Rajneesh Nath

@KrishPatelMD @RahulBanerjeeMD @NitinJainMD @ASkarbnik @mshadman @DrMDavids @DanilovLab @DebbieMStephens @RyanWJacobs @LoriLeslieMD @AdamKittai @BrianHill_MDPhD @andrewlipskymd @calliecoombsmd @dbranderMD Either choice is delaying the inevitable. We need to throw allo ScT in the midst too. Mortality is in the 10-20 range. And a good number off all therapy and cured.

@NitinJainMD @ASkarbnik @mshadman @DrMDavids @DanilovLab @DebbieMStephens @RyanWJacobs @LoriLeslieMD @AdamKittai @BrianHill_MDPhD @andrewlipskymd @calliecoombsmd @dbranderMD This is the ultimate shout for pt centered decision-making. Such different experience for pts to potentially be on continuous tx and live w/ the uncertainty of relapse while on tx versus potentially extremely durable remissions off therapy albeit for a small subset of patients

Now that liso-cel is approved for CLL, when would you likely use it? @mshadman @DrMDavids @DanilovLab @DebbieMStephens @RyanWJacobs @LoriLeslieMD @AdamKittai @NitinJainMD @BrianHill_MDPhD @andrewlipskymd @calliecoombsmd @KrishPatelMD @dbranderMD

@TalhaBadarMD Excellent summary of P53 mutated AML. Any data/comments on donor source for allo SCT- specifically cord blood?

6/9 Allogeneic Immunotherapy Preemptive DLI to enhance GVL effect with low dose HMA in HR MDS/AML has been evaluated with 2yrs OS ~ 65.5%. Study not specifically evaluated TP53m pts. doi.org/10.1038/s41409…

1/9 Weekend review 🧵 Transplant or not to transplant for #TP53m AML Potential factors that can potentially impact outcome: co-occurring mutations, complex CG, mutation type missense vs truncating, depth of remission, conditioning intensity, post transplant strategy #leusm

@BijoyTelivala @OncBrothers @RenoHemonc @AaronGoodman33 @Eddie_Cliff @Dr_AmerZeidan @beatalleukemia Sonora Quest in Tempe Arizona will result NGS in 72 hours if they are told that it is a newly diagnosed AML.

We all talk about NGS for AML In the community it takes 3 weeks to get NGS back NeoGenomics @OncBrothers @RenoHemonc @AaronGoodman33 @Eddie_Cliff @Dr_AmerZeidan @beatalleukemia

@LoriMuffly @sghmd @drkomanduri @DrMonzrAlMalki @ASTCT @Chrislemieux90 @DrMiguelPerales Additional possibility is prolonged HMA/ Ven if the patient goes into an early CR. Limited data with haplo DLI but certainly a possibility. Be prepared for higher incidence of acute gvhd

@LoriMuffly @sghmd @drkomanduri @DrMonzrAlMalki @ASTCT @Chrislemieux90 @DrMiguelPerales While it is tempting to change the donor, I am not sure that we have data to support it. EBMT has shown similar outcomes of same versus different donor ncbi.nlm.nih.gov/pmc/articles/P… Without being prescriptive, I would go with the the highest intensity that you think you can give

Ok now this patient has relapsed 7 mos post fl/cy/tbi3 haplo. No 10/10 and only 1 possible 9/10 in registry. Has another 20 yo child. No bad mutations and ven naive. If cr2 w ven/aza- what regimen/donor? @sghmd @drkomanduri @DrMonzrAlMalki @ASTCT @Chrislemieux90 @DrMiguelPerales

@LoriMuffly @DrMiguelPerales @sghmd @BldCancerDoc @drkomanduri @AmyDeZern @DrMonzrAlMalki @CatherineLeeMD @arpitapgandhi @khera_nandita @hamiltkyb @hemedoc @ASTCT Thiotepa 2.5- 5 mg/kg, fludarabine and Mel 100

What is your institutional SOC conditioning regimen for haplo for int risk AML in a fit 63 yo? @DrMiguelPerales @sghmd @BldCancerDoc @drkomanduri @AmyDeZern @DrMonzrAlMalki @CatherineLeeMD @arpitapgandhi @khera_nandita @hamiltkyb @hemedoc @ASTCT

@dgomezalmaguer Clearly, there is a role for allo in a young patient with good PS , high risk disease and with good response ( CR)to frontline therapy. What was your conditioning? TBI? What was the gvhd prophylaxis? PTCy?

Allo HSCT for young patient with Myeloma . He obtained CR with Dara-VRD. This PET is perfect. One year after transplant. 100% chimerism and MRD negative. Allogeneic transplant in Myeloma is still an option in selected patients .

@MarkFaberDO @BannerHealth @MattUlricksonMD @RoswellLeukemia Welcome aboard Mark

I am thrilled to announce that I have accepted a position at @BannerHealth as a Malignant Hematologist with a focus on #MDS and #MPN under the guidance of @MattUlricksonMD ! I am extremely grateful to my mentors at @RoswellLeukemia for their guidance over the past 5-6 years!

@GomezDLeonMD Your favorite RIC with PTCy. TKI for two years post SCT

Patient with CML chronic phase MMR3 develops severe aplastic anemia. Has matched donor. Which conditioning would you use?

@LugoMd @Anand_88_Patel @Daver_Leukemia @NicholasShortMD @MartinTallman @LuskinMarlise @DrHKantarjian @AaronGoodman33 @TalhaBadarMD Favorite ALL regimen at your center. If MRD neg blin x 4 bard on the LBA. Not sure blin needs to follow on E1910

Given the practice changing results of E1910. What are your thoughts on using for treatment for patients aged 18-30 @Anand_88_Patel @Daver_Leukemia @NicholasShortMD @MartinTallman @LuskinMarlise @DrHKantarjian @AaronGoodman33 @TalhaBadarMD

@GvHD_Meade @GomezDLeonMD Other the other hand there is no data suggesting that is not useful either.

@GomezDLeonMD I do not know of any data that suggests that BMT after consolidation is useful if the patient is in CR/MRD-.

Young person with AML M5, 85 WBC at diagnosis, normal karyotype. No molecular data. Receives 7+3 plus HIDACx3 negative MRD by flow, comes for HSCT consult, you do not have access to MUDs #BMTsm #Leusm You recommend:

@BMDACCstemcell Our talented crew who made #SCTsymposiumBMDACC possible. A big shoutout to our APPs, nurses, physicians, pharmacists, CryoLab, data management group, Quality team, MAs, AAs and Research team!!!

@khera_nandita @ASTCT Congratulations Nandita

Thank you @ASTCT for the opportunity to share my experiences as a woman physician in the field!! Women's History Month Spotlight: Nandita Khera, MD, MPH nucleus.astct.org/Full-Article/w…

@Rfonsi1 Looks like the obituary is being written when the person ( SCT for lymphoma) is still alive. SCT will still be there. Don’t forget the cytopenias (30%) and prolonged B lymphopenia ( and consequent low IGG) . Allo SCT is still curative after progression from CAR-T

What is the future of SCT for RR lymphoma?

@RocioCamachoMD If the patient continues to have detectable MRD at the end of consolidation , allo would be appropriate

@NeeshR0 Thank you doctor. Those test are at diagnosis. The karyotype is in 20 metaphases and unfortunately there is no quant PCR inv16 at our center. How does quant PCR influence your treatment in regards to number of consolidations, HSCT and overall follow up?

43 yo male with AML and inv 16 detected by FISH, in 1CR. G banding karyotype at diagnosis: 44, X, -Y [1], +3 [4], -6 [1], del 1p [1], del 17p [1] and del 3q [1]. Next step in treatment:

@bpiperdi Sorry to hear about your loss .

It’s hard to find words! Mom passed away this morning peacefully exactly 4 weeks from Dad. May Allah reunite them in Janatul Firduz (highest place in Heaven) She is my soul, my teacher, my guide and always pushed us to best out of us. RIP Ama and Papa! World is pretty empty 🥲🥲