Channita Langsy

Hematologist from Laos

[Henry C Fung| MM, lymphoma, leukemia & CART @HenrychihangFu1]

🩸 ASH iron-deficiency guidelines: a concern from the cancer/BMT clinic.

Cancer, CAR-T, HCT & GVHD patients can have high ferritin but severe iron-restricted erythropoiesis. ASH recognizes that inflammation can make stored iron unavailable. bloodadvances.2025015950.pdf

TSAT <20% gets my attention.
<15% worries me.
<10% + anemia? I strongly consider iron despite high ferritin.

Dialysis taught us: stored iron ≠ available iron.

Don’t let ferritin alone deny patients iron they may need. 🩸

[Thor Halfdanarson @OncoThor]

You want to know more about how to treat chemotherapy induced thrombocytopenia with thrombopoietin receptor agonists?

@BloodPortfolio has you covered...

https://t.co/JzgV1qQaFn

[Henry C Fung| MM, lymphoma, leukemia & CART @HenrychihangFu1]

🧬 No more chemo for follicular lymphoma?

FL is an immune-responsive disease.

Immune modulation → immune amplification → T-cell redirection

R² became the backbone. Add CD19 targeting with tafasitamab or CD3×CD20 T-cell engagement with epcoritamab, and responses deepen, even in anti-CD20-refractory disease.

The future may be less chemotherapy, and more intelligent immunity. ⚡

#FollicularLymphoma #Immunotherapy #Medtwitter

[Uriel Suárez @UsuarezMD]

American Society of Hematology 2026 guidelines for diagnosis of iron deficiency

https://t.co/tdVXQLHyrA

[Hamza Hashmi @hhashmi87]

#MyelomaTips: I have seen several referrals recently for myeloma based on isolated incidental finding of hypercalcemia.

➡️Isolated hypercalcemia is rarely myeloma.
➡️If hypercalcemia is the only abnormal finding with no anemia, renal impairment, or bone lesions; myeloma is an unlikely explanation.
➡️In iStopMM (n=2,546 MGUS pts), only 3% with persistent hypercalcemia had MM and every single one also had bone lesions/other CRAB features (Blood 2022;140:10099)
➡️Look elsewhere before anchoring on MM.
#MedTwitter #MultipleMyeloma #MMSM #MedEd

[Blood Journals Portfolio @BloodPortfolio]

Cellular and bispecific therapies show promising activity for CNS myeloma, whereas IT therapy appears to have limited efficacy. CNS myeloma is rare, aggressive, and strongly associated with high-risk cytogenetics and multifocal EMD. Read in Blood Advances: https://t.co/mRC6limT6Y

[Mostafa Faisal @MostafaFaisal14]

🧬 Plasma Cell Leukemia + BsAbs: real-world multicenter data

📊 122 PCL pts across 15 centers
💊 Teclistamab 37% | Elranatamab 11% | Talquetamab 53%

🎯 ORR 55%
• Tal LOT: 61%
• Tal Bridge: 58%
• Elranatamab: 46%
• Teclistamab: 33%

[British Journal of Haematology @BrJHaem]

LTB-TREAT: A validated international prognostic model for time to treatment in low tumour burden follicular lymphoma
https://t.co/XmytvWIdZz

[Mostafa Faisal @MostafaFaisal14]

Early Safety and Feasibility Results from a Phase II Trial of De-Escalated Ptcy and Ruxolitinib for Gvhd Prophylaxis in Older Patients Undergoing Reduced Intensity Conditioning Allogeneic HCT | Blood | American Society of Hematology https://t.co/P0rVIpU95G

[Benlazar S M A @smbenlazar]

B-cell precursor acute lymphoblastic leukaemia: Origins, classification, and therapeutic advances https://t.co/P9aS6B4Yuy #ALL #leusm

[Mostafa Faisal @MostafaFaisal14]

IFM 2026 Recommendations for First-Line Treatment of Newly Diagnosed Multiple Myeloma
https://t.co/9QugHY86fD

[Blood Journals Portfolio @BloodPortfolio]

High response rate (ORR 56%, CR 42%) and durable CR (1‑year DoCR 75.7%). Primary refractory/early relapsed disease, ECOG PS of &gt;1, and bulky disease of ≥7.5 cm predicted lower CR rates and shorter PFS. Read the article in Blood ICT: https://t.co/rXe2RVodmn

[Raul Cordoba, MD, PhD @DrRaulCordoba]

#Hematology Barriers to Patient Referral and Completion of #CARTCell Therapy for Relapsed/Refractory Large B-Cell #Lymphoma #lymsm https://t.co/31nrknsqos

[Dr. Chokri Ben Lamine @abouabdrahman0]

🩸🛡️ Preventing CRS & ICANS after CAR-T and bispecific antibodies: intervene before toxicity escalates!

1️⃣ BIOLOGY MATTERS
Greater CAR-T expansion is associated with more severe CRS/ICANS. With bispecifics, toxicity often clusters around initial step-up doses.

📌 Reducing CRS does not necessarily prevent ICANS—assess each separately.

2️⃣ BEFORE CAR-T
🔹 Refer early.
🔹 Optimize disease burden with appropriate bridging.
🔹 Consider product-specific toxicity alongside efficacy and eligibility.
🔹 Establish baseline neurological assessment and a monitoring plan.

🧠 The slide’s “4-1BB less toxic than CD28” is a broad observation; the complete product and patient context matter.

3️⃣ PROPHYLAXIS: PRODUCT-SPECIFIC EVIDENCE
💊 ZUMA-1 cohort 6 studied dexamethasone 10 mg orally daily on days 0–2, starting before axi-cel infusion, alongside earlier toxicity intervention.

✅ Severe CRS was uncommon, without an apparent loss of efficacy—but this was a nonrandomized cohort, not a universal CAR-T prophylaxis regimen. ZUMA-1 cohort 6

🧪 Other approaches under investigation:
• Prophylactic anakinra
• Fractionated CAR-T dosing in selected B-ALL protocols
• Concurrent BTK inhibition in selected settings
• JAK1 inhibition with itacitinib

These require protocol-specific interpretation. Anakinra phase II | Itacitinib phase II

4️⃣ BISPECIFIC ANTIBODIES
🔹 Follow approved step-up dosing and steroid premedication.
🔹 Obinutuzumab pretreatment is part of the glofitamab schedule.
🔹 Individualize inpatient/outpatient monitoring.
🔹 Prophylactic tocilizumab has emerging evidence, including in myeloma; applicability varies by agent and protocol. Tocilizumab prophylaxis study

5️⃣ WHEN TOXICITY DEVELOPS
🌡️ CRS: prompt tocilizumab ± corticosteroids according to grade, trajectory and product guidance.
🧠 ICANS: corticosteroids are central when treatment is indicated. Tocilizumab does not treat isolated ICANS; use it for concurrent CRS.

🚨 Persistent or worsening toxicity:
Reassess for infection, disease progression and alternative causes; escalate supportive care, corticosteroids and selected rescue therapy such as anakinra with the cellular-therapy/ICU team. Jain, Smith & Shah—Blood

#CART #BispecificAntibodies #CRS #ICANS #SOHO26 #ASH26

[Mehak Trehan @mehak_trehan]

Aza-Ven vs Induction: What Changes in Our Clinical Practice?
Beautiful paper!

1. Fit ≠ automatic 7+3.
In selected non-favourable-risk, FLT3-wild-type AML, Aza-Ven is now a reasonable frontline option.

2. Get molecular data early.
CBF AML, FLT3-mutated AML and younger NPM1-mutated AML were excluded SO this is not a blanket replacement for induction.

3. Think transplant from Day 1.
HCT rates were 60% with Aza-Ven vs 40% with induction.

4. Huge relevance for Indian resource constraints.
First 30-day inpatient stay: 12.5 vs 27.3 days; ICU use: 0% vs 10%.

5. Low intensity ≠ low toxicity.
Cytopenias remain significant, but grade ≥3 infections and bleeding were lower with Aza-Ven.

[Mostafa Faisal @MostafaFaisal14]

FL lines of therapy @SocietyofHemOnc @SOHO26

[Rahul Banerjee, MD, FACP @RahulBanerjeeMD]

Nicest graphic I've seen on this! Excellent @JCO_ASCO review of IMiDs ➡️ CELMoDs in myeloma over time.

Easy to think of CELMoDs and TCEs as foes in this space, e.g. Iber-Dd vs tec-dara.

But in reality, most CELMoD use will likely be as maintenance after/with TCEs (or ASCT)!

[Mike Thompson, MD, PhD, FASCO @mtmdphd]

PIVOT-CLL - Pirobrutinib, Venetoclax, Obinotuzumab Treatment in First Line CLL [Sep 10, 2026] @NitinJainMD #SOHO2026 #CLLsm #leusm #caxtx PFS &amp; OS

[Benlazar S M A @smbenlazar]

APL in Niemann-Pick Disease | ASH Image Bank | American Society of Hematology https://t.co/qH5YU9zZTI #ASHImageBank

[Henry C Fung| MM, lymphoma, leukemia & CART @HenrychihangFu1]

We bank stem cells for the future. Why not bank T cells before we ruin them? 🧬🧊

New Blood data suggest CAR-T fitness may already be imprinted before manufacturing, with fitter CD4 T-cell states linked to more durable ide-cel outcomes.

Moffitt adds a fascinating proof-of-concept: earlier cryopreserved T cells from stem-cell collection could still generate fitter experimental BCMA CAR-T years later than later-collected cells from the same patients.

Then reality interrupts 😂: if early T cells are better, why not just give CAR-T earlier?

Bank early? Manufacture early? Treat early?

Maybe the next frontier is not only how we engineer T cells, but when we capture them.

#CART #MultipleMyeloma #Hemetwitter