Chelsie Derman is an associate editor for 

who covers psychiatry, sleep medicine, geriatrics, migraine, and allergy. She joined MJH Life Sciences in September 2023 after graduating from The College of New Jersey with a bachelor’s degree in journalism and professional writing. In her free time, she enjoys creative writing and reading.

A new study identified IgE⁺ plasmablasts as the dominant drivers of seasonal IgE boosts in 

The cellular mechanisms driving seasonal surges in allergen-specific IgE have not been well defined. Therefore, investigators examined the role of plasmablasts in mediating these increases during pollen exposure.

Using longitudinal sampling across pollen seasons, epitope mapping, basophil activation assays, and IgE VH sequencing, the team found that when patients are naturally exposed to birch pollen, they produce more IgE antibodies from plasmablasts that target the Bet v 1 allergen. This increase happens without a similar rise in IgG antibodies. The findings clarify how effector cells are reloaded with allergen-specific IgE during seasonal exposure and position IgE⁺ plasmablasts as a potential therapeutic target in allergic disease.

The study showed that bet v 1–specific IgE levels increased significantly during peak pollen exposure compared with pre-season measurements (TP1 vs TP3; 

 <.01) and declined again after the season (TP3 vs TP5; 

 < 0.05). In contrast, bet v 1–specific IgG1 and IgG4 levels did not show significant seasonal changes, indicating that the IgE boost occurred without a synchronized IgG response.

In several individual patients, IgE kinetics were completely dissociated from IgG1 and IgG4 trajectories. Flow cytometry demonstrated a significant increase in circulating IgE⁺ plasmablasts (CD19⁺CD27⁺CD38⁺CD20low) during the pollen season, supporting their role as the primary source of secondary IgE production.

In this Q&A, investigators Maria Byazrova and Rudolf Valenta, both from the Federal Medical Biological Agency of Russia (FMBA Russia), discussed the study’s key insights, how these findings challenged the assumption that memory B cells drive IGE recall responses, and how these results helped explain why patients often experience worsening allergic symptoms with repeated seasonal exposure.

 What is the key new insight this study provides about the cellular source of seasonal increases in allergen-specific IgE?

 Plasmablasts are one of the main cells [that] are part of the secondary IgE-induced response. In this case, plasmablasts, which are one of the subset[s] of the B cells… [are] temporary [and] arise in the bloodstream after the high allergen exposure. They are producing secondary IgE, which can reward effector cells [and]

can induce allergic reactions. The plasmablasts are [an] extremely important subpopulation if we are talking about allergy development

 IG antibodies here have an unusually very short half-life, so usually it's about 3 days. So, if you start to develop IG antibodies when you are born here, you [can] become allergic. The thing is that CIG antibodies, if they [were] only in the circulation, would disappear very quickly, but they can bind to the receptors on the inflammatory cells, like… muscles and basophils. These cells can bind [to] the IG for a prolonged period, but the cells must be reloaded so that the person has an allergic reaction after a while.

 How do your findings challenge the assumption that memory B cells or secondary class switching drive IGE recall responses?

 I think one of the strengths in our paper [was that] we showed that IG antibodies recognize different epitopes than IgG, and we analyzed the secondary antibody response with…the wild type [of] allergen that is folded and with fragments. Fragments worked with IgG, but not with IG. So, we can differentiate that there is no IgG boost, because we do not see that when we analyze with the broken parts of the antigen, the sequential epitopes.

 How did these results help explain why patients often experience worsening allergic symptoms with repeated seasonal exposure?

 When we have the birch pollen season, B cells activate, and they differentiate into the IGE plasmablast with [the] help of T cells. After this, this plasma blast circulates, which is literally activated B cells; they are producing IGE. This increase[s] the sensitivity of the patient during the birch pollen season because this additional IG can arm the effective cells.

HCPLive: what does the reloading of basophils with allergen specific IGE after seasonal exposure reveal about the timing and reversibility of allergic sensitivity?

It's the same with the mast cells. They quickly reload. It's a kind of cycle when you watch it. For example, seasonal allergy, when the person is out of the season without allergen exposure, the IG [levels] start to drop down and so does with a little bit of a time shift.

In principle, if you put a person, let's say, for a year or two here to a different place where there [are] no birch trees, the sensitivity will drop further down. That means that you need to reload all the time, again and again, to maintain this sensitivity

Byazrova, M., Litovkina, A., Eckl-Dorna, J. 

 Seasonal allergen exposure recalls IgE+ plasmablasts to reload allergic effector cells. 

https://doi.org/10.1007/s44466-025-00018-w

Articles

In this Q&A, investigators Maria Byazrova and Rudolf Valenta discuss findings on plasmablast's role in seasonal IgE surge when it comes to birch allergy.

News

news page, resources on the topics of disease- and specialty-specific medical news and expert insight can be found. Content includes articles, interviews, videos, podcasts, and breaking news on health care research, treatment, and drug development.

Clinical

clinical page is a resource for content on every specialty, disease, and topic available on our medical news site.

Allergy

Allergy condition center page is a comprehensive resource for clinical news and insights on allergic and inflammatory diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for food and seasonal allergies, as well as allergic asthma and related conditions.

Seasonal Allergy

Seasonal IgE Surge in Birch Allergy Driven by IgE⁺ Plasmablasts: Q&A With Investigators

Abigail Brooks is an assistant managing editor for 

She joined MJH Life Sciences in August 2023 shortly after graduating from Monmouth University where she earned her BA in Communication with a concentration in Public Relations/Journalism and later an MA in Interactive Digital Media. She enjoys traveling, running, and reading books. She can be reached at abrooks@mjhlifesciences.com.

Credit: Murdoch Children’s Research Institute in Melbourne

BridgeBio Pharma has announced positive topline results from PROPEL 3, a global phase 3 study of oral infigratinib in children living with achondroplasia, showing it met the primary endpoint of change from baseline in annualized height velocity (AHV) at week 52 (

As described in a February 12, 2026, release from the Company, US Food and Drug Administration (FDA) New Drug Application (NDA) and Marketing Authorization Application (MAA) submissions planned in the second half of 2026 for achondroplasia. Additionally, given the strength of the PROPEL 3 data, BridgeBio plans to accelerate the development of oral infigratinib in hypochondroplasia, and is enrolling the observational run-in for the phase 3 trial.

"Achondroplasia is a genetic condition driven by FGFR3 that affects more than stature alone, with consequences on physical functioning and independence that can impact widely over a person’s lifetime,” Ravi Savarirayan, MD, PhD, of Murdoch Children’s Research Institute in Melbourne, Australia, and global lead investigator for PROPEL 3, said in a statement. “Infigratinib is the first oral therapy designed to target FGFR3 and directly address the underlying cause of achondroplasia. In the broadest age range studied to date, oral infigratinib has demonstrated the highest and most significant improvement in annualized growth velocity, along with the first statistically significant improvement in body proportionality, in children aged 3 to 8 years, reported for any therapy approved or in development for this condition. Taken together, these best-in-class results highlight the transformative potential for infigratinib to address aspects of achondroplasia beyond linear height, and with a product administered orally.”

Oral infigratinib is the only therapeutic option in development for achondroplasia to have Breakthrough Therapy Designation from the FDA. The September 2024 designation was supported by preliminary clinical evidence from the PROPEL 2 clinical trial, meeting the FDA’s requirement of potentially demonstrating substantial improvement in efficacy over available therapies on clinically significant endpoint(s). In Cohort 5 of the study (0.25 mg/kg/day), oral treatment with infigratinib resulted in a statistically significant and sustained increase in AHV, with a mean change from baseline of +2.51cm/yr at month 12, and +2.50 cm/yr at month 18 (P = .0015) and statistically significant improvement in body proportionality at month 18 (P = .001).

PROPEL 3 was a global, one-year, 2:1 randomized, double-blinded placebo-controlled clinical study assessing the efficacy and safety of infigratinib in children with achondroplasia aged 3 to <18 years with open growth plates. Through week 52, the study met its primary endpoint for change from baseline in AHV superior to placebo, with an LS mean treatment difference of +1.74 cm/year (

<.0001) and a mean treatment difference of +2.10 cm/year.

Consistent with the primary endpoint, the secondary endpoint of absolute AHV at week 52 showed a significant improvement with infigratinib compared to placebo, with the infigratinib arm achieving the greatest LS mean absolute AHV reported to date in a randomized trial in achondroplasia (5.96 cm/year vs 4.22 cm/year on placebo). Change from baseline in height Z-score (achondroplasia reference population) was also superior to placebo, with an LS mean treatment difference of +0.32 SD (

<.0001), the largest difference observed in a randomized trial in achondroplasia; the LS mean change from baseline on the treatment arm was +0.41 SD, the largest improvement observed on a treatment arm in a randomized trial for achondroplasia.

In a pre-specified exploratory analysis in children younger than 8 years of age of the key secondary endpoint of change from baseline in upper-to-lower body proportionality at week 52, oral infigratinib is the first therapeutic option to show statistical significance against placebo in a randomized trial for achondroplasia, demonstrating an LS mean decrease of -0.05 against placebo (

<.05). In the overall population, infigratinib achieved an LS mean decrease of -0.05, the largest reduction observed in a treatment arm in a randomized achondroplasia trial, with a favorable LS treatment difference of -0.02 versus placebo at week 52 (

In the study, infigratinib was well-tolerated, with no discontinuations related to the study drug and no serious adverse events related to the study drug. A total of 3 cases (4%) of hyperphosphatemia were reported and were all mild, transient, asymptomatic, and not requiring dose reductions or discontinuations. No adverse events associated with inhibition of FGFR1 or FGFR2 were observed, nor were adverse events associated with CNP analogues: symptomatic hypotension, injection site reactions, or hypertrichosis.

Based on these data, BridgeBio described plans to meet with regulatory authorities to discuss plans for submission of a NDA and MAA for infigratinib in the second half of 2026 to support approval. The Company also intends to accelerate the development of infigratinib for hypochondroplasia, and is enrolling participants in the observational run-in for the phase 3 trial. BridgeBio also has an ongoing clinical trial of infigratinib for the newborn to <3 year old age groups in achondroplasia in the PROPEL Infant & Toddler trial.

“Today’s announcement represents another milestone in achondroplasia research and, pending regulatory review, expands available care to include an oral therapeutic option, offering individuals and families additional choice as they consider their healthcare goals and preferences,” Michael Hughes, Chair of the Biotech Industry Liaison Committee at Little People of America, said in a statement. “BridgeBio’s commitment to engaging with and learning from the dwarfism community reflects a focus on listening to lived experience and recognizing diverse priorities in shaping research efforts. Within this context, the observed improvement in body proportionality with one year of treatment in the PROPEL 3 study is an outcome that individuals and families have identified as meaningful, may be relevant to physical function, and continues to be evaluated to understand its broader significance.”

BridgeBio Reports Positive Phase 3 Topline Results for Oral Infigratinib with the First Statistically Significant Improvements in Body Proportionality in Achondroplasia. BridgeBio. February 12, 2026. Accessed February 12, 2026. 

https://investor.bridgebio.com/news/news-details/2026/BridgeBio-Reports-Positive-Phase-3-Topline-Results-for-Oral-Infigratinib-with-the-First-Statistically-Significant-Improvements-in-Body-Proportionality-in-Achondroplasia/default.aspx

BridgeBio. bridgebio announces infigratinib is the first ever investigational therapeutic option for achondroplasia to be awarded breakthrough therapy designation by the fda. September 17, 2027. Accessed February 12, 2026. 

https://investor.bridgebio.com/news/news-details/2024/bridgebio-announces-infigratinib-is-the-first-ever-investigational-therapeutic-option-for-achondroplasia-to-be-awarded-breakthrough-therapy-designation-by-the-fda-09-17-2024/default.aspx

BridgeBio’s phase 3 PROPEL 3 trial showed oral infigratinib significantly increased annualized height velocity at week 52 versus placebo in children with achondroplasia, with concurrent gains in absolute AHV and height Z-score. A prespecified analysis in those <8 years demonstrated the first statistically significant improvement in upper-to-lower body proportionality versus placebo. Safety was favorable, with no drug-related serious AEs or discontinuations and infrequent, mild hyperphosphatemia. Regulatory filings are planned for 2H 2026, alongside expansion into hypochondroplasia.

The data represent the highest and most significant improvement in AHV and the first statistically significant improvement in body proportionality in achondroplasia.

Endocrinology

The HCPLive endocrinology page is a comprehensive resource for clinical news and insights on endocrine system conditions. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for diabetes, hormonal disease, and more.

Oral Infigratinib Meets Annualized Height Velocity Endpoint in Phase 3 Achondroplasia Trial

Ashfaq Marghoob, MD, is a dermatologist specializing in the diagnosis and treatment of cancers of the skin and the director of the Memorial Sloan-Kettering regional skin cancer clinic.

Credit: St. Jude Children’s Research Hospital

, Ashfaq Marghoob, MD, spoke with HCPLive about several key takeaways from his portion of the ‘Pediatric Dermoscopy Workshop: Dermoscopy in Infants, Children, Teens and Young Adults’ session, with a strong emphasis on pattern recognition and reassurance in pediatric populations.

Marghoob, MD, a dermatologist who specializes in the diagnosis and treatment of skin cancer, is the director of the Memorial Sloan-Kettering regional skin cancer clinic. A central theme of his session was spotlighting common areas of clinician anxiety, particularly nevi on the scalp in children. He reviewed several characteristic benign scalp patterns, their dermoscopic features, and supporting literature demonstrating no established association with 

 Looking ahead, Marghoob also expressed optimism about artificial intelligence (AI) in melanoma screening.

The following is a transcription of this portion of his discussion of the session and its major highlights, conducted on-site with the 

Would you highlight some of the key points made in your pediatric dermascopy workshop that you feel are important for clinicians to take home with them?

Basically, what I concentrated on is that there is a group of lesions that clinicians somehow have anxiety about. I honed in on those lesions, and one of them is a lesion on the scalp. Let’s say I'm seeing a nevus on a child’s scalp. For some reason, it causes anxiety for clinicians. It may be that having it on the scalp is a harbinger or a sign that this child may eventually develop ‘Atypical mole syndrome.’

What I drilled down on was the dermoscopic features of the nevi that occur in the scalps of kids. We have the so-called ‘eclipse’ nevus, the ‘reverse eclipse’ nevus, the ‘cockade’ nevus, and the ‘balloon cell’ nevus. Those are sort of the four types of nevi that are frequent on the scalp. And for whatever reason, they often will get sent to me for referral as to what we do for these. I think that these are all benign patterns.

This is kind of reassuring, providing the literature to show that there are, in fact, benign patterns never been associated with melanoma. We encourage individuals to just monitor them, realizing also that, since they are children, over the course of time, these will become a little bit bigger. That is normal, and that shouldn't justify their removal. It's sort of a reassurance from a dermatoscopic perspective, [telling them] from a literature perspective, these lesions on the scalp are benign.

Were there any other elements you highlighted in the pediatric dermoscopy session worth highlighting for clinicians viewing this interview?

 The second thing that we covered is lesions on the palms and soles in kids. Again, there's a myth out there that if you see a lesion on the palm and sole, you always have to cut it out. I'm not sure where that myth began, but it is one that kind of permeates across not only dermatologists, but family physicians as well. As I said, I don't know what it's founded in, but dermoscopy has been proven to have distinct patterns in children that are benign. We don't have to cut them out. We don't even have to monitor them.

One of the key things to remember is that in nevi, as I mentioned before, you have parallel lines in the invagination…In adults, this line tends to be a solid, single line. But in children, it is very often a double line, or the lines are made out of dots. That sometimes confuses clinicians. I kind of highlighted what they look like and that they are benign. Then the second pattern that we see on the palms and soles of kids is something called the ‘peas in a pod’ pattern, where you'll see parallel lines in the furrows and dots on the ridge. These, when you biopsy them, tend to have a congenital feature. And again, based on dermoscopy, these are reassuring patterns. Then I highlighted what the histopathology correlates are for this specific pattern. So again, patterns of reassurance for clinicians.

Then the third thing I covered in the pediatric dermoscopy talk was melanonychia striata, so having pigmented nails in children. Kids form moles on their nail unit that will resemble melanoma in every way. They'll encompass more than half the nail, the full nail, they'll have pigment around on the cuticle, hyponychium, and everywhere. The only reassurance we have is that kids don't get melanoma of the nail unit. So we need to have a little bit of patience and monitor them.

Zooming out, what are you most looking forward to in the dermatology space in 2026, specifically related to these topics?

 I think that probably the area that I'm most interested in right now is making screening for melanoma more efficient and maybe more fail-proof. What do I mean by that? If the patient comes in, the conventional method right now is we examine them, and sometimes we have images that we compare. But it is me, the human, comparing [images] and looking for change. But we have to acknowledge that the human brain is not 100%...I think that the AI technology that is out there now will make that [type of mistake] extremely unlikely. The ability for AI to compare images, for example, is something that has been used forever.

So, this idea that computers can find new and change lesions, I think, will ensure that we will not miss anything. Add to that a second layer. On the lesion level, we have AI technology that is likely to come to bear. If you have a troubling lesion about which you're not quite sure, and we're not talking about lesions that 100% are benign or 100% malignant, but in between, AI may actually be able to help us in the management of those lesions. Then it may decide on what type of follow-up, biopsy, or no biopsy. Although it's in its infancy on that side, I do think that within my lifetime that I will see that somehow permeate into our clinical practice.

The quotes used in this interview summary were edited for the purposes of clarity.

Marghoob had no disclosures of note to highlight.

Marghoob A. Dermoscopy Workshop: Special Site Dermoscopy. Presented at the 2026 Maui Derm Hawaii Conference, January 25-29.

Ring C, Cox N, Lee JB. Dermatoscopy. Clin Dermatol. 2021 Jul-Aug;39(4):635-642. doi: 10.1016/j.clindermatol.2021.03.009. Epub 2021 Mar 19. PMID: 34809768.

Pediatric dermoscopy can reduce clinician anxiety by emphasizing pattern recognition and evidence-based reassurance. Common benign scalp nevi patterns in children—including eclipse, reverse eclipse, cockade, and balloon cell nevi—lack established melanoma associations and typically warrant observation despite expected growth. Acral nevi in pediatrics often show reassuring dermoscopic variants (e.g., double/dotted lines, “peas in a pod”) that do not require routine excision or monitoring. Pediatric melanonychia striata can mimic nail melanoma; conservative follow-up is usually appropriate. AI may improve change detection and triage of equivocal lesions.

In this Q&A segment of his interview, Marghoob speaks on-site at Maui Derm on tips related to dermoscopy and skin cancer detection.

Dermatology

The HCPLive dermatology page is a resource for medical news and expert insights on skin disease. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for dermatologic conditions, and more.

Conference

 conference coverage page features articles, videos, and expert-led live coverage from major medical meetings throughout the year.

Discussing Pediatric Dermoscopy and AI for Skin Cancer Detection, With Ashfaq Marghoob, MD

Finerenone Outperforms Spironolactone for Heart Failure Exacerbation in HFpEF, With Nihar Desai, MD, MPH

Finerenone use was associated with lower risks of heart failure exacerbation and all-cause mortality compared to spironolactone in patients with 

heart failure with preserved ejection fraction (HFpEF)

, based on a recent retrospective cohort study.

Phase II studies have associated finerenone with reduced risks of hyperkalemia and deterioration in kidney function when compared with spironolactone and eplerenone in patients with 

. The recent FINEARTS-HF trial has also highlighted finerenone, investigating its efficacy in reducing heart failure hospitalization in patients with HFpEF. However, despite these trials, finerenone does not yet have an approved indication for HFpEF.

“Spironolactone is a very important and highly effective therapy. The evidence to support its use in patients with reduced ejection fraction heart failure are unequivocal,” Nihar Desai, MD, MPH, associate professor of medicine at Yale School of Medicine and a contributing author in this study, told 

 in an exclusive interview. “However, the question arises regarding mid-range and preserved ejection fraction patients; spironolactone actually doesn’t have that as part of its indications. In contrast, using finerenone in those patients with an EF of ≥40% saw substantial clinical benefits.”

Desai and colleagues performed a retrospective observational cohort study via the TriNetX database, identifying all patients with a diagnosis of HFpEF. The team notes the potential limitations of TriNetX’s lack of additional datapoints, such as echocardiographic parameters and NYHA functional class, and the possible misclassification of patients within the HFpEF category.

Patients were then further stratified based on finerenone or spironolactone use within 1 year of diagnosis. Concomitant spironolactone and/or finerenone use was excluded in both cohorts. The primary outcomes of the analysis were first or subsequent heart failure exacerbations, acute myocardial infarction, hypokalemia, ischemic stroke, all-cause mortality, sudden cardiac death, and hyperkalemia within a 1-year follow-up period. Acute myocardial infarction and ischemic stroke were included as secondary endpoints.

Ultimately, the study included 254,417 patients with HFpEF; after propensity score matching, 491 patients were enrolled in each cohort, yielding a total of 982 participants. During the follow-up, the finerenone arm saw substantially lower statistically significant risk of heart failure exacerbation (55.2% vs 72.9%; HR, 0.63; 95% CI, 0.54-0.74; 

 <.001). Additionally, finerenone was associated with lower risks of all-cause mortality compared to spironolactone (4.1% vs 11.8%; HR, 0.38; 95% CI, 0.23-0.64; 

Investigators also recorded a lower risk of hypokalemia in the finerenone cohort versus spironolactone (8.4% vs 15.1%; HR, 0.58; 95% CI, 0.4-0.85; 

 <.001). Despite not being statistically significant, similar trends were noted for hyperkalemia (13.8% vs 16.1%; HR, 0.96; 95% CI, 0.69-1.33). Sudden cardiac death was rare across both cohorts, affecting only 1 patient in the spironolactone arm and 10 in the finerenone arm.

Desai and colleagues also performed subgroup analyses for patients with CKD and 

. Those with CKD saw substantially lower risk of heart failure exacerbation with finerenone versus spironolactone (59.4% vs 74.1%; HR, 0.63; 95% CI, 0.53-0.74; 

 <.001). The diabetes mellitus subgroup also saw lower heart failure exacerbation risk with finerenone (56.6% vs 74%; HR, 0.59; 95% CI, 0.5-0.69; 

Despite the strength of these data, this study is solely hypothesis-generating. Desai and colleagues encourage further research, including head-to-head randomized controlled trials of finerenone versus spironolactone in HFpEF, to inform the debate over its safe and efficacious use in real-world settings.

“If we’re going to follow the evidence and what the literature would tell us, finerenone would be a primary strategy in those patients with an EF ≥40% if finerenone is not available, or if there are other barriers that might restrict the use of finerenone,” Desai said. “Spironolactone is maybe an option B for a patient on the edges, but for most of our patients, we believe the data – finerenone seems to be the most effective MRA for those patients.”

Editor’s Note: Desai reports disclosures with Amgen, AstraZeneca, Novartis, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, and others.

Almas T, Shelig M, Al-Hindawi A, et al. Steroidal versus non-steroidal mineralocorticoid receptor antagonists in heart failure with preserved ejection fraction: A propensity-matched multi-network nationwide cohort study. European Heart Journal - Quality of Care and Clinical Outcomes. Published online January 30, 2026. 

Pitt B, Kober L, Ponikowski P, et al. Safety and tolerability of the novel non-steroidal mineralocorticoid receptor antagonist BAY 94-8862 in patients with chronic heart failure and mild or moderate chronic kidney disease: a randomized, double-blind trial. Eur Heart J. 2013;34(31):2453-2463. 

McCausland FR, Vaduganathan M, Claggett BL, et al. Finerenone and Kidney Outcomes in Patients With Heart Failure: The FINEARTS-HF Trial. J Am Coll Cardiol. 2025;85(2):159-168. 

Videos

Desai discusses his recent observational cohort study indicating finerenone’s substantial reduction of heart failure exacerbation risk in patients with HFpEF.

Cardiology

Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...

Heart Failure

The HCPLive heart failure page is a resource for medical news and expert insights on HF. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for heart disease, reduced and preserved ejection fraction, and more.

Alex Hillenbrand is an assistant editor for 

. She earned her BA in English from Lafayette College in 2023 and went on to write for pop culture, entertainment, and sports media outlets before joining MJH Life Sciences in 2025. In her free time, Alex enjoys cooking, going on walks, and meeting new people. Contact her at mjhlifesciences.com.

are 8 clinical recommendations and 1 research-only recommendations to guide management of relapsed or refractory 

 in adolescents and young adults (AYAs), emphasizing immunotherapy approaches.

, the 2026 Guidelines for Management of Relapsed/efractory ALL in AYAs underscore a paradigm shift toward immunotherapies, including blinatumomab and inotuzumab, over chemotherapy while reinforcing the importance of patient-informed, individualized clinical decision-making.

AYAs sit in a unique pocket of clinical care management, especially in ALL, and are considered a high-risk population. This distinction stems from their distinct disease biology, including increased rates of T-ALL and Philadelphia-like (Ph-like) ALL compared with pediatric patients. Historically, AYAs have experienced inferior outcomes, driven in part by gaps between pediatric and adult treatment paradigms, challenges with treatment adherence, and higher rates of treatment-related toxicity.

Although adoption of pediatric-inspired regimens has been associated with improved survival among AYAs compared with traditional adult protocols, outcomes in the relapsed or refractory setting remain suboptimal, highlighting an ongoing treatment gap.

To address the gap in AYAs patients, a multidisciplinary panel of hematologists, AYA psychosocial care specialists, pharmacists, methodologists, and patient representatives created these guidelines. They used Grading of Recommendations Assessment, Development and Evaluation (GRADE), including GRADE Evidence-to-Decision frameworks, for evidence assessment and recommendation formation.

The panel focused on immunotherapy, targeted therapies, allogeneic hematopoietic stem cell transplantation (allo-HSCT), and central nervous system (CNS)-directed therapy.

In refractory or relapsed ALL, the panel recommends the use of targeted agents, such as blinatumomab and/or inotuzumab, to induce remission due to their efficacy and potentially favorable toxicity profiles. Although the evidence for survival benefits, remission rates, and reduced toxicity is of low certainty, panelists consider it relevant in guiding treatment.

Specifically, the guidelines recommend blinatumomab over chemotherapy for patients with first relapse or refractory B-cell ALL, based on low-certainty evidence demonstrating increased remission rates, improved survival, and reduced toxicity. Inotuzumab is similarly recommended over chemotherapy in this setting. These agents are increasingly incorporated into contemporary treatment strategies and may serve as bridges to subsequent therapies, including allo-HSCT, depending on patient- and disease-specific factors.

In contrast, while emerging therapies such as daratumumab and CD7-directed CAR T-cell approaches have demonstrated promising activity, particularly in T-ALL, the panel concluded the current evidence is insufficient to support routine use outside of clinical trials. This limitation is especially relevant for AYAs with relapsed or refractory T-ALL, including both nelarabine-naïve and nelarabine-exposed patients.

Overall, the panel acknowledged meaningful progress in immunotherapy for relapsed or refractory T-ALL but emphasized that available data do not yet justify widespread adoption beyond the clinical trial setting. Key evidence gaps include the lack of head-to-head comparisons between immunotherapies and chemotherapy, as well as a shortage of prospective trials designed to define optimal sequencing, combinations, and treatment duration tailored specifically to AYAs.

Accordingly, the guidelines issue a research-only recommendation that, when feasible, individuals with relapsed or refractory T-ALL be offered enrollment in clinical trials evaluating novel agents such as daratumumab, CAR T-cell therapies, BCL-2 inhibitors, tyrosine kinase inhibitors, and other emerging approaches. Further research is encouraged to assess both short- and long-term outcomes, including toxicity, fertility, and health-related quality of life.

DuVall AS, McNeer J, Cheung MC, et al. ASH 2026 Guidelines for Frontline Management of Acute Lymphoblastic Leukemia in Adolescents and Young Adults. 

. Published online February 11, 2026. doi:

https://doi.org/10.1182/bloodadvances.2021006469

Wang AY, Muffly LS, Stock W. Philadelphia Chromosome–Negative B-Cell Acute Lymphoblastic Leukemia in Adolescents and Young Adults. 

. Published online January 29, 2020:JOP.19.00197. doi:

Makhani S, Khalid N, Robinson K, Agarwal A, Hussain M, Goel R. Predictors of long-term survival in adolescents and young adults with acute lymphoblastic leukemia: 20 years of insight from a nationally representative database. 

ASH 2026 guidance for adolescents and young adults with relapsed/refractory ALL prioritizes immunotherapy-based salvage over conventional chemotherapy, reflecting distinct AYA biology and historically inferior outcomes. A multidisciplinary panel used GRADE methods to craft eight clinical recommendations plus one research-only recommendation, spanning targeted agents, transplant integration, and CNS-directed therapy. For first relapse or refractory B-ALL, blinatumomab and inotuzumab are favored despite low-certainty evidence, citing improved remission, survival, and toxicity profiles. For T-ALL, routine use of emerging agents remains trial-limited pending stronger comparative and sequencing data.

The American Society of Hematology released new 2026 Guidelines for Management of Relapsed/Refractory ALL in AYAs, discussing immunotherapy and personalized decision making. 


Hematology

ASH Releases 8 Recommendations for Relapsed, Refractory Acute Lymphoblastic Leukemia in Adolescents, Young Adults

Adam Bress, PharmD, MS, is a professor of the department of population health sciences at the University of Utah School of Medicine and director of the Integrating Medicine & Policy to Achieve Healthcare Transformation (IMPACT HSR) program.

Bress highlights the potential shortcomings of relying on the Apple Watch as a diagnostic tool for hypertension, discussing its potential for false negatives.

Hypertension

The HCPLive hypertension page is a resource for medical news and expert insights on high blood pressure. This page features expert-led coverage, articles, videos and research on the therapies and development of treatments for hypertension, and more.

Apple Watch Hypertension Notifications May Give False Reassurance, With Adam Bress, PharmD, MS

Jonggi Choi, MD, PhD, is an associate professor at Asan Medical Center, University of Ulsan College of Medicine, and visiting scholar at Mass General Hospital.

Choi describes existing evidence on statin use in patients with liver disease and reviews his new research about their potential utility in PBC.

Hepatology

Cholangitis

cholangitis page, resources on the topics of medical news and expert insight into cholangitis can be found. Content includes articles, interviews, videos, podcasts, and breaking news on research, treatment, and drug development in PBC, PSC, and more!

Statins and Improved Long-Term Liver Outcomes in PBC, With Jonggi Choi, MD, PhD

Tim Smith joined the MJH Life Sciences team in 2022 and is currently an associate editor for HCPLive. He is also the executive producer of two podcasts: Skin of Color Savvy and The Medical Sisterhood. Previously, he was the producer of the Lungcast podcast. He graduated from UC Berkeley and worked in multimedia journalism as a staff writer prior to joining MJH. You can contact him at tsmith@mjhlifesciences.com.

These data highlight the impact of rezpegaldesleukin therapy on adults with moderate-to-severe atopic dermatitis in the phase 2b REZOLVE-AD study.

Atopic Dermatitis

Atopic Dermatitis condition center page, audiences can find a variety of coverage mediums for medical news and updates, including articles, video interviews, podcasts, and breaking news on dermatitis research, treatment, and drug development.

REZOLVE-AD: Rezpegaldesleukin Improves Symptoms of Atopic Dermatitis

FDA grants Priority Review for Takeda’s oveporexton, an oral orexin agonist for narcolepsy type 1, showing near-normal symptom control in phase 3.

FDA News

Sleep

On the HCPLive sleep page, resources on the topics of medical news and expert insight into sleep medicine can be found. Content includes articles, interviews, videos, podcasts, and breaking news on sleep apnea, insomnia, narcolepsy, and more.

FDA Accepts NDA, Grants Priority Review for Oveporexton to Treat Narcolepsy Type 1

Positive topline data from Hengrui’s phase 2 clinical trial of once-daily oral ribupatide highlight weight loss of up to 12.1% with no observed plateau at 26 weeks.

Obesity Management

Obesity Management condition center page, resources on the topics of medical news and expert insight into clinical weight management can be found. Content includes articles, interviews, videos, podcasts, and breaking news on obesity research, treatment, and drug development.

Ribupatide, An Oral Dual GLP-1/GIP, Achieves Weight Loss in Phase 2 Obesity Trial

Ryan Livingston joined the MJH Life Sciences team in March of 2025, shortly after graduating from TCNJ with a bachelor’s degree in English. He enjoys creative writing, reading, and scuba diving. He can be reached at rlivingston@mjhlifesciences.com.

Patients with severe hypertriglyceridemia and MASLD saw reductions in fasting triglyceride and improvements in remnant cholesterol and hepatic fat.

MASH / MASLD

The HCPLive MASH & MASLD page is a comprehensive resource for clinical news and insights on metabolic dysfunction-associated steatotic liver disease and steatohepatitis. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for fatty liver disease, steatohepatitis, and more.

Dyslipidemia

TLC-2716 Achieves Primary Endpoints in Phase 2a Trial in Patients With SHTG and MASLD

An interview conducted at Maui Derm 2026 highlights a presentation by Raj Chovatiya, MD, PhD, on managing atopic dermatitis and itch in 2026.

Atopic Dermatitis and Pruritus Management Updates for 2026, With Raj Chovatiya, MD, PhD

Frank Gonzalez is an attending physician at Children’s Hospital Los Angeles and an assistant professor of clinical pediatrics at Keck School of Medicine of USC.

A retrospective study found an independent association between increased pain episodes in sickle cell disease and the cold in light of increasingly extreme weather.


Sickle Cell

Sickle Cell condition center page, resources on the topics of medical news and expert insight into sickle cell disease can be found. Content includes articles, interviews, videos, podcasts, and breaking news on sickle cell research, treatment, and drug development.

Extreme Cold Independently Associated with Pain Episodes in Pediatric Sickle Cell Disease

Nancy Reau, MD, is Professor of Internal Medicine, Richard B. Capps Chair of Hepatology, Associate Director of Solid Organ Transplantation, and Section Chief of Hepatology at Rush University Medical Center.

In this segment of a Liver Lineup episode, experts discuss where the new US Dietary Guidelines miss the mark for alcohol recommendations.

Why Alcohol Recommendations in the New Dietary Guidelines Fall Short

Lina Jia, MD, PhD, from Beth Israel Deaconess Medical Center, Harvard Medical School, and Xuanwu Hospital in China.

A prospective study finds adolescents with MDD show faster response, fewer cognitive effects, and better tolerability with magnetic seizure therapy than adults.


Psychiatry

Psychiatry condition center page is a comprehensive resource for clinical news and insights on mental illnesses. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for depression, schizophrenia, bipolar disorder, anxiety, and more.

Major Depressive Disorder

Major Depressive Disorder condition center page, resources on the topics of medical news and expert insight into depression can be found. Content includes articles, interviews, videos, podcasts, and breaking news on MDD research, treatment, and drug development.

Latest News

Seasonal IgE Surge in Birch Allergy Driven by IgE⁺ Plasmablasts: Q&A With Investigators

Oral Infigratinib Meets Annualized Height Velocity Endpoint in Phase 3 Achondroplasia Trial

Discussing Pediatric Dermoscopy and AI for Skin Cancer Detection, With Ashfaq Marghoob, MD

Finerenone Outperforms Spironolactone for Heart Failure Exacerbation in HFpEF, With Nihar Desai, MD, MPH

ASH Releases 8 Recommendations for Relapsed, Refractory Acute Lymphoblastic Leukemia in Adolescents, Young Adults