Guillaume Richard-Carpentier

Canadian Hematologist 🇨🇦👨🏼‍⚕️🩸Proudly Gay 🏳️‍🌈 Princess Margaret Cancer Centre / UofT. Interested in AML, ALL and MDS 🔬🧬💊

[Guillaume Richard-Carpentier @grichardmd]

@Dr_AmerZeidan I am purple 💜

[Guillaume Richard-Carpentier @grichardmd]

@nihardesai89 Referral to lymphoma group 😂

[Guillaume Richard-Carpentier @grichardmd]

@nihardesai89 @NEJM @DrAkhilX @AbbasiMuqtadir @ashwinrajenesh @DrPyaricetamoI @KirtanPatolia @HemOncFellows @MorphologyAmigo @VaqueraH_md @leftyindian @NicoGagelmann Could be CML, but I don’t see any eosino, baso and there seems to be a lot of immature forms with a hiatus in maturation. I would say AML with maturation (M2), if we push it maybe t(8;21).
Management: Count the blast percentage 😂 and Cytoreduction with Hydrea or Cytarabine

[Guillaume Richard-Carpentier @grichardmd]

@nihardesai7 @Haemophage @BldCancerDoc @IvanPasic Depends of the context. Single TP53 mut without adverse risk cyto, no HSCT. I would consider HSCT for double hit TP53 with CK (5+ abn) or low hypodiploidy which are usually associated, and more frequently MRD+

[Guillaume Richard-Carpentier @grichardmd]

@tomam04 @Hans_BMTProgram @pmcancercentre @UofT Congratulations!! 🥳 I’m excited for you to join the team and have you as a colleague! 👍🏼

[Guillaume Richard-Carpentier @grichardmd]

@nihardesai7 @ASH_hematology @Hans_BMTProgram @Haemophage @NicoGagelmann @HemOncFellows @VJHemOnc @IvanPasic @tomam04 @pmcancercentre @gvhd_hub @TheFellowOnCall @OncBrothers Congratulations Nihar!! That’s a lot! 🏆
Now good luck on preparing 5 posters and 1 presentation 😅

[Guillaume Richard-Carpentier @grichardmd]

Poll question of the day! 🤔💡🩸 How do you treat a fit 60 y.o. man with TP53-mutated MDS-IB2 with complex/monosomal karyotype, 15% BM blasts? Best induction to achieve CR and proceed to transplant. Feel free to also comment! #leusm #MDS #AML

[Guillaume Richard-Carpentier @grichardmd]

@RobertAvramMD Consult cardiology 😅

[Guillaume Richard-Carpentier @grichardmd]

@nihardesai7 Thank you for sharing! Great endeavour, but they unfortunately didn’t address indication bias. They don’t have a control cohort. So it doesn’t really convince me. But you cannot go against virtue and praise for CT scan to be done only when absolutely indicated! 😇👍🏼

[Guillaume Richard-Carpentier @grichardmd]

@TalhaBadarMD Interesting paper! Thank you!
But yikes! 25% 30-day mortality with HMA+Ven?! Including 4% TLS-related deaths? What happened? Were patients receiving infectious prophylaxis and appropriate TLS prophylactic measures? What happened?

[Guillaume Richard-Carpentier @grichardmd]

@tomam04 Haha! I feel you ;)
I’m sure you’ll do great! 👍🏼

[Guillaume Richard-Carpentier @grichardmd]

@FralickMike @stephglancylee @UofT_DoM @GIMtoronto Also PNH. Can present acutely with severe hemolysis or life-threatening thromboses.

Otherwise, anything hematological 🤓🩸🔬 Systemic mastocytosis, POEMS, Langerhans cell histiocytosis! All easily misdiagnosed 🎭 That’s why hematology is so interesting!

[Guillaume Richard-Carpentier @grichardmd]

@FralickMike @stephglancylee @UofT_DoM @GIMtoronto Suggest adding Acute promyelocytic leukemia! 🙏🏼 Starting ATRA ASAP saves lives. Literally. Or may prevent neurovegetative state from a severe non-fatal ICH… When in doubt give ATRA; no side effects if given until APL is ruled out.

[Guillaume Richard-Carpentier @grichardmd]

@nihardesai7 Don’t worry! No guilt for you this weekend 👍🏼We’ve got you covered! 😂 See you later on the ward! 👨🏼‍⚕️🤓😂

[Guillaume Richard-Carpentier @grichardmd]

@nihardesai7 @BrownJHM @NicoGagelmann @MorphologyAmigo @HaemBytes @wowuniqueorns @KrutiPatel2000 @AshutoshSinghMD @PeterItebimien 🔬🔥

[Guillaume Richard-Carpentier @grichardmd]

@nihardesai7 @zucenka @NicoGagelmann So cute paper, but I feel that it raises more questions than provide answers to the clinically relevant questions.

[Guillaume Richard-Carpentier @grichardmd]

@nihardesai7 @zucenka @NicoGagelmann MRD status pre-HSCT did not statistically impact OS (but we don’t see HR). If that’s true, that’s bad news for benefit of these Ven-based regimens to eradicate MRD. In general, did pts who achieved MRD- have better outcomes? I haven’t seen that analysis, but very important.

[Guillaume Richard-Carpentier @grichardmd]

@nihardesai7 😂😂 Truth 😂😂