@SultanNeazy من ناحية ثانية ارى انه من الافضل انك تخلص مديسن احسن من تروح دايركت على ( هيما او اندو ) لأنك تحتاج المديسن كثير وتكون نظرتك دايما شاملة افضل من كونها مقصورة في تخصص واحد. دائما المديسن وتخصصاته متداخلة بشكل كبير. عموما الله يوفقك ويكتب لك مافيه خير.
@3aa714@Fbabtain الموضوع المثار الآن هو حول الهجرة والعمل بشكل دائم هناك. بالنسب�� للدراسة كثير يطلعون ويدرسون فترة ويرجعون وهذا شي طبيعي والدولة تتكفل فيه. وهذا شي مخالف تماما عن الهجرة
📌 EBMT 2025 Indications for HCT & CAR-T (Practice Recommendations)
🔹 General Principles
•EBMT updates every 4–5 yrs; this is the 9th special report.
•Decisions must balance disease risk, HCT risk, NRM, non-HCT options, and patient QoL.
•Registry harmonization & JACIE standards emphasized.
•Rise in CAR-T & gene therapy reshaping transplant indications.
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🧬 Acute Myeloid Leukemia (AML)
•Allo-HCT in CR1 → indicated for adverse risk & most intermediate risk (per ELN/NCCN).
•Not indicated in favorable risk unless MRD+.
•Mutations mandating HCT: ASXL1, BCOR, EZH2, RUNX1, SRSF2, TP53, etc.
•RIC vs MAC: RIC ↓NRM, MAC ↓relapse (best in MRD+).
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🧪 Acute Lymphoblastic Leukemia (ALL)
•Ph+ ALL: HCT standard in CR1 (imatinib + chemo), but role evolving with 3rd gen TKIs + mAbs.
•Ph− ALL: HCT indicated if MRD >0.01% after 3 blocks or high-risk cytogenetics (e.g., KMT2A, low hypodiploidy).
•CAR-T: ZUMA-3, FELIX → >70% CR in R/R B-ALL; consolidation allo-HCT may be needed post CAR-T relapse.
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🧬 Chronic Myeloid Leukemia (CML)
•TKIs remain SOC; HCT only if failing ≥3rd gen TKI, T315I mutation, or intolerance.
•Indicated in advanced phase or progression.
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🧩 Myeloproliferative Neoplasms (MF focus)
•HCT = only curative option.
•Indicated if Int-2/high DIPSS or high MIPSS70/MYSEC-PM.
•Splenomegaly >5 cm → spleen-directed therapy (JAKi) pre-HCT.
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🧩 MDS & CMML
•MDS: HCT for IPSS-R high/very high or IPSS-M moderate-high/high/very high.
•Lower risk → delayed HCT unless progression or high-risk mutations.
•CMML: HCT in CPSS-Mol high, or Int-2 + extra risk factors (splenomegaly, hyperleukocytosis).
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🧬 CLL
•Novel agents (BTKi + BCL2i) changed landscape.
•HCT only for double-refractory patients (failed BTKi + venetoclax).
•Allo-HCT considered for Richter’s transformation (clonally related).
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🩸 Lymphomas
•LBCL: CAR-T (axi-cel/liso-cel) is 2nd line SOC for primary refractory/early relapse. Auto-HCT still option for late relapse.
•FL: Auto-HCT in POD24 or transformed FL; CAR-T (axi-cel, tisa-cel) approved from 3rd/4th line.
•MCL: Bruton’s TKIs first line; CAR-T after ≥2 lines (esp. BTKi failure).
•PTCL/CTCL: Allo-HCT curative in R/R; auto-HCT for CR1 in selected subtypes.
•HL: Auto-HCT SOC in R/R; allo-HCT after failed BV & CPI; CAR-T investigational.
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🧩 Multiple Myeloma (MM)
•Auto-HCT still SOC frontline in fit patients.
•Allo-HCT reserved for high-risk in trials.
•CAR-T (ide-cel, cilta-cel) → outstanding efficacy in R/R MM (PFS ~55% @27mo).
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🧬 Non-malignant & Solid Tumors
•SAA: MSD-allo-HCT is SOC ≤40 yo; MUD considered in young (<18).
•Hemoglobinopathies:
•Thalassemia: HCT if no severe organ damage.
•SCD: HCT if severe phenotype & no severe organ damage.
•Gene therapy emerging as alternative.
•Solid tumors: HCT rarely indicated; CAR-T under evaluation (gliomas, sarcomas).
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🎯 Exam Pearls for Fellows
•AML: Allo-HCT in CR1 adverse/intermediate (MRD+).
•ALL: MRD >0.01% = HCT indication.
•LBCL: CAR-T now 2nd line SOC (axi-cel/liso-cel).
•CLL: Only “double-refractory” = HCT.
•MDS/CMML: Use IPSS-M / CPSS-Mol for decision.
•SAA: Age >40 → outcomes decline sharply.
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🔗 Full reference: Greco R, Ruggeri A, et al. Indications for haematopoietic cell transplantation and CAR-T for haematological diseases, solid tumours and immune disorders: 2025 EBMT practice recommendations. Bone Marrow Transplant. 2025. DOI: 10.1038/s41409-025-02701-3
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Credits for sharing to Dr. Ahmed Alahmadi
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#HCT #CART #EBMT2025 #HemOnc #Transplant
@17111Star@alq3oud@TreeSaudi عندي رحلة من الرياض الى تكساس، تأخرت ٩ ساعات وتم اضافة محطتين توقف زيادة وفي العودة تأخرت الرحلة كذلك، ومع كل هذا ماجاني اي تعويض واستمريت في المطالبات اكثر من ٦ اشهر بدون فايدة، طبعا تأميني كان من عند احد البنوك المعروفة وللأسف كنت مأمن على اعلى فئة عندهم.
Honored to present my recent paper at the #SCTS meeting today! A great opportunity to share insights and connect with experts in the field. Exciting discussions—looking forward to what’s next! #CardiothoracicSurgery#Research#SCTS2025”