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Single-cell dissection of plasma cell clonal evolution to smoldering multiple myeloma after CD19 CAR-T cell therapy in B-cell acute lymphoblastic leukemia

Chimeric antigen receptor T (CAR-T) cell therapy has revolutionized the treatment of B-cell malignancies, achieving deep and durable remissions in patients with B-cell acute lymphoblastic leukemia (B-ALL).1 Despite remarkable therapeutic successes, rare but clinically significant secondary hematologic malignancies have been reported during CAR-T cell therapy, often driven by lineage switching or clonal selection.2 Moreover, CAR-T cell therapy drives profound remodeling of the immune microenvironment, and the sustained inflammatory signaling may promote clonal evolution and influence disease progression.3 High-resolution approaches, such as single-cell RNA sequencing (scRNA-seq) and single-cell B-cell receptor sequencing (scBCR-seq), enable characterization of transcriptional programs, clonal identity, and temporal dynamics to dissect CAR-T cell therapy-induced clonal evolution and immune remodeling.4

Here, we report a case of B-ALL with B-cell receptor (BCR) heterogeneity at diagnosis that evolved into smoldering multiple myeloma (SMM) following CD19-targeted CAR-T therapy. The co-occurrence of B-ALL and SMM is exceptionally rare, as it requires malignant clones at distinct stages of B-cell development. This case provides a unique opportunity to dissect how CAR-T cell therapy drives B-lineage clonal evolution and reshapes the immune microenvironment. To this end, bone marrow mononuclear cells (BMMNC) were collected at multiple time points and subjected to longitudinal scRNA-seq and scBCR-seq to track dynamic changes in malignant and immune cell populations, thereby elucidating the mechanisms of clonal evolution and immune remodeling following CAR-T cell therapy. The patient gave informed consent and was enrolled in a clinical trial registered at clinicaltrials.gov (Identifier: NCT00123456).

A 13-second eye test may help predict recovery of consciousness after severe brain injury

A simple bedside eye test may help predict recovery of consciousness in patients with severe brain injuries, according to new research presented at the European Academy of Neurology (EAN) Congress 2026.

The study found that a previously overlooked phase of the pupil response to light, known as the late light-off response (LOR), predicted improvements in consciousness seven days later in patients with acute brain injury. In contrast, standard pupil measurements already widely used in intensive care units (ICUs), including the Neurological Pupil Index (NPi) and pupillary light reflex (PLR) latency, did not predict later gains in consciousness.

Newly identified fossil sheds light on evolutionary history of saber-toothed cats

Fossils tucked away in a museum drawer and identified merely as “feline” are actually from a very ancient and enigmatic saber-toothed cat that inhabited North America more than 5 million years ago. Newly identified by a UC Berkeley paleontologist, the nearly complete skull helps clarify how these large-fanged felines evolved over millennia before going extinct about 10,000 years ago.

One clear takeaway is that these cats started out with smaller fangs—the upper canines—but evolved increasingly longer ones that may have led to their ultimate demise. California’s state fossil, Smilodon fatalis (originally called S. californicus), was the culmination of that trend. It had some of the largest upper canines of any saber-toothed animal—up to 7 inches (18 centimeters) long—but was the last saber-toothed animal to survive.

According to Berkeley postdoctoral fellow Narimane Chatar, the cranium, teeth and lower jaw (or mandible) she stumbled upon in the American Museum of Natural History in New York are from the species Adelphailurus kansensis, originally discovered in Kansas and known only from jaw fragments and teeth. Now, with the first complete skull of the cat, she has been able to tentatively place the animal within the family tree of saber-toothed carnivores and contrast it with the most recognizable saber-toothed cat, Smilodon, which ranged throughout the Americas.

Scratching that bug bite might feel good at first but science explains why it’s a bad idea

You’ve likely heard it since childhood: Don’t scratch that bug bite or rash, you’ll make it worse. But why would something that feels so good be bad?

A lot of things can cause itchiness, sometimes serious diseases. Whatever the cause, doctors have long warned that scratching too much can damage the skin. Now researchers better understand why even a mildly annoying itch could put you on an itch-and-scratch cycle if you give in.

How did they find out? In part by putting tiny “cones of shame” onto mice to uncover what happens on a cellular level when an itch gets scratched—or left alone.

When a pool or pond turns green with algae, don’t reach for chemicals—nature has better solutions

When the Lincoln Memorial Reflecting Pool turned green with algae just days after a US$15 million renovation, the U.S. government scrambled for chemicals and expensive technical solutions to fix the iconic landmark.

Trying to kill algae with chemicals is a common response when community ponds or other water features go green. But as a scientist who studies freshwater ecology, I can tell you there are better solutions that cost far less, last longer and carry less risk of harm to pets and wildlife.

Rather than battling against nature, these alternatives work with nature for long-term solutions.

Hospital AI tool predicts low blood sugar in patients up to 24 hours in advance

Cedars-Sinai Health Sciences University investigators developed an AI-based model that can identify hospitalized patients at risk of low blood sugar up to 24 hours before the condition occurs. The long short-term memory (LSTM) model, described in npj Digital Medicine, could help clinicians intervene earlier and prevent complications, including, in severe cases, seizures, coma and long-term heart arrhythmias.

The model addresses a longstanding challenge in hospital care. Low blood sugar, also called hypoglycemia, is a common and potentially life-threatening complication among hospitalized patients, including those receiving diabetes treatment, those who are fasting before procedures or those in critical care. However, there are no widely used tools for predicting which hospitalized patients may develop hypoglycemia.

“Today, most hospital care for hypoglycemia is reactive, and we respond after a patient’s blood sugar drops,” said Roma Gianchandani, MD, senior author of the study and vice chair of quality and innovation in the Department of Medicine and program director for diabetes.

AI can be an ally in rooting out ransomware threats

AI can be used to prevent cybersecurity threats linked to ransomware, says University of Cincinnati researcher Nelly Elsayed.

“We are in a hype era of AI,” says Elsayed, associate professor in the UC School of Information Technology. “Some people support it, others fear it, but in general people who design technology are trying to use it for good.”

Elsayed, founder and leader of the Applied Machine Learning and Intelligence Lab at UC, recently published research in the Journal of Information Security and Applications, arguing that generative AI may be an ally in strengthening ransomware defense.

The AI Future No One Wants to Talk About

Go to https://ground.news/sabine to get 40% off the Vantage plan and see through sensationalized reporting. Stay fully informed on events around the world with Ground News.

In today’s video I speculate about the future of artificial intelligence.

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Don’t forget about thrombosis in acute promyelocytic leukemia

Firstly, why examine the role of thromboembolic disease in APL when serious bleeding is essentially universal? Thromboembolic episodes are more common than may be appreciated in this setting. The 16% incidence of thromboembolic events observed by Rodriguez-Viega and co-workers is higher than the 12% found in patients with acute myeloid leukemia.5 Furthermore, the major cause of treatment failure in APL is early death and the development of clotting is associated with early death. Early death in APL occurs most frequently during the first 24–48 hours after presentation. Understandably, very few, if any, of such patients are enrolled on clinical trials. Enrollment on a trial would facilitate further insights into thromboembolic events and may pave the way for prevention and therapeutic intervention.

Secondly, why are patients with APL predisposed to develop thrombosis? After all, the disease is infamous for its life-threatening and potentially catastrophic bleeding. This prominent characteristic was recognized by Dr. Leif Hillstad, who is credited with the first description of APL as a distinct clinical entity in 1957.6 Acute promyelocytic leukemia cells are associated with the release of plasminogen activator inhibitor-1, tissue factor, and TNFα. These proteins, together with a decrease in thrombomodulin which functions as an anticoagulant by binding to thrombin, favor the balance towards thromboembolic events7 (Figure 1). Alternatively, with the generation of annexin II, plasminogen activators, and podoplanin, a transmembrane protein which interacts with cell lectin superfamily 2 (CLEC-2) on platelets to induce platelet aggregation and adhesion to lymphatic vessels,8 bleeding is much more commonly present. Furthermore, direct proteolysis of fibrinogen and von Willebrand factor contributes to bleeding. This compilation of processes explains why some patients with APL have bleeding while others have thromboembolic episodes and some have both depending on the balance of procoagulant and anticoagulant proteins. However, bleeding, usually clinically manifested by large ecchymoses on the trunk and extremities, is the major hallmark of the disease.

Finally, how can thromboembolic events in APL be prevented? The most important thing is to maintain a high level of suspicion. The report by Rodriguez-Veiga and co-workers reminds us to be vigilant for the possibility of thromboembolic events in patients with APL. The risk of thrombosis was 1.4% among low-risk patients (presenting WBC 40×109/L), 4.9% for intermediate-risk patients (WBC 10×109/L and platelet count 10×109/L). In contemporary practice, low-and intermediate-risk groups are combined since outcomes among these patients proved to be similar.

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