HLH-like toxicities after CAR-T and Structure-Function Relationships of FNAIT

In this week's episode, Blood editor Dr. Laura Michaelis interviews Drs. Matthew Frank and Jieqing Zhu on their latest articles published in volume 147 issue 22 of Blood. Dr. Frank discusses "How I treat HLH-like toxicities after immune effector cell therapy", in which the two cases presented emphasize the need for early identification, the use of anticytokine therapy with either emapalumab or ruxolitinib when organ toxicities worsen despite conventional CRS-directed treatment, and the need for ancillary supportive care as central to success. Dr. Zhu shares insights from "Structural Basis of HPA-1 a Alloimmunization in FNAIT and Allosteric Regulation of Integrin Conformation" where they probed the structure-function relationships underpinning interactions of alloantibodies against the most common target, human platelet antigen 1a (HPA-1a). Their data can help explain why some alloantibodies cause severe hemorrhagic FNAIT while others result in milder, asymptomatic thrombocytopenia.