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 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 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.