Maria A Torres Viera

[Dr. Chokri Ben Lamine @abouabdrahman0]

🧵 EBMT 2026 Recommendations: Auto & Allo-HSCT in Adult Hodgkin Lymphoma

1️⃣ Who should undergo Auto-HSCT? 🩸
🔹 Standard of care for chemosensitive relapsed/refractory (R/R) Hodgkin lymphoma
🔹 Aim for PET metabolic complete response (mCR) before transplant
🔹 Selected early-stage relapses may avoid transplant with modern systemic therapy ± RT

2️⃣ Best salvage before Auto-HSCT 💉
✅ Incorporate Brentuximab vedotin (BV) and/or PD-1 inhibitors:
• Brentuximab vedotin
• Nivolumab
• Pembrolizumab
Choice depends on:
📌 Prior therapy
📌 Disease bulk
📌 Time to relapse

#HemeTwitter #EBMT

3️⃣ PET matters! 🔬
🎯 Achieving mCR before Auto-HSCT offers the best outcomes.
⚠️ If only low-volume PR remains after BV/PD-1-based salvage, Auto-HSCT is still reasonable.
🧠 Interpret PET cautiously after PD-1 therapy because inflammatory uptake may mimic disease.

4️⃣ Conditioning & Radiotherapy ☢️
🧪 BEAM remains the preferred conditioning.
Alternatives:
➡️ LEAM
➡️ Thiotepa-based regimens (during BCNU shortages)

🎯 RT may benefit persistent PET-positive disease before or after transplant.

5️⃣ Consolidation after Auto-HSCT 📈
High-risk patients should receive:
✅ Brentuximab vedotin consolidation (up to 16 total cycles, including pre-transplant exposure)

💡 Off-label:
• Pembrolizumab
• Nivolumab
• BV + PD-1 combinations
may be considered in selected patients.

6️⃣ When is Allo-HSCT indicated? 🧬
✅ Standard curative option after Auto-HSCT relapse in eligible patients.
⚠️ Patients achieving durable CR with PD-1 inhibitors may defer transplant individually.

Before Allo-HSCT:
⏳ Prefer ≥6 weeks from last PD-1 inhibitor dose.

7️⃣ Preferred Allo-HSCT approach 🏥
👨‍👩‍👧 Donor preference:
1️⃣ Matched sibling
2️⃣ Matched unrelated
3️⃣ Haploidentical / mismatched unrelated

🧪 Reduced-intensity conditioning preferred.
🛡️ Post-transplant cyclophosphamide (PTCy) is the preferred GVHD prophylaxis.

8️⃣ Relapse after Allo-HSCT 🔄
Management is individualized:
⬇️ Taper immunosuppression
🧬 Donor lymphocyte infusion (DLI)
💉 Brentuximab vedotin
🛡️ PD-1 inhibitors (carefully due to GVHD risk)
☢️ Radiotherapy
🧪 Clinical trials & emerging cellular therapies

9️⃣ Key Take-Home Pearls 💎
✅ Auto-HSCT remains standard for chemosensitive relapse.
✅ BV/PD-1 agents have transformed salvage therapy.
✅ PET-guided decision-making is central.
✅ PTCy has become the preferred GVHD prophylaxis in Allo-HSCT.
✅ Biomarker-guided and transplant-free strategies remain active research areas.

📚 Reference: EBMT Practice Harmonisation & Guidelines Committee. Autologous and allogeneic haematopoietic cell transplantation in adult patients with Hodgkin lymphoma. Lancet Haematology. 2026;13:e484–e493. Autologous and allogeneic haematopoietic cell transplantation.pdf

Credits
📝 Bazarbachi A, Advani R, Ahmed S, Carlo-Stella C, Castagna L, Eichenauer DA, El-Cheikh J, Hamadani M, Martinez C, Nicholson E, Peggs KS, Perales MA, Schmitz N, Specht L, Tanase AD, Onida F, Ruggeri A, Rossi C, Aljurf M, André M, Sánchez-Ortega I, Yakoub-Agha I, Sureda A.
EBMT Practice Harmonisation and Guidelines Committee & Lymphoma Working Party.

#HodgkinLymphoma #HSCT #BMT #CellTherapy #EBMT #HemeTwitter #Oncology #MedEd

[Maria A Torres Viera @matorresviera]

Las enfermedades infecciosas no esperan: no es momento de ceder terreno https://t.co/Apo8d2jT8W

[Maria A Torres Viera @matorresviera]

https://t.co/AiJPaunBiV en horror por las recientes decisiones tomads por la Administracion de Trump e inmunizaciones para covid Aquí les dejo una reflexion En contagium por dr. carlos Gabriel Torres Viera. Infectologo en USA.

[Maria A Torres Viera @matorresviera]

@AlcaldiaBaruta Hasta cuando esos huecos en el asfalto de la principal del cafetal???

[Maria A Torres Viera @matorresviera]

@eliasayegh @ElHatillo Y los huecos redoma hatillo hasta cuando please??

[American College of Cardiology @ACCinTouch]

Patients with active or past cancer presenting with acute #chestpain are at a higher risk of NSTEMI, prolonged hospitalization, and all-cause mortality, with lower efficacy of the ESC 0/1-hour rule-out algorithm. Get the study details: https://t.co/TpUuZhdu5X #ESCCongress

[Maria A Torres Viera @matorresviera]

@IbethTens @josesilvaf Mejor bloquear esa anti "especie" humana, esa que uno no quiere tener cerca amigo, olor fétido que necesitas alejar

[Sociedad Venezolana de Cardiología @CardiologiaSVC]

En este 2022 nos volveremos a encontrar en una nueva edición del Curso Cardiovascular de Caracas, que reunirá a los mejores especialistas en cardiología de Venezuela y el mundo, desde el 25 al 28 de abril. 🩺👨🏽‍⚕️

❤️ Regístrese en este link: https://t.co/WEFNDb3o2G

[Prof. Feynman @ProfFeynman]

Don't just teach your children how to be successful, teach them how to respond when they are not successful, teach them how to handle failures and learn from their mistakes. 🧠

[Maria A Torres Viera @matorresviera]

@josesilvaf La neutrofilia sugiere mayor fenómeno inflamatorio, del tipo inmunotrombosis, donde el neutrofico se activa en un programa alto reclutamiento y "netosis" (neutrophils traps)

[José Silva Figueroa @josesilvaf]

La primera vacuna que se usó fue la de la viruela y decían que los que se la ponían se volvían vacas
A mi me la pusieron a los 11 años y aún no me salen los cachos ni el rabo

[Ran Balicer @RanBalicer]

Israel - updated status:

💉 (graph)

🤧
* ZERO! (0) Covid deaths yesterday
First such day in >1yr!
* ~10 infections /M/d (100-fold drop)
* Hospital Covid wards closing

😷
Masks off in open areas
Schools fully open
Green passes (in high-risk indoor setting)

Vaccines work!

1/2

[Comtok @comtokapp]

Nos estrenamos en 2021 usando nuestra nueva plataforma de videollamadas. Zoom, bye 👋🏽!!!
Con esto las teleconsultas son más cool. Con múltiples participantes y con la posibilidad de compartir pantalla 🥳💛

[The Lancet @TheLancet]

NEW—New guidance on the effects of #longcovid was published today. However, those with lived experience are concerned the guidance is lacking and risks the mismanagement and missed pathology of long covid and its many symptoms. @RobinGorna et al. Comment: https://t.co/vG3rBhhhhy

[Comtok @comtokapp]

Comtok es una plataforma de comunicación y colaboración para equipos de profesionales de la salud, conveniente y confidencial.

🤳Conecta con tus pacientes.
💳Cobra por tus consultas.
🗃️Conduce tu consultorio.
🧑‍⚕️Cohesiona tu equipo de trabajo.
🏥Colabora con tus colegas.

[Laureano Marquez @laureanomar]

La mala conciencia que tiene esta gente es tan atroz, que ellos mismos estan convencidos de que reunirse con ellos desacredita a la gente decente. Digno de un estudio psiquiátrico.

[Mati Aristeguieta @MatiAriste]

Tibisay es tan arrecha que es capaz de certificar firmas de personas de cualquier nacionalidad en segundos. (Siempre que sean a favor de...)

[Maria A Torres Viera @matorresviera]

LA SOCIEDAD ESQUIZOFRENIFORME http://t.co/AtX4rVwyP3 vía @Psicovivir

[Runrunes @RunRunesWeb]

Los trabajadores de Guayana le hicieron el vacío por tanta ruina y atropellos - http://t.co/IbKHCv0eCy por @damianprat

[Leopoldo López @leopoldolopez]

Terminó de declarar la perito que analizó los discursos de Leopoldo. Perito: "Nunca hubo llamado a la violencia por parte de Leopoldo López"