providing optimism for organ function recovery and enhanced quality of life and survival, especially in patients with severe diseases.</p>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":" ","pages":"101299"},"PeriodicalIF":6.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096009","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}
Blood ReviewsPub Date : 2025-04-25DOI: 10.1016/j.blre.2025.101298
Mohamed Yassin, Caterina Minniti, Nirmish Shah, Salam Alkindi, Fateen Ata, Mohammed Qari, Abdullah Al Zayed, Jaffer Altooq, Mona Al Rasheed, Maria Domenica Capellini
{"title":"Evidence and gaps in clinical outcomes of novel pharmacologic therapies for sickle cell disease: A systematic literature review highlighting insights from clinical trials and real-world studies.","authors":"Mohamed Yassin, Caterina Minniti, Nirmish Shah, Salam Alkindi, Fateen Ata, Mohammed Qari, Abdullah Al Zayed, Jaffer Altooq, Mona Al Rasheed, Maria Domenica Capellini","doi":"10.1016/j.blre.2025.101298","DOIUrl":"https://doi.org/10.1016/j.blre.2025.101298","url":null,"abstract":"<p><p>This systematic review aims to summarise the clinical outcomes of l-glutamine, crizanlizumab, and voxelotor in the treatment of sickle cell disease (SCD) based on clinical trials and real-world data and to identify any gaps in the observations. The review identified 97 studies reporting data until 31 May 2024. A pivotal phase III study of l-glutamine showed that patients treated with l-glutamine had a 25 % reduction in pain crises and 33 % fewer hospital days compared to placebo. l-glutamine was generally well tolerated with minimal side effects. Real-world studies of l-glutamine emphasize patient adherence and obstacles to medication accessibility and approval as key concerns. In the SUSTAIN study, a 5-mg/kg dose of crizanlizumab reduced the occurrence of vaso-occlusive crises (VOCs) and hospitalizations by 45 % and 41 %, respectively. Real-world studies of crizanlizumab showed a reduction in complicated VOC events. The high discontinuation rate and results of the STAND trial led to a significant decrease in the use of crizanlizumab. The HOPE trial demonstrated a 51 % improvement in hemoglobin response and a reduction in hemolytic markers in patients treated with voxelotor. While some real-world studies have reported a decrease in VOCs and hospitalizations, the results are inconsistent and not conclusive. Further studies are needed to assess the impact of these novel therapies on end-organ-specific complications of SCD.</p>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":" ","pages":"101298"},"PeriodicalIF":6.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998774","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}
Blood ReviewsPub Date : 2025-04-11DOI: 10.1016/j.blre.2025.101289
Akihiro Ohmoto, Yoshiyuki Yamada, Shigeo Fuji
{"title":"Transplant-acquired allergy in HCT-recipients: Reference for clinical management.","authors":"Akihiro Ohmoto, Yoshiyuki Yamada, Shigeo Fuji","doi":"10.1016/j.blre.2025.101289","DOIUrl":"https://doi.org/10.1016/j.blre.2025.101289","url":null,"abstract":"<p><p>Transplant-acquired allergy (TAA) is well known in pediatric patients undergoing liver transplantation. Regarding allogeneic hematopoietic cell transplantation (allo-HCT), the clinical characteristics of TAA have not been fully elucidated. Clinical manifestations of TAA include eczematous dermatitis, allergic rhinitis, and asthma. It is known that allergic diseases are transferable from allergic donors to non-allergic recipients via allo-HCT. The potential mechanism is the transfer of allergen-specific memory B cells resulting in Th2-skewed allergy-specific immune responses. Retrospective studies have suggested that cord blood transplantation (CBT) and the immunosuppressant tacrolimus have a significant impact on the development of TAA. The reported prevalence varies according to study design, diagnostic methods, and study population, and the suspected allergens vary widely among individuals. Prospective cohort studies and further mechanistic investigations are warranted to provide robust evidence on the prevalence and risk factors associated with TAA.</p>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":" ","pages":"101289"},"PeriodicalIF":6.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051176","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}
Blood ReviewsPub Date : 2025-04-11DOI: 10.1016/j.blre.2025.101287
A. Kannan , K. Jeffrey , S. Misbah , K. Ramasamy
{"title":"Practical guidance on the prevention and management of infection in multiple myeloma patients: A case-based approach","authors":"A. Kannan , K. Jeffrey , S. Misbah , K. Ramasamy","doi":"10.1016/j.blre.2025.101287","DOIUrl":"10.1016/j.blre.2025.101287","url":null,"abstract":"<div><div>The risk of infection in multiple myeloma patients is significant, due to immune dysfunction secondary to myeloma, immunosenescence and age-related comorbidities, given the elderly myeloma patient demographic. Newer treatments, despite providing unprecedented improvements in disease-control, have further elevated infection risk. This risk is so substantial that we are approaching a period where a subset of older myeloma patients may be more likely to die secondary to infectious complications imposed by redirected T-cell therapy rather than from myeloma. As a result, it is essential to provide myeloma patients with the appropriate prophylaxis and monitoring against infection. In this review, we discuss disease-related, patient-related and treatment-related reasons for the increased infection risk in myeloma patients, and how to both prevent and manage this risk through creating a dynamic, infection prevention plan that is personalised to the individual patient.</div></div>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":"72 ","pages":"Article 101287"},"PeriodicalIF":6.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035164","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}
Blood ReviewsPub Date : 2025-04-09DOI: 10.1016/j.blre.2025.101288
Raffaele Palmieri, Anna Candoni, Francesco Di Raimondo, Giuseppe Rossi, Massimo Breccia, Fabrizio Pane, Paola Volpicelli, Benedetta Neri, Paola Finsinger, Morena Caira, Felicetto Ferrara
{"title":"Navigating acute myeloid leukemia towards better outcomes: Treatment pathways and challenges for patients ineligible for intensive chemotherapy.","authors":"Raffaele Palmieri, Anna Candoni, Francesco Di Raimondo, Giuseppe Rossi, Massimo Breccia, Fabrizio Pane, Paola Volpicelli, Benedetta Neri, Paola Finsinger, Morena Caira, Felicetto Ferrara","doi":"10.1016/j.blre.2025.101288","DOIUrl":"https://doi.org/10.1016/j.blre.2025.101288","url":null,"abstract":"<p><p>Acute myeloid leukemia (AML) is an aggressive hematologic malignancy that affects primarily older individuals. Patients ineligible to receive intensive standard chemotherapy followed by consolidation with/without hematopoietic stem cell transplant have a suboptimal prognosis. In recent years, significant advances have been made in the AML field leading to the development of new anti-leukemic approaches, including lower-intensity therapies specifically developed for patients who are ineligible for intensive chemotherapy. As the available options for this hard-to-manage and historically undertreated patient category are increasing, selecting the best treatment for each patient is crucial and ever more challenging. Accordingly, accurate patient evaluation is required to guide this decision-making process. There is currently no consensus on how to evaluate patients' fitness status, and the available tools that were originally developed for this purpose might not be adequate in the setting of the new treatment options. In this review we describe current management of AML patients unfit for intensive chemotherapy, aiming to highlight current challenges and suggest possible strategies for an accurate therapeutic selection. For this purpose, we will first provide an overview of epidemiology and classification of AML, and then move to current anti-leukemic treatments for unfit patients and the tools used for evaluating patient eligibility for a specific treatment. Finally, we will suggest possible measures to improve the management of AML patients in the era of novel lower-intensity regimens.</p>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":" ","pages":"101288"},"PeriodicalIF":6.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065222","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}