Blood advances最新文献

{"title":"Interpreting pulmonary function tests in allogeneic hematopoietic cell transplant recipients.","authors":"Nicola Alexandra Adderley, Jane Turner, Paul A Carpenter, Guang-Shing Cheng","doi":"10.1182/bloodadvances.2026022101","DOIUrl":"https://doi.org/10.1182/bloodadvances.2026022101","url":null,"abstract":"<p><p>Pulmonary complications are a significant cause of non-relapse mortality in allogeneic hematopoietic cell transplant (HCT) recipients. Pulmonary function tests (PFTs) are recommended to screen for asymptomatic lung function decline that precedes overt disease. HCT clinicians must understand the critical importance of PFTs in the post-HCT context and be able to identify abnormalities for timely intervention. This article provides a concise summary of contemporary PFT interpretation practices, tailored to clinicians caring for this complex patient population. Key principles, including comparison of pre-transplant and routine post-transplant studies, the importance of longitudinal assessments, and consideration of the clinical context of the HCT survivor, are illustrated through case vignettes. We review remaining fundamental questions about the application of PFTs post-transplant and suggest a path towards improved implementation and utilization of PFT data to guide clinical decision-making.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126690","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}

{"title":"Clinical Features and Outcomes of Therapy-Related Myeloid Neoplasms After CAR T-Cell Therapy.","authors":"Michael D Jain, Alaa Ali, Jaime Roman Diaz, Showkat Hamid, Peter Cheng, Saurabh Dahiya, Francesca Sillito, Maeve A O'Reilly, Kai Rejeski, Marion Subklewe, Gloria Iacoboni, Pere Barba, Ana Benzaquen, Javier Delgado-Serrano, Claire Roddie, David A Sallman, Eric Padron, Frederick L Locke, Jay Y Spiegel, Najla Al-Ali, Zachary Thompson, Jongphil Kim, Zhuoer Xie, Rami S Komrokji","doi":"10.1182/bloodadvances.2026021831","DOIUrl":"https://doi.org/10.1182/bloodadvances.2026021831","url":null,"abstract":"<p><p>Therapy-related myeloid neoplasms (t-MN) after chimeric antigen receptor (CAR) T-cell therapy occur with short latency, but whether they carry an independent survival disadvantage is unclear. We assembled a multicenter retrospective cohort of 399 adults with t-MN after CAR T-cell therapy (n=56), autologous hematopoietic cell transplantation (auto-HCT; n=98), or standard chemotherapy/radiation (n=245), and constructed a nearest-neighbor latency-matched cohort (n=220). Median latency was 15.2 months for post-CAR-T versus 38.0 and 30.0 months for post-auto-HCT and standard therapy (p<0.001). In the matched cohort, median overall survival (OS) was 9.1 months for post-CAR-T versus 16.9 and 18.7 months for post-auto-HCT and standard therapy (p=0.013). In multivariable Cox models, the hazard ratio for overall mortality was 1.98 (95% CI 1.33-2.94) for post-CAR-T and 0.99 (95% CI 0.74-1.32) for post-auto-HCT, each relative to standard therapy; The post-CAR-T estimate was 1.85 (95% CI 1.21-2.82) after adjustment for TP53 status and 2.15 (95% CI 1.23-3.76) in an era-restricted cohort with near-complete molecular data. TP53 variant allele frequency independently predicted OS (HR 1.14 per 10% increment, 95% CI 1.03-1.26). The hazard ratio for allogeneic HCT, modeled as a time-varying covariate, was 0.74 (95% CI 0.52-1.06). Post-CAR-T t-MN carries an independent survival disadvantage not explained by TP53 clone burden; allogeneic HCT remains the only potentially curative option.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126569","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}

{"title":"Alveolar distribution of ruxolitinib in pulmonary alveolar proteinosis developing during the treatment of chronic GVHD.","authors":"Souichi Shiratori, Yuki Tazawa, Reiki Ogasawara, Munehiro Matsumoto, Shuhei Yoshikawa, Yui Moritsugu, Keiko Yasuda, Mitsuru Sugawara, Yoh Takekuma, Daigo Hashimoto, Takanori Teshima","doi":"10.1182/bloodadvances.2026021990","DOIUrl":"https://doi.org/10.1182/bloodadvances.2026021990","url":null,"abstract":"","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126636","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}

{"title":"Allogeneic stem cell transplantation in aggressive Adult T cell leukemia/lymphoma: a prospective multicenter study.","authors":"Ambroise Marçais, Ludovick Lhermitte, Veronique Avettand Fenoel, Amani Ouedrani, Clemence Loiseau, Clarisse Cazelles, Louise Naveau, Adrien Gilbert, Lucile Debus, Phillipe Hélias, Alice-Andrée Mariaggi, Viviane Gournay, Clara Caillon, Saskia Ingen-Housz-Oro, Emilie Corvilain, Gandhi-Laurent Damaj, Stephanie Nguyen, Pierre Aubert, Michael Loschi, Vahid Asnafi, Felipe Suarez, Olivier Hermine","doi":"10.1182/bloodadvances.2026020323","DOIUrl":"https://doi.org/10.1182/bloodadvances.2026020323","url":null,"abstract":"<p><p>Adult T-cell leukemia/lymphoma (ATL) is associated with a dismal prognosis in aggressive subtypes, with a median overall survival (OS) of less than one year. In Japan, first line chemotherapy followed by allogeneic stem cell transplantation (allo-SCT) is recommended for eligible patients, yet this strategy is scarcely reported elsewhere, especially among ethnic minorities. We prospectively evaluated the feasibility and outcome of allo-SCT in this setting. Between 2016 and 2024, 80 ATL patients were enrolled; 74 (median age 50 years) received frontline chemotherapy (CHO(E)P regimen +/-Brentuximab Vedotin in CD30 positive cases). Of these, 39 subsequently proceeded to allo-SCT using a Thiotepa-Busulfan-Fludarabine conditioning regimen after at least one line of chemotherapy. Two-year OS from first line therapy was 45 %. Time-dependent analysis demonstrated a significant survival benefit for allo-SCT (hazard ratio, 0.32). Uncontrolled disease was the primary reason for transplant ineligibility. At transplantation, 27 patients were in complete remission (CR,) 5 in partial response (PR) and 7 had stable/progressive disease. Donor sources included haploidentical (56%), matched sibling (26%), and unrelated donors (18%). Three-year OS and progression-free survival were both 52%, while one-year non-relapse mortality and cumulative relapse incidence were 15% and 35%, respectively. Absence of CR/PR at allo-SCT was the main risk factor for poor outcomes. Tailored HTLV-1/ATL molecular and flow-cytometric monitoring of assessable patients in remission, revealed that tumor clones became undetectable after allo-SCT, suggesting a potent graft-versus-ATL effect. Overall, our findings support the benefit of allo-SCT in eligible ATL patients. Clinical Trial Identifier: NCT05237245.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126609","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}

{"title":"The impact of platelet transfusion prior to lumbar puncture: do the risks of transfusion exceed potential benefits?","authors":"Ryan Metcalf, Paula Dhiman, Yoshimi Anzai, Gordon H Guyatt, Simon J Stanworth","doi":"10.1182/bloodadvances.2026021889","DOIUrl":"https://doi.org/10.1182/bloodadvances.2026021889","url":null,"abstract":"","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104336","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}

{"title":"The total serum N-glycome landscape of hematological malignancies.","authors":"Yueyi Xu, Xiaoqing Dong, Junli Zhang, Jue Wang, Cuiling Zhang, Hongming Huang, Xiaofeng Shi, Xuejun Zhu, Xuezhong Zhang, Lei Xu, Yuwen Zhou, Chao Zhang, Xiaoyan Shao, Peipei Xu, Yong Xu, Yonggong Yang, Jing Wang, Yan Xu, Di Zhou, Hua Bai, Dongming Zhou, Cuiying Chitty Chen, Bing Chen, Jian Ouyang","doi":"10.1182/bloodadvances.2026020546","DOIUrl":"https://doi.org/10.1182/bloodadvances.2026020546","url":null,"abstract":"<p><p>A holistic and dynamic view of the glycomic landscape in hematological malignancies (HMs) remains poorly characterized, hindering clinical the application of glycomics in HMs. We launched a large-scale analysis of multicenter cohorts, combining retrospective (n=1,370) and prospective longitudinal (n=130) data across major HM types. We defined distinct total serum N‑glycome (TSNG) profiles for multiple myeloma, lymphoma, and acute leukemia at diagnosis, revealing shared and disease-specific signatures that support their diagnostic and subtyping potential. TSNG features changed with disease status. Key glycans decreased significantly upon complete remission and increased again at relapse. Receiver operating characteristic curve analyses demonstrated that TSNG could distinguish disease states, supporting its utility for assessing treatment response. We systematically mapped the TSNG landscape of HMs, established its clinical relevance across diagnosis, subtyping, and treatment monitoring, providing a framework for advancing the glycomics-based understanding and management of these malignancies.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104351","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}

{"title":"Home Monitoring of Neutrophil Counts by Patients with Cyclic and Congenital Neutropenia.","authors":"Merideth L Kelley, Audrey Anna Bolyard, Vahagn Makaryan, Winnie Fong, Eric Valentin, Alexandros Drivas, Dhruv Parthasarathy, Morgan Craig, Gabriel Côté, Michael C Mackey, David C Dale","doi":"10.1182/bloodadvances.2026020979","DOIUrl":"https://doi.org/10.1182/bloodadvances.2026020979","url":null,"abstract":"","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104395","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}

{"title":"Chromatin-informed cell-free DNA approach for detection of clinically measurable disease in multiple myeloma.","authors":"Palak Bajaj, Dor David Abelman, Ping Luo, Michele Ceccarelli, Jonathan H Schatz, Dionysios C Watson, Christian N Baker, Ava Amidei, Edus H Warren, Benjamin T Diamond, Alexander M Lesokhin, Neha S Korde, Urvi A Shah, Sham Mailankody, Hani Hassoun, Eric L Smith, Dickran Kazandjian, Sacha Gnjatic, Trevor J Pugh, Damian J Green, Ola Landgren, David G Coffey","doi":"10.1182/bloodadvances.2026022335","DOIUrl":"https://doi.org/10.1182/bloodadvances.2026022335","url":null,"abstract":"<p><p>Multiple myeloma (MM) is monitored using bone marrow-based minimal residual disease (MRD) assays, which provide high sensitivity but require repeated invasive sampling and are limited to a single anatomical site. Cell-free DNA (cfDNA) offers a minimally invasive alternative, yet most cfDNA approaches rely on prior tumor profiling to identify patient-specific genomic alterations for subsequent tracking in plasma. Here, we developed MATADOR, a myeloma-specific, tumor-agnostic framework that leverages cfDNA fragmentation patterns at a fixed set of myeloma-specific chromatin-accessible regulatory regions. These regions were defined using single-nucleus ATAC-seq data from an independent MM cohort and used to quantify plasma cfDNA fragmentation at these loci without patient-specific tumor profiling. Using these locus-specific features alone, MATADOR distinguished clinically measurable from unmeasurable disease in a held-out test set with an area under the receiver operating characteristic curve (AUROC) of 0.94. These findings establish chromatin-informed cfDNA fragmentomics as a minimally invasive approach for disease assessment in MM without individualized tumor profiling, enabling blood-based assessment of disease beyond the constraints of bone marrow sampling.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104399","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}

{"title":"Impact of Metformin on the Incidence of Thrombosis in Older Adults with Polycythemia Vera or Essential Thrombocythemia and Diabetes.","authors":"Jessica M Stempel, Rong Wang, Rory M Shallis, Lourdes M Mendez, Jan Philipp Bewersdorf, Maximilian Stahl, Amer M Zeidan, Xiaomei Ma, Nikolai A Podoltsev","doi":"10.1182/bloodadvances.2026020767","DOIUrl":"https://doi.org/10.1182/bloodadvances.2026020767","url":null,"abstract":"<p><p>Individuals with myeloproliferative neoplasms (MPNs) have an increased thrombotic risk, particularly in the presence of cardiovascular comorbidities such as diabetes (DM). Metformin (MET) has been associated with a reduced incidence of MPNs; however, data on its association with thrombotic outcomes in polycythemia vera (PV) and essential thrombocythemia (ET) are limited. We conducted a retrospective study using the Surveillance, Epidemiology, and End Results-Medicare-linked database to evaluate the association between MET use and thrombotic risk in patients with MPNs and DM. We included patients with DM aged ≥66 years diagnosed with PV or ET between 2008-2019, continuously enrolled in Medicare Parts A/B/D, and followed for ≥6 months after diagnosis. Adjusted competing risk models were used to evaluate the association between MET and thrombotic risk. Among 1153 eligible patients (PV, n=528; ET, n=629), 846 (73.4%) had mild and 307 (26.6%) had severe DM. A total of 431 (37.4%) used MET. Overall, 485 (42.1%) patients experienced thrombosis after MPN diagnosis. MET use was independently associated with a reduced thrombotic risk (hazard ratio [HR]=0.78, 95% confidence interval [CI]: 0.64-0.95; p=0.02), especially among patients with severe DM (HR=0.58, 95% CI: 0.38-0.89; p=0.01), and those without prior thrombosis (HR=0.78, 95% CI: 0.62-0.97; p=0.02), but not among those with mild DM (HR=0.87, 95% CI: 0.68-1.11; p=0.27). When evaluating thrombotic event types separately, this benefit applied to arterial, but not venous thrombosis. MET use was associated with a lower thrombotic risk in older patients with PV/ET, primarily in individuals with severe DM.</p>","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104350","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}

{"title":"Cytoreduction in MPN-SVT: Is the Association Causal?","authors":"Ufuk Demirci, Ahmet Emre Eşkazan","doi":"10.1182/bloodadvances.2026022322","DOIUrl":"https://doi.org/10.1182/bloodadvances.2026022322","url":null,"abstract":"","PeriodicalId":9228,"journal":{"name":"Blood advances","volume":" ","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104314","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}