It has been 1 year since the European Hematology Association (EHA) launched its own journal. HemaSphere was created as the European journal serving the hematology community based on 4 important cornerstones: (1) led by a team of experts in the field, (2) focus on high-quality work, (3) low publication costs, and (4) open access. We believe it is important that everyone working in the field of hematology can publish in a strong open access journal with low publication fees and strong visibility. Hence, HemaSphere was created as an online open access journal. For many years, Haematologica, owned by the Ferrata Storti Foundation, served as EHA's scientific journal. As from 2019 onward, HemaSphere, fully powered by EHA, will be the only journal affiliated to the Association.
Since the publication of the first issue in December 2017, we have published a total of 7 issues including 28 articles (original articles, review articles, guideline articles, and controversies) as well as 13 letters and case reports. With these numbers, we are perfectly on track to be indexed in MEDLINE, PubMed, and PubMedCentral. HemaSphere's publication and citation data are already included in GoogleScholar, providing a first way to track citations. With a good balance between the different fields in hematology represented in the journal, we are optimistic that HemaSphere will be awarded with a respectable initial impact factor in 2020. Perhaps even more important is the general impact that the journal will gain in the field. We aim to position HemaSphere as the information source for hematology with the news and views section termed “HemaTopics,” up-to-date reviews as well as strong original articles. Importantly, we will also provide guidelines and highlight existing controversies. In this issue of the journal, our first guideline article is published1; the first controversy article was online in the October issue.2 This view is also in line with EHA's mission to promote excellence in patient care, research, and education in hematology.
Currently, we continue to see stunning new developments in our field. This is particularly true for immunotherapy and includes checkpoint inhibitors3,4 and CAR-T cells.5,6 Initially, the latter topic was more skeptically received by the medical community. Concerns included severe side effects such as the cytokine release syndrome, the restriction to acute lymphoid leukemia and relapsed/refractory B-cell lymphoma, the long distribution chain, and high costs.7 Most of these issues, however, have been overcome. This has led to more malignant diseases being evaluated for this new approach, including multiple myeloma, T-cell lymphoma, acute myeloid leukemia and others, and the handling of CAR-T cells has become better defined.
Work describing the role of the programmed death receptor 1 (PD1, official gene symbol PDCD1)8 and CTLA49 led to the development of checkpoint inhibitors and has just been awarded the noble price 2018. Tasuku Honjo and James P. Allison and their coworkers are to be congratulated for their visionary work! The discovery of PD1 and CTLA4 has led to breathtaking responses in the majority of malignant diseases including metastatic malignant melanoma, lung cancer, and others. PD1 expressed on the surface of T-cells as well as CTLA4 operate by different mechanism: they function as a T-cell brake. This allows T-cells to identify and destroy malignant cells in a phlethora of different cancers. One of the most sensitive malignancies for PD1 inhibition is Hodgkin lymphoma. This might in part be due to the small number of malignant Hodgkin- and Reed-Sternberg cells embedded among a vast amount of reactive cells. More recently, correlative analyses in relapsed/refractory classical Hodgkin Lymphoma found PD-L1 (CD274) and MHC class II expression by HRS-cells predictive for response to anti-PD1 therapy. Recent research also shows that HL immune-evasion is facilitated by PD1+ NK-cells and PD-L1+ macrophages. Mass cytometry additionally revealed PD1− regulatory and PD1+ effector CD4+ T-cells in proximity to HRS-cells.10
These are thrilling times for hemato/oncologists, as discussed in a previous HemaTopics article.11 Will there be more to come? Almost certainly! The jury is out already to find interactive partners for both checkpoint inhibition and CAR-T cells. For sure you will be able to follow these and other major topics in the next issues of HemaSphere. Stay tuned!
1. Itzykson R, Fenaux P, Bowen D, et al Diagnosis and treatment of chronic myelomonocytic leukemias in adults. Recommendations from the European Hematology Association and the European LeukemiaNet. HemaSphere.
2. Eichenauer DA, André M, Johnson P, et al Controversies in the treatment of classical Hodgkin lymphoma. HemaSphere.
3. Ansell SM, Lesokhin AM, Borrello I, et al PD-1 blockade with Nivolumab in relapsed or refractory Hodgkin's lymphoma. N Engl J Med.
4. Moy RH, Younes A. Immune checkpoint inhibition in Hodgkin lymphoma. HemaSphere.
5. Bach PB. National coverage analysis of CAR-T therapies: policy, evidence, and payment. N Engl J Med.
6. Buechner J, Kersten MJ, Fuchs M, et al Chimeric antigen receptor-T cell therapy: practical considerations for implementation in Europe. HemaSphere.
7. Bach PB, Giralt SA, Saltz LB. FDA approval of tisagenlecleucel: promise and complexities of a $475000 cancer drug. JAMA.
8. Ishida Y, Agata Y, Shibahara K, et al Induced expression of PD-1, a novel member of the immunoglobulin gene superfamily, upon programmed cell death. EMBO J.
9. Leach DR, Krummel MF, Allison JP. Enhancement of antitumor immunity by CTLA-4 blockade. Science.
10. Galluzzi L, Zitvogel L, Kroemer G. Immunological mechanisms underneath the efficacy of cancer therapy. Cancer Immunol Res.
11. Hallam S. Immunotherapy frontiers in hematology. HemaSphere.