Tontarn Chutima

Hematologist from Thailand.
Love myeloma's world!!!

[Gareth Morgan @DrGarethMorgan1]

Start of the IMS genomic meeting brings a blizzard of questions on functional high risk multiple myeloma

[Raj Chakraborty @rajshekharucms]

Key highlights from my Best of ASCO (+EHA) 2026 talk on #MultipleMyeloma & AL #Amyloidosis — Bispecific Antibodies were the major theme:
✅Teclistamab (± Dara) outperforms traditional triplets at 1st relapse
✅Mezigdomide+Kd: new option for CD38/IMiD-refractory pts
✅BCMA-BsAbs must be favored for 2nd-line in AL #amyloidosis post Dara-CyBorD
#ASCO26 #mmsm

[Robert Z. Orlowski @Myeloma_Doc]

#Myeloma Paper of the Day: T-cell composition before apheresis & CAR-T (CD4/CD8 CAR-T ratio >0.09, more non-activated/-cytolytic CAR-T) & endogenous T-cell phenotypes (increased % PD1+ cytotoxic T cell & ICOS-TIGIT+ Treg) post-infusion link w/ PFS: https://t.co/Ayj6xy4yTd. #mmsm

[Robert Z. Orlowski @Myeloma_Doc]

#Myeloma Paper of the Day: Transcriptomic profiling of CASSIOPEIA pts identified 5 subtypes & 3 risk categories w/ 72-month PFS rates of 70%/51%/27% & refined value of MRD by identifying high-risk pts in whom MRD was insufficient to predict outcome: https://t.co/d2NlUjUMtA. #mmsm

[nizar jacques bahlis @NBahlis]

Anti-BCMA TCE in newly diagnosed myeloma. New era is here, end of HCT? congrats @RaabMarc @RascheLeo https://t.co/qkK5AsaonW

[Vincent Rajkumar @VincentRK]

Just out: Our study using NHANES samples in persons age 10-49 shows that MGUS starts at a younger age in Black people and that there is a markedly higher risk of MGUS in African Americans compared to White people. The 2-3 fold high risk of MGUS in Black people is the reason why Multiple Myeloma is 2-3 fold more likely to occur in African Americans compared to the White population. Study done in collaboration with @DrOlaLandgren over 15 years. This is the third paper and uses highly sensitive mass spectrometry.

Monoclonal Gammopathy of Undetermined Significance (MGUS) is the premalignant precursor of multiple myeloma. The reason age adjusted prevalence of myeloma in African Americans is mainly because they have a 2-3 fold higher higher risk of MGUS and not felt to be due to a higher risk of progression of MGUS to myeloma. This is an important point. Genetic differences in other words predispose to the “polyp” (MGUS) but not the cancer (myeloma).

We believe there is a genetic predisposition to the origin of MGUS presumably due to an aberrant response to antigen stimulation in Blacks in the US and in Western Africa compared to Whites. We don’t think that the disparity in the occurrence of MGUS is due to environmental exposure differences. For one it’s seen in all socio economic strata. Second the higher prevalence is seen in studies we did in Ghana exactly similar to what we see in African Americans. And third, in a study we did in a Southern US cohort where we looked at African American and White women living in the same region with same socioeconomic status, we found a 2-3 fold higher risk of MGUS in African American women. So it’s unlikely to be environmental differences. Our study of other modifiable risk factors in NHANES doesn’t explain the disparity.

We suspect that the disparity we see in African Americans and in studies Western Africa, may or may not be present in Eastern African countries. Which is why we are studying the Somali population in Minnesota currently.

Our NHANES study just published @BloodCancerJnl shows that the disparity in occurrence of MGUS is apparent even at age 30-39 in African Americans compared to White population in America.

https://t.co/XzxrKVGfY6

[Robert Z. Orlowski @Myeloma_Doc]

#Myeloma Paper of the Day: Study of fat aspiration for diagnosis/screening of #amyloidosis in 2830 patients from 2013 to 2020: finds compelling sensitivity for AL and better sensitivity in females for all major subtypes: https://t.co/NLnYN5DCke. #alsm

[Muzaffar Qazilbash @Transplant_Doc]

Predictors of early treatment failure (PFS: <12 months) with cilta-cel in RRMM: prior anti-BCMA Rx, EMD, CAR-HEMATOTOX score >/=2, BM MRD +ve and < CR on PET/CT at 3 months. #mmsm #bmtsm @ZanwarSaurabh https://t.co/DCLFLCR22b

[Raj Chakraborty @rajshekharucms]

I used this slide in a recent presentation to highlight that the question of CAR T➡️BsAb vs BsAb ➡️CAR T sequencing in #Myeloma can't be reliably answered by retrospective studies. It's similar to how retrospective studies mostly show OS benefit with upfront ASCT but no RCT has shown that since VRD! This is often a nuanced (and long) discussion with patients!
@HealthTree

[Saurabh Zanwar @ZanwarSaurabh]

Our experience in CNS multiple myeloma is now out in @BloodAdvances.

Key findings:
• CNS-MM noted in ~7% of all extramedullary myeloma cases
• Median OS of 4 months after CNS diagnosis
• High-risk cytogenetics and additional visceral involvement were associated with ⬆️ CNS-MM
• CAR-T and bispecifics demonstrated improved outcomes over conventional therapies, though significant unmet need remains
• Intrathecal therapy showed limited benefit (small n though)

Excellent work led by our third year fellow Dr. Xiao from @MayoHemeOnc @MayoCancerCare
#mmsm

https://t.co/idTKrlVf3J

[Robert Z. Orlowski @Myeloma_Doc]

#Myeloma Paper of the Day: Teclistamab-based induction in TE NDMM shows MRD- CR rate 91.8% (45/49) by pre-maintenance timepoint, 100% in evaluable samples & post-induction cycle 3 (10-5 (46/46)), 6 (10-5 (46/46) & 10-6 (46/46)); ORR was 100%: https://t.co/JI0HRixT9o. #mmsm

[Vincent Rajkumar @VincentRK]

Don’t miss: Today at 7 pm central. An update of what’s new in myeloma from
#ASCO26 #EHA26 #IMWG26

IMWG conference series webinar. I will be joined by @NikhilMunshiMD @SagarLonialMD - and we will answer your questions.

Moderated by @IMFmyeloma CEO Heather Cooper Ortner. See link for registration. https://t.co/IxfZm6DDt8

[Rahul Banerjee, MD, FACP @RahulBanerjeeMD]

@Tontarnnaja Agreed 100% - that’s my thought as well!

[Robert Z. Orlowski @Myeloma_Doc]

#Myeloma Paper of the Day: Minimally invasive characterization of peripheral blood measurable residual disease in myeloma by high-sensitivity detection of ctDNA by NGS shows higher positive predictive value (88.9% vs. 34.5%) for relapse vs. BM NGF: https://t.co/Y2pdKxv0gb. #mmsm

[Tontarn Chutima @Tontarnnaja]

Higher activity of malignant plasma cell may produce more IL6 which suppress albumin product?

[Rahul Banerjee, MD, FACP @RahulBanerjeeMD]

Excellent @JCOCCI_ASCO article by Movassagh et al: ML algo to predict MGUS.

When I first read that low total protein predicted MGUS later, I suspected a typo. Turns out it wasn't! Alb ⬇️before M-spike⬆️ as shown below:

Intriguing to tailor MGUS screening studies in future.

[Rahul Banerjee, MD, FACP @RahulBanerjeeMD]

Excellent @JCOCCI_ASCO article by Movassagh et al: ML algo to predict MGUS.

When I first read that low total protein predicted MGUS later, I suspected a typo. Turns out it wasn't! Alb ⬇️before M-spike⬆️ as shown below:

Intriguing to tailor MGUS screening studies in future.

[Muzaffar Qazilbash @Transplant_Doc]

MRD +ve status by NGF in apheresis product correlated with suboptimal response to induction, and predicted an early progression and a shorter PFS (HR: 1.7) after ASCT #mmsm #bmtsm @mvmateos @NoemiPuig2 https://t.co/UeGLV2EGqw

[Hira Mian @HiraSMian]

As bispecific antibodies move up in earlier lines, every myeloma physician/center will need to deliver these drugs. Here is our review for implementing these therapies @CarlynRTanMD @szusmani @MyelomaCanada @HamiltonMyeloma @HamHealthSci @McMasterU @JCOOP_ASCO @MSKCancerCenter

[Mostafa Faisal @MostafaFaisal14]

Dexamethasone for Management of Cytokine Release Syndrome Associated With Talquetamab in Patients With Relapsed/Refractory Multiple Myeloma
https://t.co/MdVHLG8Eyu

[Robert Z. Orlowski @Myeloma_Doc]

#Myeloma Paper of the Day: Need for early transfusion after CAR T indicates high inflammation and severe acute toxicity, whereas the need for late transfusion is associated with poor remission, higher non-relapse mortality, and shorter survival: https://t.co/ddtJaJyHNs. #mmsm