The problem of acquired hemophilia.

modern leukemia and lymphoma sequencing standards, is an improvement in signal-to-noise ratio for Hodgkin lymphoma given the incredible rarity of the Reed-Sternberg cell in its background nest of inflammatory infiltrate. Previous studies relying on laser capture microdissection could also increase the signal-to-noise ratio, but at the cost of time, effort, and still-low cell numbers. This work raises additional questions. Variant allele frequencies range from 2% to 100% within single cases. Does this imply intratumoral heterogeneity? Do individual or multiple HRS cells exist as clones and subclones with different alterations and characteristics within the same lymphoma, and if so, what would that mean for molecularly targeted therapy? Overall, this work is exciting for several reasons. It advances our knowledge of the genetic makeup of cHL but also demonstrates the feasibility of a new technique that could in the future be extended to provide additional information about transcription and potentially protein expression. The demonstration that restoration of B2M loss can reverse a characteristic phenotype is an important functional validation of a key finding and is timely and relevant because immune therapies are now being explored in Hodgkin lymphoma. 10 Conflict-of-interest disclosure: The author declares no competing financial interests. n REFERENCES 1. Reichel J, Chadburn A, Rubinstein PG, et al. Flow sorting and exome sequencing reveal the oncogenome of primary Hodgkin and Reed-Sternberg cells. Preparation of high-quality next-generation sequencing libraries from picogram quantities of target DNA. purification of classical Hodgkin cells from lymph nodes by flow cytometry and flow cytometric cell sorting. landscape of Hodgkin lymphoma cell lines determined by whole-exome sequencing. 6. Steidl C, Diepstra A, Lee T, et al. Gene expression profiling of microdissected Hodgkin Reed-Sternberg cells correlates with treatment outcome in classical Hodgkin lymphoma. major histocompatibility complex class I expression on Reed-Sternberg cells in relation to the cytotoxic T-cell response in Epstein-Barr virus-positive and-negative Hodgkin's disease. TNFAIP3 (A20) is a tumor suppressor gene in Hodgkin lymphoma and primary mediastinal B cell lymphoma. blockade with nivolumab in relapsed or refractory Hodgkin's lymphoma[published online ahead of print December 6, 2014]. N Engl J Med. In this issue of Blood, Andreas Tiede et al report the results of a German, Austrian, and Swiss registry (GTH-AH study) of acquired hemophilia and identify prognostic factors that may guide the choice of immunosuppressive treatment (IST) to eradicate the autoantibody contributing to the outcome of the syndrome. A cquired hemophilia A (AHA) is an autoimmune disease caused …