{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:18:20Z","timestamp":1783012700463,"version":"3.54.6"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Cold agglutinin disease (CAD) is a rare form of autoimmune hemolytic anemia (AIHA). CAD occurs in the context of a small clonal B\u2010cell lymphoproliferation restricted to blood and\/or bone marrow (BM), without overt or extramedullary lymphoma. The WHO\u2010HAEM5 introduced a description of the CAD\u2010associated lymphoproliferative disorder (CAD\u2010LPD) in the BM as a desirable criterium for CAD. Still, data on BM pathology underlying CAD remain scarce. We assessed the clinical and pathologic characteristics of a large patient cohort with cold\u2010type AIHA. A total of 85 BM biopsies of 56 patients were evaluated. In 10 patients (18%), pathology revision revealed other overt B\u2010cell malignancies leading to a diagnosis of cold agglutinin syndrome. In the remaining 46, evidence for B\u2010cell clonality was found in the vast majority (45; 98%), manifesting as a paraproteinemia and\/or clonal B\u2010cells or plasma cells in BM. Most of these 45 had an M\u2010protein (89%), evidence of monoclonal B\u2010cells and\/or plasma cells in BM tissue (89%), and were\n                    <jats:italic>MYD88<\/jats:italic>\n                    wild\u2010type (100%). Surprisingly, while ancillary methods detected clonality in the majority (84%), only 5 (11%) of 45 CAD cases strictly fulfilled the WHO\u2010HAEM5 morphological description for CAD\u2010LPD. These data imply that sensitive techniques should be used in BM evaluation in CAD.\n                  <\/jats:p>","DOI":"10.1111\/ejh.70194","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T09:51:56Z","timestamp":1776419516000},"page":"384-395","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Bone Marrow Pathology in Cold Agglutinin\u2010Mediated Autoimmune Hemolytic Anemia: A Study of 56 Cases"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2942-9385","authenticated-orcid":false,"given":"Anne\u2010Marie L.","family":"Becking","sequence":"first","affiliation":[{"name":"Amsterdam University Medical Centers, Department of Hematology University of Amsterdam, Cancer Center Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie J.","family":"Bernelot Moens","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Centers, Department of Hematology University of Amsterdam, Cancer Center Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Jos\u00e9","family":"Kersten","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Centers, Department of Hematology University of Amsterdam, Cancer Center Amsterdam  Amsterdam the Netherlands"},{"name":"Lymphoma and Myeloma Center Amsterdam (LYMMCARE)  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0939-6948","authenticated-orcid":false,"given":"Femke V. M.","family":"Mulder","sequence":"additional","affiliation":[{"name":"Sanquin Research and Landsteiner Laboratory of the Amsterdam University Medical Centers University of Amsterdam  Amsterdam the Netherlands"},{"name":"Department of Hematology Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven T.","family":"Pals","sequence":"additional","affiliation":[{"name":"Lymphoma and Myeloma Center Amsterdam (LYMMCARE)  Amsterdam the Netherlands"},{"name":"Amsterdam University Medical Centers, Department of Pathology University of Amsterdam, Cancer Center Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianne","family":"Koens","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Centers, Department of Pathology University of Amsterdam, Cancer Center Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3229-9556","authenticated-orcid":false,"given":"Josephine M. I.","family":"Vos","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Centers, Department of Hematology University of Amsterdam, Cancer Center Amsterdam  Amsterdam the Netherlands"},{"name":"Lymphoma and Myeloma Center Amsterdam (LYMMCARE)  Amsterdam the Netherlands"},{"name":"Sanquin Research and Landsteiner Laboratory of the Amsterdam University Medical Centers University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.282.6281.2023"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.10062"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020005674"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2017004390"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000476"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2033982"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-02-474437"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1159\/000438964"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI108547"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.146126"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-06-583021"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2019.100648"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000036"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2027760"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021014955"},{"key":"e_1_2_11_17_1","unstructured":"\u201cPhase II Trial of Zanubrutinib in Primary Cold Agglutinin Disease \u201dCaZa Study 2023 [cited Stichting Hemato\u2010Oncologie voor Volwassenen Nederland Recruiting] https:\/\/clinicaltrials.gov\/study\/NCT06067048."},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-04-778175"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.091702"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200710"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15063"},{"key":"e_1_2_11_22_1","volume-title":"WHO Classification of Tumours, 5th Edition 2022: Haematolymphoid Tumours Part B","author":"Naresh K. N. B. S.","year":"2024"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403202"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-04-839480"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2022.280953"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.70069"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.17842"}],"container-title":["European Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.70194","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ejh.70194","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.70194","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:32:08Z","timestamp":1783009928000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ejh.70194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,17]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/ejh.70194"],"URL":"https:\/\/doi.org\/10.1111\/ejh.70194","archive":["Portico"],"relation":{},"ISSN":["0902-4441","1600-0609"],"issn-type":[{"value":"0902-4441","type":"print"},{"value":"1600-0609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,17]]},"assertion":[{"value":"2026-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}