Pediatric Hematology Oncology Journal
525 posts
@PHOJournal
https://t.co/VdrXEe1Kb2 Official Journal of PHO Chapter of Indian Academy of Pediatrics https://t.co/PZDsoC5jKD
TNT (Triple-Negative Thrombocytosis) Treatment Algorithm — Proposed by BJHaem, Godfrey et al. — shown at the 3rd Kuwait Hematology Conference 🧬 First question: Clonal or non-clonal? 🔍 Second question: Megakaryocyte atypia or not? ➡️ These 2 answers place every patient into 1 of 4 treatment pathways. ⸻ 🟥 1) Clonal marker + Megakaryocyte atypia Triple-Negative ET with clonal marker (cTNT-ET / ITAM-C) • Age ≥60 or refractory symptoms or cardiovascular RFs → Aspirin if no bleeding risk • Age ≥60, prior vascular event, persistent Plt ≥1500×10⁹/L, or refractory symptoms → Consider cytoreduction • Monitor for evolution toward PMF/MDS/other MPN ⸻ 🟧 2) Non-clonal + Megakaryocyte atypia ITAM (Idiopathic thrombocytosis with atypical megakaryocytes / TN-ET without clonal markers) • Age ≥60, symptoms, or CV risk → Consider aspirin • Age ≥60, prior vascular event, Plt ≥1500×10⁹/L, or multiple CV RFs → Consider cytoreduction • Monitor carefully for transformation; marrow should be repeated if phenotype changes ⸻ 🟦 3) Clonal marker + No megakaryocyte atypia CTUS (Clonal thrombocytosis of undetermined significance) • Age ≥60 or symptoms or CV RFs → Could consider cytoreduction (case-by-case) • Aspirin can be considered depending on risk profile and Plt count • Monitor for evolution to ET/MPN ⸻ 🟩 4) Non-clonal + No megakaryocyte atypia ITUS (Idiopathic thrombocytosis of undetermined significance) • Usually benign course • Annual FBC monitoring • Aspirin only if another indication (e.g., CV risk) • Cytoreduction not recommended ⸻ Key Factors That Determine Treatment 1️⃣ Clonal or non-clonal? 2️⃣ Megakaryocyte atypia present or absent? 3️⃣ Age ≥60? 4️⃣ Symptoms? 5️⃣ Thrombosis history? 6️⃣ Cardiovascular risk factors? 7️⃣ Platelet count? ⸻ #MPN #TNT #TripleNegativeET #ET #CTUS #ITUS #Thrombocytosis #Hematology #NGS #KuwaitHematologyConference #SOHO25 #EmiratesHematologySociety
Bedside clinical skills have been diminished by an overreliance on technology. A new Review Article presents educational strategies for reinvigorating the bedside encounter and shows how much can be learned from it. Read the review “Strategies to Reinvigorate the Bedside Clinical Encounter,” the latest in the Medical Education series, by Brian T. Garibaldi, MD, MEHP, and Stephen W. Russell, MD, from @NUFeinbergMed and the University of Alabama at Birmingham (@UABNews): nej.md/4nUirnP
