Discover and read the best of Twitter Threads about #BMTsm
Most recents (9)
Blood smears @ASH_hematology 🧵Heme boards
🩸Malignant Hematopoietic Neoplasms🩸
#mmsm #lymsm #leusm #bmtsm
1⃣ classic Hodgkin's lymphoma
🩸Reed-Sternberg cell👇
🩸Most common: Nodular sclerosis 👇(fibrosis)
🩸Usually:CD30+, CD15+, weak PAX5 +. CD20-, CD45-
🩸9p24.1 alteration
🩸Malignant Hematopoietic Neoplasms🩸
#mmsm #lymsm #leusm #bmtsm
1⃣ classic Hodgkin's lymphoma
🩸Reed-Sternberg cell👇
🩸Most common: Nodular sclerosis 👇(fibrosis)
🩸Usually:CD30+, CD15+, weak PAX5 +. CD20-, CD45-
🩸9p24.1 alteration
Blood smears @ASH_hematology 🧵Heme boards
🩸Malignant Hematopoietic Neoplasms🩸
#mmsm #lymsm #leusm #bmtsm
2⃣ Nodular lymphocyte-predominant Hodgkin lymphoma
🩸popcorn cell (from germinal center B-cell)👇
🩸CD20+ (different than cHL),Rituxan used in ttt
🩸can transform(DLBCL)
🩸Malignant Hematopoietic Neoplasms🩸
#mmsm #lymsm #leusm #bmtsm
2⃣ Nodular lymphocyte-predominant Hodgkin lymphoma
🩸popcorn cell (from germinal center B-cell)👇
🩸CD20+ (different than cHL),Rituxan used in ttt
🩸can transform(DLBCL)
Blood smears @ASH_hematology 🧵Heme boards
🩸Malignant Hematopoietic Neoplasms🩸
#mmsm #lymsm #leusm #bmtsm
3⃣ Follicular lymphoma
🩸Bone marrow with small lymphocytes👇
🩸CD20+,CD10+,BCL6+,BCL2+,CD5-
🩸t(14;18) in up to 90% of cases
🩸Malignant Hematopoietic Neoplasms🩸
#mmsm #lymsm #leusm #bmtsm
3⃣ Follicular lymphoma
🩸Bone marrow with small lymphocytes👇
🩸CD20+,CD10+,BCL6+,BCL2+,CD5-
🩸t(14;18) in up to 90% of cases
After ending two weeks on the BMT inpatient service, here is a 🧵 on my favorite BMT CTN trials that I teach to every new fellow/PA/NP/pharmacist/trainee on rounds.
I love these trials, and look forward to the ongoing ones!
(CAVEAT-trials simplified for purpose of 🧵)
#bmtsm
I love these trials, and look forward to the ongoing ones!
(CAVEAT-trials simplified for purpose of 🧵)
#bmtsm
BMT CTN 0201
Peripheral blood VS bone marrow source for unrelated donor transplant for blood cancers
Primary Endpoint= 2 year OS was similar
⬆️chronic GVHD with peripheral blood
⬇️ long term QOL with peripheral blood
pubmed.ncbi.nlm.nih.gov/23075175/
Peripheral blood VS bone marrow source for unrelated donor transplant for blood cancers
Primary Endpoint= 2 year OS was similar
⬆️chronic GVHD with peripheral blood
⬇️ long term QOL with peripheral blood
pubmed.ncbi.nlm.nih.gov/23075175/
BMT CTN 0102
Autotransplant followed by either non myeloablative allo transplant or a tandem auto for myeloma
Primary Endpoint=3 yr PFS, similar between both arms
⭐️Role for allogenic transplant limited- role of tandem limited now too (see next tweet)
pubmed.ncbi.nlm.nih.gov/21962393/
Autotransplant followed by either non myeloablative allo transplant or a tandem auto for myeloma
Primary Endpoint=3 yr PFS, similar between both arms
⭐️Role for allogenic transplant limited- role of tandem limited now too (see next tweet)
pubmed.ncbi.nlm.nih.gov/21962393/
Long awaited study (at least for me) on maintenance after hematopoietic cell transplant (BMT) for patients with TP53 acute myeloid leukemia (AML) or myeloid dysplastic syndrome (MDS) @JCO_ASCO ascopubs.org/doi/full/10.12…
Congrats to all !
It's a tricky one. A🧵#leusm #bmtsm #mdssm
Congrats to all !
It's a tricky one. A🧵#leusm #bmtsm #mdssm
Prologue: TP53 mutation is present in ~15-20% and is associated with a poor prognosis in AML and MDS, even in patients who undergo BMT. acsjournals.onlinelibrary.wiley.com/doi/10.1002/cn…
Eprenetapopt is a prodrug, small-molecule p53 reactivator, converted into an active moiety, 2-methylene quinuclidine-3-one, stabilizing p53 and targets cellular redox balance to increase oxidative stress & induce cell death.
#Medtwitter friends: I've been having a blast on the BMT service with @c_j_gibson and planning next week's #bmtsm #leusm teaching theme:
📰 Why we do what we do in allogeneic transplantation for myeloid malignancies: Classic/Pivotal trials/papers.
Any you'd add/swap out?
📰 Why we do what we do in allogeneic transplantation for myeloid malignancies: Classic/Pivotal trials/papers.
Any you'd add/swap out?
1⃣ Chemo vs. Auto vs. Allo in AML
Cassileth PA et al. Chemotherapy compared with autologous or allogeneic bone marrow transplantation in the management of acute myeloid leukemia in first remission. NEJM 1998
nejm.org/doi/full/10.10…
Cassileth PA et al. Chemotherapy compared with autologous or allogeneic bone marrow transplantation in the management of acute myeloid leukemia in first remission. NEJM 1998
nejm.org/doi/full/10.10…
2⃣ Donors - Related vs. Unrelated
Gupta V et al. Comparable survival after HLA-well-matched unrelated or matched sibling donor transplantation for acute myeloid leukemia in first remission with unfavorable cytogenetics at diagnosis. Blood. 2010
ashpublications.org/blood/article/…
Gupta V et al. Comparable survival after HLA-well-matched unrelated or matched sibling donor transplantation for acute myeloid leukemia in first remission with unfavorable cytogenetics at diagnosis. Blood. 2010
ashpublications.org/blood/article/…
🧵Our latest in @BloodJournal
@coleman_lindsley @c_j_gibson @DanaFarberNews
Older patients with AML undergoing HCT have high rates of relapse & non-relapse mortality
We investigated how outcomes relate to both baseline characteristics and molecular MRD
tinyurl.com/4bn76ham
@coleman_lindsley @c_j_gibson @DanaFarberNews
Older patients with AML undergoing HCT have high rates of relapse & non-relapse mortality
We investigated how outcomes relate to both baseline characteristics and molecular MRD
tinyurl.com/4bn76ham
2. @DrChrisHourigan and others have shown that AML pts with mutations at remission (molecular MRD) have more relapse➡️ inferior survival after HCT, especially if receiving reduced intensity conditioning.
tinyurl.com/23rrbjte
tinyurl.com/23rrbjte
3. We wondered:
1⃣ Is prognostic impact of MRD the same for patients age ≥ 60 (underrepresented in RCTs)?
2⃣ Is mutation persistence related to features present at diagnosis?
1⃣ Is prognostic impact of MRD the same for patients age ≥ 60 (underrepresented in RCTs)?
2⃣ Is mutation persistence related to features present at diagnosis?
Happy to share our latest paper w/ @SibaElHussein as lead author, out today in @BMTjournal ⚡️Acquired WT1 mutations contribute to relapse of NPM1mut AML following allogeneic hematopoietic stem cell transplant rdcu.be/cEuxv #hemepath #leukemia #hemepathMDA
WT1 mutations are present in ~7% of de novo AML, are typically Lof mutation involving exons 7-9 of the gene. They frequently (~15%) co-occur w/ NPM1mut & have detrimental impact in this setting, shown by @AkEisfeld and colleagues in bit.ly/3eWQtXw @LeukemiaJnl
We studies a cohort of de novo NPM1-mut AML. 7% had concurrent WT1 mutations at baseline. 22% (15/67) relapsed; 4 (27%) with newly acquired Lof WT1-mut. Illustrated by @furudateken
#TCTM21 Significantly worse EFS and higher incidence of graft failure among #SickleCell disease patients undergoing #BMTsm on Medicaid compared to private insurance - Very important study from @CIBMTR by Tatenda Geraldine Mupfudze and colleagues tct.confex.com/tct/2021/meeti…
Similar trend in #BMTsm utilization in adult acute leukemia patients’ - public insurance, race and older age has significant influence on #HCT utilization, abstract by Silas Day #TCTM21 tct.confex.com/tct/2021/meeti…
#TCTM21 Naseem Esteghamat identified disparities in auto #HCT utilization, specifically among African Americans vs Whites (OR: 0.68), patients covered on Medicare or Medicaid vs private insurance (OR: 0.79), and those with lower SES (OR: 0.71). tct.confex.com/tct/2021/meeti…
What happens to hematopoietic transplant recipients who develop #COVID19?
Transplant recipients and transplanters have been asking this question ever since the pandemic began.
Our analysis using @CIBMTR data is out today in @TheLancetHaem thelancet.com/journals/lanha…. 1/
Transplant recipients and transplanters have been asking this question ever since the pandemic began.
Our analysis using @CIBMTR data is out today in @TheLancetHaem thelancet.com/journals/lanha…. 1/
While there have been close to 100,000 papers related to COVID-19 listed on @NCBI @NLM_NIH #Pubmed, there are very few that address outcomes after #COVID19 in #BMTsm patients, a few are listed in the next tweet: 2/
1. Spanish experience from @GETH_info onlinelibrary.wiley.com/doi/10.1002/pb…
2. Chicago (@RushMedical, @UChicago & @NUFeinbergMed) & New York City (@MountSinaiNYC) experience in @LeukemiaJnl nature.com/articles/s4137…
3. @sloan_kettering experience in @jclinicalinvest jci.org/articles/view/… 3/
2. Chicago (@RushMedical, @UChicago & @NUFeinbergMed) & New York City (@MountSinaiNYC) experience in @LeukemiaJnl nature.com/articles/s4137…
3. @sloan_kettering experience in @jclinicalinvest jci.org/articles/view/… 3/
1/ Key data presented #ASH20 from the FORTE, EMN02 and IFM-2009 trials further strengthen the role of transplant in myeloma. FORTE trial also provides key randomized data for dual maintenance. #mmsm #bmtsm Highlights below.
2/ Higher sustained MRD negativity and PFS benefit with KRD-ASCT vs KRD in the FORTE trial presented by Dr. Francesca Gay.
KR maintenance also leads to improved outcomes in all subgroups vs R maintenance alone. #mmsm #ASH20
KR maintenance also leads to improved outcomes in all subgroups vs R maintenance alone. #mmsm #ASH20
3/ IFM 2009 trial: Known higher MRD negativity and better PFS with early vs delayed ASCT.
Even amongst MRD negative group, those in the early SCT group have better PFS.
Similar OS and PFS-2 with early vs. delayed SCT.
3/4th pts in delayed grp received transplant at relapse
Even amongst MRD negative group, those in the early SCT group have better PFS.
Similar OS and PFS-2 with early vs. delayed SCT.
3/4th pts in delayed grp received transplant at relapse
