Pierre Rodriguez

1. June 2020, on my way to IM residency in the middle of #Covid #Pandemic. Afraid but excited! 2. June 2023, I’m an internist con my way to #HemeOnc fellowship. Grateful! Don’t give up, keep pushing. You’ll be there soon! #Match2024 #Meded #MedStudentTwitter @CookCountyIMR

Las cámaras de una cafetería abierta toda la noche grabaron algo que hizo llorar a millones de personas. Era una madrugada helada de invierno. Afuera llovía. Adentro, música suave y apenas unos pocos clientes. El reloj marcaba las 2:36 a.m. 🧵

Me encantó esta publicación de 'E!' resaltando las 12 veces en las que Shakira ha sido "LA PRIMERA LATINA" 🧵

#weekend_review #AML #leusm 🧵 Optimizing Venetoclax Duration in AML (Ven + HMA) Key observations from available data: 🔹 VIALE-A established efficacy (CR/CRi 66%, median OS 14.7 mo), not necessarily the ideal duration for every patient; Persistent cytopenias and infectious complications remain major barriers to prolonged exposure. 🔹 Karrar et al. (Mayo) suggest shorter durations (14 vs 21 vs 28 days) may be feasible in selected patients, but shorter duration should NOT be assumed to be intrinsically less myelosuppressive (AJH) 🔹 Prospective evidence does NOT currently support routine universal 7–14 day induction Venetoclax. 🔹 7+7 French study showed comparable response after 2nd cycle but toxicity was similar to 28 day venetoclax. 🔹 FILO data raise an important concept: treatment-free remission may be feasible after prolonged MRD-negative remission in favorable-risk disease (ELN2024), highlighting the importance of biology rather than fixed duration. 🔹 Metronomic/weekly Dec+Ven approaches and ongoing randomized studies (Opti-AML/Beat AML) may further redefine exposure strategies. Current practice increasingly individualizes Venetoclax duration based on: ✓ Age/frailty ✓ Comorbidities ✓ Molecular profile/genomics ✓ Disease burden and response kinetics ✓ MRD status ✓ Cytopenias/infection risk ✓ Tolerability and treatment goals The question may no longer be: “How long should Venetoclax be given?” Instead: “For which patient, at what disease state, and for how long?” Right patient. Right biology. Right duration. #AML #leusm #Venetoclax

👏Important new paper from our group led by .@TapKadia & @AlexBataller 👉just out in @AjHematology | #Cladribine #leusm #endcancer | @sanamloghavi onlinelibrary.wiley.com/doi/epdf/10.10…

The #WorldCup2026 is coming and no one like @shakira to release a world anthem like #DaiDai ⚽️ Feel it, got everything you needed Now bring it like you mean it Just like you mean it Dale, no olvide' lo que vales Juega como tú sabes Como tú sabe' open.spotify.com/track/0kosUz0j…

@Beno10_MFC 19112 (move the top and bottom stick on 0 to create a 1 | |

High level of creativity is needed here. Boost your creativity Can you make a number larger than 902 by moving only 2 sticks?

From Maracaná Stadium, here is “Dai Dai,” the @FIFAWorldCup Official Song 2026. Coming 5/14. We’re ready! ⚽️🐺 @burnaboy

#SHAKIRA makes history in Copacabana, becoming the 1ST Latin Artist to perform to over 2 Million people at a single concert! 💪🏆🥇🌶️🪘🥁🧑‍🎤🎤💥2⃣Ⓜ️ 👥👤🌊🇧🇷🐐👑❤️‍🔥

A must read! How to select a donor in the era of PTCy Favor MRD - MUD - Haplo vs MMUD? Urgency of HCT, DSA, age and other factors to consider 🚨 ashpublications.org/blood/article-…

🧬 NCCN Guidelines v3.2026 – Germline Testing in Myelodysplastic Syndromes Credits: Dr. Mohammad Al-Shinnag, KFSHRC 📘 Hereditary Myeloid Malignancy Predisposition Syndromes (HMMS) 🩸 Recognized by NCCN as critical in patients with suspected inherited risk of MDS/AML. 🎯 Identification guides diagnosis, treatment, transplant decisions, and family counseling. ⸻ 🔬 Appropriate DNA Sources for Germline Testing 🧫 Skin Fibroblasts – Gold Standard ✅ Recommended to exclude somatic mutations and clonal hematopoiesis. 📌 Provides uncontaminated constitutional DNA. 👄 Buccal Swabs ⚠️ Acceptable alternative with caution. 🔍 Risk of peripheral blood contamination must be considered. 🩸 Peripheral Blood or Bone Marrow ⚠️ May be used during remission. ❗ Limitations include clonal hematopoiesis, somatic mosaicism, or reversion events. ⸻ 🧪 Key NCCN Recommendations 📊 Multigene Testing (NGS-Based Panels) 🧬 Recommended for comprehensive germline assessment. 🎯 Enables identification of hereditary predisposition syndromes. 🧾 Accurate Interpretation is Essential 🔍 Variant classification depends on laboratory expertise and clinical context. 📈 Variants may be reclassified as new evidence emerges. ⚠️ Somatic Panels Do NOT Exclude Germline Mutations 🩸 Testing performed on blood or marrow for somatic mutations may detect constitutional variants. 📌 A negative somatic panel does not rule out an inherited predisposition. 🧬 Complementary Diagnostic Modalities 📊 NGS and chromosomal genomic array testing (CGAT) detect: ✔️ Copy number variants (CNVs) ✔️ Copy-neutral loss of heterozygosity (cnLOH) ⸻ 🧬 Additional Laboratory Evaluations 🦴 Fanconi Anemia (FA) – Chromosome breakage analysis. 🧫 Shwachman-Diamond Syndrome – Low pancreatic isoamylase and serum trypsinogen. 🧬 Short Telomere Syndromes – Telomere length assessment via flow-FISH. 🩸 Diamond–Blackfan Anemia – Elevated erythrocyte adenosine deaminase. ⸻ 🎯 Clinical Implications 🧬 Confirms hereditary cancer predisposition. 👨‍👩‍👧 Enables cascade testing and genetic counseling. 🩺 Guides donor selection for hematopoietic stem cell transplantation. 📊 Influences surveillance, prognosis, and therapeutic decisions. ⸻ 📌 Key Takeaway 🔬 Skin fibroblasts are the preferred DNA source, multigene NGS panels are recommended, and somatic testing alone is insufficient to exclude germline predisposition. #NCCN #MDS #GermlineTesting #HereditaryMyeloidMalignancies #PrecisionMedicine #NGS #Hematology #KFSHRC

@Marcela252016 Olimpia Peregrina

Busco un nombre de niña ridículamente antiguo. Piensa en un nombre de bisabuela. Muy antiguo y raro.

Explore the @ASH_hematology 2026 #AcuteLymphoblasticLeukemia guidelines for asparaginase management, including recommendations on dosing, premedication, TDM, and switching formulations in AYA patients with #ALL. bit.ly/48n4lGo #ALLsm #leusm #MedEd

Esta canción es igual o mejor que los temas de Shakira en los 90s. Pero la gente se miente diciendo que ella dejo de hacer buenas baladas después de LS.

By limiting venetoclax administration to 7 days and adjusting the doses of concomitant intensive chemotherapy no significant safety issues reported with a median recovery times of 14 days for neutrophils and 13 days for platelets after induction therapy!

7-day VEN combined with dose-adjusted IC as induction treatment for ND-AML. CRc rate of 90.3%, with a MRD negativity rate of 92.2% by flow. After a median follow-up of 18 months, the mOS and event-free survival (EFS) were not reached! #AML #Leukemia clinical-lymphoma-myeloma-leukemia.com/article/S2152-…

An emerging triplet option for newly diagnosed FLT3 -- mutated acute myeloid leukemia | Haematologica haematologica.org/article/view/1… #leusm

American Society of Hematology 2026 Guidelines for the Diagnosis and Management of Severe Acquired Aplastic Anemia | Blood Advances | American Society of Hematology ashpublications.org/bloodadvances/…

🎯 Focused High-Yield Summary — ALAL / MPAL (Expert Level) 🧬 Definition ALAL = acute leukemia without clear single-lineage commitment → MPAL: ≥2 lineages → AUL: no lineage ⸻ 🧪 Diagnostic Core (MANDATORY) • ≥20% blasts • Exclude defined AML/ALL entities • Integrate: morphology + flow + genetics • Flow cytometry = key driver ⸻ 🧬 Classification (WHO-HEM5 / ICC) 1.Genetic-defined MPAL •BCR::ABL1 •KMT2A rearranged •ZNF384, BCL11B 2.Immunophenotypic MPAL •B/myeloid •T/myeloid •B/T ± myeloid ⸻ 🧪 Lineage Assignment (CRITICAL PEARL) B-lineage • CD19 backbone • Strong CD19 → +1 marker (CD10/CD22/CD79a) • Weak CD19 → +2 markers T-lineage • CD3 (cytoplasmic or surface) • Must be strong intensity Myeloid lineage • MPO ≥50% neutrophil intensity (WHO) • OR monocytic differentiation (≥2 markers: CD14, CD64, CD11c, NSE, lysozyme) ⸻ ⚠️ Key Pitfalls • Dim MPO ≠ myeloid → often B-ALL with aberrancy • CD79a unreliable if T-lineage present • % positivity irrelevant → intensity matters • Must compare with internal controls ⸻ 🧬 Patterns of Disease • Biphenotypic → single clone, dual lineage • Bilineal → ≥2 distinct blast populations • Minor clone clinically relevant → may dominate relapse ⸻ 🧬 Genetic Highlights • BCR::ABL1: common, adult, B/myeloid • KMT2A: monocytic bias, CD10− • ZNF384: lineage plasticity, switch during disease ⸻ ⚖️ WHO vs ICC Differences • WHO: no minimum % for minor clone • ICC: ≥5% required • WHO emphasizes antigen pattern + maturation ⸻ 🧠 Clinical Implications • Treatment choice depends on dominant lineage • ALL-like vs AML-like therapy still debated • Targeted therapy critical (e.g., TKI in BCR::ABL1) • High relapse risk + lineage switch ⸻ 🧩 Take-Home Algorithm 1.Confirm ≥20% blasts 2.Perform flow → check CD19 / CD3 / MPO 3.Apply intensity-based lineage criteria 4.Identify mono vs multi-population 5.Add genetics → refine subtype 6.Define dominant lineage → guide therapy ⸻ #MPAL #ALAL #Hematology #Leukemia #FlowCytometry #BoneMarrow #KFSHRC

Updates in low/intermediate-risk MDS ashpublications.org/hematology/art… #mds