Affirming Hormone Treatment for a Transgender Adolescent After a Venous Thromboembolic Event.

BACKGROUND: Medical affirmation, including gender-affirming hormones, is an essential component in the treatment of many transgender and gender-diverse youth. The risk of venous thromboembolism (VTE) during testosterone therapy for gender-affirming care is not fully elucidated. OBSERVATION: The case describes a 17-year-old transgender male treated with testosterone therapy who presented with an occlusive deep vein thrombosis of right axillary and subclavian veins. Testosterone level was 920 ng/dL at the time of the deep vein thrombosis, and he had no risk factors for VTE. A complete hypercoagulable workup was negative. CONCLUSIONS: The possibility of testosterone therapy as a risk factor for VTE may suggest the need to include this information during informed consent discussions. Long-term anticoagulation may be considered for those restarting testosterone therapy.

Discarded portions of bone marrow aspirates are a new resource for patient-derived mesenchymal stem and stromal cells.

Bone marrow-derived mesenchymal stem and stromal cells (BM-MSCs) protect malignant cells from chemotherapy and are important potential therapeutic targets. Isolating primary BM-MSCs for research traditionally requires the sacrifice of valuable cell populations from within the same sample. To avoid this, we report here a resource for isolating patient-derived BM-MSCs from the red blood cell layer of ficoll gradients of bone marrow aspirates, a resource that has until now been universally discarded. This resource yields BM-MSCs nearly identical to those obtained conventionally and includes cells with a more stem-cell like nature. Obtaining primary BM-MSCs in this way will likely expand opportunities to study this important cell population.