21 August 2025 (Thursday) - ASH Update

The nice people at ASH sent their update today. They’ve been sending them for some time, but there’s no denying that they go right over my head. But then, a lot of the journals do that. If I stick at them and read around and find out, then (just maybe) something might stick in my head.

After all, isn’t that what CPD is all about?

BLOOD COMMENTARIES       Cracking the POD24 code in follicular lymphoma     Florian Scherer   Blood August 2025, Vol.146, 899-900. doi: 10.1182/blood.2025029930     A burden too high for CAR T cells in CLL     Arnon P. Kater ; Maria Themeli   Blood August 2025, Vol.146, 901-902. doi: 10.1182/blood.2025029368     Protecting the epithelium and taming GVHD     Yishan Ye; Mohamad Mohty   Blood August 2025, Vol.146, 903-905. doi: 10.1182/blood.2025029271     The landscape of disease: mapping aplastic anemia     Patrick M. Brunner   Blood August 2025, Vol.146, 905-906. doi: 10.1182/blood.2025029791     Deep dive into shallow myeloma cell pool     Mehmet K. Samur   Blood August 2025, Vol.146, 906-907. doi: 10.1182/blood.2025029778     CALR-ifying ATF6/BCL-xL activation by type 2 CALR mutations     Fan He ; Stephen T. Oh   Blood August 2025, Vol.146, 907-908. doi: 10.1182/blood.2025029864     When TNFα is out, IFN-γ drives anemia of inflammation     Laura Silvestri   Blood August 2025, Vol.146, 908-910. doi: 10.1182/blood.2025030006     Checkpoint-primed allo-HCT in HL: cure gains, risk remains     Paul J. Bröckelmann; Bastian von Tresckow   Blood August 2025, Vol.146, 911-912. doi: 10.1182/blood.2025029908

PLENARY PAPER       Combined PET and ctDNA response as a predictor of POD24 for follicular lymphoma after first-line induction treatment     Alexis Claudel; Anne-Ségolène Cottereau; Emmanuel Bachy; Emmanuel Itti ; Pierre Feugier; Cedric Rossi; Francois Lemonnier; Vincent Camus; Nicolas Daguindau ; Guillaume Cartron; Emmanuelle Nicolas-Virelizier; Diana-Laure Mboumba; Christophe Cardoso; Côme Bommier; Benoit Tessoulin; Christophe Fruchart; Adrien Gilbert; Eric Durot; Emmanuel Fleck; Gian Matteo Pica; Hacene Zerazhi; Stephanie Guidez; Morgane Cheminant; Clementine Sarkozy; Luc Xerri; Laetitia Vercellino; Nesrine Trabelsi; Lucie Gomes; Cedric Portugues; Pierre-Julien Viailly; Marie-Hélène Delfau-Larue; Franck Morschhauser   Blood August 2025, Vol.146, 913-925. doi: 10.1182/blood.2024027727

PERSPECTIVE       Challenges in GVHD and GVL after hematopoietic stem cell transplantation for myeloid malignancies     Gerard Socie   Blood August 2025, Vol.146, 926-937. doi: 10.1182/blood.2025028617

CLINICAL TRIALS AND OBSERVATIONS       ZUMA-8: a phase 1 study of brexucabtagene autoleucel in patients with relapsed/refractory chronic lymphocytic leukemia     Matthew S. Davids; Saad S. Kenderian; Ian Flinn; Brian T. Hill; Michael Maris; Paolo Ghia; Michael Byrne ; Nancy L. Bartlett; John M. Pagel; Yan Zheng; Justyna Kanska; Wangshu Zhang ; Enrique Granados; Javier Pinilla-Ibarz   Blood August 2025, Vol.146, 938-943. doi: 10.1182/blood.2024027460     Phase 1/2 study of high-dose palifermin for GVHD prophylaxis in patients undergoing HLA-matched unrelated donor HCT     Eduard Schulz; Lauren M. Curtis; Noa G. Holtzman; Seth M. Steinberg; Kaska Wloka ; Alen Ostojic; Alain Mina; Najla El Jurdi; Filip Pirsl; Ashley Carpenter ; Mahshid Golagha; Arlene Sirajuddin; Theo Heller; Brian C. Shaffer; Frances T. Hakim ; Jeffrey S. Rubin; Ronald E. Gress; Steven Z. Pavletic   Blood August 2025, Vol.146, 944-950. doi: 10.1182/blood.2024028303

IMMUNOBIOLOGY AND IMMUNOTHERAPY       Imaging mass cytometry reveals the order of events in the pathogenesis of immune-mediated aplastic anemia     Emma S. Pool; Sietse J. Luk; Marieke E. Ijsselsteijn; Vincent van Unen; Noel F. C. C. de Miranda; J. H. Frederik Falkenburg; Frits Koning; Mirjam H. M. Heemskerk; Jennifer M.-L. Tjon   Blood August 2025, Vol.146, 951-963. doi: 10.1182/blood.2025028723

LYMPHOID NEOPLASIA       Ultrasensitive detection of circulating multiple myeloma cells by next-generation flow after immunomagnetic enrichment     Marta Lasa; Carmen Gonzalez; Laura Notarfranchi; Anastasiia Zherniakova ; Diego Alignani; Leire Burgos; Maria Jose Calasanz; Paula Rodriguez-Otero; Jose J. Perez ; Clara Gomez; Veronica Gonzalez de la Calle; Felipe de Arriba; Luis Palomera; Miguel Angel Alvarez Rivas; Esther Clavero; Enrique M. Ocio; Ana Pilar Gonzalez-Rodriguez; Sunil Lakhwani ; Angela Ibañez; Albert Oriol; Anna Sureda; Laura Rosiñol; Christiane Siewert; Alberto Orfao; Juan-Jose Lahuerta; Joan Blade; Maria-Victoria Mateos ; Jesus F. San-Miguel; Maria-Teresa Cedena; Joaquin Martinez-Lopez; Noemi Puig; Bruno Paiva; on behalf of the PETHEMA/GEM cooperative group   Blood August 2025, Vol.146, 964-970. doi: 10.1182/blood.2025029234

MYELOID NEOPLASIA       Type 2 calreticulin mutations activate ATF6 to promote BCL-xL–mediated survival in myeloproliferative neoplasms     Nicole S. Arellano; William L. Heaton ; Mirielle C. Nauman; Abigail E. Runnels; Jacky Gomez-Villa; Daniele Vanni; Melissa Gaviria; Maihi Fujita; Nathan M. Krah; Michele Ciboddo; Saveg Yadav; Callie T. Brown; Parker D. Bowden; Amy K. Chen; Christopher Henning; Silvia Catricalà ; Ilaria Carola Casetti; Oscar Borsani; Elisa Rumi; Daniela Pietra; Isabelle Plo ; Caroline Marty; Marco Marchetti; Ami B. Patel; Caner Saygin; Shannon E. Elf   Blood August 2025, Vol.146, 971-983. doi: 10.1182/blood.2024026940

RED CELLS, IRON, AND ERYTHROPOIESIS       TNFα signaling restores steady-state hematopoiesis in a TNFαKO mouse model of anemia of inflammation     Amaliris Guerra; Vania Lo Presti; Ding-Wen Chen; Ana Catarina Martins; Ariel Rivera; Nolan Hamilton; Pankja Sharma; Yelena Z. Ginzburg; Carlo Castruccio Castracani; Carla Casu; Ritama Gupta; Raffaella Gozzelino; Edward M. Behrens ; Laura F. Bennett; Robert F. Paulson; Peter Kurre; Stefano Rivella   Blood August 2025, Vol.146, 984-997. doi: 10.1182/blood.2025029352

THROMBOSIS AND HEMOSTASIS       The T follicular helper/T follicular helper regulatory pathway in FVIII immune responses in mice     Weiqing Jing; Jocelyn A. Schroeder; Saurabh Kumar; Juan Chen; Yuanhua Cai; Lynn M. Malec; Alexander L. Dent; Weiguo Cui; Qizhen Shi   Blood August 2025, Vol.146, 998-1010. doi: 10.1182/blood.2025029470

TRANSPLANTATION       Outcomes of allogeneic HCT in Hodgkin lymphoma in the era of checkpoint inhibitors: a joint CIBMTR and EBMT analysis     Miguel-Angel Perales; Farrukh T. Awan; Ariane Boumendil; Jinalben Patel; Luca Castagna; Emanuele Angelucci; Herve Finel; Alexander Kulagin; Bertram Glass; Paolo Corradini; Alex F. Herrera; Didier Blaise; Mohamed A. Kharfan-Dabaja ; Khalid Halahleh; Sairah Ahmed; Carmen Martínez; Sebastian Giebel; Silvia Montoto ; Richard J. Jones; Nausheen Ahmed; Ryan C. Lynch; Marcos J. De Lima; Mazyar Shadman ; Craig S. Sauter; Kwang W. Ahn; Mehdi Hamadani; Ali Bazarbachi; Anna Sureda   Blood August 2025, Vol.146, 1011-1029. doi: 10.1182/blood.2024027197

CONTINUING MEDICAL EDUCATION (CME) QUESTIONS       Allo-HCT in Hodgkin lymphoma after CPI       Blood August 2025, Vol.146, 1030. doi: 10.1182/blood.2025030720

18 August 2025 (Monday) - BTLP-TACT Exercise

Time for another BTLP-TACT exercise. We kicked off with something of a false start when it told me it was unable to generate a scenario, but eventually it presented me with one case – a one year old lad with a nose bleed.

He grouped as O Rh(D) Positive with a negative antibody screen.

I got it right…

15 August 2025 (Friday) - BTLP-TACT Exercise

I’ve got a few minutes spare (and another snarky email saying I’m not doing enough BTLP-TACT exercises) so here goes:

 

70175 – a sixty-four year-old woman with CVA needing group and save

She grouped as O Rh(D) Positive with a negative antibody screen.

 

35842 – a forty-three year old woman having caesarean section also needing group and save.

She grouped as A Rh(D) Positive with a negative antibody screen

 

I got it right (this time).

 

14 August 2025 (Thursday) - Botyroid Nuclei

*Hypersegmented neutrophils*: are neutrophils with more than the typical three to five nuclear lobes or segments. Hypersegmentation is often associated with megaloblastic anaemia, particularly due to vitamin B12 or folate deficiency.

It can also be seen in myelodysplastic syndromes and other conditions affecting bone marrow function.

 

However this should not be confused with neutrophils showing a “botryoid nucleus”; a botryoid nucleus refers to a nucleus that has a grape-like clustering or lobulation with nine or ten tight lobes. Hyper-hypersegmented (!)

While less common than hypersegmentation, it is seen in heat stroke, influenza A, encephalitis, and drug overdoses including cocaine and methamphetamine intoxication.

 

Here’s a link.

13 August 2025 (Wednesday) - Medical Tourism

Here’s something to make you think (well, it made me think). We had a case of anti-U the other week. Yesterday we had a case of anti Mi(a). There’s obscure for you. 

It turns out that the frequency of the Mi(a) antigen is less than 0.1% among Caucasians, Negro and Japanese people, but in South-East Asia, the frequency is different. In Chinese blood donors in Hong Kong it is 6.28%, 88% in the Ami mountain people of Taiwan and 9.6% in Malaysian blood donors.

Well… this isn’t news, it it? There has always been racial variations in the distribution of blood groups. But… I saw an advert on Facebook the other day advertising going half way round the world for cheap orthopaedic surgery. Whilst you may well be getting first-class treatment, you’ll also be getting blood from local donors (if transfused). And possibly getting anti-Mi(a) and potentially other antibodies to rare (in the UK) antigens which may be an issue. Do UK screening cells have the Mi(a) antigen and all the other obscure (in the UK) ones?
I don’t know… 

 

12 August 2025 (Tuesday) - BTLP-TACT Exercise

There’s so much else I might be doing, but there’s a heatwave and it is far too hot to do anything… so I thought I might as well do a BTLP-TACT exercise.

I was presented with one case – a twenty-three year-old woman requiring group and save prior to a caesarean section.

She grouped as A Rh(D) Positive and the control *was* negative (!)

The antibody screen was negative.

I got the thumbs-up.

11 August 2025 (Monday) - Horiba Newsletter

The latest update from Horiba arrived in my in-box today. A case study on sickle cell anaemia, storage changes, a little test… something for nothing is always worth having.