Thrombin generation: biochemical possibilities and clinical reality

In this issue of Blood, under the unassuming title “Sample conditions determine the ability of thrombin generation parameters to identify bleeding phenotype in FXI deficiency,” Pike et al publish observations on a very rare condition, but the results validate the real-life importance of a scheme of thrombin generation that has been emerging from biochemical research over the last decades and that challenges such stereotypes as the “clotting cascade” and “primary and secondary hemostasis.” Moreover, this article shows how a bleeding phenotype is best recognized in the laboratory.