The prognosis of peripheral T-cell non-Hodgkin lymphomas (PTCL) is dismal, particularly in the relapsed/refractory (r/r) setting, where 3-year overall survival (OS) is 20%-30%. No superior second-line therapy for PTCL has been universally established, and durable remissions rely on consolidation with allogeneic haematopoietic stem cell transplantation (alloHSCT). Enhancing response rates to salvage therapy is, therefore, crucial to increase transplant eligibility. We retrospectively evaluated the efficacy of bendamustine, gemcitabine and vinorelbine combination (BeGeV) in 24 consecutive patients with r/r PTCL treated at our centre since 2017. BeGeV achieved an overall response rate (ORR) of 66% and a complete remission rate (CRR) of 41%. After a median follow-up of 41.8 months, 1-year progression-free survival (PFS) and OS were 37.5% and 58.3% respectively. Outcomes differed by histology: PTCL not otherwise specified (PTCL-NOS) showed inferior responses (ORR 41%, CRR 16%) compared with T-follicular helper lymphomas (PTCL-TFH; ORR 100%, CRR 75%) and systemic anaplastic large cell lymphoma (sALCL; ORR 75%, CRR 50%). Survival analyses confirmed substantial differences across subtypes, with 12-month PFS and OS rates of 8.3% and 41.7% for PTCL-NOS, 50% and 75% for sALCL and 75% and 75% for PTCL-TFH respectively. Despite the limitations of small sample size and retrospective design, this study provides preliminary evidence supporting BeGeV as a potential bridge to alloHSCT in r/r PTCL-TFH and sALCL.

Schmidt-Barbo etal. High pre-treatment peripheral blood T cell receptor (TCR) clonality as a predictor of prolonged response in immune thrombocytopenia to the British Journal of Haematology. Br J Haematol 2026 (Online ahead of print). doi: 10.1111/bjh.70310 and Jauch etal. Efficacy and safety of eltrombopag in combination with dexamethasone as first-line treatment in adult patients with newly diagnosed immune thrombocytopenia for the British Journal of Haematology. Br J Haematol 2026 (Online ahead of print). doi: 10.1111/bjh.70312.

Haematology is at a crossroads, divided between haemato-oncology and the disparate disciplines collectively known as 'non-malignant' haematology. This latter term is a misnomer that devalues a spectrum of complex, life-threatening conditions and contributes to workforce shortages and research inequities. This article argues for the formal adoption of the term Medical Haematology to redefine this domain. We chart its central role across medicine, from guiding anticoagulation, transfusion and thrombosis care across specialties to addressing global health challenges. We highlight its pioneering contributions to molecular medicine and immunotherapy, exemplified by gene therapy for haemophilia and the repurposing of chimeric antigen receptor T cells for autoimmune disease. Finally, we present a forward-looking blueprint involving establishment of 'Blood Teams', revamping educational curricula and championing equity to secure the speciality's future. Embracing Medical Haematology is a strategic imperative to reflect the life-threatening nature of many conditions within the speciality, attract trainees, rebalance research priorities and firmly re-establish haematology's indispensable role at the heart of modern medical practice.

Despite red blood cell (RBC) immunization being a frequent complication of chronic transfusion in myelodysplastic syndromes (MDS), its prognostic significance remains unclear. We analysed 486 transfused patients diagnosed with MDS. Prognostic impact of RBC immunization (allo- or autoantibodies) was evaluated as a time-dependent covariate. Competing risk methods were applied to estimate the cumulative incidence of immunization. Sixty-nine patients (14.2%) developed RBC immunization, most commonly anti-K and anti-E, which was more frequent in patients transfused before MDS diagnosis (subhazard ratio [SHR]: 2.9, 95% confidence interval [CI]: 1.6-5.4; p = 0.001) and Rh(D)-negative blood group (SHR: 1.9, 95% CI: 1.1-3.2; p = 0.026). RBC immunization was associated with a significant and independent reduction in remaining survival (hazard ratio: 11.9, 95% CI: 7.3-19.6; p = 0.001), without differences between auto- and alloantibodies. RBC immunization was followed by increased transfusion intensity, but transfusion requirements also rose in non-immunized patients over time. RBC immunization did not predict progression to acute myeloid leukaemia (AML). A trend towards fewer new antibodies was observed during hypomethylating therapy. RBC immunization is independently associated with reduced survival in transfusion-dependent patients with MDS, irrespective of AML progression. These findings highlight the potential prognostic relevance of RBC antibodies and call for further investigation into the mechanisms linking immunization, transfusion burden and survival outcomes.

Immune thrombocytopenia (ITP) is an autoimmune disorder that occurs in children and adults, and it is characterized by a reduced platelet count. Hetrombopag, a novel thrombopoietin receptor agonist (TPO-RA) for second-line ITP treatment, lacks thorough efficacy and safety evaluation in paediatric patients. In this study, we assessed complete response (CR), response (R), overall response (OR), no response (NR), durable response (DR), relapse and treatment-free response (TFR) rates in 93 paediatric ITP patients who were treated with hetrombopag. The results demonstrated that the CR rate, R rate, OR rate, NR rate, DR rate, relapse rate and TFR rate were 61.3%, 15.1%, 76.3%, 23.7%, 76.1%, 26.8% and 52.1% respectively. Patients with newly diagnosed ITP exhibited a higher TFR rate than those with persistent or chronic ITP. Furthermore, among the nine patients who switched from other TPO-RAs, seven patients achieved OR during initial treatment, including three patients who achieved CR and four patients who achieved R. The overall incidence of adverse events was 37.6%, with no serious adverse events reported. Our findings highlight that hetrombopag is both safe and effective in paediatric patients and may serve as a viable option for patients for whom first-line therapy fails.

Small nucleolar ribonucleic acids (snoRNAs) are a class of small non-coding RNAs involved in the post-transcriptional modification of ribosomal RNAs (rRNA) and small nuclear RNAs (snRNA). Mounting evidence indicates that specific snoRNAs are drivers of oncogenesis, but their role in B-cell precursor acute lymphoblastic leukaemia (BCP-ALL) is unknown. We found that a small subset of 30 snoRNAs is commonly deregulated in BCP-ALL. Small Cajal body-specific RNA 12 (scaRNA12) was the strongest downregulated snoRNAs in BCP-ALL. Forced expression of scaRNA12 in BCP-ALL cells largely recovered the level of uridine-46 pseudouridylation of U5 snRNA (U5:Ψ46), an important RNA modification for proper splicing and gene expression regulation. We found that scaRNA12 controls a set of genes that belong to pathways that are frequently affected in BCP-ALL samples. We show that scaRNA12 activates p53, which is commonly affected in BCP-ALL even in the absence of p53 mutations. We show that scaRNA12 expression decreased the expression of upstream p53 regulators and provide novel evidence for a role of scaRNA12 in p53 regulation. We found that forced expression of scaRNA12 in BCP-ALL increased p53 activity and significantly enhanced the sensitivity of BCP-ALL to chemotherapeutic reagents. Together, our results suggest a tumour-suppressing role for scaRNA12 in BCP-ALL.