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Outbreak of Severe Methemoglobinemia during Maritime Migration

September 1, 2026

This is a fascinating toxicology detective story with real hematology lessons. Among 82 mostly young male migrants arriving in Lampedusa, median methemoglobin was 45% (43% were at 50% or higher), and the culprit was dermal absorption of N-methylaniline, a gasoline additive, from fuel-contaminated seawater pooling in the boats. Our takeaway is the delayed hemolysis: it hit most patients with available data around days 2 to 4 (up to day 7), every patient with transfusion data needed blood, 4 had splenic rupture, and G6PD deficiency turned up in 16 of 44 tested. It's a good reminder that antidotes only work if they are on the shelf.

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Orca-T vs allogeneic hematopoietic stem cell transplantation (Precision-T): a multicenter, randomized phase 3 trial Open Access

March 1, 2026

This is an impressive advance in allo transplant, Orca-T cutting moderate–severe cGVHD dramatically (≈13% vs 44%) and nearly doubling cGVHD-free survival at 1 year (78% vs 38%) while also lowering NRM and serious infections is hard to ignore. Overall survival (OS) isn’t statistically different yet, but the combination of better disease control, less toxicity, and preserved immune reconstitution makes this feel like a meaningful step toward safer, more “engineered” transplants rather than just better immunosuppression.

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Engasertib versus Placebo for Bleeding in Hereditary Hemorrhagic Telangiectasia

November 1, 2025

This randomized, double-blind, placebo-controlled phase 1b trial of engasertib (an oral AKT1/2 inhibitor) in patients with HHT with moderate-to-severe epistaxis, showing dose-dependent reductions in epistaxis duration and frequency over 12 weeks, with further improvement through 12 months in the open-label extension. The 40 mg dose reduced monthly epistaxis duration by 41.4% and frequency by 27.8% vs placebo, and increased epistaxis-free days by 4.6/month. Safety was manageable and most notably, no thromboembolic signals were observed. Larger studies are needed, but this could be a game changer for our HHT patients sent to us for management of bleeding and anemia.

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