VenetoMax

POEMS Syndrome: Clinical Manifestations, Pathophysiology, and Therapeutic Approaches @japacademy Aala Dweik ,Hadeel Dweik #mmsm @utswcancer ➡️journals.lww.com/japa/fulltext/…

🎉 Out now in the British Journal of Haematology 🙌🏽 ⤵️ PTCy to 35 mg/kg improves platelet engraftment and ⤵️ bloodstream infections peri-transplant WITHOUT ⤴️ acute GvHD after MUD transplant 💪🏽 Team @pmcancercentre 🙌🏽 @BrJHaem share.google/R7USoQ94Q3Go4h…

Just out in @NEJM Effective therapy of extra medullary relapsed myeloma with teclistamab plus talquetamab (Tec-Tal). RedirecTT-1 #ASH25 @myelomaMD @szusmani @mvmateos 80% response rate. 60% PFS at 12 months. nejm.org/doi/full/10.10…

Aza-Ven should be the standard in LMICs where 7+3 is way more toxic #ASH25 #Leusm

🚨 This is it people … you heard it first at #ASH25 🚨 ELN #MRD 205 guidelines are in press in @BloodPortfolio Bad news: It’s more complicated than before… 🤯 Good news: there’s an app for it 😉 eln-aml-mrd-2025.vercel.app

Some relevant abstracts on hematologic malignancies (12): 1. ascopubs.org/doi/10.1200/JC… TAKEAWAYS:

This article reviews current approaches to salvage #alloHCT for primary graft failure, highlighting a promising one-day conditioning strategy and the urgent need for standardized regimens to improve outcomes. astctjournal.org/article/S2666-…

💥 GLOFIT-POLA delivers CAR-T–like efficacy in R/R LBCL! Phase Ib/II 🧪 Regimen Obinutuzumab pre-dose ➕ Pola 1.8 mg/kg × 6 cycles ➕ Glofitamab 2.5→10→30 mg × 12 cycles 👥 Population 129 pts | HGBCL 34% | Prior CAR-T 22% | Primary Refractory 62% 🎯 Results (IRC) ✅ ORR 78% | CR 60% 🕒 Median PFS 12.3 mo | OS 33.8 mo 💪 HGBCL CR 66% | Post-CAR-T CR 50% ⚠️ Safety CRS 43% (Gr 1-2 = 42%) | Grade ≥3 AEs 59% | Fatal AEs 9% 🧩 Takeaway Fixed-duration, off-the-shelf, chemo-light regimen - durable & manageable. Next → #SKYGLO frontline trial. #Lymphoma #DLBCL #Bispecifics #CAR-T #OncoTwitter @ASCO @esmo_open @OncoAlert 📖 Hutchings et al. J Clin Oncol 2025. 🔗 ascopubs.org/doi/10.1200/JC…

AML-defining cytogenetic and molecular abnormalities (regardless of blast count)between the WHO 5th Edition (2022) and the International Consensus Classification (ICC 2022). #leusm #MedTwitter #hemonctrainees #when_on_service

🧬 Not all DLBCLs are created equal - POLA knows the difference. 📊 Real-world (n = 740, 2015–24) Polatuzumab used in 🔹Frontline (305) 🔹R/R (435) COO classified by Hans IHC algorithm 🔥 R/R LBCL: •ORR 59.7% vs 36.3% ➜ OR 2.6 (p<0.0001) •CR 35.7% vs 17.7% ➜ OR 2.6 (p<0.0001) •PFS benefit → HR 0.64 (p = 0.0006) 💊 Frontline (Pola-R-CHP): No subtype gap → Pola neutralizes COO risk 💡 Takeaway: Hans IHC still rules 🧪 🔹 Non-GCB = POLA favorite in R/R 🔹 Frontline Pola-R-CHP = great equalizer 📖 Scheffer-Cliff et al., Clin Cancer Res 2025 DOI: aacrjournals.org/clincancerres/… #DLBCL #Lymphoma #HemOnc #OncoTwitter #ESMOOpen @OncoAlert @esmo_open @ASCO

🔥 KMT2A-rearranged & NPM1-mutated AML – Why Menin Inhibitors Work 🔬 🧬 KMT2A (MLL) biology •Chromatin modifier controlling HOX gene expression •HOX overexpression = leukemogenesis (blocks differentiation) 🧩 Menin = key cofactor •Acts as a scaffold protein that links KMT2A → HOX genes •Required for transcriptional activation in KMT2Ar and NPM1-mut AML 💣 Pathogenic mechanism •KMT2A rearranged AML → ↑ HOXA/MEIS1 → leukemia •NPM1-mut AML uses menin–KMT2A pathway despite no rearrangement → same HOX overdrive 🛑 Solution: MENIN INHIBITION •Menin inhibitors (e.g. Revumenib) block KMT2A–menin interaction •↓ HOXA/MEIS1 → restores myeloid differentiation ✅ •Leads to deep remissions + MRD negativity in trials ✨ Why it matters •Targets genetic core driver in KMT2Ar & NPM1-mut AML •Works in relapsed/refractory and post-transplant relapse •Differentiation-like activity similar to ATRA in APL (conceptually) #AML #KMT2A #NPM1 #Menin #Revumenib #TargetedTherapy #Leukemia #Hematology #SOHOKSA #SOHO

🧵 NEJM 2025 MGUS Review 🩸🔬 1️⃣ MGUS = Premalignant plasma-cell disorder 🔹 Seen in ~5% of adults >50y 👴👵 🔹 Risk of progression → myeloma, WM, or plasmacytoma ≈ 1%/yr 🔹 Can cause organ damage → MGCS (kidney 🩺, nerves 🧠, skin 🟤, thrombotic 🩸) 2️⃣ Pathogenesis 🔎 🔹 First hit: trisomies / IGH translocations 🔹 Progression: ↑ clone size + secondary hits (APOBEC, MYC, RAS/MAPK) + immune escape 🔹 Often silent for years before MM diagnosis 3️⃣ Diagnosis 🧪 🔹 M-protein <3 g/dL + <10% BM plasma cells + no CRAB 🚫 🔹 Use SPEP/IFE or mass spectrometry 💻 🔹 Always check FLC ratio 🔥 🔹 Imaging only if higher risk or suspicious 🩻 4️⃣ Risk stratification 📊 🔹 Factors: M-protein ≥1.5 g/dL 📈, IgA/IgM type, abnormal FLC ratio ⚠️ 🔹 20-yr risk ↑ to 58% if all 3 factors present vs 5% if none 🔹 Use iSTOPMM calculator to decide on baseline BM biopsy 5️⃣ Management 💊 🔹 No routine therapy 🚫 🔹 Monitor at 6 mo → yearly if stable ⏳ 🔹 Aim: detect progression before organ damage 🔹 Treat MGCS (e.g., AL amyloidosis, MGRS, POEMS) with clone-directed Rx 🩹 6️⃣ Key complications ⚠️ 🔹 MGRS → GN, C3 disease 🩸 → needs renal biopsy 🔹 MGNS → sensory neuropathy 🤲 🔹 Bone loss & ↑ thrombotic risk 🦴🩸 7️⃣ Prognosis 📈 🔹 Lifetime risk of progression ≈11% at 25 yrs 🔹 Risk persists—doesn’t fade over decades 🔹 Emerging tools: genomics 🧬, single-cell RNAseq 🧫, immune/micro-env profiling 🌐 🙏 Credit to Dr. Mohammed Al-Shahrani for sharing this landmark review with the hematology community 🌟 — empowering earlier recognition, smarter follow-up & precision care for MGUS patients. #MGUS #NEJM2025 #MGRS #MGNS #Hematology #ClinicalPearls

#Myeloma Paper of the Day: IFM2017-03 trial of Revlimid/Darzalex w/ 2 cycles of dex versus triplet w/ continuous dex finds DRAMATICALLY reduced progression risk (53.4 mos (95% CI 35.3-not reached) vs. 22.5 mos (HR 0.51, 95% CI 0.37-0.70, p<0.0001)): pubmed.ncbi.nlm.nih.gov/41038184/. #mmsm

Every time I heard Erdheim–Chester or Rosai–Dorfman I was 🤯 confused. “What is this? Definitely not my cup of tea!” But once you know the key difference 👇 •Erdheim–Chester → CD68+, CD1a–, Touton giant cells •Langerhans → CD68+, CD1a+, S100+ •Rosai–Dorfman → CD68+, CD1a–, S100+, emperipolesis Trust me—suddenly it all makes sense. 🧩 #Rheumatology #Immunology #Sullysrounds #MedX #Medtwitter #Mnemonics #Medicine #History @DrAkhilX @IhabFathiSulima @Janetbirdope @Lupusreference @RheumNow #MedTwitter #RheumTwitter @drkeithsiau

What's going to be different with the new IMWG response criteria? Main changes: - FLC >=10 mg/dL with abnormal ratio takes precedence over urine (but urine is not gone) - No more sCR - Bone marrow to confirm CR can be performed +/- 6 weeks from blood testing. - 24-hour urine at baseline, and if M-protein present, retest only to confirm CR - Patients can be considered to have PD if they meet criteria by a variable not considered measurable at baseline (major weakness with current response criteria is that it misses light chain escape). Next, imaging....

📊 Treatment Landscape for DLBCL – SOHO25 🧬 🔹 Frontline •IPI 0–1 → R-CHOP •IPI 2–5 → Pola-R-CHP 🔹 Relapsed / Refractory •Relapse ≤12 mo or refractory •CAR-T: Axi-cel, Liso-cel •Non-CAR-T: Glofit/Epco + GemOx, Tafa/Len, Mosun/Pola •Relapse >12 mo •AutoSCT candidate → Chemo + AutoSCT •Not auto candidate → Liso-cel, Glofit/Epco + GemOx, Tafa/Len, Mosun/Pola 🔹 3rd Line+ •Options: CAR-T, Glofitamab, Epcoritamab, Tafa/Len, Lonca, Pola-BR 🚀 Key Takeaway: •CAR-T prioritized in early relapse (<12 mo). •BsAbs (Glofit, Epco, Mosun) firmly integrated from 2L onward. •AutoSCT still standard for late relapse & chemosensitive disease. #DLBCL #CART #BsAb #SOHO25 #Lymphoma

สำหรับผู้สูงอายุ ฉีดวัคซีนไข้หวัดใหญ่แบบขนาดสูงกับแบบปกติ ต่างกันไหม? Paper เพิ่งตีพิมพ์ใน New England และนำเสนอในงาน ESC มีกลุ่มศึกษาเป็นผู้สูงอายุกว่า 3 แสนคน (อายุเฉลี่ย 73 ปี) เปรียบเทียบระหว่างวัคซีนไข้หวัดใหญ่ขนาดสูงกับขนาดปกติที่ฉีดกันทั่วไป แล้วดูอัตราการนอน รพ ด้วยไข้หวัดใหญ่หรือปอดบวม ผลออกมาไม่ต่างกันครับ สรุป ผู้สูงอายุทุกคนควรได้รับวัคซีนไข้หวัดใหญ่ครับ แต่ไม่จำเป็นต้องฉีดแบบขนาดสูงก็ได้ ประสิทธิผลในการป้องกันไข้หวัดใหญ่รุนแรงหรือปอดบวมพอ ๆ กัน (แต่ราคาวัคซีนต่างกัน 3 เท่า) nejm.org/doi/full/10.10…

@Fiatopichan แบบนี้ต้องบอกที่ละคับ 555

เซ็ง ไปช่วยงานที่หนึ่ง เสาร์ อาทิตย์ ทำ 9-16 น. สรุปเขาบอกทีหลังว่า ไม่มีตังให้ ทำฟรีนะ

ส่วนตัวคือ.. ด่วนคือโทร ไม่ด่วนคือส่งข้อความ จะนับว่าไม่มีมารยาทก็ต่อเมื่อ โทรมาเช้าเกิน ดึกเกินไป เวลานอน เวลาทำงาน แล้วโทรมาเรื่องที่ไม่ด่วนจริงๆ หรือด่วนของมึงคนเดียวไม่ใช่ด่วนของกู ไม่สะดวกรับแล้วโทรรัวๆ หลายสาย ต้องเรื่องคอขาดบาดตายเท่านั้น ถ้าสนิทก็เป็นข้อยกเว้น โทรได้โลด

🧐Rarity in hematology🧐 Blastic Plasmacytoid Dendritic Cell Neoplasm (#BPDCN) Rare but aggressive blood cancer with a name as complex as its behavior Let's break it down in an educational🧵