Are you a hematologist or a generalist provider seeking clarity on how to best counsel patients with sickle cell disease (SCD) who are interested in gene therapy? Join us for a podcast session focused on important patient considerations for gene therapy, tailored for SCD providers and clinicians. This session aims to provide practical insights to facilitate clear communication between providers, patients with SCD, and their families about treatment options.

Learning Objectives

1. Understand the Basics of Gene Therapy Treatments & SCD: By the end of the podcast, listeners will be able to identify some basic tenants of transformative treatments for sickle cell disease (SCD), focusing on how gene therapy treatments compare to other disease modifying treatments.
2. Counseling Patients and Families: Listeners will be given suggestions on what key information to provide to patients and families that are interested in gene therapies, especially considering the build-up to gene therapy and also potential long-term effects.
3. Enhance Communication Skills: This episode will suggest effective communication strategies to provide patients with both perspective and empathy while discussing gene therapy and other treatment options.

Speakers: Alexis Thompson, MD, and Sujit Sheth, MD

Description:

For general hematologists with a foundational understanding of thalassemia, this episode discusses the changing demographics due to immigration and refugee resettlement. It covers the diagnosis process from newborn screening to older individuals, emphasizing genetic testing due to numerous mutations and varied phenotypes. The importance of correctly diagnosing older individuals previously misdiagnosed with iron deficiency refractory to treatment is highlighted. The episode also addresses regular transfusions, iron chelation, and monitoring for complications, along with advances in blood supply safety, reduced alloimmunization risks through extended typing, and MRI monitoring. Finally, novel agents in practice and development, including luspatercept, PK activators, and gene therapy, will be explored.
 

Learning Objectives:

1. Understand the changing landscape of thalassemia in the US. 
2. Revisit the state-of-the-art diagnostic and treatment approaches. 
3. Learn about novel therapeutics in the thalassemia field.

Dr. Sanjay Juneja (@TheRealOncDoc) and Dr. David Russler-Germain (@dgermain21) discuss the importance of genomic testing and how to understand and interpret test results when treating patients with lymphoma. They also discuss the importance of selecting appropriate therapeutic agents to manage hematologic malignancies. This project is a collaboration between the American Society of Hematology and the Leukemia & Lymphoma Society.
 Access and complete the GENOM modules (for which you can claim CME and MOC credit) via ASH Academy On Demand!
Music: "Happy Medium" performed by Zac Nelson, used under license from Shutterstock.  

Dr. Sanjay Juneja (@TheRealOncDoc) and Dr. Jacqueline Barrientos discuss the importance of genomic testing and how to understand and interpret test results when treating patients with chronic lymphocytic leukemia (CLL). They also discuss the importance of selecting appropriate therapeutic agents to manage hematologic malignancies. This project is a collaboration between the American Society of Hematology and the Leukemia & Lymphoma Society.
 Access and complete the GENOM modules (for which you can claim CME and MOC credit) via ASH Academy On Demand!
Music: "Happy Medium" performed by Zac Nelson, used under license from Shutterstock.

HemeTalks: Conversations in Hematology Education is a brand-new podcast from the American Society of Hematology (ASH)! Listen to educational content from ASH developed by subject-matter experts to meet your professional education needs. Whether you’re a clinician or researcher, ASH has innovative education for every career stage and subspecialty.   

Season 1, Genomics Essentials in Hematologic Malignancies: Perspectives, will launch next week! Six, 15-minute episodes featuring faculty from academic and community oncology settings will shed light on the importance of genomics to the diagnosis, risk stratification, and prognosis, as well as disease monitoring and therapeutic decision-making in hematologic malignancies.

Bookmark the ASH Podcast webpage and subscribe to HemeTalks today via Apple Podcasts, Spotify, Google Podcasts, or wherever you listen to podcasts, to be notified when Season 1 is live!

Music: "PeriTune - Investigation2(Suspense-Royalty Free Music)" by PeriTune is licensed under CC BY 3.0.

Dr. Azam Farooqui (@azamfarooqui ) and Dr. Monique Hartley-Brown (@DrMHB1) discuss therapeutic considerations regarding current and emerging agents for patients with multiple myeloma from underrepresented racial and ethnic groups.

Coming Soon!

Prepare to enhance your knowledge through the IMPACT II online learning module on ASH Academy On Demand! Participants will develop an increased ability to identify variations in factors influencing mortality and survival outcomes among individuals from racial and ethnic minority groups with multiple myeloma.

Music: “Happy Medium” Zac Nelson (shutterstock.com). Licensed under Shutterstock: Standard License.

Dr. Azam Farooqui (@azamfarooqui )and Dr. Sikander Ailawadhi answer the question: Why do we need earlier diagnosis and intervention in patients with multiple myeloma from underrepresented racial and ethnic groups?

Coming Soon!

Prepare to enhance your knowledge through the IMPACT II online learning module on ASH Academy On Demand! Participants will develop an increased ability to identify variations in factors influencing mortality and survival outcomes among individuals from racial and ethnic minority groups with multiple myeloma.

Music: “Happy Medium” Zac Nelson (shutterstock.com). Licensed under Shutterstock: Standard License.

Dr. Azam Farooqui (@azamfarooqui) and Dr. Urvi Shah (@UrviShahMD) identify factors that impact outcomes for patients with multiple myeloma from underrepresented racial and ethnic groups.

Coming Soon!

Prepare to enhance your knowledge through the IMPACT II online learning module on ASH Academy On Demand! Participants will develop an increased ability to identify variations in factors influencing mortality and survival outcomes among individuals from racial and ethnic minority groups with multiple myeloma.

Music: “Happy Medium” Zac Nelson (shutterstock.com). Licensed under Shutterstock: Standard License.

Season 2: IMPACT II: Impacting Multiple Myeloma in All CommuniTies

Unlock insights into the treatment of multiple myeloma within underrepresented racial and ethnic populations with this series of three enlightening podcast episodes. Join experts from both academic and community oncology settings as they dive into critical aspects of clinical risk, survival outcomes, and treatment considerations.

Episode 1: Uncover the factors influencing outcomes for multiple myeloma patients from underrepresented racial and ethnic groups with Dr. Shah.

Episode 2: Join Dr. Ailawadhi in exploring a hypothetical scenario of equal conditions and envision how mortality and survival outcomes may differ for multiple myeloma patients from underrepresented groups. 

Episode 3: Gain valuable insights from Dr. Hartley-Brown as she discusses therapeutic considerations for both current and emerging agents tailored to multiple myeloma patients from underrepresented racial and ethnic backgrounds.

Are you ready to expand your understanding of multiple myeloma treatment disparities? Listen to Season 2 of HemeTalks on Apple Podcasts, Spotify, Google Podcasts, or your preferred podcast platform! Don't forget to bookmark the ASH Podcast webpage for easy access.

Coming Soon ASH Academy On Demand!

Prepare to enhance your knowledge through the IMPACT II online learning module on ASH Academy On Demand! Participants will develop an increased ability to identify variations in factors influencing mortality and survival outcomes among individuals from racial and ethnic minority groups with multiple myeloma.

Music: "PeriTune - Investigation2(Suspense-Royalty Free Music)" by PeriTune is licensed under CC BY 3.0.

Dr. Michael Diaz (@mdiazoncmd) and Dr. Namrata Chandhok (@NamrataChandhok) discuss the importance of genomic testing and how to understand and interpret test results when treating patients with myelodysplastic syndromes and clonal hematopoiesis. They also discuss the importance of selecting appropriate therapeutic agents to manage hematologic malignancies. This project is a collaboration between the American Society of Hematology and the Leukemia & Lymphoma Society.
 Access and complete the GENOM modules (for which you can claim CME and MOC credit) via ASH Academy On Demand!
Music: "Happy Medium" performed by Zac Nelson, used under license from Shutterstock.

Dr. Michael Diaz (@mdiazoncmd) and Dr. James Blachly (@jamesblachly) discuss the importance of genomic testing and how to understand and interpret test results when treating patients with acute myeloid leukemia. They also discuss the importance of selecting appropriate therapeutic agents to manage hematologic malignancies. This project is a collaboration between the American Society of Hematology and the Leukemia & Lymphoma Society. Access and complete the GENOM modules (for which you can claim CME and MOC credit) via ASH Academy On Demand!
Music: "Happy Medium" performed by Zac Nelson, used under license from Shutterstock.

Dr. Michael Diaz (@mdiazoncmd) and Dr. Emily K. Curran (@ECurranMD) discuss the importance of genomic testing and how to understand and interpret test results when treating patients with acute lymphoblastic leukemia. They also discuss the importance of selecting appropriate therapeutic agents to manage hematologic malignancies. This project is a collaboration between the American Society of Hematology and the Leukemia & Lymphoma Society.
 Access and complete the GENOM modules (for which you can claim CME and MOC credit) via ASH Academy On Demand!
Music: "Happy Medium" performed by Zac Nelson, used under license from Shutterstock.

Dr. Sanjay Juneja (@TheRealOncDoc) and Dr. Ajai Chari (@AjaiChari) discuss the importance of genomic testing and how to understand and interpret test results when treating patients with myeloma. They also discuss the importance of selecting appropriate therapeutic agents to manage hematologic malignancies. This project is a collaboration between the American Society of Hematology and the Leukemia & Lymphoma Society.
 Access and complete the GENOM modules (for which you can claim CME and MOC credit) via ASH Academy On Demand!
Music: "Happy Medium" performed by Zac Nelson, used under license from Shutterstock.  

Join us for an insightful podcast episode featuring the Co-Chairs of the upcoming 2024 ASH Annual Meeting, where we explore the planning process and strategic goals that shaped this year’s program. Discover how the Co-Chairs ensured the Education Program meets the diverse needs of the hematology community, and the unique challenges faced during the planning and how they were overcome. Gain exclusive insights into what makes this event the premier gathering for professionals in the field. Whether attending in person or virtually, find out how you can maximize your experience and apply the latest advancements to your practice or research.

Learning Objectives:

1. Understand the Planning Process: Learn about the strategic goals, collaborative efforts, and decision-making that guided the design of the Education Program for the 66th ASH Annual Meeting, ensuring it addresses the diverse needs of the hematology community.
2. Overcome Planning Challenges: Learn about the specific challenges encountered during the planning of this year’s program and how they were effectively managed to deliver a meaningful experience for attendees.
3. Impact on Practice and Research: Understand how this year’s program is designed to impact attendees' practices and research, fostering advancements in the field of hematology.

Join us as we explore blood transfusion safety, focusing specifically on Transfusion-Related Acute Lung Injury (TRALI) and Transfusion-Associated Circulatory Overload (TACO). Tailored for general hematologists with a foundational understanding of transfusion medicine, this session delves into the pathophysiology, clinical presentation, diagnostic criteria, and management strategies for TRALI and TACO. Through advanced discussions, participants will deepen their knowledge of these complications, enabling them to recognize, diagnose, and manage TRALI and TACO effectively in clinical practice.

Learning Objectives:

1. Gain a thorough understanding of the pathophysiology and clinical presentation of TRALI and TACO.
2. Familiarize with the diagnostic criteria and differential diagnosis of TRALI and TACO.
3. Develop effective management strategies for TRALI and TACO to ensure transfusion safety and enhance patient outcomes.

Are you a healthcare professional seeking clarity on the evolving treatments for sickle cell disease (SCD)? 

In this 20-minute episode, experts from cellular therapy and bone marrow transplantation (BMT) explore key updates in SCD care, including curative therapies, gene-editing innovations, and BMT approaches. They address practical challenges in integrating these treatments into practice and discuss strategies to improve access and outcomes. Tune in to discover how collaboration between cellular therapy and BMT providers is transforming care and paving the way for better patient experiences. 

Learning Objectives 

1. Understand recent advancements in curative therapies, including gene editing and BMT, for sickle cell disease. 
2. Identify key challenges and barriers to integrating new treatments into clinical practice for SCD patients. 
3. Explore collaborative care strategies between cellular therapy and BMT providers to improve patient outcomes and access. 

Dr. Rahma Warsame (@RWarsameMD) sits down with Dr. Margo Rollins to explore the critical clinical importance of diverse blood donors and unique challenges faced in recruiting and retaining a diverse donor pool. They then delve into practical strategies and opportunities to overcome these barriers. Join us to gain valuable insights into how enhancing donor diversity can significantly improve patient outcomes and promote health equity.

Learning Objectives: To educate hematologists on…

1. The importance of donor diversity in blood donations.
2. Challenges faced in recruiting and retaining a diverse pool particularly from BIPOC communities.
3. Strategies toward overcoming these barriers.

Dr. Shakira Grant and Dr. Irum Kahn explore the fascinating history of stem cell transplants, beginning with its origins and milestones in the field such as the evolution of haploidentical transplants, a groundbreaking approach that has expanded donor options and improved outcomes for patients from diverse backgrounds. They then examine the clinical implications of these advancements, their transformative impact on patient care, and the power of diversity in donation.

Learning Objectives: To educate hematologists on…

1. Key barriers patients face in accessing stem cell transplantation, including financial, racial-ethnic, and logistical challenges,
2. The importance of racial and ethnic diversity in stem cell donor registries and the steps being taken to improve it, and
3. Policy-level solutions and interventions aimed at reducing cost barriers for patients needing stem cell transplantation.

Dr. Anjlee Mahajan (@anjleemd), Dr. Angela Weyand (@acweyand) and Dr. Michelle Sholzberg (@sholzberg ) delve into how current standards of care may contribute to disparities in the diagnosis and treatment of iron deficiency, particularly among female patients, as well as sharing compelling valuable insights into important considerations in addressing and overcoming these challenges to advance quality of care and improved outcomes for patients.

Learning Objectives: To educate hematologists and coordinating healthcare providers, where possible, on…

1. Some health inequities and challenges in providing comprehensive care to women with iron deficiency,
2. Examples of identifying and treating patients with iron deficiency, and
3. Practical steps we can all take to improve care of patients with iron deficiency.

Join us on HemeTalks as Dr. Christin DeStefano and Dr. Drew Helmer discuss the impact of military toxic exposures on the development of hematologic malignancies, including leukemia, lymphoma, and myeloma. Learn about the challenges of diagnosing and treating these cancers, advancements in research, and strategies for improving care for military members and veterans. 

Learning Objectives:

1. Discuss challenges in studying the effects of toxic exposures commonly experienced during military service and their links to hematologic cancers. 
2. Understand the unique evaluation and treatment challenges for hematologic malignancies in veterans and active-duty military members. 
3. Explore hematology-specific research and initiatives aimed at improving early detection and care for this population. 

In this episode of HemeTalks, Dr. Jill Johnsen and Dr. Michelle Sholzberg explore Von Willebrand Disease (VWD), the most common inherited bleeding disorder. The discussion delves into the disease's pathophysiology, diagnostic challenges, and the latest advancements in treatment. Learn about the complexities of diagnosing VWD, and discover we are working together to improve outcomes. This episode provides valuable insights for hematologists and healthcare professionals involved in the management of bleeding disorders.  

Learning Objectives:  

1. Understand the different ways that Von Willebrand Disease can present.  
2. Identify the challenges and best practices for diagnosing Von Willebrand Disease.  
3. Understand treatment options for Von Willebrand Disease and importance of personalized care. 

Join us for an insightful discussion on thrombotic microangiopathy (TMA) in pregnancy with Drs. Richard Burwick and Shruti Chaturvedi as we navigate the complexities of diagnosing and managing hypertensive disorders in pregnancy. These conditions often present overlapping clinical and laboratory features, making timely and accurate intervention challenging. Through the case of a 32-year-old woman at 30 weeks' gestation with severe hypertension, headache, and new-onset thrombocytopenia, we will explore key diagnostic considerations, the distinguishing features of preeclampsia with severe features, Hemolysis, Elevated Liver enzymes, and Low Platelets (HELLP) syndrome, and TMA, and the best strategies for optimizing maternal and fetal outcomes in these high-risk situations. This episode offers practical, evidence-based insights to enhance the recognition and management of pregnancy-related TMA and hypertensive disorders. 

Learning Objectives: 

1. Differentiate between preeclampsia with severe features, HELLP syndrome, and TMA using clinical and laboratory findings. 
2. Identify the most appropriate diagnostic tests to confirm the underlying etiology in pregnant patients with hypertension and thrombocytopenia. 
3. Discuss immediate and long-term management strategies, including when to initiate delivery and the role of plasma exchange in suspected TMA. 

Join us for an insightful discussion on hereditary hemorrhagic telangiectasia (HHT) with Drs. Hanny Al-Samkari and Adrienne Hammill as we explore the challenges in diagnosing and managing this genetic disorder. HHT is characterized by the development of bleeding nasal and gastrointestinal telangiectasias, as well as arteriovenous malformations (AVMs) in visceral organs and the central nervous system. Patients with HHT almost universally experience recurrent, often severe nose bleeding, and commonly develop gastrointestinal bleeding and complications of AVMs in the lung, liver, and/or brain. Through the case of a 40-year-old woman with recurrent bleeding episodes, we will explore the clinical features, diagnostic workup, and treatment options for HHT. This episode will provide valuable, evidence-based insights into how to approach the diagnosis and management of patients with HHT to improve outcomes and prevent complications. 

Learning Objectives: 

1. Identify the hallmark clinical features and diagnostic criteria for hereditary hemorrhagic telangiectasia (HHT). 
2. Explain the role of imaging and genetic testing in diagnosing HHT and assessing vascular malformations. 
3. Discuss management strategies, including proper pharmacologic management of chronic epistaxis and gastrointestinal bleeding, proper management of anemia, and management of AVMs. 

Join us for an insightful discussion with Drs. Natalia Neparidze and Saad Z. Usmani as we explore treatment strategies for relapsed multiple myeloma following BCMA-targeted therapy failure. With CAR T-cell therapy and bispecific antibodies revolutionizing myeloma treatment, clinicians are now faced with new challenges as patients relapse after BCMA-directed therapies. 

Through the case of a 62-year-old woman who relapsed one year post-BCMA CAR T-cell therapy, we will discuss mechanisms of resistance, treatment sequencing, and the role of novel agents like selinexor-pomalidomide-dexamethasone. This episode will provide hematologists with practical strategies to navigate post-BCMA treatment failure and optimize patient outcomes. 

 Learning Objectives 

1. Understand mechanisms of resistance and progression following BCMA-targeted therapy. 
2.  Explore non-BCMA treatment options, including alternative targets and novel agents. 
3.  Recognize key factors influencing treatment selection and patient management. 

Join Drs. Caimi and Sdrimas for a focused discussion on the coordination of CAR-T therapy between academic and community practices. As CAR-T use expands, ensuring seamless communication and shared responsibilities between care teams is essential. Using a real-world patient case, this episode explores how to navigate logistics, manage toxicities, and support patients in both settings—delivering collaborative, high-quality care. 

Learning Objectives:

1. Understand the shared roles and responsibilities in CAR-T patient management across care settings 

2. Identify communication strategies that support safe and effective care coordination 

3. Explore real-world barriers and solutions to bridging academic and community practice collaboration

Clinical Pearls:

1. Early and Appropriate Referral is Crucial: 
   • Community oncologists should refer patients early in the disease course. Being ineligible for transplant does not mean a patient is ineligible for CAR-T. Timely referral (i.e. before any other therapy is started unless clinically needed) allows for proper evaluation, manufacturing logistics, and bridging therapy if needed. 
2. Clear, Bidirectional Communication is Key to Safe Co-management: Successful shared care relies on:
   •  Identified point persons at both the academic and community sites (often including nurse coordinators).
   • Timely updates about treatment timelines and toxicity events. Ideally, same day if a toxicity occurs. Weekly updates for treatment timelines.
   • Use of standardized handoff templates and direct lines of communication to ensure continuity, safety, and efficiency in post-infusion      monitoring.
3. Empowering the Community Practice Enhances Access and Outcomes:
   • Academic CAR-T centers, hematologists, nursing staff, and CAR-T coordinators educating community providers on late toxicities, infection risks, and long-term monitoring enables safe local care.

Helpful resources:

• https://ashpublications.org/blood/article/141/20/2405/494965/Introduction-to-a-How-I-Treat-series-on-emergent
• https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(24)00094-9/abstract
• https://www.astct.org/Education/Practice-Guidelines 

Join us for a vital conversation on thalassemia in pediatric hematology with Drs. Sujit Sheth and Ashutosh Lal. Thalassemia is one of the most common inherited blood disorders in children globally, especially in populations from the Mediterranean, Middle East, South Asia, and Africa. This episode explores the different types of thalassemia, strategies for early diagnosis, the importance of transfusion and chelation therapies, and evolving curative options like stem cell transplantation and gene therapy. Using the case of a young child with beta-thalassemia major, we’ll examine both challenges and new hope on the horizon for long-term disease management.  

Learning Objectives:  

1. Understand the types and diagnostic approach to thalassemia in pediatric patients 
2. Review current standards of care including transfusions and chelation therapy 
3. Explore curative treatment options, including stem cell transplant and gene therapy 

Clinical Pearls: 

1. The thalassemias are a group of disorders of ineffective erythropoiesis, with a wide spectrum of clinical presentations, ranging from a mild anemia to transfusion dependence. 
2. The diagnosis is based on the clinical presentation, routine hematologic testing and for a more complete picture and some prognostic relevance, genetic testing of the alpha and beta globin genes. 
3. Management includes close monitoring for all patients, episodic or regular transfusions, iron chelation therapy as indicated, and assessment for stem cell transplant or gene therapy in specific cases.

Join us for an important conversation with Dr. Andrew Hintel and Dr. Lauren Merz as we explore how the Duffy null phenotype shapes absolute neutrophil count (ANC) and what this means for clinical care and trial design. Although common among individuals of African, Middle Eastern, and North African ancestry, the Duffy null phenotype is often misunderstood, leading to unnecessary procedures, inappropriate dose modifications, and exclusion from potentially life-saving therapies.

Through real-world examples, we discuss how standard ANC cutoffs can disadvantage Duffy null patients, the implications for chemotherapy, immunosuppressive drugs, and clozapine, and how recent updates to Common Terminology Criteria for Adverse Events grading criteria intersect with this biology. The episode also highlights ongoing efforts, supported by ASH and the Doris Duke Foundation, to establish adult and pediatric reference intervals and promote more inclusive clinical trial practices.

This discussion will equip hematologists and oncologists with practical insights to better interpret neutrophil counts, advocate for equitable trial access, and optimize treatment decisions for patients with the Duffy null phenotype.

Learning Objectives:

1. Understand the ANC by Duffy Status Project: Describe the rationale behind reconsidering absolute neutrophil count (ANC) reference ranges based on Duffy status and its implications for patient care.

2. Apply Clinical Trial Recommendations: Identify key recommendations for including patients with Duffy-null associated neutrophil counts in clinical trials and explain why these changes are important for equitable trial design.

3. Utilize Educational Resources: Recognize the educational tools and resources available to support clinicians, researchers, and institutions in adopting updated ANC reference ranges and practices.

Clinical Pearls:

1. The Duffy null phenotype is found in 10% of people United States and results in an absolute neutrophil count lower limit of normal of ~1200/uL.

2. Clinical trials do not account for this variation which results in disparities in eligibility, systemic anticancer therapy administration, and adverse event reporting.

3. The American Society of Hematology strongly recommends obtaining Duffy status in all clinical trials

In this episode of HemeTalks, Alyssa Deffenbaugh and Dr. Toyosi Onwuemene explore the challenges of diagnosing, managing, and living with atypical hemolytic uremic syndrome (aHUS). Listeners will gain insight from a patient advocate and individual living with aHUS, as well as a physician who supports patients through diagnosis and ongoing management. Together, they highlight the importance of advocacy, community, and building a shared understanding between patients and providers. 

Learning Objectives:  

By the end of this episode, listeners will be able to: 

1. Describe at least two challenges individuals with aHUS and providers face in achieving accurate diagnosis and effective management. 
2. Identify one practical action patients or their support networks can take to advocate for better understanding, diagnosis, or management of aHUS. 
3. Describe at least one way community support helps patients, and one way it helps providers navigate aHUS more effectively through shared knowledge or encouragement.  

Clinical Pearls 

1. The aHUS Foundation offers essential patient-support resources for individuals living with aHUS, including active Facebook communities and annual conferences that help patients and families stay informed and connected. The American Society of Hematology website also provides valuable educational resources for clinicians seeking information related to rare conditions such as aHUS.
2. The annual conferences hosted by the aHUS Foundation create valuable opportunities for patients and caregivers to meet others navigating aHUS, share experiences, and build a shared understanding of life with the condition. 

The aHUS Alliance Action website provides globally sourced educational materials, patient stories, and practical tools that support understanding of aHUS. 

This podcast is part of the Rare Diseases Educational Series, developed by the American Society of Hematology and supported by Alexion.

In this episode, Drs. Ronak Mistry and Jori May discuss the challenging decision of when to test for inherited thrombophilias and how results inform anticoagulation management. The use of thrombophilia testing has long been debated in the hematology community, due in large part to limited data and the complexity of estimating recurrent thrombotic risk. Through the case of a 36-year-old woman with a proximal deep vein thrombosis 4 weeks after an uncomplicated vaginal delivery, we explore the importance of defining provoking factors, evaluating bleeding risk, exploring previous thrombotic challenges and family history, and ultimately whether thrombophilia testing may be helpful to determine the need for long term anticoagulation.

Learning Objectives:

1. Accurately interpret the results of laboratory tests for inherited hypercoagulable disorders.
2. Identify appropriate clinical situations where testing for inherited hypercoagulable disorders can be considered.
3. Discuss how inherited thrombophilias influence decisions on the duration of anticoagulation in VTE without major transient risk factors.

Clinical Pearls:

1. Assay selection, appropriate timing of testing, and accurate interpretation of results are foundational to the use of thrombophilia testing in the care of patients with VTE.
2. The use of thrombophilia testing to guide the duration of anticoagulation in patients with VTE without major transient risk factors is debated and therefore must be individualized to every patient.

Monoclonal gammopathy of undetermined significance (MGUS) is a common but often confusing finding on serum protein electrophoresis (SPEP) reports. In this HemeTalks episode, Drs. Rahma Warsame and Jason Chen discuss how to interpret abnormal SPEP results, evaluate patients with suspected MGUS, and differentiate between benign and concerning findings. Using real-world cases, they highlight key clinical decision points, follow-up strategies, and how to communicate results with patients effectively. Tune in for expert guidance on navigating this diagnostic gray zone in hematology.

Learning Objectives:  

1. Recognize the clinical significance of MGUS and how it is detected 
2. Understand how to interpret MGUS lab testing results in the context of monoclonal gammopathies 
3. Identify when to refer, monitor, or investigate further in patients with MGUS

Clinical Pearls:

1. MGUS is a premalignant condition that is a diagnosis of exclusion. It is defined by the presence of a serum monoclonal protein (M-protein) less than 3 g/dL, bone marrow plasma cellsl <10%, and no end organ damage (CRAB) 
2. MGUS can progress to multiple myeloma, AL amyloidosis, Waldenstrom’s macroglobulinemia 
3. Confirmatory tests for MGUS include: SPEP, FLC assay, and bone marrow (only if high risk features are present.

Join Professor Brea Lipe and Professor Sagar Lonial as they discuss the changing treatment landscape of smoldering multiple myeloma (SMM). With a recently approved treatment for high-risk SMM, knowing how to differentiate and manage SMM compared with monoclonal gammopathy of undetermined significance (MGUS) and multiple myeloma (MM) has never been more crucial. Professors Lipe and Lonial review the case of a 58-year-old man in good health with no anemia or other health concerns, whose annual checkup reveals an isolated finding of elevated total protein. As they follow this patient’s journey, they discuss best practice in diagnosis, risk stratification, and management of SMM. Finally, they consider the factors affecting decision-making in the context of data from early intervention trials that aimed to either delay progression to active MM or, potentially, to cure SMM. 

Learning Objectives:

• Explain the distinction between MGUS, SMM and MM 
• Describe the key tests required for a basic workup of a case of suspected clonal plasma cell disorder 
• Explain how patients with SMM may be risk-stratified 
• Evaluate the factors that influence the decision to treat or monitor a case of high-risk SMM 
• Discuss published clinical trial data on high-risk SMM management approaches 

Join us for an insightful discussion on myelodysplastic neoplasms (or MDS) with Drs. DeZern and Mack as we review the current standards in diagnosis of MDS using cutting edge molecular techniques. This marrow failure syndrome requires thoughtful and accurate diagnosis to ensure appropriate risk assessment for clinical decision making. We will then review relevant therapeutic choices and how to monitor on and off therapy through the case of a 68 yo male with a 6-year history of disease. We will explore key diagnostic considerations, the distinct testing required for prognostication and the therapies available in lower and high-risk disease. This episode offers practical, evidence-based insights to enhance the recognition and management of MDS.

Learning Objectives:

1. Understand accurate diagnostic testing needed in MDS including core and aspirate, iron stain, IHC, and molecular diagnostics (MK and NGS)
2. Review limited therapeutic options currently available in MDS
3. Discuss management strategies at each stage of this disease from lower risk to higher risk with suitable monitoring plans

Clinical Pearls:

1. Comprehensive diagnosis and reassessment during disease course guide best practices for treatment
2. Treatment is warranted at phases of the disease with symptoms predominantly related to cytopenia

TTP is a hematologic emergency that demands immediate recognition and treatment to prevent fatal outcomes. In this HemeTalks episode, Dr. Yazan Abou-Ismail and Dr. Kolton Smith discuss the diagnostic hallmarks, therapeutic advances, and follow-up strategies for patients with TTP.

Through the lens of a clinical case, they explore the impact of caplacizumab, the importance of ADAMTS13 testing, and how to differentiate TTP from other TMAs. Tune in for practical insights that every hematologist and frontline provider should know.

Learning Objectives:

1. Recognize clinical and laboratory features indicative of TTP.
2. Understand the evolving treatment landscape, including the role of caplacizumab.
3. Apply principles for acute and chronic management of both congenital and acquired TTP.

Clinical Pearls:

1. Always consider iTTP diagnosis in any patient with findings of thrombotic microangiopathy, as early recognition is critical.
2. When iTTP is suspected, it is essential to start empiric therapy immediately—untreated disease carries a high mortality risk.
3. Monitor closely for disease exacerbation or relapse even after initial clinical response is achieved.

Multiple myeloma care is evolving faster than ever, with new therapies, treatment strategies, and possibilities emerging at an unprecedented pace. In this episode, hematologist Dr. Devarakonda and Kathy Giusti, founder of the Multiple Myeloma Research Foundation, come together for a candid, practical conversation about what this rapid progress means for patients, caregivers, and providers.

They explore why where you’re treated matters, how timing, sequencing, and dosing decisions shape outcomes, and what it takes to be an informed patient in today’s complex care environment. Through real-world stories and clinical insight, the conversation highlights the importance of collaboration between community and academic care teams, the growing role of the patient voice in decision-making, and the need to balance cutting-edge treatment with quality of life.

Whether newly diagnosed or navigating later lines of therapy, this episode offers practical guidance for making confident, informed decisions in multiple myeloma care.

Key Takeaways

• Multiple myeloma is increasingly treatable, with patients living longer than ever. Advances in therapy are leading to remission for many patients and significantly improving survival outcomes.
• Where you’re treated—and your care team—matters more than ever. The most effective care is team-based, involving academic specialists, community oncologists, and the patient along with their  caregiver working together.
• Treatment decisions are more complex: timing, sequencing, and dosing all matter. With a growing number of options, patients and providers must navigate when and how to use therapies through ongoing, informed discussions.
• Being informed is essential to navigating care today. Patients have more access to information than ever before, and using that information effectively supports shared decision-making with their care team.

La atención del mieloma múltiple está evolucionando más rápido que nunca, con la aparición de nuevas terapias, estrategias de tratamiento y posibilidades a un ritmo sin precedentes. En este episodio, el hematólogo Dr. Devarakonda y Kathy Giusti, fundadora de la Multiple Myeloma Research Foundation (Fundación para la Investigación del Mieloma Múltiple), se reúnen en una conversación sincera y práctica sobre lo que este rápido avance significa para los pacientes, sus cuidadores y el personal de salud.

Ambos analizan por qué el lugar donde recibes el tratamiento es crucial, cómo las decisiones sobre el momento oportuno, la secuencia y las dosis de los medicamentos definen los resultados, y qué se necesita para ser un paciente informado en el complejo entorno de salud actual. A través de historias reales y una visión clínica, la conversación resalta la importancia de la colaboración entre los oncólogos locales y los centros médicos de alta complejidad, el rol cada vez mayor de la voz del paciente en la toma de decisiones, y la necesidad de equilibrar los tratamientos de vanguardia con la calidad de vida.

Ya sea que enfrentes un diagnóstico reciente o estés navegando por opciones para etapas más avanzadas de la enfermedad, este episodio ofrece una guía práctica para tomar decisiones seguras e informadas en la atención del mieloma múltiple.

Puntos clave

• El mieloma múltiple es cada vez más tratable y los pacientes viven más tiempo que nunca. Los avances terapéuticos están logrando la remisión en muchos pacientes y mejorando significativamente las tasas de supervivencia.
• El lugar donde te tratas —y tu equipo médico— importa más que nunca. La atención más eficaz es la que se realiza en equipo, donde colaboran los especialistas académicos, los oncólogos de la comunidad, y el paciente junto a su cuidador trabajando de manera conjunta.
• Las decisiones de tratamiento son más complejas: el momento, la secuencia y las dosis son factores clave. Con un número creciente de opciones, los pacientes y los médicos deben evaluar cuándo y cómo utilizar las terapias mediante un diálogo continuo e informado.
• Estar informado es esencial para gestionar tu atención hoy en día. Los pacientes tienen más acceso a la información que nunca; utilizarla de manera eficaz facilita la toma de decisiones compartidas con su equipo médico.

Join Dr. Maureen Achebe and Dr. Lauren Merz for an in‑depth exploration of the Absolute Neutrophil Counts (ANC) by Duffy Status project, a multicenter effort to define what “normal” ANC and white blood cell counts (WBC) look like in people with the erythrocyte Duffy null variant. Using data from 23 sites across the United States, the project established Duffy null-specific ANC and WBC reference intervals for both adults and children as well as highlighted how often healthy Duffy null individuals have ANC and WBC that fall below conventional laboratory cutoffs. 

The episode unpacks the key findings: in healthy adults with Duffy null status, the ANC reference interval has a lower limit of normal near 1,000/µL, substantially below many institutional “normal” thresholds and far below the traditional neutropenia threshold of 1,500/uL. Similar downward shifts are seen across pediatric age groups with lower limits of normal ranging from 500/uL to 900/uL depending on age category. The faculty discuss how, under current institutional ranges, a sizeable proportion of otherwise healthy Duffy null patients are labeled as neutropenic or leukopenic which often prompts unnecessary workups, referrals, and reduced access to clinical trials or certain medications.  

Drs. Merz and Achebe then turn to implementation. They outline how laboratories can develop, verify, and adopt Duffy null-specific reference intervals and practical ways to integrate this information into electronic medical records, decision-support tools, and clinical communication. They also highlight education strategies for clinicians, trainees, and patients to ensure that a low ANC in a Duffy‑null individual is interpreted appropriately and not reflexively pathologized. 

Listeners will come away with a clear understanding of new adult and pediatric Duffy null-specific ANC and WBC reference intervals as well as practical steps to implement this data into the healthcare system and clinical practice.

Learning Objectives: 

1. Describe how adult and pediatric Duffy null-specific ANC and WBC reference intervals were established and why traditional institutional ranges are inadequate for this population. 

2. Understand how to interpret ANC and WBC values in patients with the Duffy null phenotype using the new reference intervals.

3. Identify practical steps for health systems to adopt Duffy null‑specific reference intervals and effectively communicate these changes to colleagues, patients, and learners.

Clinical Pearls: 

1. In healthy adults with Duffy null status, the lower limit of normal ANC is 1,000/µL—meaning many healthy individuals are misclassified as neutropenic or abnormal by current standards.  

2. The lower limit of normal ANC for Duffy null children ranges from 500-900/uL with approximately a third of children with ANC <1500/uL.   

3. Implementation of Duffy null-specific infrastructure depends on coordinated efforts with a multidisciplinary team including transfusion medicine, clinical pathology, hematology, EMR IT, health equity specialists, medical educators, and patient advocates.