Vidhya Murthy

Excited to share our new paper in @BrJHaem , led with @DrLornan on behalf of the UK Blood Cancer Research Network MPN Clinical Study Group 🧵 Real-world treatment patterns & outcomes in accelerated and blast-phase MPNs — the largest UK cohort to date. 👇 doi.org/10.1111/bjh.70…

Conferences are great for CPD- much of what we hear isn’t immediately usable in our system. Let experts distil it down😀 👇Join the brilliant @Paneeshas @VidhyaMurthy1 & others I learnt a lot from both Maybe they teach you a thing or two :) #medicine #hematology #medtwitter

AML@ relapse. Revised prognostic model ashpublications.org/bloodadvances/…

Great talk Gillian @horne_gillian. Fabulous 7th academy. Thanks to the organisers for putting together a fantastic programme @CoplandMhairi @charliecraddock Steve Knapper, Mike Dennis and Victoria Potter.

We report incidence of NPM1-wildtype relapses in pts treated with VEN-based frontline tx in AML.   🔴Overall, absolute # of relapses in NPM1 AML after VEN is ⬇️  🔴the fraction of NPM1-wildtype relapses ⬆️ with the⬆️ intensity of chemo backbone added to VEN.  🔴 NPM1 wildtype relapses occur later and often had MR mutations.  And ALL (8/8) had a different flow immunophenotype compared to original AML.  🔴We proposed that these were ‘new’ AMLs, that arose from common preleukemic (CH) precursor, but that the original NPM1-mutated AML was ‘cured’. onlinelibrary.wiley.com/action/oidcSta… @AjHematology

Peripheral cell morphological alterations may signal early dysplastic shifts. In the Lifelines cohort, a high RDW links to high-risk mutational patterns in CH and stratifies the risk of death in CCUS buff.ly/Yt6TAKE @lifelinesnl @umcg

Outcomes of patients with newly diagnosed acute myeloid leukemia with FLT3-tyrosine kinase domain mutations: Prognostic implications of NPM1 co-mutation acsjournals.onlinelibrary.wiley.com/doi/10.1002/cn…

1/4 SERUM FERRITIN Regulated at two levels: ✅ Cytokines (transcriptional control) ✅ Iron levels (translational control)

#Space #Update On a cold, wind-brushed outpost at 14,000 ft in Ladakh, 2 #analogue crew will begin living in isolation to simulate physiological & psychological effects of a space mission as part of @isro experiment starting today. Facility built by a Bengaluru firm. 1/n

GSLV-F16/NISAR From a majestic liftoff to the flawless separation, witness the full journey. Watch spectacular moments of NISAR launching aboard GSLV-F16 and its precise separation, captured on-board. A milestone in global space collaboration. #ISRO #NASA #GSLVF16 #NISAR

🔥 2025 ELN CML MANAGEMENT UPDATE 🔥 📌 Diagnosis 🧬 •Mandatory detection of BCR::ABL1 via CBA, FISH, RT-PCR. •NGS recommended in blast phase (BP), not routine in chronic phase. •ASXL1 mutations 🔬 → adverse prognostic marker in CP. •Transcript type (e13a2 vs e14a2) may influence depth of response, but no therapeutic decision change yet. 📌 Disease Classification 🩸 •WHO 2022: CML is now biphasic: •Chronic Phase (CP) <20% blasts. •Blast Phase (BP) ≥20% blasts. •Accelerated phase concept omitted but still acknowledged for risk stratification. 📌 Prognosis 🔎 •ELTS score replaces older prognostic models to predict CML-specific mortality ➡️ ELTS Calculator 📌 Monitoring 🧪 •Blood counts every 2 weeks until CHR. •BCR::ABL1 PCR IS scale every 3 months until MMR, then q4-6 months. •Use RT-qPCR or ddPCR. •Monitoring definitions: •MR4: ≤0.01% •MR4.5: ≤0.0032% •MR5: ≤0.001% 📌 Treatment Milestones 🛣️ TimeBCR::ABL1 ISAction 3mo≤10%Favorable 6mo≤1%Favorable 12mo≤0.1%Favorable 🔺 Unfavorable: >10% @3mo, >1% @12mo → switch TKI if confirmed. 📌 Mutation Testing 🧬 •Indicated for: •TKI resistance •Progression to BP •Relapse post-alloSCT •NGS preferred, Sanger acceptable. •ddPCR can track specific mutations. 📌 First-Line Therapy 💊 •Asciminib: Now FDA-approved 1st line (ASC4FIRST trial): superior MMR vs imatinib/2G TKI with less toxicity. •Imatinib, dasatinib, nilotinib, bosutinib remain standards. •Dosing explorations: •Dasatinib: 50mg daily shows reduced pleural effusion. •Bosutinib: Titration from 100mg to 400mg recommended to limit GI toxicity. 📌 Second-Line & Beyond 🔄 •Switch TKI based on mutation profile: •e.g. T315I → Ponatinib or Asciminib. •Ponatinib dosing per OPTIC trial: Start 45mg, taper to 15mg once BCR::ABL1 IS <1%. 📌 Allo-SCT 🧬 •Reserved for: •Resistance to ≥2 TKIs. •BP or advanced phase. •Early donor search in 2GTKI resistance. 📌 Treatment Free Remission (TFR) ✅ •Criteria: •≥3 years on TKI. •≥1 year sustained DMR. •Euro-SKI: ~46% maintain TFR at 12mo. •DESTINY trial: TKI dose reduction before stopping improves TFR rates. 📌 Practical Tips & Pearls 💡 •Always confirm PCR trends before switching TKIs. •Tailor TKI choice to comorbidities: •Pulmonary disease: ❌ Dasatinib. •Diabetes/vascular risk: ❌ Nilotinib. •Monitor and address compliance before declaring resistance. •Involve transplant teams early if high-risk mutations/ACA. 📌 Exam Pearls 📝 •Most common BCR::ABL1 mutations → T315I, E255K/V, F359V/I/C. •ELTS score >2: high risk. •MR4.5 defines deep molecular response for TFR. 📚 Reference Apperley JF, et al. 2025 European LeukemiaNet recommendations for the management of CML. Leukemia. 2025. Link #CML #Leukemia #Hematology #ELN2025 #TFR #Asciminib #BCRABL1 #HemeOnc

Disease Trajectories and Glucocorticoid Exposure in VEXAS Syndrome Treated with Cytokine-Directed Therapies sciencedirect.com/science/articl…

Clinical significance of preleukemic somatic GATA1 mutations in children with Down syndrome ashpublications.org/blood/article/… 10 year project with Irene Roberts and numerous collaborators. Natural history of myeloid preleukaemia and leukaemia in newborns and young children with T21.

It’s finally out in Blood!! A new molecular scoring system improving ESA response prediction in LR-MDS (ESA-PSS-M). Check it out! Thanks to all the collaborators #precisionmedicine #MDS ashpublications.org/blood/article-…

South India’s longest-know Car-T therapy survivors in Bengaluru return to daily life | Bengaluru News - this is amazing news ⁦@Immuneel_⁩ is really delivering on its promise of curing incurable cancers. So proud to hear these heart warming stories. timesofindia.indiatimes.com/city/bengaluru…

#regenerative medicine in type 1 DM: #Stem cell–derived islets (zimislecel) infusion in portal vein restored islet function @NEJM Outcomes in 14 patients -All patients had detectable C-peptide -100% reached HbA1c <7% -83% became insulin-independent nejm.org/doi/full/10.10…

Intermediate-Dose Cytarabine as Postinduction AML Therapy | NEJM Evidence evidence.nejm.org/doi/full/10.10…

Prognostic factors for allogeneic haematopoietic cell transplantation outcomes in primary refractory AML (2013–2022): A retrospective study by the adult AML working group of the Japanese Society for Transplantation and Cellular Therapy @BrJHaem share.google/3OE1DQ6wCnsyBZ…

Disappointing. Subgroup analysis will be key.

Happy 15th Birthday to Queen Elizabeth Hospital @uhbtrust. Fantastic celebrations with Special Kind, Connected and Bold awards. Great to hear aspirations and strategies from the specialties and poster displays of their achievements.