rabiihouda,

clinical hematology, Rabat, Morocco.

[Aju Mathew @ajumathew_]

A very nice AI-based tool from #MASCC for supportive care information.

I guess the AI wave has swept over the #oncology landscape as well.

There were so many presentations on the use of AI in prevention, screening, diagnosis and treatment. Some hype, some truly promising.

[Vincent Rajkumar @VincentRK]

PERSEUS is the gold standard benchmark outcome for Newly Diagnosed Myeloma

6 year overall survival: 86%
6 year PFS 81%
with quad induction and Dara-Len maintenance.

As we test bispecifics, ADCs, CARTs etc, any new approach should be better. A new therapy CANNOT have even 5% all cause mortality in first 4 years.

There is no room for error with infection related mortality. No early drop off. No learning curve. As a field we have to establish preventive measures to prevent infection related deaths. #IMS26

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

#IMS26 #mmsm Oral- % of functional cure with the use of Tec-Dara @Myeloma_Society

Estimated functional cure of 87% with Tec-Dara showing excellent promise of such therapy.

➡️Future will need time limited therapy (Stop and see what will happen)

➡️Assess cumulative toxicity with longer use of this therapy (infections most imp)- Non relapse mortality will be imp

Future is bright in myeloma

[Raj Chakraborty @rajshekharucms]

Incredible 2-year PFS with Ramantamig in a ~95% CD38-refractory and 100% triple-class exposed population! These results are substantially superior compared to single-agent BCMA BsAbs and BCMA or GPRC5D CAR Ts in similar population. Based on these results, its plausible that we will see a near-flat PFS curve with Ram in Trilogy-5!
#IMS26
@AlGarfall @MileHighMyeloma

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

🧬 Daratumumab: beyond a myeloma antibody.

For two decades, Revlimid has been the backbone and immune amplifier of myeloma therapy.

But is the backbone changing? 👑

Dara does more than kill CD38+ myeloma cells. It remodels the immune ecosystem, depleting CD38+ Tregs, Bregs and MDSCs while expanding and diversifying T-cell populations.

Then partner the platform with an immune amplifier:
Lenalidomide → Iberdomide

Or with T-cell redirection:
Teclistamab → Talquetamab

MAIA → AURIGA → Iber-Dara → MajesTEC-3 → MonumenTAL-3

Different partners. Different mechanisms. One evolving strategy.

Revlimid may have ruled the myeloma kingdom for two decades. Is Dara ready for the crown? 👑

Perhaps Dara is no longer simply another drug in the combination.

It is becoming the immune platform upon which we build the next generation of myeloma therapy.

#MultipleMyeloma #MMSM #MedTwitter

[Uriel Suárez @UsuarezMD]

New Paradigms in the Management of Castleman Disease in: Journal of the National Comprehensive Cancer Network - Ahead of print https://t.co/dqUvDwkDKX

[Vincent Rajkumar @VincentRK]

My 2026 Update on Diagnosis, Risk Stratification, and Treatment of Myeloma is out! #OpenAccess

It’s current including all recent advances in immunotherapy. Managed to squeeze in iberdomide approval from 6 days ago! Bookmark!

https://t.co/VUheu7xlMr

[Dr. Chokri Ben Lamine @abouabdrahman0]

🩸 MULTIPLE MYELOMA 2026 UPDATE

🔎 Diagnosis
≥10% clonal plasma cells/plasmacytoma + ≥1 myeloma-defining event:
🔸 CRAB
🔸 BM plasma cells ≥60%
🔸 FLC ratio ≥100 with involved FLC ≥100 mg/L
🔸 >1 focal MRI lesion

⚠️ High-risk cytogenetics
🧬 del(17p)/TP53 mutation
🧬 Biallelic del(1p)
🧬 t(4;14), t(14;16) or t(14;20) + gain(1q)/del(1p)
🧬 gain(1q) + del(1p)

🚀 Newly diagnosed MM
✅ Preferred induction: Dara-VRd or Isa-VRd
✅ ASCT for eligible patients; selected standard-risk patients may collect stem cells and defer ASCT
✅ Frailty—not age alone—should guide treatment intensity

🛡️ Maintenance
🔹 Lenalidomide + daratumumab/isatuximab preferred
🔹 In standard-risk disease, consider limited-duration lenalidomide
🔹 High-risk: continue intensified maintenance; VR is an alternative

🔁 Relapsed MM
1️⃣ First relapse: cilta-cel or teclistamab–daratumumab when anti-CD38 sensitive; cilta-cel or a BCMA bispecific when anti-CD38 refractory
2️⃣ Later relapse: CAR-T, bispecific antibodies, belantamab mafodotin or an active triplet
🎯 Talquetamab for heavily pretreated disease
🎯 Venetoclax for t(11;14)

⏳ High-risk smoldering MM
💉 Consider daratumumab for 3 years; otherwise observation remains appropriate.

🧠 MCQ: Which is high-risk?
A) Isolated t(11;14)
B) gain(1q) + del(1p) ✅
C) Hyperdiploidy

🩺 OSCE pearl: Confirm SLiM-CRAB → obtain complete FISH → assess frailty/ASCT eligibility → individualize induction, maintenance and supportive care.

📚 Credit: Prof. S. Vincent Rajkumar, Mayo Clinic
American Journal of Hematology, 2026
🔗 DOI: 10.1002/ajh.70475⁠

#MultipleMyeloma #Hematology #Myeloma #CARTcell #BispecificAntibodies

[Oliverio @LuisOliverio]

Actualizaciones 2026 de Mieloma Múltiple (MM) de American Journal of Hematology. Cambian algunas cosas:

🔴 La terapia inicial ya no es triple. Sino cuádruple: Dara-VRd o Isa-VRd para todos, sean o no candidatos a trasplante.
🔴 El trasplante dejó de ser "el primer paso". Va después de 3–4 ciclos, y en riesgo estándar se puede diferir hasta la primera recaída.
🔴 Nueva definición de alto riesgo (IMS/IMWG): t(4;14) sola ya NO es alto riesgo. Necesita gain(1q) o del(1p) concomitante. Igual gain(1q) aislado.
🔴 El mantenimiento sí mejora la mortalidad. Estándar: lenalidomida + anti-CD38. 2 años en riesgo estándar, hasta progresión en alto riesgo.
🔴 Mieloma latente de alto riesgo: daratumumab 3 años (AQUILA Trial). Antes era solo observar.
🔴 Primera recaída: cilta-cel o Tec-Dara desplazan al triple clásico.
🔴 Ya no: trasplante en tándem, consolidación post-trasplante y alogénico.

Es un tema complejo pero muy interesante. Completo en (https://t.co/3O93s10lns).

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

Who should receive FLAG-IDA-VEN as induction for newly diagnosed AML?

The results are impressive: CRc ~95%, MRD negativity ~90%.

But perhaps we are asking the wrong question.

The question is not whether FLAG-IDA-VEN is active. It clearly is. The question is whether its deeper early response translates into enough durable benefit to justify substantially greater treatment intensity.

Once TP53-mutated AML is separated out, the differences among contemporary approaches may be considerably smaller than the early response rates suggest. Importantly, less-intensive VEN-based therapy can still successfully bridge a substantial proportion of patients to allo-HCT.

So what are we buying with FLAG-IDA-VEN?

More early MRD negativity? Probably.

But do we get more sustained MRD negativity?
More patients to allo-HCT?
Better EFS?
Better OS?

We don’t know.

What we do know is the price of greater intensity: more cytopenias, transfusions, infections, antibiotics/antifungals, hospitalization, supportive care and resource utilization.

NCCN lists FLAG-IDA-VEN as a Category 2B option for selected patients, not a preferred induction regimen.

And the future may increasingly be VEN + biology rather than VEN + more chemotherapy: FLT3 inhibitors, menin inhibitors, IDH inhibitors and other targeted approaches.

A randomized trial could define the true incremental benefit of FLAG-IDA-VEN.

It will probably never happen.

Until then, the added benefit appears marginal at best, while the added treatment burden is very real.

DEEPEST RESPONSE ≠ BEST OUTCOME.
SAME BRIDGE TO ALLO. DIFFERENT TREATMENT BURDEN.
WHERE IS THE ADDED VALUE?

🧬 In Biology We Trust.

#AML #Medtwitter

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

1/7 Lenalidomide maintenance: what have two decades of trials actually taught us?

The PFS benefit is remarkably consistent—but population, duration, exposure, biology, and trial design all matter.

A visual mini-series on what the evidence proves—and what it does not.

#MultipleMyeloma #MedTwitter

[Mostafa Faisal @MostafaFaisal14]

Eltrombopag Added to Standard Immunosuppressive Treatment as Front-Line Therapy for Severe Aplastic Anemia: Long-Term Outcomes of the Phase-3 Randomized Superiority EBMT-SAAWP RACE Study
https://t.co/jhwym4tBjC

[Vincent Rajkumar @VincentRK]

https://t.co/URmEGy3xvU

One-stop free-to-use website to risk stratify myeloma, MGUS, smoldering myeloma, Waldenstroms Macroglobulinemia, Amyloidosis.

Also links to iStopMM calculator to determine when a bone marrow is needed in MGUS.

Will be regularly updated. More calculators and links to key articles will be added soon!

[Haematologica @Haematologica]

Landmark Paper in Hematology: results of the seminal trial published by Bacigalupo et al. in 1991 highlighted the power of immune-mediated leukemia control after allogeneic transplantation.
Read more in Haematologica
https://t.co/8knZFfLmjI

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

https://t.co/PFgNbH0cnt

[Talha Badar @TalhaBadarMD]

MAXILUS trial (#EHA26, S173 | Della Porta et al.): luspatercept at the max-approved 1.75 mg/kg SC Q3W from cycle 1 in transfusion-dependent LR-MDS.

Phase 3b, open-label, non-randomized, 2-cohort (ESA-naïve & ESA-R/R/I) — both arms get luspatercept, no active comparator.

Signal (ESA-naïve, n=54):
• 81.5% met primary endpoint (RBC-TI ≥8wk + concurrent Hb ↑≥1 g/dL, Wks 1–24)
• RBC-TI ≥8wk 83.3%, ≥12wk 75.9%; median peak Hb 11.3 (Δ +3.2 from baseline 8.1)
• Held up in RS− (73.9%) & sEPO ≤200 (86%); DOR not reached
• ESA-R/R/I more modest but real: 61.5% primary endpoint, median ≥12wk TI DOR 59.6wk

caveats:
• Non-randomized, no comparator → can’t be benchmarked head-to-head. COMMANDS-comparable endpoint here (RBC-TI ≥12wk + Hb ↑≥1.5) is 72.2%, numerically above the COMMANDS luspatercept arm — but cross-trial + enriched population, NOT a fair comparison.
• Max dose front-loaded (vs standard 1.0→1.75 titration); design can’t isolate how much benefit is the ceiling dose vs the population.
• Selected for response (sEPO ≤200, Hb ≤10).
• Safety isn’t free: Gr3/4 TEAE 68.5%; EOIs incl fractures 13%, HTN, kidney toxicity, malignancies. 4 Gr5 TEAEs (7.7%) in ESA-R/R/I. Early HR-MDS progression ~4%.
• Median f/u ~11 mo → OS, QoL, durability, late toxicity all pending.

[Vincent Rajkumar @VincentRK]

Based on the latest data at #ASCO26 awe can consider bispecifics especially teclistamab (has the most data) alone or in combination with daratumumab in first relapse of myeloma.

Here is our latest https://t.co/x9KJzoJyXJ approach to first relapse.

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

#ASCO26 #mmsm
High-Risk Multiple Myeloma: Redefining Risk and Rethinking Therapy
@DrGarethMorgan1

Summary of Phase 3 Randomized Trials in Early Line Relapse, Outcomes in Selected Populations

[UT MD Anderson @UTMDAnderson]

The triplet combination of quizartinib, decitabine and venetoclax improved overall survival in older patients with newly diagnosed FLT3-ITD AML, Dr. Musa Yilmaz shared at #ASCO26. Learn more: https://t.co/pxHZDcxXXx @MusaYilmazMD #EndCancer

[NEJM @NEJM]

In the GALE CRUSTED trial, higher-dose ivermectin plus permethrin was no better than standard-dose ivermectin plus permethrin, but both regimens were effective, leading to cure in 75% and 82% of the patients, respectively. Full trial results: https://t.co/tCKUAG1RWU