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Review
. 2025 Oct;77(10):1305-1316.
doi: 10.1002/art.43195. Epub 2025 Jun 28.

Expert Perspective: Hematologic Malignancies and Vasculitis

Michelle L Robinette  1 , Hetty E Carraway  2
Affiliations
Review

Expert Perspective: Hematologic Malignancies and Vasculitis

Michelle L Robinette et al. Arthritis Rheumatol. 2025 Oct.
No abstract available

PubMed Disclaimer

Figures

Figure 1
Figure 1
(A) CT abdomen pelvis coronal section shows fat stranding along the suprarenal and infrarenal abdominal aorta (arrowheads) out of proportion to degree of atherosclerosis. (B) PET CT transverse section shows corresponding FDG uptake in circumferential abdominal aorta (arrowhead). (C and D) Hematoxylin and eosin stained bone marrow core biopsy specimen demonstrates hypercellular marrow with limited fat due to granulocytic and monocytic hyperplasia with (D) dysplastic megakaryocytes (black arrows) and peripheral monocytosis consistent with chronic myelomonocytic leukemia. CT, computed tomography; FDG, fluorodeoxyglucose; PET, positron emission tomography.
Figure 2
Figure 2
Flowchart showing evaluation of hematologic abnormalities in patients with known or suspected vasculitis starting with laboratory tests obtained in rheumatology clinical practice. Some hematologic abnormalities, such as anemia and thrombocytosis, are common in patients with vasculitis. Other abnormalities are uncommon and should lead to hematology consultation, with relative level of urgency here depicted by degree of darker shade. ALC, absolute lymphocyte count; AMC, absolute monocyte count; AML, acute myeloid leukemia; ANA, antinuclear antibody; ANC, absolute neutrophil count, APLS, antiphospholipid syndrome; CBC, complete blood cell count; CMP, comprehensive metabolic panel; CMV, cytomegalovirus; CRP, C‐reactive protein; CT, computed tomography; EBV, Epstein‐Barr virus; EPO, erythropoietin; ESR, erythrocyte sedimentation rate; EtOH, ethanol; FISH, fluorescence in situ hybridization; FLC, free light chains; GC, glucocorticoid; HBV, hepatitis B virus; HCV, hepatitis C virus; Hgb, hemoglobin; HTLV‐1, human T lymphotropic virus type 1; INR, international normalized ratio; KIR, killer cell immunoglobulin‐like receptor; LDH, lactate dehydrogenase; LFTs, liver function tests; LGL, large granular lymphocyte; MCV, mean cell volume; MMA, methylmalonic acid; NGS, next‐generation sequencing; NK, natural killer; PET, positron emission tomography; PLT, platelet count; PNH, paroxysmal nocturnal hemoglobinuria; PT, prothrombin time; PTT, partial thromboplastin time; RBC, red blood cell; RDW, red cell distribution width; RPR, rapid plasma reagin; SFLC, serum free light chain; SPEP, serum protein electrophoresis; TCR, T cell receptor; TSH, thyroid‐stimulating hormone; UA, urinalysis; Vit, vitamin. Color figure can be viewed in the online issue, which is available at http://onlinelibrary.wiley.com/doi/10.1002/art.43195/abstract.
Figure 3
Figure 3
Treatment algorithm of VCHM. Clinical trial availability and patient eligibility are variable but clinical trials are preferred if possible. AML, acute myeloid leukemia; AZA, azathioprine; C5i, complement five inhibitor; CMML, chronic myelomonocytic leukemia; CYC, cyclophosphamide; DMARD, disease‐modifying antirheumatic drug; DNMTi, DNA methyltransferase inhibitor; EBV, Epstein‐Barr virus; HM, hematologic malignancy; HSCT, hematopoietic stem cell transplantation; IL‐6Ri, interleukin‐6 receptor inhibition; JAKi, JAK inhibitor; MDS, myelodysplastic syndrome; MMF, mycophenolate mofetil; MTX, methotrexate; NK, natural killer; RTX, rituximab; RUX, ruxolitinib; TNFi, tumor necrosis factor inhibitor; VCHM, vasculitis with concomitant hematologic malignancy; VEXAS, vacuoles, E1 enzyme, X‐linked, autoinflammatory, somatic syndrome. Color figure can be viewed in the online issue, which is available at http://onlinelibrary.wiley.com/doi/10.1002/art.43195/abstract.
See this image and copyright information in PMC

References

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