Pub Date : 2026-02-26DOI: 10.1016/j.tmrv.2026.150979
Jensyn Cone Sullivan, Jay S Raval, Nicole D Zantek, David L Allison, Gaurav Gupta, Caroline R Alquist, Nour Al Mozain, Hlaing Tint, Louise Helander, Lisa Boggio, Jose Pérez-Carrillo, Kyle Annen
Primary thrombocytosis is associated with increased risk of thromboembolism and bleeding. Therapeutic plateletpheresis (TPP), capable of rapid, transient platelet (Plt) count reduction, is employed as an emergency intervention for symptomatic thrombocytosis while awaiting the therapeutic effect of medical cytoreductive therapy. Nonetheless, the effect of TPP on outcomes and optimal role for TPP remain poorly understood. Critical analytic review of highest-pertinence and -quality articles was performed with the goal of establishing current knowledge gaps to direct original case data collection. Retrospective review of TPP procedures at six United States sites over ten years was performed. Pre-TPP symptoms, medical cytoreduction, adverse events (AEs), and 30-day post-TPP outcomes were analyzed. Critical analytic review revealed no randomized controlled trial (RCT) or controlled trials (CT) of TPP versus first-line medical therapies, and insufficient information on symptoms, goals, criteria-based determination of course, and post-TPP outcomes. New data presented here details 45 adult patients receiving TPP for thrombocytosis. TPP was performed rarely (of n = 6 sites, median 4.5 TPP/10 years, range 4-20). The most frequent diagnosis was myeloproliferative neoplasm (MPN) (34, 75.6%). The most frequent symptoms were any neurologic symptoms (present pre-64.4% of TPPs). TPP goals were commonly Plt-related (n = 85, 94.4% total TPP) and were met in 72.9% of TPP with stated Plt-related goals. Often, (n = 11/50 single TPP or series) TPP was begun or continued despite resolution of the stated indication for TPP. AE occurred during 20% of TPP and were predominantly hypocalcemia related (17/18, 94.4%). Four patients died within 30 days post TPP, three of stroke, one of a non-stroke neurologic complication. All deaths were deemed unrelated to TPP. Critical analytic reviews revealed no RCTs or CTs, a paucity of data on TPP goals and prescribed courses, and significant variability in AE reporting. Little information on long-term outcomes is available. Without controlled evidence supporting clinical outcome benefit of TPP for symptomatic thrombocytosis, utilization is expected to be rare and guideline-informed, following careful consideration of known risk in the setting of unclear benefit.
{"title":"Therapeutic Plateletpheresis for Thrombocytosis: Critical Analytic Reviews and Original Multicenter Experience.","authors":"Jensyn Cone Sullivan, Jay S Raval, Nicole D Zantek, David L Allison, Gaurav Gupta, Caroline R Alquist, Nour Al Mozain, Hlaing Tint, Louise Helander, Lisa Boggio, Jose Pérez-Carrillo, Kyle Annen","doi":"10.1016/j.tmrv.2026.150979","DOIUrl":"https://doi.org/10.1016/j.tmrv.2026.150979","url":null,"abstract":"<p><p>Primary thrombocytosis is associated with increased risk of thromboembolism and bleeding. Therapeutic plateletpheresis (TPP), capable of rapid, transient platelet (Plt) count reduction, is employed as an emergency intervention for symptomatic thrombocytosis while awaiting the therapeutic effect of medical cytoreductive therapy. Nonetheless, the effect of TPP on outcomes and optimal role for TPP remain poorly understood. Critical analytic review of highest-pertinence and -quality articles was performed with the goal of establishing current knowledge gaps to direct original case data collection. Retrospective review of TPP procedures at six United States sites over ten years was performed. Pre-TPP symptoms, medical cytoreduction, adverse events (AEs), and 30-day post-TPP outcomes were analyzed. Critical analytic review revealed no randomized controlled trial (RCT) or controlled trials (CT) of TPP versus first-line medical therapies, and insufficient information on symptoms, goals, criteria-based determination of course, and post-TPP outcomes. New data presented here details 45 adult patients receiving TPP for thrombocytosis. TPP was performed rarely (of n = 6 sites, median 4.5 TPP/10 years, range 4-20). The most frequent diagnosis was myeloproliferative neoplasm (MPN) (34, 75.6%). The most frequent symptoms were any neurologic symptoms (present pre-64.4% of TPPs). TPP goals were commonly Plt-related (n = 85, 94.4% total TPP) and were met in 72.9% of TPP with stated Plt-related goals. Often, (n = 11/50 single TPP or series) TPP was begun or continued despite resolution of the stated indication for TPP. AE occurred during 20% of TPP and were predominantly hypocalcemia related (17/18, 94.4%). Four patients died within 30 days post TPP, three of stroke, one of a non-stroke neurologic complication. All deaths were deemed unrelated to TPP. Critical analytic reviews revealed no RCTs or CTs, a paucity of data on TPP goals and prescribed courses, and significant variability in AE reporting. Little information on long-term outcomes is available. Without controlled evidence supporting clinical outcome benefit of TPP for symptomatic thrombocytosis, utilization is expected to be rare and guideline-informed, following careful consideration of known risk in the setting of unclear benefit.</p>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 2","pages":"150979"},"PeriodicalIF":2.5,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147492209","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}
Pub Date : 2026-02-23DOI: 10.1016/j.tmrv.2026.150963
RishiRaj Sinha
{"title":"ABO Matching for Platelets: When Surrogates Lead and Clinical Evidence Lags.","authors":"RishiRaj Sinha","doi":"10.1016/j.tmrv.2026.150963","DOIUrl":"https://doi.org/10.1016/j.tmrv.2026.150963","url":null,"abstract":"","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 2","pages":"150963"},"PeriodicalIF":2.5,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482399","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}
Pub Date : 2026-02-01DOI: 10.1016/j.tmrv.2026.150960
RishiRaj Sinha
{"title":"Trust Over Knowledge: Rethinking Donor Iron Supplementation Strategies in Modern Blood Services.","authors":"RishiRaj Sinha","doi":"10.1016/j.tmrv.2026.150960","DOIUrl":"https://doi.org/10.1016/j.tmrv.2026.150960","url":null,"abstract":"","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":" ","pages":"150960"},"PeriodicalIF":2.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312890","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}
Pub Date : 2026-01-01Epub Date: 2025-12-20DOI: 10.1016/j.tmrv.2025.150958
Hitoshi Ohto , Kenneth E. Nollet , Jill R. Storry
Maternal alloantibody-induced hemolytic disease of the fetus and newborn (HDFN) remains a significant concern worldwide. Alloimmune HDFN can be pathogenetically named by the specific alloantibodies involved. Moreover, four mechanistic pathway types are generally recognized in clinical practice: classical or extravascular hemolysis; immune-pressure-escaped, also known as antibody-mediated antigen-modulation; apoptotic or dysplastic; and failed transaction. Another proposed pathway is worthy of discussion: lactation-mediated. Management strategies for alloimmune HDFN should take account of these underlying mechanisms.
{"title":"Five Pathogenetic Classifications for Alloimmune Hemolytic Disease of the Fetus And Newborn","authors":"Hitoshi Ohto , Kenneth E. Nollet , Jill R. Storry","doi":"10.1016/j.tmrv.2025.150958","DOIUrl":"10.1016/j.tmrv.2025.150958","url":null,"abstract":"<div><div>Maternal alloantibody-induced hemolytic disease of the fetus and newborn (HDFN) remains a significant concern worldwide. Alloimmune HDFN can be pathogenetically named by the specific alloantibodies involved. Moreover, four mechanistic pathway types are generally recognized in clinical practice: classical or extravascular hemolysis; immune-pressure-escaped, also known as antibody-mediated antigen-modulation; apoptotic or dysplastic; and failed transaction. Another proposed pathway is worthy of discussion: lactation-mediated. Management strategies for alloimmune HDFN should take account of these underlying mechanisms.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150958"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927327","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}
Pub Date : 2026-01-01Epub Date: 2025-09-11DOI: 10.1016/j.tmrv.2025.150928
Lorna Cain , Asha Aggarwal , Louise J. Geneen , Carolyn Dorée , Lise J. Estcourt , Rebecca Cardigan , Michael Desborough
Transfusion of ABO identical platelets is recommended in national guidelines, though transfusion of ABO non-identical platelets has been widely adopted to ensure availability and reduce wastage. When ABO non-identical platelets are necessitated, there is a lack of consensus on prioritisation of major or minor compatibility. We conducted a systematic review and meta-analysis (PROSPERO CRD42023450792) of randomised and non-randomised studies to assess whether there is a difference when comparing ABO-identical and non-identical (major, minor, bi-directional mismatch) platelet transfusions. From 4177 potential references, 18 studies met our criteria: 3 randomised controlled trials (RCTs), 8 prospective and 7 retrospective observational studies. Evidence was very low certainty as to whether there was a difference from transfusion of ABO identical or non-identical platelets, where data were available, for clinically significant (WHO grade 2+ and 3+) bleeding, mortality, acute transfusion reactions, platelet refractoriness. Platelet increments were the most frequently reported outcomes. Overall, there was a paucity of evidence for clinical outcome data including bleeding risk for ABO identical compared to non-identical transfusion. We make recommendations for designing and reporting future platelet ABO matching studies based on our observations in this review. Future studies should consider the effect of repeated exposure to ABO identical or non-identical transfusions and known confounders.
{"title":"ABO matching for platelet transfusions for prevention or treatment of bleeding: A systematic review with meta-analysis","authors":"Lorna Cain , Asha Aggarwal , Louise J. Geneen , Carolyn Dorée , Lise J. Estcourt , Rebecca Cardigan , Michael Desborough","doi":"10.1016/j.tmrv.2025.150928","DOIUrl":"10.1016/j.tmrv.2025.150928","url":null,"abstract":"<div><div>Transfusion of ABO identical platelets is recommended in national guidelines, though transfusion of ABO non-identical platelets has been widely adopted to ensure availability and reduce wastage. When ABO non-identical platelets are necessitated, there is a lack of consensus on prioritisation of major or minor compatibility. We conducted a systematic review and meta-analysis (PROSPERO CRD42023450792) of randomised and non-randomised studies to assess whether there is a difference when comparing ABO-identical and non-identical (major, minor, bi-directional mismatch) platelet transfusions. From 4177 potential references, 18 studies met our criteria: 3 randomised controlled trials (RCTs), 8 prospective and 7 retrospective observational studies. Evidence was very low certainty as to whether there was a difference from transfusion of ABO identical or non-identical platelets, where data were available, for clinically significant (WHO grade 2+ and 3+) bleeding, mortality, acute transfusion reactions, platelet refractoriness. Platelet increments were the most frequently reported outcomes. Overall, there was a paucity of evidence for clinical outcome data including bleeding risk for ABO identical compared to non-identical transfusion. We make recommendations for designing and reporting future platelet ABO matching studies based on our observations in this review. Future studies should consider the effect of repeated exposure to ABO identical or non-identical transfusions and known confounders.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150928"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228717","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}
Pub Date : 2026-01-01Epub Date: 2025-12-31DOI: 10.1016/j.tmrv.2025.150959
Amber Meulenbeld , Lucile Malard , Elodie Pouchol , Mart Janssen , Syria Laperche , Jean-Baptiste Thibert , Katja van den Hurk
Many blood establishments have hemoglobin (Hb) measurement policies to prevent anemia in blood donors. However, despite evidence of iron deficiency (ID) in donors with normal Hb levels, only few blood establishments have implemented iron management strategies. Recently, the Dutch and French national blood services implemented ferritin-guided donation interval policies, albeit in different ways. While in the Netherlands ferritin is measured every 5 donations, in France ferritin measurements are performed in predefined risk groups. We compared rates of ID (ferritin <15 ng/mL), low ferritin (15-30 ng/mL), and low Hb between the Netherlands and France before and after policy implementation. We also compared donor return rates and ferritin levels after ferritin-based deferrals. We found that before the policy change there were differences in rates of ID and low ferritin, but Hb deferral rates were very similar. After the policy change, more ferritin measurements were performed in the Netherlands, but both countries had similar ID rates (∼4.5% and ∼1% of measured females and males, respectively). Return rates within one year after the end of deferral for ID were similar in both countries (∼60% for females and ∼80% for males), but French donors had higher ferritin upon return despite the shorter deferral period. Because this is an observational study using retrospective data, and due to a lack of the standardization of ferritin measurements, comparisons need to be interpreted with caution. Nonetheless, the results offer valuable insights concerning the impact of ferritin-guided donation intervals for blood establishments that consider the implementation of similar policies.
{"title":"Impact of Ferritin-Guided Donation Interval Policies in the Netherlands and France","authors":"Amber Meulenbeld , Lucile Malard , Elodie Pouchol , Mart Janssen , Syria Laperche , Jean-Baptiste Thibert , Katja van den Hurk","doi":"10.1016/j.tmrv.2025.150959","DOIUrl":"10.1016/j.tmrv.2025.150959","url":null,"abstract":"<div><div>Many blood establishments have hemoglobin (Hb) measurement policies to prevent anemia in blood donors. However, despite evidence of iron deficiency (ID) in donors with normal Hb levels, only few blood establishments have implemented iron management strategies. Recently, the Dutch and French national blood services implemented ferritin-guided donation interval policies, albeit in different ways. While in the Netherlands ferritin is measured every 5 donations, in France ferritin measurements are performed in predefined risk groups. We compared rates of ID (ferritin <15 ng/mL), low ferritin (15-30 ng/mL), and low Hb between the Netherlands and France before and after policy implementation. We also compared donor return rates and ferritin levels after ferritin-based deferrals. We found that before the policy change there were differences in rates of ID and low ferritin, but Hb deferral rates were very similar. After the policy change, more ferritin measurements were performed in the Netherlands, but both countries had similar ID rates (∼4.5% and ∼1% of measured females and males, respectively). Return rates within one year after the end of deferral for ID were similar in both countries (∼60% for females and ∼80% for males), but French donors had higher ferritin upon return despite the shorter deferral period. Because this is an observational study using retrospective data, and due to a lack of the standardization of ferritin measurements, comparisons need to be interpreted with caution. Nonetheless, the results offer valuable insights concerning the impact of ferritin-guided donation intervals for blood establishments that consider the implementation of similar policies.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150959"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023551","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}
Pub Date : 2026-01-01Epub Date: 2025-12-10DOI: 10.1016/j.tmrv.2025.150951
Femmeke Prinsze , Hans Vrielink , Yared Paalvast , Ryanne Lieshout-Krikke , Katja van den Hurk
Demands for plasma continue to rise, but the effects of frequent donations on donor-health remain unclear. The aim of this observational study was to assess associations of plasma donation frequencies with biomarker (protein, ferritin, and hemoglobin) levels, and to evaluate the contribution of high or very high-frequency donors to the collected plasma. We included all plasma donors (N = 42,390) of 2019 who donated only plasma in 2 preceding years. Total protein and hemoglobin were measured in all donors, ferritin only in a subpopulation (N = 953). Associations between the number of donations and biomarker levels were analyzed using linear regression, adjusted for age and days since previous donation, and stratified by sex and menopausal status. We grouped the donors based on their yearly donation frequency: low frequency (LF) 1 to 6, medium frequency (MF) 7 to 12, high frequency (HF) 13 to 18 and Very High Frequency (VHF) >18. Linear regression analyses showed significant negative associations between numbers of donations and protein (odds ratios: males −0.04 (−0.05 to −0.03), premenopausal females −0.09 (−0.11 to −0.03), postmenopausal females −0.05 (−0.07 to −0.04)) and ferritin levels (odds ratios: males −1.98 (−2.47 to −1.48), premenopausal females −1.81 (2.23 to −0.75), postmenopausal females −1.24 (−2.10 to −0.38)). HF- and VHF-donors (6% of donors) are predominantly male with high donation volumes, contributing approximately 17% to the amount of collected plasma. High-frequency plasma donations are associated with significantly lower protein and ferritin, but not Hb levels. Despite the low number of HF- and VHF-donors, their contribution to the plasma supply is high.
{"title":"Donation-Induced Protein and Iron Depletion in High-Frequency Plasma Donors","authors":"Femmeke Prinsze , Hans Vrielink , Yared Paalvast , Ryanne Lieshout-Krikke , Katja van den Hurk","doi":"10.1016/j.tmrv.2025.150951","DOIUrl":"10.1016/j.tmrv.2025.150951","url":null,"abstract":"<div><div>Demands for plasma continue to rise, but the effects of frequent donations on donor-health remain unclear. The aim of this observational study was to assess associations of plasma donation frequencies with biomarker (protein, ferritin, and hemoglobin) levels, and to evaluate the contribution of high or very high-frequency donors to the collected plasma. We included all plasma donors (<em>N</em> = 42,390) of 2019 who donated only plasma in 2 preceding years. Total protein and hemoglobin were measured in all donors, ferritin only in a subpopulation (<em>N</em> = 953). Associations between the number of donations and biomarker levels were analyzed using linear regression, adjusted for age and days since previous donation, and stratified by sex and menopausal status. We grouped the donors based on their yearly donation frequency: low frequency (LF) 1 to 6, medium frequency (MF) 7 to 12, high frequency (HF) 13 to 18 and Very High Frequency (VHF) >18. Linear regression analyses showed significant negative associations between numbers of donations and protein (odds ratios: males −0.04 (−0.05 to −0.03), premenopausal females −0.09 (−0.11 to −0.03), postmenopausal females −0.05 (−0.07 to −0.04)) and ferritin levels (odds ratios: males −1.98 (−2.47 to −1.48), premenopausal females −1.81 (2.23 to −0.75), postmenopausal females −1.24 (−2.10 to −0.38)). HF- and VHF-donors (6% of donors) are predominantly male with high donation volumes, contributing approximately 17% to the amount of collected plasma. High-frequency plasma donations are associated with significantly lower protein and ferritin, but not Hb levels. Despite the low number of HF- and VHF-donors, their contribution to the plasma supply is high.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150951"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886385","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}
Pub Date : 2026-01-01Epub Date: 2025-12-13DOI: 10.1016/j.tmrv.2025.150954
Na Li
{"title":"Reply to “Strengthening Translational Pathways: The Need for Readiness and Fairness Assessment in Transfusion AI Models”","authors":"Na Li","doi":"10.1016/j.tmrv.2025.150954","DOIUrl":"10.1016/j.tmrv.2025.150954","url":null,"abstract":"","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150954"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886387","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}
Pub Date : 2026-01-01Epub Date: 2025-07-17DOI: 10.1016/j.tmrv.2025.150909
Ayesha Butt , Anish Sharda , Alfred Ian Lee , Jason S Knight
Antiphospholipid syndrome (APS) is an autoimmune prothrombotic disorder defined by the presence of one or more antiphospholipid antibodies (aPL) in conjunction with clinical manifestations such as thrombosis and/or obstetrical complications. One of the notable recent developments in APS research is the identification of a contributory role for neutrophil extracellular traps (NETs) in its pathogenesis, establishing a mechanistic link between thrombosis, inflammation, and complement activation. NETs, composed of decondensed chromatin and neutrophil-derived granule proteins, are released in response to various infectious and sterile triggers. In individuals with APS, elevated NET levels and the presence of anti-NET antibodies have been observed, aligning with thrombotic events and enhanced complement system activation. Studies support an emerging model that neutrophils are primed in APS to form NETs as a central mechanism in the development of thrombosis. This review explores multiple mechanisms linking NETs and thrombosis in APS including: contribution of aPL to enhanced leukocyte adhesion and the induction of NETosis via P-selectin glycoprotein ligand-1 (PSGL-1) and the transcription factor KLF2; cyclic AMP and the adenosine A2A receptor on the neutrophil surface as negative regulators of NETosis and thrombus formation in APS; and NET-mediated resistance to activated protein C leading to hypercoagulability, amongst others. Intervening in NET-related pathways represents a promising therapeutic strategy to mitigate thrombotic risk in APS, underscoring the need for ongoing investigation into neutrophil-mediated mechanisms in this autoimmune disorder.
{"title":"Analytical Review: Neutrophil Extracellular Traps and Antiphospholipid syndrome","authors":"Ayesha Butt , Anish Sharda , Alfred Ian Lee , Jason S Knight","doi":"10.1016/j.tmrv.2025.150909","DOIUrl":"10.1016/j.tmrv.2025.150909","url":null,"abstract":"<div><div>Antiphospholipid syndrome (APS) is an autoimmune prothrombotic disorder defined by the presence of one or more antiphospholipid antibodies (aPL) in conjunction with clinical manifestations such as thrombosis and/or obstetrical complications. One of the notable recent developments in APS research is the identification of a contributory role for neutrophil extracellular traps (NETs) in its pathogenesis, establishing a mechanistic link between thrombosis, inflammation, and complement activation. NETs, composed of decondensed chromatin and neutrophil-derived granule proteins, are released in response to various infectious and sterile triggers. In individuals with APS, elevated NET levels and the presence of anti-NET antibodies have been observed, aligning with thrombotic events and enhanced complement system activation. Studies support an emerging model that neutrophils are primed in APS to form NETs as a central mechanism in the development of thrombosis. This review explores multiple mechanisms linking NETs and thrombosis in APS including: contribution of aPL to enhanced leukocyte adhesion and the induction of NETosis via P-selectin glycoprotein ligand-1 (PSGL-1) and the transcription factor KLF2; cyclic AMP and the adenosine A<sub>2A</sub> receptor on the neutrophil surface as negative regulators of NETosis and thrombus formation in APS; and NET-mediated resistance to activated protein C leading to hypercoagulability, amongst others. Intervening in NET-related pathways represents a promising therapeutic strategy to mitigate thrombotic risk in APS, underscoring the need for ongoing investigation into neutrophil-mediated mechanisms in this autoimmune disorder.</div></div>","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150909"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812713","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}
Pub Date : 2026-01-01Epub Date: 2025-12-15DOI: 10.1016/j.tmrv.2025.150956
Sunny Dzik , Jeannie Callum , Zoe McQuilten
{"title":"Transfusion Medicine Reviews in 2026","authors":"Sunny Dzik , Jeannie Callum , Zoe McQuilten","doi":"10.1016/j.tmrv.2025.150956","DOIUrl":"10.1016/j.tmrv.2025.150956","url":null,"abstract":"","PeriodicalId":56081,"journal":{"name":"Transfusion Medicine Reviews","volume":"40 1","pages":"Article 150956"},"PeriodicalIF":2.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886388","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}
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