The relevance of the coagulation screen before surgery.

Coagulation testing has long been part of the routine assessment of the preoperative patient, with the aim of identifying those with a bleeding disorder who might suffer significant perioperative bleeding. Some of the issues surrounding this involve the low prevalence of bleeding disorders in the general population, and the implications of further testing for both the patient and the health-care system. Studies suggest that this practice is not evidence based and is considered to be outdated. Most guidelines now advise against routine coagulation screens before surgery, and instead recommend taking a thorough personal and family history of bleeding in order to determine the need for further investigations. This review analyses current evidence on this topic and provides a comprehensive view of the relevance of preoperative coagulation testing.

Recent Developments in Cellular Immunotherapy for HSCT-Associated Complications.

Allogeneic hematopoietic stem cell transplantation is associated with serious complications, and improvement of the overall clinical outcome of patients with hematological malignancies is necessary. During the last decades, posttransplant donor-derived adoptive cellular immunotherapeutic strategies have been progressively developed for the treatment of graft-versus-host disease (GvHD), infectious complications, and tumor relapses. To date, the common challenge of all these cell-based approaches is their implementation for clinical application. Establishing an appropriate manufacturing process, to guarantee safe and effective therapeutics with simultaneous consideration of economic requirements is one of the most critical hurdles. In this review, we will discuss the recent scientific findings, clinical experiences, and technological advances for cell processing toward the application of mesenchymal stromal cells as a therapy for treatment of severe GvHD, virus-specific T cells for targeting life-threating infections, and of chimeric antigen receptors-engineered T cells to treat relapsed leukemia.