American Journal of Hematology最新文献

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Undetectable Hydroxyurea in an Untimed Blood Sample Does Not Establish Nonadherence. 在非定时血液样本中检测不到羟基脲不能建立不粘连。
IF 9.4 1区 医学
American Journal of Hematology Pub Date : 2026-10-01 Epub Date: 2026-08-09 DOI: 10.1002/ajh.70469
Zhichao Zhao, Ting Shen
{"title":"Undetectable Hydroxyurea in an Untimed Blood Sample Does Not Establish Nonadherence.","authors":"Zhichao Zhao, Ting Shen","doi":"10.1002/ajh.70469","DOIUrl":"10.1002/ajh.70469","url":null,"abstract":"","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":" ","pages":"2704-2705"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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 Pitfalls of Categorizing Donor Age: Arbitrary Cutoffs Fail to Predict Survival in Haploidentical HCT. 供体年龄分类的陷阱:任意截断不能预测单倍体HCT的生存率。
IF 9.4 1区 医学
American Journal of Hematology Pub Date : 2026-10-01 Epub Date: 2026-07-28 DOI: 10.1002/ajh.70440
Yosra M Aljawai, Denái Milton, Rohtesh S Mehta, Portia Smallbone, Jeremy Ramdial, George Chen, Partow Kebriaei, Yago Nieto, David Marin, Uday Popat, Betul Oran, Richard E Champlin, Elizabeth J Shpall
{"title":"The Pitfalls of Categorizing Donor Age: Arbitrary Cutoffs Fail to Predict Survival in Haploidentical HCT.","authors":"Yosra M Aljawai, Denái Milton, Rohtesh S Mehta, Portia Smallbone, Jeremy Ramdial, George Chen, Partow Kebriaei, Yago Nieto, David Marin, Uday Popat, Betul Oran, Richard E Champlin, Elizabeth J Shpall","doi":"10.1002/ajh.70440","DOIUrl":"10.1002/ajh.70440","url":null,"abstract":"","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":" ","pages":"2683-2690"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Unique Aspects of Allogeneic Hematopoietic Stem Cell Transplantation in VEXAS Syndrome: One Size Does Not Fit All. 异基因造血干细胞移植治疗VEXAS综合征的独特之处:一种方法并不适合所有患者。
IF 9.4 1区 医学
American Journal of Hematology Pub Date : 2026-10-01 Epub Date: 2026-08-06 DOI: 10.1002/ajh.70465
Abhishek A Mangaonkar, Hassan B Alkhateeb
{"title":"Unique Aspects of Allogeneic Hematopoietic Stem Cell Transplantation in VEXAS Syndrome: One Size Does Not Fit All.","authors":"Abhishek A Mangaonkar, Hassan B Alkhateeb","doi":"10.1002/ajh.70465","DOIUrl":"10.1002/ajh.70465","url":null,"abstract":"","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":" ","pages":"2696-2697"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Targeted Next-Generation Sequencing of JAK2, CALR, and MPL in 10 326 Patients With Suspected Myeloproliferative Neoplasm. 10326例疑似骨髓增生性肿瘤患者JAK2、CALR和MPL的靶向新一代测序
IF 9.4 1区 医学
American Journal of Hematology Pub Date : 2026-10-01 Epub Date: 2026-08-09 DOI: 10.1002/ajh.70468
Lucie Rigolot, Mathias Chea, Laetitia Largeaud, Naïs Prade, Stéphanie Dufrechou, Pauline Condom, Thomas Lhossein, Pierre-Yves Juvin, Julie Riol, Elise Frébet, Hugo Migné, Isabelle Legoff, Carole Boivert, Barnabé Daniau, Philippe Gueudet, Pierre Bories, Françoise Huguet, Suzanne Tavitian, Eric Delabesse, Véronique De Mas
{"title":"Targeted Next-Generation Sequencing of JAK2, CALR, and MPL in 10 326 Patients With Suspected Myeloproliferative Neoplasm.","authors":"Lucie Rigolot, Mathias Chea, Laetitia Largeaud, Naïs Prade, Stéphanie Dufrechou, Pauline Condom, Thomas Lhossein, Pierre-Yves Juvin, Julie Riol, Elise Frébet, Hugo Migné, Isabelle Legoff, Carole Boivert, Barnabé Daniau, Philippe Gueudet, Pierre Bories, Françoise Huguet, Suzanne Tavitian, Eric Delabesse, Véronique De Mas","doi":"10.1002/ajh.70468","DOIUrl":"10.1002/ajh.70468","url":null,"abstract":"","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":" ","pages":"2698-2703"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Dasatinib Exposure and Risk of CMV Reactivation in Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia. 达沙替尼暴露和费城染色体阳性急性淋巴细胞白血病CMV再激活的风险。
IF 9.4 1区 医学
American Journal of Hematology Pub Date : 2026-10-01 Epub Date: 2026-07-28 DOI: 10.1002/ajh.70452
Lubna Osman-Kardash, Ahmed Alnajar, Anthony D Anderson, Ellen Madarang, Mikkael Sekeres, Justin Watts, Terrence Bradley, Wenhui Li, Jill Lykon, Mohammed Raja, Antonio Jimenez Jimenez, Amer Beitinjaneh, Trent Wang, Mark Goodman, Lazaros Lekakis, Jay Spiegel, Noa G Holtzman, Denise Pereira, Damian Green, Jose F Camargo
{"title":"Dasatinib Exposure and Risk of CMV Reactivation in Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia.","authors":"Lubna Osman-Kardash, Ahmed Alnajar, Anthony D Anderson, Ellen Madarang, Mikkael Sekeres, Justin Watts, Terrence Bradley, Wenhui Li, Jill Lykon, Mohammed Raja, Antonio Jimenez Jimenez, Amer Beitinjaneh, Trent Wang, Mark Goodman, Lazaros Lekakis, Jay Spiegel, Noa G Holtzman, Denise Pereira, Damian Green, Jose F Camargo","doi":"10.1002/ajh.70452","DOIUrl":"10.1002/ajh.70452","url":null,"abstract":"","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":" ","pages":"2691-2695"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Correction to "Impairment of Innate Immunity and Depletion of Vaccine-Induced Memory B and T Cells in the Absence of the Spleen". 修正“先天免疫损伤和疫苗诱导的记忆B细胞和T细胞在脾脏缺失时的耗竭”。
IF 9.4 1区 医学
American Journal of Hematology Pub Date : 2026-10-01 Epub Date: 2026-07-30 DOI: 10.1002/ajh.70461
{"title":"Correction to \"Impairment of Innate Immunity and Depletion of Vaccine-Induced Memory B and T Cells in the Absence of the Spleen\".","authors":"","doi":"10.1002/ajh.70461","DOIUrl":"10.1002/ajh.70461","url":null,"abstract":"","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":" ","pages":"2706"},"PeriodicalIF":9.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Clonally Related Chronic Lymphocytic Leukemia and Malignant Histiocytic Neoplasm (Histiocytic Sarcoma With Overlapping Langerhans Cell Phenotype): Divergent Evolution From a Shared Cell‐Of‐Origin 克隆相关慢性淋巴细胞白血病和恶性组织细胞肿瘤(具有重叠朗格汉斯细胞表型的组织细胞肉瘤):来自共享细胞起源的不同进化
IF 12.8 1区 医学
American Journal of Hematology Pub Date : 2026-09-05 DOI: 10.1002/ajh.70494
Adelaide J. Kwon,Lindsay K. Hill,Reiko Tachibana,Estelle Oertling,Lin He,Jeffrey Gagan,Prasad Koduru,Franklin Fuda,Jing Xu,Miguel Cantu,Stephen Chung,Benjamin Kroger,Praveen Ramakrishnan Geethakumari,Weina Chen
{"title":"Clonally Related Chronic Lymphocytic Leukemia and Malignant Histiocytic Neoplasm (Histiocytic Sarcoma With Overlapping Langerhans Cell Phenotype): Divergent Evolution From a Shared Cell‐Of‐Origin","authors":"Adelaide J. Kwon,Lindsay K. Hill,Reiko Tachibana,Estelle Oertling,Lin He,Jeffrey Gagan,Prasad Koduru,Franklin Fuda,Jing Xu,Miguel Cantu,Stephen Chung,Benjamin Kroger,Praveen Ramakrishnan Geethakumari,Weina Chen","doi":"10.1002/ajh.70494","DOIUrl":"https://doi.org/10.1002/ajh.70494","url":null,"abstract":"","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"9 1","pages":""},"PeriodicalIF":12.8,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148893675","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}
引用次数: 0
Autoantibodies to Extracellular Erythrocyte Band 3 Epitopes Are Associated With Anemia in Plasmodium vivax Infection 胞外红细胞3带表位自身抗体与间日疟原虫感染贫血相关
IF 9.4 1区 医学
American Journal of Hematology Pub Date : 2026-09-03 Epub Date: 2026-07-29 DOI: 10.1002/ajh.70463
Aline Marzano-Miranda, Vanessa G. Fraga, Cor Jésus F. Fontes, Simone Ladeia-Andrade, Marcelo U. Ferreira, Daniella C. Bartholomeu, Érika M. Braga
{"title":"Autoantibodies to Extracellular Erythrocyte Band 3 Epitopes Are Associated With Anemia in Plasmodium vivax Infection","authors":"Aline Marzano-Miranda,&nbsp;Vanessa G. Fraga,&nbsp;Cor Jésus F. Fontes,&nbsp;Simone Ladeia-Andrade,&nbsp;Marcelo U. Ferreira,&nbsp;Daniella C. Bartholomeu,&nbsp;Érika M. Braga","doi":"10.1002/ajh.70463","DOIUrl":"10.1002/ajh.70463","url":null,"abstract":"<p>\u0000 <i>Plasmodium vivax</i>-associated anemia is a multifactorial clinical outcome, in which the destruction of uninfected red blood cells (uRBCs) plays a major role in disease development and severity. Here, we identified autoantibody targets within the extracellular loops of Band 3 (B3), a major erythrocyte transmembrane protein. <i>In silico</i> epitope prediction identified six of the seven potentially immunogenic extracellular domains of B3. Patients with \u0000 <i>P. vivax</i>\u0000 infection who were anemic (<i>n</i> = 79) and non-anemic (<i>n</i> = 95), and 40 healthy donors from a non-endemic area were included as negative controls. In addition, 15 anemic and 15 non-anemic infected individuals were also analyzed immediately before treatment (D0) and on Days 7, 14, and 28 after antimalarial therapy. Synthetic peptides corresponding to the six B3 domains were robustly recognized by autoantibodies from \u0000 <i>P. vivax</i>\u0000 -infected patients. Anemic individuals exhibited prominent autoantibody responses, particularly against loops 4 and 6. IgG3 was the predominant subclass targeting these loops and remained detectable up to 28 days post-treatment, suggesting a possible role in the persistence of anemia even after parasite clearance. In contrast, IgG1 was the principal subclass recognizing the peptides corresponding to loops 1, 2, and 3, indicating a significant response to senescent domains during \u0000 <i>P. vivax</i>\u0000 infection. Analysis of IgG subclass against full-length B3 confirmed the presence of both IgG1 and IgG3 responses. The pro-inflammatory properties of these IgG subclasses support the hypothesis that anti-B3 autoantibodies contribute to the immunopathogenesis of \u0000 <i>P. vivax</i>\u0000 -related anemia. Collectively, these findings identify potential targets for future mechanistic investigations and therapeutic intervention strategies.</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"101 10","pages":"2592-2604"},"PeriodicalIF":9.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.70463","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Eltrombopag Added to Standard Immunosuppressive Treatment as Front-Line Therapy for Severe Aplastic Anemia: Long-Term Outcomes of the Phase-3 Randomized Superiority EBMT-SAAWP RACE Study Eltrombopag加入标准免疫抑制治疗作为严重再生障碍性贫血的一线治疗:3期随机优势EBMT-SAAWP RACE研究的长期结果
IF 9.4 1区 医学
American Journal of Hematology Pub Date : 2026-09-03 Epub Date: 2026-07-19 DOI: 10.1002/ajh.70445
Antonio M. Risitano, Simona Iacobelli, Austin Kulasekararaj, Marleen van Os, Sofie R. Terwel, Joe Tuffnell, Brian Piepenbroek, Morag Griffin, Constantijn J. M. Halkes, Christian Recher, Fiorenza Barraco, Edouard Forcade, Juan Carlos Vallejo, Beatrice Drexler, Jean-Baptiste Mear, Roochi Trikha, Shreyans Gandhi, Anna Maria Raiola, L. G. M. Daenen, Marco R. de Groot, Etienne Daguindau, Erfan Nur, Wilma Barcellini, Nigel H. Russell, Louis Terriou, Anna Paola Iori, Walter Barberi, Anna Sureda, Isabel Sánchez-Ortega, Blanca Xicoy, Isidro Jarque, James Cavenagh, Flore Sicre de Fontbrune, Camilla Frieri, Talha Munir, Jennifer M. L. Tjon, Suzanne Tavitian, Aline Praire, Laurence Clement, Florence Rabian, Luana Marano, Anita Hill, Elena Palmisani, Petra Muus, Serena Marotta, Fabiana Cacace, Marica Laurino, Jakob R. Passweg, Gérard Socié, Ghulam J. Mufti, Carlo Dufour, Régis Peffault de Latour, Severe Aplastic Anaemia Working Party of the EBMT
{"title":"Eltrombopag Added to Standard Immunosuppressive Treatment as Front-Line Therapy for Severe Aplastic Anemia: Long-Term Outcomes of the Phase-3 Randomized Superiority EBMT-SAAWP RACE Study","authors":"Antonio M. Risitano,&nbsp;Simona Iacobelli,&nbsp;Austin Kulasekararaj,&nbsp;Marleen van Os,&nbsp;Sofie R. Terwel,&nbsp;Joe Tuffnell,&nbsp;Brian Piepenbroek,&nbsp;Morag Griffin,&nbsp;Constantijn J. M. Halkes,&nbsp;Christian Recher,&nbsp;Fiorenza Barraco,&nbsp;Edouard Forcade,&nbsp;Juan Carlos Vallejo,&nbsp;Beatrice Drexler,&nbsp;Jean-Baptiste Mear,&nbsp;Roochi Trikha,&nbsp;Shreyans Gandhi,&nbsp;Anna Maria Raiola,&nbsp;L. G. M. Daenen,&nbsp;Marco R. de Groot,&nbsp;Etienne Daguindau,&nbsp;Erfan Nur,&nbsp;Wilma Barcellini,&nbsp;Nigel H. Russell,&nbsp;Louis Terriou,&nbsp;Anna Paola Iori,&nbsp;Walter Barberi,&nbsp;Anna Sureda,&nbsp;Isabel Sánchez-Ortega,&nbsp;Blanca Xicoy,&nbsp;Isidro Jarque,&nbsp;James Cavenagh,&nbsp;Flore Sicre de Fontbrune,&nbsp;Camilla Frieri,&nbsp;Talha Munir,&nbsp;Jennifer M. L. Tjon,&nbsp;Suzanne Tavitian,&nbsp;Aline Praire,&nbsp;Laurence Clement,&nbsp;Florence Rabian,&nbsp;Luana Marano,&nbsp;Anita Hill,&nbsp;Elena Palmisani,&nbsp;Petra Muus,&nbsp;Serena Marotta,&nbsp;Fabiana Cacace,&nbsp;Marica Laurino,&nbsp;Jakob R. Passweg,&nbsp;Gérard Socié,&nbsp;Ghulam J. Mufti,&nbsp;Carlo Dufour,&nbsp;Régis Peffault de Latour,&nbsp;Severe Aplastic Anaemia Working Party of the EBMT","doi":"10.1002/ajh.70445","DOIUrl":"10.1002/ajh.70445","url":null,"abstract":"<p>The RACE study (NCT02009747) compared horse antithymocyte globulin (hATG) plus cyclosporine A (CsA) ± eltrombopag as initial immunosuppressive treatment (IST) for severe aplastic anemia. Here we report the final 2-year analysis of this prospective randomized phase III study. One hundred ninety-seven treatment-naive patients were randomized to standard IST (hATG 40 mg/kg × 4 days and CsA 5 mg/kg/day; arm A; <i>n</i> = 101) or standard IST + eltrombopag at the dose of 150 mg/day (arm B; <i>n</i> = 96) from day +14 until 6 months (or 3 months, in case of complete response). The median follow-up was 23.2 months. The 2-year cumulative incidence of complete response was significantly superior in arm B (62.4% vs. 35.3%; <i>p</i> &lt; 0.001). The 2-year overall survival (OS) was 86% in arm A and 91% in arm B (<i>p</i> = 0.081), with hazard ratio (HR), adjusted for age and disease severity, of 0.54 (<i>p</i> = 0.064). The 2-year disease-free survival (DFS) was 56% vs. 37% (adjusted HR = 0.49; <i>p</i> &lt; 0.001), while event-free survival (EFS) was 48% vs. 32% (<i>p</i> &lt; 0.001), with adjusted HR = 0.54 (<i>p</i> &lt; 0.001), both significantly superior for arm B. The cumulative incidence of relapse was comparable in the two arms, while evolution to clinical paroxysmal nocturnal hemoglobinuria was 8% in arm A and 1% in arm B (<i>p</i> = 0.041). The risk of clonal evolution remained negligible, with one patient in arm A and two in arm B developing karyotypic abnormalities. The initial hematological response benefit of eltrombopag added to IST as front-line treatment of AA is associated with better 2-year OS, DFS, and EFS without increased risk of secondary myeloid malignancies.</p>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"101 10","pages":"2520-2532"},"PeriodicalIF":9.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajh.70445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Monoclonal Gammopathy of Thrombotic Significance 单克隆γ病的血栓形成意义。
IF 9.4 1区 医学
American Journal of Hematology Pub Date : 2026-09-03 Epub Date: 2026-08-09 DOI: 10.1002/ajh.70467
Matthew Ho, Saurabh Zanwar, Shaji Kumar, S. Vincent Rajkumar
{"title":"Monoclonal Gammopathy of Thrombotic Significance","authors":"Matthew Ho,&nbsp;Saurabh Zanwar,&nbsp;Shaji Kumar,&nbsp;S. Vincent Rajkumar","doi":"10.1002/ajh.70467","DOIUrl":"10.1002/ajh.70467","url":null,"abstract":"<div>\u0000 \u0000 <p>Monoclonal gammopathy of undetermined significance (MGUS) is an asymptomatic premalignant precursor to multiple myeloma (MM). While development of end-organ damage in MM largely reflects increasing clonal burden, emerging evidence indicates that qualitative properties of the monoclonal immunoglobulins in MGUS can be directly pathogenic, leading to serious organ injury independent of disease burden. This has led to the recognition of a broader spectrum of disorders collectively termed monoclonal gammopathy of clinical significance (MGCS). MGCS can be further subclassified based on the organ system involved; for example, monoclonal gammopathy of renal significance specifically refers to monoclonal immunoglobulin-driven renal injury. Along these lines, we propose monoclonal gammopathy of thrombotic significance (MGTS) as encompassing thrombotic disorders in which there is definitive, mechanistically supported evidence that a monoclonal (M)-protein associated with a clonal plasma or B-cell disorder directly contributes to thrombosis. Based on current evidence, monoclonal protein–induced immune thrombocytopenia and thrombosis is the only disorder that meets our criteria for MGTS. Other thrombotic disorders, such as thrombotic microangiopathy and antiphospholipid syndrome, may occur in the setting of a monoclonal protein and have biologically plausible M-protein-mediated mechanisms; however, direct evidence implicating the M-protein in thrombosis is currently lacking. Accordingly, we provisionally classify these disorders as thrombotic syndromes associated with M-proteins, pending causal validation. We also highlight thrombotic disease associations with multifactorial pathogenesis that should not be classified as MGTS. Broader recognition of MGTS is essential to advance consensus definitions, establish diagnostic criteria, and develop evidence-based management strategies for this clinically important group of disorders.</p>\u0000 </div>","PeriodicalId":7724,"journal":{"name":"American Journal of Hematology","volume":"101 10","pages":"2616-2631"},"PeriodicalIF":9.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700519","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}
引用次数: 0
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