Adrián Zuno

Medical guidelines have destroyed critically thinking in medicine.

Poor guy died because the doctor had been fooled into the myth of contrast nephropathy. When death is on the Iine, fuck the kidneys.

🚨 TAKE HOME MESSAGE 🚨#CART26 #Myeloma If ALC > 5000 day 10-14 after CART infusion: start Dexametasone! ❗️100% no CRS/ICANS/Parkinsonism❗️ @EHA_Hematology @young_eha @TheEBMT_Trainee @TheEBMT

🚨New in Leukemia: HARMONY NPM1 classification reassigns >40% of NPM1-mut patients into a different risk category with potential clinical impact on allo-HSCT decision-making 🔓Free access link: nature.com/articles/s4137… @HarmonyFoundEU @LeukemiaJnl @HematoCAUSA

1/13 I posted a poll asking: In acute GI bleed anemia, would you give 1 g IV iron regardless of ferritin? Results: • 27% yes — anticipate iron debt • 12% sometimes • 21% only if ferritin is low • 41% no

Todos apelamos al sentido común, ¿pero qué es común en un mundo tan diverso?

3ed de OncoHematoCritics, escenarios complejos requieren más trabajo en equipo. 🤝 @UCI_12Octubre

I’m not smart enough to be a myeloma doctor, @VincentRK 🙃

One of the main goals of our review article in @NEJM on MGUS was to provide clear clarifications on the concept of “monoclonal gammopathy of clinical significance” (MGCS). It’s all very confusing in the literature and can cause problems for patients if we are not totally clear of the concepts. Read on to be 100% sure of the concepts so you can take care of your patients correctly! 1) First key concept: MGUS is a clinically indolent condition that usually remains quiet for an entire lifetime. The problem with MGUS is that it can progress to symptomatic malignancy (like multiple myeloma), or cause a variety of non-malignant, serious, and clinically important diseases that are collectively referred to as “monoclonal gammopathy of clinical significance” (MGCS). 2) Second key concept: MGCS is like the title of chapter in a textbook. It is NOT the name of a disease. Within the term “MGCS” are several distinct diseases, each of which has its own diagnostic criteria, clinical manifestations, and treatment strategies. So you simply cannot diagnose “MGCS” and treat but need to identify the specific disease. All that the term MGCS does is to alert you that MGUS can cause serious non-malignant diseases besides progression to malignancy. 3) Third key concept is: Some of the MGCS conditions are multi-system disorders like light chain amyloidosis and light chain deposition disease. Some MGCS disorders on the other hand are restricted to one organ leading to more confusing terms like “monoclonal gammopathy of renal significance” (MGRS), “monoclonal gammopathy of dermatologic significance” (MGDS), monoclonal gammopathy of neurological significance” (MGNS), and so on. These are also like titles of book chapters NOT the names of a disease. Within each term are specific unique diseases. 4) Fourth key concept is: For taking care of the patient you need to know the name of the exact disease. Not just add an umbrella term like “MGCS” or “MGRS”. So for example instead of diagnosing “MGRS” you need to be clear exactly which kidney disease the monoclonal protein is accused of causing! MGUS is so common and so many people can have a MGUS and a completely unrelated kidney disease. MGUS plus kidney disease doesn’t mean “MGRS”. Most of the time the two have nothing to do with each other. There are specific kidney diseases that are casually related to the monoclonal protein and if we suspect MGRS for some reason we need to work up and make the specific diagnosis which needs a kidney biopsy: proliferative glomerulonephritis with immunoglobulin deposits (PGNMID), C3 glomerulonephritis, and so on. Each of these disease have their unique clinical and lab manifestations, and treatment strategies. 5) Fifth key concept is: with more and more sensitive tests for MGUS and more and more testing done for MGUS we are all going to find M proteins associated with a variety of clinical problems, 99% of which are NOT caused by the M protein. I am hugely concerned with labels like MGCS and MGRS wrongly applied. And the last thing we want is Dara-VRd for a DVT just because there is a paper that says M proteins can cause blood clots! This Review will be a good place to start for getting all the key concepts straight. nejm.org/doi/abs/10.105…

@Itsinmyblood92 CLL & cold agglutinin disease?

55 y/o male with 6 months of weight loss, asthenia & adynamia. Last week: new-onset dyspnea, dizziness, blurry vision. Labs: Hb 3, Plt 196k, WBC 448k. Bilateral cervical nodes, hepatosplenomegaly, LDH 700. BM: 92% mature lymphocytes. 1st two PB , last two BM . Comments 🧐🧐

CONGRESS | #EHA2025 | POSTER Alicia Aguirre, @HUReinaSofia, shares findings from a retrospective study of inotuzumab followed by cellular therapy in R/R B-ALL (N=68). ORR = 77.9%; higher CR/MRD negative rates in patients aged ≤25 years vs ≥25 years (84.6% vs 53.8%; p = 0.043). Younger age (p = 0.027) and MRD negativity (p = 0.013) were associated with better OS. Grade 3-4 hematologic toxicity = 53%; Grade 3-4 hepatotoxicity = 7%; veno-occlusive disease = 16.2%. Inotuzumab is an effective treatment option for R/R B-ALL with high MRD negativity rates and acceptable survival rates. Follow our live feed for more updates: lymphoblastic-hub.com/medical-inform… #leusm #ALLsm #MedicalCongress

📣 We are proud to announce the new open-access EU CAR-T Handbook, now available in a digital format on our website. @GoCARTcoalition @EHA_Hematology This updated version includes new developments in CAR-T according to the latest clinical data and regulatory advancements. Access the handbook ⬇️ ebmt.org/education/cart… Editors 👥 Mahmoud Aljurf @aljurf100, Chiara Bonini, @CChabannon, @JulioDelgadoHem, Martin Dreyling, @JKuball, @AnnalisaRugger1 , Marion Subklewe and @AnnaSureda5 #CARTcelltherapy #CellTherapy

@FernandoGLMD Muchas felicidades Fer!

Si te interesa la #Hematología y quieres formarte en un servicio puntero, este es tu sitio! #Eligehematología #MIR2025 #2MIR25

@GHematologica @sehh_es @SEHHJoven C

Macrófago fagocitando células hematopoyéticas en paciente con sme hemofagocítico Elija la falsa a Frecuente que sea reactivo a otras patologías b Suele cursar con citopenias c Este hallazgo es imprescindible para el diagnóstico d Se acompaña de elevación reactantes fase aguda

🔬 ¡Lanzamos un nuevo proyecto de leucemia linfoblástica aguda (LLA)! 🌎💉 Si tratas adultos con LLA en LATAM, te invitamos a participar completando nuestro formulario. 🔗 docs.google.com/forms/d/e/1FAI… Tu aporte será clave para mejorar la atención de LLA en la región.

El INCMNSZ felicita a la Dra. María Roberta Demichelis Gómez por su nombramiento como Jefa del Departamento de Hematología y Oncología.

Aspirin may not be enough for VTE prevention in #MultipleMyeloma (14.8% VTE and significant bleeding risks). IMPEDE-VTE, was superior to SAVED and PRISM when assessing thrombosis risk in this patient population. @ELShematology rpthjournal.org/article/S2475-…

I’m giving a talk about CNS involvement of B cell lymphoma in the @ContactoAmeh meeting happening in Veracruz the following days I have some questions, please RT #lymsm #lymphoma

@HematoRules Yo me preguntaría primero si la paciente tiene antecedentes que justifiquen evaluar una trombofilia. 🔹La asociación entre infertilidad y trombofilia es controversial. 🔸Buscar mutaciones para MTHFR no está recomendado. #TWDFNR pmc.ncbi.nlm.nih.gov/articles/PMC91…

#HematoEnRed #Docencia Un casito para comentar y analizar juntos Paciente de 34 años sin antecedentes de interés, en proceso de FIV Solicitan estudio de trombofilia encontrando “Heterocigosis la mutación c.665CT (p.Ala222Val) del gen MTHFR” Solicitan IC a #Hematologia