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.

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 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.

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 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.

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.