IV Iron during Acute Infection and Revisiting iTTP Refractoriness

In this week's episode, *Blood* editor Dr. James Griffin interviews Drs. Haris Sohail and Lucas Kühne on their latest articles published in volume 147 issue 21 of *Blood*. In this CME article titled, "Retrospective, Real-World Study of IV Iron Use to Treat Iron deficiency Anemia During Acute Infection",  Sohail et al show that IV iron given during acute infection with iron deficiency anemia is associated with improved 14-day and 90-day survival as well as hemoglobin recovery. Although this report has the limitations of a retrospective study, these findings challenge current practice and support randomized trials that include patients with infection. In "Revisiting Clinical Response and Refractoriness in Immune Thrombotic Thrombocytopenic Purpura", Kühne et al show in a multicenter registry study of 204 patients that refractoriness during caplacizumab treatment in immune TTP is uncommon and, when observed, is typically associated with confounding clinical factors. These findings underscore the importance of careful clinical reassessment and evaluation for alternative etiologies in patients with delayed platelet recovery, rather than attributing such cases to true treatment resistance.