MD. Msc. Ricardo Fabián Mosquera C.

MD. Msc. x2, Hematologist, ex BMT SOLCA Quito ,ex professor of hematology at USFQ, expostgraduate professor at UTI, I currently work at the ICO in BCN

[Tour de France™ @LeTour]

🔄 RT if you think 🇪🇨@RichardCarapazM is the Super-combative of the #TDF2026!

🔄 RT si vous pensez que 🇪🇨 Richard Carapaz est le Super-combatif du #TDF2026 !

👋 @century21fr l @EFprocycling

[MisterChip (Alexis) @2010MisterChip]

Si España gana su segunda Copa del Mundo el próximo domingo sortearé MIL QUINIENTOS DÓLARES (1500$) entre todos los seguidores que hagan RT.

[MisterChip (Alexis) @2010MisterChip]

Si España se clasifica para la final de la Copa del Mundo sortearé MIL DÓLARES entre todos los seguidores que hagan RT.

[Papa Heme @Papa_Heme]

It’s about time we remove CNS ppx in DLBCL from the NCCN guidelines.

High-Dose Methotrexate as CNS Prophylaxis in Ultra High-Risk Large B-Cell Lymphoma: An International Multicenter Analysis | Journal of Clinical Oncology https://t.co/cWhKcpvIzh

[Toby Eyre @tobyeyre82]

Grateful to @DrJFriedberg for an hugely insightful editorial in @JCO #EHA2026

End of Methotrexate for CNS Prophylaxis in Diffuse Large B-Cell Lymphoma | Journal of Clinical Oncology https://t.co/Z2hMvGNC8b

[JoseLuisAA 🇪🇺 @aguayo_UM]

Perfectamente explicado para quien quiera entenderlo, si tiene 4 minutos de tiempo y le preocupa su #salud, la actual y sobre todo la del futuro.
#HuelgaMédica
⁦@sanidadgob⁩ ⁦@cesm_sindicatos⁩

[Oncobites.tv @OncobitesTv]

¡Ya disponible lo más destacado de ASH 2025!

Del 6 al 9 de diciembre, Orlando se convirtió en el centro mundial de la hematología, y nuestro equipo ya ha reunido las novedades que pueden transformar la práctica clínica.

¡Entra y descubre la cobertura completa!

[Mostafa Faisal @MostafaFaisal14]

Impact of Stem Cell Mobilization with Chemotherapy versus G-CSF Alone for Multiple Myeloma Patients with Suboptimal Response Before Autologous Stem Cell Transplant
https://t.co/byBmgLzDvT

[Ajay Major, MD, MBA @majorajay]

Discharge HD-MTX when level <0.30 #ASH25
- 117 pt encounters, 62% met early d/c criteria
- no persistent AKI or LFTs abnormalities
- more cytopenias w/ early d/c, but no admissions for cytopenias
- fewer admit days w/ early d/c
Can d/c w/ 3d leucovorin/Nabicarb. #lymsm #leusm

[Antelm Pujol, MD PhD @AntelmPujol]

📚 ESCRIBIR A MANO vs TECLADO: ¿QUÉ TE HACE APRENDER MÁS? ✍️⌨️

Un metaanálisis de 24 estudios en universitarios encontró que:
•✍️ Apuntar a mano mejora el rendimiento académico ~12%
•⌨️ Escribir en ordenador solo aumenta la cantidad escrita ~46%

🎯 Conclusión:
Escribir más no es aprender más.
A mano se recuerda más y se sacan mejores notas.

[Dr. Chokri Ben Lamine @abouabdrahman0]

🛡️ Anti-Infective Prophylaxis in CLL/SLL by Prof Ahmed Absi

🧬 BTK inhibitors (ibrutinib, acalabrutinib, zanubrutinib)
• 🚫 No antibacterial
• 🚫 No antifungal
• 🚫 No PJP
• 🚫 No HSV/VZV
• 🚫 No CMV

💊 Venetoclax
• 🚫 No antibacterial
• 🚫 No antifungal
• 🚫 No PJP
• 🚫 No HSV/VZV
• 🚫 No CMV

🧪 Anti-CD20 mAbs (rituximab, ofatumumab, obinutuzumab)
• 🚫 No antibacterial
• 🚫 No antifungal
• 🚫 No PJP
• 🚫 No HSV/VZV
• 🚫 No CMV

🔥 Duvelisib
• 🚫 No antibacterial
• 🚫 No antifungal
• ✅ PJP prophylaxis required
• 🚫 No HSV/VZV
• 🔎 CMV monitoring recommended

🧴 Alkylators (chlorambucil)
• 🚫 No antibacterial
• 🚫 No antifungal
• 🚫 No PJP
• 🚫 No HSV/VZV
• 🚫 No CMV

🧬 Bendamustine
• 🚫 No antibacterial
• 🚫 No antifungal
• 🚫 No PJP
• 🚫 No HSV/VZV
• 🚫 No CMV

💉 Fludarabine (purine analog monotherapy)
• 🚫 No antibacterial
• 🚫 No antifungal
• ⚠️ PJP (depends on lymphopenia)
• ✅ HSV/VZV prophylaxis
• 🚫 No CMV

🧬 Purine analog + anti-CD20
• 🚫 No antibacterial
• 🚫 No antifungal
• ⚠️ PJP sometimes
• 🚫 No HSV/VZV
• 🚫 No CMV

🟡 Chlorambucil + anti-CD20
• 🚫 No antibacterial
• 🚫 No antifungal
• 🚫 No PJP
• 🚫 No HSV/VZV
• 🚫 No CMV

🧪 Purine analog + cyclophosphamide
• 🚫 No antibacterial
• 🚫 No antifungal
• ⚠️ PJP sometimes
• 🚫 No HSV/VZV
• 🚫 No CMV

🧬 Purine analog + cyclophosphamide + anti-CD20 (FCR-like)
• 🚫 No antibacterial
• 🚫 No antifungal
• ✅ PJP prophylaxis required
• 🚫 No HSV/VZV
• 🚫 No CMV

🩸 Alemtuzumab
• 🚫 No antibacterial
• 🚫 No antifungal
• ✅ PJP prophylaxis
• ✅ HSV/VZV prophylaxis
• 🔎 Weekly CMV PCR monitoring

#CLL #SLL #HemeFellows #ASH #SOHO #KFSHRC

[Oncology Brothers @OncBrothers]

Daratumumab is now approved for high risk smoldering myeloma based off #AQUILA: PhIII, Dara vs Obs:

- 39 cycles/3yrs of dara
- mPFS 63.1% vs 40.8% at years
- OS at 5yrs 93% vs 86.9%
- 5.7% discontinued dara because of AEs

#MedTwitter #HemeTwitter #OncTwitter #mmsm

[Papa Heme @Papa_Heme]

Nice curves from ZUMA-5

Axi-cel may be considered a curative intent treatment in R/R indolent follicular/marginal zone lymphoma???

https://t.co/jVUowlFJdv

[Dr. Chokri Ben Lamine @abouabdrahman0]

🔥 Asciminib Safety Advantage vs Other TKIs (Week 96 Data – NEJM 2023)
Safety profile ✅ Better than Imatinib and 2nd-gen TKIs (Dasatinib/Nilotinib/Bosutinib)

📊 Grade ≥3 Adverse Events
•Asciminib: 44.5% ✅ lowest
•Imatinib: 49.5%
•2nd-gen TKIs: 59.8% ❌ highest toxicity

⛔ AEs Leading to Discontinuation
•Asciminib: 5.0% ✅ best tolerance
•Imatinib: 13.1%
•2nd-gen TKIs: 12.7%

⚙️ AEs Leading to Dose Interruption
•Asciminib: 33% ✅ lowest
•Imatinib: 41.4%
•2nd-gen TKIs: 57.8% ❌ worst

📉 54% lower risk of discontinuation due to AEs vs 2G TKIs
(HR 0.46; 95% CI 0.21–1.02)

✅ Clinical Pearl
Asciminib = safer, better tolerated, less treatment interruption → ideal for patients intolerant to prior TKIs.

⸻

✅ MCQ (Board Style)

Which of the following is TRUE regarding asciminib safety?

A) Has higher discontinuation rates than nilotinib
B) Causes more grade ≥3 AEs than bosutinib
C) Has fewer dose interruptions than 2G TKIs
D) More QTc prolongation than ponatinib

✅ Correct Answer: C

⸻

🩺 OSCE Scenario – Treatment Intolerance

Case:
A 55-year-old with CML-CP failed dasatinib due to recurrent pleural effusions and bosutinib due to diarrhea and liver enzyme elevation. He is anxious about toxicity from another TKI. What do you recommend?

Key Answer Points:
✅ Switch to asciminib – best safety profile after ≥2 TKIs
✅ Lower risk of discontinuation vs 2G TKIs
✅ Counsel on monitoring (CBC, lipase/amylase, LFTs)
✅ Emphasize adherence + molecular monitoring

⸻

#CML #Asciminib #STAMP #TKI #Safety #Hematology #ELN2024 #NCCN2025 #HemaFellows #BoardReview #SOHO25

[Dr Rishabh Jain @DrRishabhOnco]

🚨 POLARIX 5-Year Update: Does Pola-R-CHP sustain its edge over R-CHOP in frontline DLBCL?

👥 Population
• n=879 (global ITT)
• Untreated int/high-risk DLBCL
• Median FU: 64 mo

⚔️ Arms
🧪 Pola-R-CHP (n=440)
💊 R-CHOP (n=439)

📊 Efficacy
⏳ 5-yr PFS: 64.9% vs 59.1% | HR 0.77
📈 OS: 82.3% vs 79.5% | HR 0.85 (NS)
🔄 Fewer subsequent therapies with Pola-R-CHP
💀 Lymphoma-related deaths: 46 vs 62

📈 Subgroups
✅ Stronger benefit in IPI 3-5, ABC-DLBCL, double-expressors
⚠️ DHL/THL results discordant (investigator vs central)

💉 Safety
• Long-term tolerability similar
• No new late toxicities
• Fewer secondary malignancies (5 vs 12)

💡 Takeaway
Durable PFS gain without added long-term toxicity → Pola-R-CHP cements itself as frontline SoC in DLBCL.

📖 Morschhauser F, Salles G, Sehn LH, et al. J Clin Oncol. 2025.
🔗 👉 https://t.co/2u7U8ngeIh

#OncoTwitter #MedTwitter #Lymphoma #DLBCL
@OncoAlert @myesmo @ASCO @JCO_ASCO @esmo_open

[Toby Eyre @tobyeyre82]

Five-Year Outcomes of the POLARIX Study Comparing Pola-R-CHP and R-CHOP in Patients With Diffuse Large B-Cell Lymphoma | Journal of Clinical Oncology https://t.co/NZkv93u7IF

[Dilo con dibujos @dilocondibujos_]

Todo se puede

[MD. Msc. Ricardo Fabián Mosquera C. @drrfmc]

🤣🤣🤣

[Uriel Suárez @UsuarezMD]

Indications for haematopoietic cell transplantation and CAR-T for haematological diseases, solid tumours and immune disorders: 2025 EBMT practice recommendations | Bone Marrow Transplantation ⁦@AnnaSureda5⁩ ⁦@RaffaellaGrecoM⁩ https://t.co/LakAKMGupj

[Ahmed Kotb @AhmedKo45911157]

🩸 Maintenance in AML (Quazar AML-001)
📊 CC-486 vs placebo after chemo
🕑 Median FU: 41 mo
⏱️ OS gain: 24.7 vs 14.8 mo (+9.9)
⚖️ HR 0.69 (p=0.0009)
💡 Oral azacitidine extends survival, establishing maintenance as new AML standard
#AML #SOHO25