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Radiotherapy for indolent primary cutaneous B-cell lymphoma: an international multicenter ILROG analysis. 放疗治疗惰性原发性皮肤b细胞淋巴瘤:一项国际多中心ILROG分析。
IF 20.3 1区 医学 Q1 HEMATOLOGY Pub Date : 2026-03-13 DOI: 10.1182/blood.2025032050
Michael Oertel,Bouthaina S Dabaja,Dennis Görlich,Bjorn R Thomas,Van Sim,Philippa Johnstone,Ayesha Hashmi,Mario Levis,Bradley Ackerson,Christina Hague,Christopher R Weil,John Plastaras,Daniel Edward Roos,Youlia Kirova,Rainer Fietkau,Penny Q Fang,Andrea K Ng,Felix Bock,Yolanda D Tseng,Philipp Linde,Jürgen Dunst,Stephanie A Terezakis,Teresa Easwaran,Jan C Peeken,Andrea Wittig,Hong In Yoon,Randa Tao,Timothy M Illidge,Chris R Kelsey,Umberto Ricardi,Michael S Binkley,Belinda A Campbell,Stephen Lloyd Morris,Khaled Elsayad,Michael Storck,Richard T Hoppe,Hans Theodor Eich
Radiotherapy is an established treatment for low-grade primary cutaneous B-cell lymphoma. Recommendations on its use differ internationally, which prompted our group to conduct the present analysis. Twenty-two institutions participated in this international study. Patient eligibility required a diagnosis of limited (T1/T2) primary cutaneous marginal zone or follicle center lymphoma treated with radiotherapy between 1995 and 2023. Data were collected retrospectively until February 2024 in the framework of the International Lymphoma Radiation Oncology Group. Overall, 535 patients were analyzed. Predominant locations were the head (40%) and trunk (36%). Radiotherapy had a median dose of 24 Gy in fractions of 2 Gy. Complete responses were seen in 91% at a median time of 3.6 months following radiotherapy. There was no statistically significant difference between treatments ≤4 Gy or >4 Gy for complete or overall response rates (p=0.077 and p=0.056). However, there was an inferior duration of local control with ≤4 Gy (5-year local control 73% ± 12% vs. 96% ± 2%; p<0.001). Radiation dose was the main prognostic factor in the univariate and multivariate Cox analysis; however, higher doses did not translate into an overall survival benefit. Toxicities rarely exceeded grade 2 but were more frequent in the >4 Gy group. Radiotherapy remains an effective treatment option for indolent skin lymphoma with low toxicities. High response rates are observed with low doses ≤4 Gy. In comparison to conventional doses, these treatments have a shorter duration of local control but a favorable toxicity profile.
放疗是低级别原发性皮肤b细胞淋巴瘤的常用治疗方法。关于其使用的建议在国际上有所不同,这促使我们小组进行了目前的分析。22个机构参与了这项国际研究。患者资格要求在1995年至2023年间接受放疗的有限(T1/T2)原发性皮肤边缘区或滤泡中心淋巴瘤诊断。数据是在国际淋巴瘤放射肿瘤学组织的框架下回顾性收集到2024年2月。总共分析了535例患者。主要部位为头部(40%)和躯干(36%)。放射治疗的中位剂量为24gy,分成2gy的部分。在放疗后3.6个月的中位时间内,91%的患者完全缓解。治疗≤4 Gy和治疗≤4 Gy两组的完全缓解率和总缓解率无统计学差异(p=0.077和p=0.056)。然而,≤4gy组的局部控制时间较短(5年局部控制时间73%±12% vs 96%±2%;p4gy组)。放疗仍然是一种有效的治疗选择,无痛皮肤淋巴瘤低毒性。低剂量≤4 Gy时,观察到高反应率。与常规剂量相比,这些治疗具有较短的局部控制时间,但具有良好的毒性。
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引用次数: 0
TMEM187 is a novel modulator in the regulation of erythropoiesis. TMEM187是一种新的红细胞生成调节因子。
IF 20.3 1区 医学 Q1 HEMATOLOGY Pub Date : 2026-03-13 DOI: 10.1182/blood.2025031135
Yutong Liu,Wenxin Zhang,Jing Cai,Di Zhou,Hongting Zhao,Weichen Dong,Biao Zhao,Yao Lu,Shuangying Hao,Yibing Ding,Nizhen Jiang,Tong Qiao,Kuanyu Li
Erythropoiesis, the process of red blood cell production, is highly dependent on iron uptake via transferrin and its receptor, transferrin receptor 1 (TfR1), but the mechanisms governing the proper recycling of TfR1 in relation to cellular iron demands remain elusive. Here, we identify human TMEM187, a Golgi transmembrane protein of unknown function, as a novel negative regulator of erythropoiesis. Lack of TMEM187 in a cell model initiates erythropoiesis without the normal induction protocol and accelerates iron uptake. Following the induction protocol, TMEM187 ablation leads to premature erythroid maturation, resulting in early phosphatidylserine ectopia and cell membrane fragility, hallmarks of cellular senescence that renders the cells susceptible to macrophage recognition and phagocytosis. In zebrafish embryos, tmem187 deletion leads to enhanced early erythropoiesis, although the phenotype is later compensated, whereas hematopoietic stem-cell expression of human TMEM187 in mice, which lack endogenously a homologous gene, resulted in compromised erythropoiesis and moderate anemia. Mechanistically, we demonstrate that TMEM187 interacts with RAB11 to restrain endosomal recycling, interfering with RAB11-GRAB association that activates RAB11. Consequently, TMEM187 modulates TfR1 recycling to the cell membrane to fine-tune iron uptake efficiency for erythropoiesis. Our findings reveal a novel modulatory pathway in which TMEM187 plays a crucial role in regulating erythroid differentiation, maturation, and senescence, providing a previously unexplored perspective of TMEM187's physiological function.
红细胞生成过程高度依赖于通过转铁蛋白及其受体转铁蛋白受体1 (TfR1)对铁的摄取,但与细胞铁需求相关的TfR1适当循环的控制机制尚不清楚。在这里,我们鉴定了人类TMEM187,一种功能未知的高尔基跨膜蛋白,作为一种新的红细胞生成负调节因子。缺乏TMEM187细胞模型启动红细胞生成没有正常的诱导方案和加速铁摄取。根据诱导方案,TMEM187消融导致红细胞过早成熟,导致早期磷脂酰丝氨酸异位和细胞膜脆弱,这是细胞衰老的标志,使细胞容易被巨噬细胞识别和吞噬。在斑马鱼胚胎中,tmem187缺失导致早期红细胞生成增强,尽管表型后来得到补偿,而在缺乏内源性同源基因的小鼠中,人类tmem187的造血干细胞表达导致红细胞生成受损和中度贫血。在机制上,我们证明TMEM187与RAB11相互作用抑制内体循环,干扰RAB11- grab关联,激活RAB11。因此,TMEM187调节TfR1再循环到细胞膜,以微调红细胞生成的铁摄取效率。我们的研究结果揭示了一个新的调节途径,其中TMEM187在调节红细胞分化、成熟和衰老中起着至关重要的作用,为TMEM187的生理功能提供了一个以前未被探索的视角。
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引用次数: 0
Defective cerebrovascular development in mice lacking TFPI is restored by activated protein C. 激活蛋白C可恢复TFPI缺失小鼠的脑血管发育缺陷。
IF 20.3 1区 医学 Q1 HEMATOLOGY Pub Date : 2026-03-13 DOI: 10.1182/blood.2025031420
Susan A Maroney,Nicholas D Martinez,Praveen Krishnamoorthy,Paul Ellery,Mark A Rasmussen,Amy E Siebert,Jennifer May,Erin Yttre,Adrianna M Jurek,Randal J Westrick,Donny Hoang,Shikan Zheng,Mark Zogg,John Patrick Sheehan,James Fitzpatrick,Tongjun Gu,Hartmut Weiler,Alan E Mast
Mice lacking Tissue Factor Pathway Inhibitor (Tfpi-/-) succumb to embryonic lethality from excess thrombin production and associated cerebrovascular defects called glomeruloid bodies. A transgene producing hyperactivatable mouse protein C (hMPC) was bred into Tfpi+/- mice to determine if excess activated PC (aPC) would correct the cerebrovascular defects in Tfpi-/- embryos. Tfpi-/-/hMPC+ embryos survived to adulthood. Despite the rescue of embryonic lethality, hMPC reduced glomeruloid body numbers by only 36% and did not prevent fibrin deposition or disruption of the blood-brain barrier within glomeruloid bodies. However, there was decreased hypoxia and cellular death in Tfpi-/-/hMPC+ brains suggesting that cytoprotective effects of hMPC contributed to Tfpi-/- rescue. The glomeruloid bodies were completely resolved in Tfpi-/-/hMPC+ P10 pups revealing a distinct temporal effect of TFPI on embryonic cerebrovascular development. Bulk RNAseq of E15.5 brain tissue identified increased angiogenesis as the overwhelming biological process altered in Tfpi-/- brain. This included changes in genes encoding apelin, adrenomedulin, and UNC5b, which was consistent with abundant endothelial tip cells within glomeruloid bodies. The increased expression of these angiogenic genes was reversed by the hMPC transgene. These findings define TFPI as an essential inhibitor of thrombin generation during embryonic angiogenesis that acts temporally within or around developing cerebral vasculature in a manner that is not compensated for by other anticoagulant proteins. The findings emphasize the importance of blood coagulation proteases and regulation of their activity in diverse biological processes.
缺乏组织因子通路抑制剂(Tfpi-/-)的小鼠会因凝血酶过量产生和相关的称为肾小球体的脑血管缺陷而导致胚胎死亡。将产生高活化小鼠蛋白C (hyperactivatable mouse protein C, hMPC)的转基因基因植入Tfpi+/-小鼠体内,观察过量活化PC (hyperactivatable mouse protein C, aPC)是否能纠正Tfpi-/-胚胎的脑血管缺陷。Tfpi-/-/hMPC+胚胎存活至成年。尽管挽救了胚胎致死性,hMPC仅减少了36%的肾小球体数量,并不能阻止肾小球体内的纤维蛋白沉积或血脑屏障的破坏。然而,在Tfpi-/-/hMPC+脑中,缺氧和细胞死亡减少,表明hMPC的细胞保护作用有助于Tfpi-/-的拯救。在Tfpi-/-/hMPC+ P10幼崽中,肾小球小体完全溶解,表明Tfpi对胚胎脑血管发育具有明显的时间效应。E15.5脑组织的大量RNAseq表明,血管生成增加是Tfpi-/-脑中压倒性的生物过程改变。这包括编码apelin、肾上腺髓质素和UNC5b的基因的变化,这与肾小球体内丰富的内皮尖端细胞一致。这些血管生成基因的表达增加被hMPC转基因逆转。这些发现将TFPI定义为胚胎血管生成过程中凝血酶生成的重要抑制剂,它在发育中的脑血管系统内或周围暂时起作用,而其他抗凝蛋白无法补偿这种作用。这些发现强调了凝血蛋白酶及其在多种生物过程中活性调控的重要性。
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引用次数: 0
IDH2 Clonal Hematopoiesis and IKAROS Loss Cooperate in a B-ALL Subtype after Lenalidomide Therapy for Multiple Myeloma. 来那度胺治疗多发性骨髓瘤后,IDH2克隆造血和IKAROS缺失在B-ALL亚型中协同作用。
IF 20.3 1区 医学 Q1 HEMATOLOGY Pub Date : 2026-03-13 DOI: 10.1182/blood.2025031047
Johanna M Horns,Thomas Beder,Axel Künstner,Malwine Jeanette Barz,Sonja Bendig,Cecilia Bozzetti,Guranda Chitadze,Nikos Darzentas,Katharina Iben,Michaela Kotrova,José-Ignacio Martín-Subero,Mayukh Mondal,Martin Neumann,Raul Fernandez Perez,Aeint-Steffen Ströh,Wiebke Weßels,Lennart Lenk,Lars Velten,Boris Böll,Krischan Braitsch,Veit L Bücklein,Johannes Duell,Christoph Faul,Walter Fiedler,Maher Hanoun,Snjezana Janjetovic,Felix Klingler,Stefan Knop,Christoph Röllig,Stefan Schwartz,Bernd M Spriewald,Björn Steffen,Klaus Wethmar,Hauke Busch,Nicola Gökbuget,Claudia D Baldus,Lorenz Bastian,Monika Brüggemann
Lenalidomide, a maintenance treatment in multiple myeloma first-line therapy, increases the risk of secondary malignancies, including B-cell precursor acute lymphoblastic leukemia (B‑ALL). We present a comprehensive molecular characterization of 57 patients with lenalidomide-associated B-ALL (LenB-ALL), revealing three mutational subgroups: (1) TP53mt (30%), (2) IDH2mt (p.R140Q) (23%) and (3) other, including NRAS/KRASmt. Remarkably, IDH2 R140Q mutations were highly enriched in LenB-ALL compared to primary B-ALL (p<0.001). Furthermore, IKZF1 intragenic deletions - often subclonal and likely RAG-mediated - were observed in 54% (7/13) of IDH2mt LenB-ALL cases. IDH2 mutations were not restricted to the leukemic clone: they persisted during MRD-negative remission and were identified in lymphoid as well as myeloid cell populations using fluorescence-activated cell sorting and single-cell RNA sequencing. This indicates a preleukemic origin of the IDH2 mutation within the context of clonal hematopoiesis. Transcriptomic and DNA methylation analyses revealed a distinct gene expression profile and a DNA hypermethylation phenotype in IDH2mt LenB-ALL, including IDH2mt-specific as well as lenalidomide-associated features. We propose that lenalidomide promotes expansion of IDH2-mutated clonal hematopoiesis and, via IKAROS downregulation, induces a maturation arrest at the B-cell precursor stage. Subsequent genetic or epigenetic alterations render leukemogenesis independent of ongoing lenalidomide exposure. Altogether, these data define IDH2mt B-ALL as a distinct molecular subtype that is markedly overrepresented after lenalidomide treatment and highlight clonal hematopoiesis as a key contributing factor in the development of LenB-ALL.
来那度胺是多发性骨髓瘤一线治疗中的一种维持治疗,它会增加继发性恶性肿瘤的风险,包括B细胞前体急性淋巴细胞白血病(B‑ALL)。我们对57例来那度胺相关B-ALL (LenB-ALL)患者进行了全面的分子表征,揭示了三个突变亚群:(1)TP53mt (30%), (2) IDH2mt (p.R140Q)(23%)和(3)其他,包括NRAS/KRASmt。值得注意的是,与原发B-ALL相比,IDH2 R140Q突变在LenB-ALL中高度富集(p<0.001)。此外,在54%(7/13)的IDH2mt LenB-ALL病例中观察到IKZF1基因内缺失(通常是亚克隆的,可能是rag介导的)。IDH2突变并不局限于白血病克隆:它们在mrd阴性缓解期间持续存在,并且在淋巴细胞和髓细胞群体中使用荧光激活细胞分选和单细胞RNA测序进行了鉴定。这表明在克隆造血的背景下,IDH2突变的白血病前起源。转录组学和DNA甲基化分析揭示了IDH2mt LenB-ALL中独特的基因表达谱和DNA超甲基化表型,包括IDH2mt特异性和来那度胺相关特征。我们提出来那度胺促进idh2突变克隆造血的扩展,并通过IKAROS下调,诱导b细胞前体成熟阻滞。随后的遗传或表观遗传改变使得白血病的发生与持续的来那度胺暴露无关。总之,这些数据将IDH2mt B-ALL定义为一种独特的分子亚型,在来那度胺治疗后显着过度代表,并强调克隆造血是LenB-ALL发展的关键因素。
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引用次数: 0
A niche for every stem cell in myeloproliferative neoplasms. 骨髓增殖性肿瘤中每个干细胞的生态位。
IF 23.1 1区 医学 Q1 HEMATOLOGY Pub Date : 2026-03-12 DOI: 10.1182/blood.2025032458
Simón Méndez-Ferrer, Angela G Fleischman
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引用次数: 0
Splitting from a lump: harmonizing ALCL classification. 从块中分离:协调ALCL分类。
IF 23.1 1区 医学 Q1 HEMATOLOGY Pub Date : 2026-03-12 DOI: 10.1182/blood.2025031931
Samuel Y Ng
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引用次数: 0
A mechanism for a VEXing problem. 解决棘手问题的机制。
IF 23.1 1区 医学 Q1 HEMATOLOGY Pub Date : 2026-03-12 DOI: 10.1182/blood.2025030986
David M Bodine
{"title":"A mechanism for a VEXing problem.","authors":"David M Bodine","doi":"10.1182/blood.2025030986","DOIUrl":"https://doi.org/10.1182/blood.2025030986","url":null,"abstract":"","PeriodicalId":9102,"journal":{"name":"Blood","volume":"147 11","pages":"1138-1139"},"PeriodicalIF":23.1,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430515","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
Lichtman MA, Rowe JM. Hyperleukocytic leukemias: rheological, clinical, and therapeutic considerations. Blood. 1982;60(2):279-283. Lichtman MA, Rowe JM。高白细胞白血病:流变学、临床和治疗方面的考虑。血。1982;60(2):279 - 283。
IF 23.1 1区 医学 Q1 HEMATOLOGY Pub Date : 2026-03-12 DOI: 10.1182/blood.2026033388
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引用次数: 0
When CAR T cells become the disease. 当CAR - T细胞成为疾病。
IF 23.1 1区 医学 Q1 HEMATOLOGY Pub Date : 2026-03-12 DOI: 10.1182/blood.2025032334
Viktoria Blumenberg, Marcela V Maus
{"title":"When CAR T cells become the disease.","authors":"Viktoria Blumenberg, Marcela V Maus","doi":"10.1182/blood.2025032334","DOIUrl":"https://doi.org/10.1182/blood.2025032334","url":null,"abstract":"","PeriodicalId":9102,"journal":{"name":"Blood","volume":"147 11","pages":"1139-1141"},"PeriodicalIF":23.1,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430613","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
Maneuvering ofCS toward precision medicine for AML? cs向AML精准医学方向发展?
IF 23.1 1区 医学 Q1 HEMATOLOGY Pub Date : 2026-03-12 DOI: 10.1182/blood.2025032403
Mattias Carlsten
{"title":"Maneuvering ofCS toward precision medicine for AML?","authors":"Mattias Carlsten","doi":"10.1182/blood.2025032403","DOIUrl":"https://doi.org/10.1182/blood.2025032403","url":null,"abstract":"","PeriodicalId":9102,"journal":{"name":"Blood","volume":"147 11","pages":"1144-1145"},"PeriodicalIF":23.1,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430634","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
期刊
Blood
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