This Week in Hematology — Jul 29, 2026

Welcome to This Week in Hematology. This week we're covering 7 notable papers spanning novel cellular and bispecific therapies in lymphoid malignancies, optimization strategies in myeloid leukemias and supportive care, and genetic determinants of thrombosis and lymphoma immunity. Let's dive in.

We begin with advances in lymphoid malignancies and multiple myeloma. In chronic lymphocytic leukemia and small lymphocytic lymphoma, the phase 1/2 TRANSCEND CLL 004 study published in Blood evaluated lisocabtagene maraleucel combined with ibrutinib in heavily pretreated relapsed or refractory patients, a population where 98% had high-risk cytogenetics and over half had failed prior Bruton tyrosine kinase inhibitor and venetoclax therapy [1]. At the recommended dose level, the complete response or remission rate reached 45% with an overall response rate of 86% [1]. The median progression-free survival stood at 31.4 months, demonstrating notable efficacy with predictable and manageable safety, including cytokine release syndrome in 80% of patients, though grade 3 events were limited to 4% with no grade 4 or 5 occurrences [1]. Moving to multiple myeloma, epitope engagement and resistance mechanisms of bispecific antibodies were explored in Blood Advances [3]. Comparing linvoseltamab and teclistamab across cell lines expressing BCMA mutations associated with teclistamab resistance, researchers found that linvoseltamab retained binding and targeted cytotoxicity against R27P and S30del mutations, whereas teclistamab exhibited reduced activity [3]. Cryogenic electron microscopy revealed distinct binding orientations, explaining why linvoseltamab is less susceptible to these specific resistance pathways [3]. Also in multiple myeloma, a large study in Blood Advances investigated measurable residual disease dynamics following autologous stem cell transplantation in 814 patients [4]. Overall, 48% achieved measurable residual disease negativity post-transplantation [4]. Independent predictors of measurable residual disease positivity included the presence of t(11;14) and pre-transplant responses less than complete remission [4]. While t(11;14) patients had lower measurable residual disease-negative rates, their 5-year progression-free survival was comparable between measurable residual disease-positive and negative groups, suggesting the standard adverse prognostic impact is partially mitigated [4]. Furthermore, high-risk cytogenetics markedly worsened outcomes primarily within the measurable residual disease-positive cohort [4].

Next, we examine optimization strategies in myeloid disorders and supportive care. In acute myeloid leukemia, the prospective randomized phase 2 OPTI-AML trial published in Blood addressed the optimal duration of venetoclax induction combined with azacitidine in older or unfit patients [2]. Comparing the standard 28-day venetoclax schedule against an abbreviated 14-day schedule over the first two cycles, the complete remission rate was 49.4% for the 28-day arm versus 43% for the 14-day arm [2]. Because this did not meet statistical non-inferiority criteria, the abbreviated schedule was not superior, though exploratory subgroups like NPM1 or IDH2 mutated patients showed higher complete remission rates with the longer 28-day exposure [2]. In supportive care for chronic liver disease, a multicenter randomized phase 3 trial in the American Journal of Hematology evaluated recombinant human thrombopoietin for patients with thrombocytopenia undergoing elective invasive procedures [5]. The primary endpoint of sustained platelet counts of at least 50 times 10 to the 9th per liter from 24 hours pre-procedure to 7 days post-procedure without emergency bleeding management was achieved by 85% of patients receiving recombinant human thrombopoietin compared to only 12.5% in the placebo group [5]. Platelet transfusions were avoided in 92.5% of the active treatment group versus 25% with placebo, with no treatment-related serious adverse events reported [5].

Finally, we turn to vascular biology and lymphoma immunology. In thrombosis, a genome-wide association meta-analysis from the INVENT Consortium published in the Journal of Thrombosis and Haemostasis investigated genetic associations with pulmonary embolism among individuals presenting with deep vein thrombosis [6]. Across over 126,000 venous thromboembolism cases, four variants replicated at genome-wide significance, including factor V Leiden, which showed an inverse association with pulmonary embolism compared to isolated deep vein thrombosis, alongside variants in FGG, F11, and SLC12A2-DT [6]. While venous thromboembolism is highly heritable, these findings confirm that the specific manifestation of pulmonary embolism versus isolated deep vein thrombosis is modestly regulated by genetics [6]. In lymphoma immunology, a study in Blood utilized syngeneic models and primary human samples to investigate immune surveillance and checkpoint inhibition in anaplastic large cell lymphoma [7]. Programmed death-ligand 1 blockade induced complete remissions in approximately 50% of treated murine animals by reversing regulatory T-cell suppression and increasing effector CD8-positive T cells [7]. Notably, CD4-positive T cells were found to be indispensable for driving these anti-tumor responses, while non-responder CD4-positive T cells exhibited an exhausted Th22-like transcriptomic signature, providing critical preclinical proof-of-concept for immunotherapy in this subtype [7].

If you only have time for one paper this week, make it the TRANSCEND CLL 004 trial of lisocabtagene maraleucel plus ibrutinib in relapsed or refractory chronic lymphocytic leukemia published in Blood [1]. This study provides vital prospective evidence that combining cellular therapy with a covalent Bruton tyrosine kinase inhibitor can achieve deep and durable responses in a heavily pretreated, high-risk population that has progressed on prior standard targeted therapies, opening a practical avenue for managing refractory disease.

Here are the key takeaways from this week in Hematology. Lisocabtagene maraleucel combined with ibrutinib yields deep and durable responses in high-risk relapsed or refractory chronic lymphocytic leukemia, with manageable safety profiles [1]. Linvoseltamab maintains binding and cytotoxic activity against specific BCMA mutations that confer resistance to teclistamab, offering a potential therapeutic sequence after progression [3]. Abbreviating venetoclax induction to 14 days in older acute myeloid leukemia patients did not meet non-inferiority criteria compared to 28 days, supporting continued use of standard duration particularly in biomarker-defined subgroups [2]. Recombinant human thrombopoietin effectively prevents thrombocytopenia-related bleeding and avoids platelet transfusions in patients with chronic liver disease undergoing invasive procedures [5]. That's your roundup for This Week in Hematology. The full transcript and references are available on the episode page in your AudioScholar library. This is an AI-curated summary — for clinical decisions, always consult primary sources and current guidelines. See you next week.

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