Graft-versus-host disease remains one of the most formidable barriers to the complete success of hematopoietic stem cell transplantation that has emerged as the curative approach for many hematopoietic malignancies because it affects quality of life and overall survival. Macrophages are among the important members of the immune system, which perform dual roles in GVHD as both therapeutic tools and targets. This review epitomizes the multifunctional role of macrophages in the pathophysiology of both acute and chronic GVHD. Macrophages play an important role in the early phase of GVHD because of their recruitment and infiltration into target organs. Furthermore, they polarize into two functionally different phenotypes, including M1 and M2. In the case of acute GVHD, most macrophages express the M1 phenotype characterized by the production of pro-inflammatory cytokines that contribute to tissue damage. In contrast, in chronic GVHD, macrophages tend toward the M2 phenotype associated with the repair of tissues and fibrosis. A critical balance among these phenotypes is central to the course and severity of GVHD. Further interactions of macrophages with other lymphocytes such as T cells, B cells, and fibroblast further determine the course of GVHD. Macrophage interaction associated with alloreactive T cells promotes inflammation. This is therefore important in inducing injuries of tissues during acute GVHD. Interaction of macrophages, B cell, fibroblast, and CD4+ T cells promotes fibrosis during chronic GVHD and, hence, the subsequent dysfunction of organs. These are some insights, while several challenges remain. First, the impact of the dominant cytokines in GVHD on the polarization of macrophages is incompletely characterized and sometimes controversial. Second, the development of targeted therapies able to modulate macrophage function without systemic side effects remains an area of ongoing investigation. Future directions involve the exploration of macrophage-targeted therapies, including small molecules, antibodies, and nanotechnology, which modulate macrophage behavior and improve patient outcomes. This underlines the fact that a profound understanding of the dual role of macrophages in GVHD is essential for developing new and more effective therapeutic strategies. Targeting macrophages might represent one avenue for decreasing the incidence and severity of GVHD and improving the success and safety of HSCT.

Leukemia, a group of blood cancers, presents a significant global health challenge. Despite advancements in conventional therapies like chemotherapy and immunotherapy, the need for more effective and less toxic treatments remains. Nanotechnology offers a promising avenue for targeted drug delivery and immune modulation in the fight against leukemia. Through the utilization of nanomaterials’ special qualities, like their small size, large surface area, and capacity to transport a variety of payloads, scientists are creating novel ways to get around the drawbacks of conventional treatments. These strategies include targeted drug delivery, immune cell activation, and overcoming drug resistance. However, challenges remain in translating these promising nanotechnological approaches into clinical applications. Addressing issues such as toxicity, biodistribution, and regulatory hurdles is crucial for the successful development of nanomedicine for leukemia. In conclusion, nanotechnology offers a promising future for the treatment of leukemia. Continued research and development are essential to unlock the full potential of nanomaterials and improve patient outcomes. The potential of nanotechnology-based strategies to improve the effectiveness of leukemia treatments is explored in this review. We go over the function of different nanomaterials in delivering therapeutic agents to leukemia cells, such as liposomes, polymeric nanoparticles, and inorganic anoparticles. We also investigate the engineering of nanomaterials to influence the immune system and promote anti-tumor reactions.

Von Willebrand disease (VWD) is a hereditary bleeding disorder characterized by a quantitative or qualitative deficiency of von Willebrand factor (VWF). Pregnancy significantly impacts hemostasis, leading to a hypercoagulable state. However, women with VWD experience unique challenges due to the interplay between pregnancy-related hormonal changes and VWF deficiencies. This review delves into the intricate relationship between VWD and pregnancy. We explored the physiological changes that occur during pregnancy, including hormonal fluctuations, hemodilution, and alterations in platelet–VWF interactions. We discuss how these changes can exacerbate bleeding tendencies in women with VWD, particularly during childbirth and the postpartum period. This review highlights the increased risk of postpartum hemorrhage (PPH) in women with VWD and the potential for severe maternal morbidity and mortality. We examine the various types of VWD and their specific implications for pregnancy outcomes. Additionally, we discuss the challenges associated with diagnosing and managing VWD during pregnancy, as well as the importance of prenatal counseling and careful monitoring. The management of VWD during pregnancy involves a multidisciplinary approach, including the use of prophylactic treatments, such as desmopressin and tranexamic acid, as well as factor replacement therapy when necessary. Careful planning of delivery, including the choice of delivery mode and the timing of interventions, is essential to minimize bleeding complications. By understanding the complexities of VWD during pregnancy and implementing appropriate management strategies, healthcare providers can significantly improve the outcomes for women with VWD and their offspring.

Context: Coronavirus disease 2019 (COVID-19) and the infection control strategies have affected breastfeeding and mother-newborn contact due to the fear of disease transmission to the baby. Objectives: This study aimed to evaluate the possibility of CPVID-19 transmission by reviewing the currently published articles. Methods: In this systematic review, 296 articles were first retrieved from IranMedex, SID, IranDoc, Magiran, Iranian Registry of Clinical Trials (IRCT), PubMed, ProQuest, Scopus, Science Direct, Medline, and Google Scholar search engine using the keywords "breastfeeding", "breast", "vertical transfer", "breast milk", "colostrum", "corona", and "COVID-19". Of the 296 retrieved articles, 16 were eligible for the review. Results: Reviewed articles included four retrospective cross-sectional studies, one cohort study, eight case reports, and three case series. Overall, the studies reported 237 RT-PCR tests on breast milk and/or nasopharyngeal or oropharyngeal swabs from mother or baby, and 156 serum antibody measurements in mother or baby. The overall findings indicated a low risk for COVID-19 transmission from mother to infant through breastfeeding, while breastfeeding was detected to transfer the antibodies to the newborn. Conclusions: Due to the low transmission risk, it was recommended that mothers with mild to moderate symptoms should breastfeed their infants with infection control measurements, while mothers with severe symptoms should use pumped breastmilk for feeding their infants.

Polycythemia vera (PV) is a myeloproliferative neoplasm. The presence of JAK2 mutations is a major diagnostic criterion for PV. PV is linked to chronic inflammation and an increased risk of thrombosis, and inflammation plays a significant part in the pathophysiology of PV. Testing for JAK2 mutations is expensive and is not available in all laboratories. Simple inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), are evaluated in this study as potential diagnostic markers for differentiating patients with PV from other patients with polycythemia. We conducted a retrospective study of the clinical and laboratory data from 281 patients with polycythemia (110 with PV and 181 with secondary polycythemia (SP)) who attended Ghaem Hospital. The diagnosis of PV was established based on the World Health Organization criteria. Individuals who did not meet the criteria were classified as having SP. The median NLR, PLR, and SII in the PV group were considerably elevated compared to the SP group (NLR: 5.00 vs. 1.86, PLR: 261.3 vs. 94.0, SII: 2432.9 vs. 368.8, p < 0.001 for all). The receiver operating characteristic analysis revealed that NLR, PLR, and SII were highly effective in differentiating PV patients from the SP group. Each of these tests showed sensitivities and specificities over 85% and an area under the curve of more than 0.9. SII, NLR, and PLR were all higher in PV than SP, suggesting that these biomarkers, particularly SII, might be helpful in the diagnosis of PV.