Christian Gallardo

SRP in Haematology TTSH

[Christian Gallardo @crbfish20002003]

https://t.co/R4TNdABeEV

[Samer Al Hadidi, MD,MS,FACP @HadidiSamer]

#mmsm #IMWG26

One important discussion point brought by @VincentRK was to be careful about the assumption that PERSEUS study PFS will be 17 yrs

While outcomes are great with quad based therapies in transplant eligible patients, such modeling need to be taken with grain of salt

Here is why
🧵

[Benlazar S M A @smbenlazar]

Defining lines of therapy in haematological malignancies : a proposed systematic framework from the EBMT Practice Harmonisation Committee
>Disease-specific examples for lymphomas.
a-DLBCL , b- DLBCL CAR-T as second LoT. c and d-Hodgkin Lymphoma https://t.co/jGFMTCLjB7 #lymsm

[Adam C Palmer @ac_palmer]

Striking difference in cell-of-origin effect between
POLARIX trial (PolaRCHP vs RCHOP) and
frontMIND trial (tafa-len-RCHOP vs RCHOP)

In POLARIX, zero benefit to GCB pts, and significant heterogeneity by COO

frontMIND does not show statistically significant heterogeneity

[Benlazar S M A @smbenlazar]

Chronic Lymphocytic Leukemia Through the Spectrum: Frontline Therapy, Sequencing With Subsequent Therapy, and Treatment of Double-Refractory Patients https://t.co/A0g4NmyO3h #ASCO26 #CLL #leusm

[Nathan Punwani @npunwani]

Why I try my best to avoid gilteritinib as a post-transplant maintenance drug in FLT3 ITD AML

Post-transplant gilteritinib increases GVHD after allo transplant. Normal wild-type FLT3 is expressed on dendritic immune cells. Gilteritinib inhibits those immune cells, and in turn knocks down T regulatory cells, exacerbating GVHD risks.

I only use gilteritinib if FLT3 ITD patients are MRD+ in the peri-transplant period. The MORPHO study showed that only this subgroup benefitted from the drug

Schematic courtesy of the Pharaoh of FLT3 himself, Dr. Mark Levis https://t.co/O0jBP8izP5

[Benlazar S M A @smbenlazar]

ROXADUSTAT IMPROVES TRANSFUSION INDEPENDENCE IN LR-MDS PATIENTS WITH ANEMIA AND HIGH TRANSFUSION BURDEN AND IN RING SIDEROBLAST POSITIVE AND NEGATIVE DISEASE: POST-HOC ANALYSIS OF MATTERHORN STUDY.. by Amer M. Zeidan ,EHA Library;
https://t.co/sNws0nAdZo #EHA26 #MDS

[Benlazar S M A @smbenlazar]

FIXED-DURATION PIRTOBRUTINIB PLUS VENETOCLAX–RITUXIMAB VERSUS VENETOCLAX–RITUXIMAB FOR PATIENTS WITH PREVIOUSLY TREATED CLL/SLL https://t.co/qgdJLRmtmL #EHA26 #CLL #leusm

[Talha Badar @TalhaBadarMD]

#ASCO26 #leusm #mdssm

First-in-human Phase 1 study of eganelisib (PI3Kγ inhibitor) in heavily pretreated R/R AML and high-risk MDS (n=21) demonstrated a manageable safety profile and encouraging preliminary activity.

Key findings:
• No MTD reached; 60 mg daily selected for expansion
• Responses observed despite refractory disease
• Patients with high PI3Kγ expression showed markedly improved outcomes
• Median OS: 27 vs 9.9 weeks for PI3Kγ-high vs PI3Kγ-low (HR 0.22)
• Biomarker-driven targeting of the leukemia microenvironment may identify patients most likely to benefit

Early signal, small cohort, and non-randomized design, but these data support further development of PI3Kγ inhibition and prospective validation of PI3Kγ as a predictive biomarker in AML/MDS.

[Blood Research @Blood_Res]

Highly cited research article in Blood Research: "Relative efficacy of systemic treatments for patients with relapsed/refractory chronic lymphocytic leukemia: a network meta-analysis ..." by Jinchul Kim et al.
Open access at: 🔗https://t.co/vN6elhFjoj
#BloodResearch #hematology

[Talha Badar @TalhaBadarMD]

#ASCO26: First-in-human dual-nanobody anti-CD5 CAR-T (SL105) demonstrated encouraging activity in heavily pretreated R/R T-cell malignancies (median 4 prior lines).

🔹 ORR 81.8%, CR/CMR 54.5% (n=22)
🔹 DL3 achieved ORR 100% and CR/CMR 63.6%
🔹 Extramedullary MRD clearance in all responders
🔹 CD5-negative escape observed in some patients

However, durability remains a challenge:
🔹 12-mo DFS 29.5%
🔹 12-mo OS 33.2%
🔹 NRM 38.6%, largely infection-related deaths

Promising proof-of-concept for CD5-targeted CAR-T in R/R T-ALL/T-NHL, but strategies to reduce infectious toxicity, improve persistence, and overcome antigen escape will be critical. #TALL

[Talha Badar @TalhaBadarMD]

#ASCO26 Poster: TP53-IDH co-mutated AML

In a large real-world cohort (n=753), co-mutation with IDH1/2 was associated with significantly improved overall survival in patients with TP53-mutated AML.

🔹 TP53+/IDH+ (n=94) vs TP53+/IDHwt (n=659)
🔹 Median OS: 9.8 vs 6.1 months
🔹 HR 0.69 (95% CI 0.52–0.92), p=0.01
🔹 Benefit remained significant after accounting for IDH inhibitor therapy and allo-HCT as time-varying covariates

Interestingly, first-line IDH inhibitor therapy or HMA/venetoclax did not independently improve EFS or OS within the IDH+ subgroup.

The TP53+/IDH+ cohort demonstrated distinct biology, with fewer MDS-related cytogenetic abnormalities and greater enrichment of epigenetic regulator mutations (TET2, ASXL1, DNMT3A).

These findings suggest that IDH co-mutation may define a biologically distinct subset of TP53-mutated AML with a comparatively favorable prognosis, warranting further molecular and prospective investigation.

#AML #Leusm #TP53 #IDH1 #IDH2 #ASCO26

[Talha Badar @TalhaBadarMD]

#ASCO26 #ALL #PhALL #leusm

Poster: Real-world ASCERTAIN study evaluating asciminib in heavily pretreated adults with relapsed/refractory or TKI-intolerant Ph+ ALL.

🔹 37 patients across multiple countries
🔹 Median 3 prior therapy lines; 95% previously exposed to ponatinib
🔹 T315I mutation present in 35%
🔹 CR/CRi achieved in 62% overall
🔹 Responses observed regardless of T315I status
🔹 Median OS 7.6 months; median RFS 7.4 months
🔹 Safety profile consistent with prior asciminib experience

While limited by its retrospective design and small sample size, these data suggest asciminib may offer a meaningful treatment option for selected patients with heavily pretreated Ph+ ALL, including those with T315I mutations and prior exposure to multiple TKIs.

[Talha Badar @TalhaBadarMD]

#ASCO26 #AML #leusm

Does venetoclax duration matter in frontline HMA+Ven for AML?

Poster: In a @MayoCancerCare analysis of 540 newly diagnosed AML patients, outcomes were driven primarily by disease biology, not venetoclax duration. Led by Dr. Naseema Gangat 👏👏👏

🔹 Similar OS across 7-, 14-, 21-, and 28-day schedules
🔹 Comparable outcomes within ELN 2024 and Mayo genetic risk groups
🔹 Higher early mortality with shorter durations likely reflected selection of frailer patients
🔹 In ELN high-risk AML, 14-day venetoclax was associated with inferior survival compared with 21- and 28-day schedules

Take-home: Venetoclax duration should be individualized based on genetics, response, cytopenias, and patient fitness rather than a one-size-fits-all approach.

[Talha Badar @TalhaBadarMD]

#ASCO26 #leusm #AML

Triplet therapy with azacitidine + venetoclax + ivosidenib in newly diagnosed, unfit IDH1-mutated AML.

🔹 ORR 95%, CRc 93% (CR 60%)
🔹 Flow MRD negativity in 91% of evaluable responders
🔹 3-year OS 79%
🔹 3-year remission duration 83%
🔹 3-year cumulative incidence of relapse only 9%

Notably, only 3 patients relapsed, all with emergence of IDH1-negative clones, highlighting deep suppression of the target clone but potential evolution of alternative leukemic populations.

[AML Hub @AML_Hub]

New publication 📝 A real-world #AML validation study, published in @BloodPortfolio, shows that compared with ELN 2024 (c-index, 0.601), ELN 2022 (c-index, 0.640; p = 0.024) and Beat AML 2024 (c-index, 0.635; p = 0.010) had greater overall prognostic performance for median OS.

Learn more about risk in AML: https://t.co/Y1JhUPbAhj

#AMLsm #leusm #MedNews #MedEd

[Muzaffar Qazilbash @Transplant_Doc]

Administration of IV iron therapy during acute infections was associated with improved 14- and 90-day survival #hematology @BloodPortfolio @CAMCHemOncIAM https://t.co/X7ad8vDvyl

[Amer Hayat @Aamer_Hayyat]

UK-AML Frontline Treatment Options

[Benlazar S M A @smbenlazar]

POLATUZUMAB VEDOTIN PLUS RITUXIMAB, IFOSFAMIDE, CARBOPLATIN, ETOPOSIDE (POLA-R-ICE) VS R-ICE AS SECOND LINE TREATMENT IN LARGE B CELL LYMPHOMA (LBCL) https://t.co/SRfVm8vWQN #EHA26 #lymsm

[Benlazar S M A @smbenlazar]

HIGH-DOSE METHOTREXATE DOES NOT REDUCE RISK OF CNS RELAPSE IN ULTRA HIGH-RISK LARGE B-CELL LYMPHOMA https://t.co/SoGvtevT48 #EHA26

[Ahmed Kotb @AhmedKo45911157]

Lower-risk MDS 📌

Anemia:
RS → luspatercept
del(5q) → lenalidomide
Others → ESA

Hypoplastic MDS → immunosuppression

Thrombocytopenia → TPO-RA

Refractory disease → HMA / consider transplant

https://t.co/c64Thejewq