Here is the big
#hairstylesforheroes
"reveal" - Nearly $75,000 raised to support the efforts our front line care team! Thanks to all who have supported and not too late to donate! Lots of great looks!
#WCMDeptofMed
@WeillCornell
Throwback to 5 years ago when Tony Fauci, at 74 yo, was suiting up to treat an Ebola patient himself because he "wanted to show his staff that he wouldn't ask them to do anything he wouldn't do himself". This is what leadership looks like.
You can learn far more about clinical research (and help patients more) by designing, conducting and analyzing clinical trials than you do by reading (or posting) tweets about them
7 pm on York Avenue between 68 and 70th street in NYC.....2/3 of the people on the street are nurses reporting for their shift
@nyphospital
@WeillCornell
- much appreciation and admiration....
Rather than a power nap pod, I think I would prefer being able to get a banana or coffee without a long line...I know a few NYC street vendors who could resolve this very well....
#ASH19
I have admiration for
#ASH18
speakers who are presenting in their non-native language (English) - for some no doubt not easy but important contributions to the meeting
“Why is it that most of those who are successful think it is all their doing” - great discussion
@PreetBharara
that touches many aspects of our society and politics
For immunocompromised individuals getting a 3rd "booster" COVID vaccine: DO NOT ASSUME that the "booster" necessarily solves potential problem of lower immunity against COVID (it doesn't for many) - need to speak w/your MD/team and often mask, distance etc - no false reassurance!
Happy and proud that our team and medical center has helped to bring forward these important/impactful phase 3 findings for patients with indolent
#lymphoma
demonstrating effects of adding lenalidomide to rituximab
#NYTopHospital
@nyphospital
@WeillCornell
Spent the beginning & end of a long day thinking about a longtime patient who died overnight - he taught & mentored many disadvantaged students & had a remarkable way of telling me on most visits that by helping him we were impacting many lives - a special man who will be missed
Patient comes for second opinion with one lymphoma diagnosis rendered previously. Sees our team, diagnosed with another subtype with entirely different prognosis and less aggressive therapy needed. Expert
#lymphoma
pathologist review so important!
Patient with new lymphoma, trying to get a PET scan to stage…….insurance representative (deciding on precertification for scan): “What stage is it?”…..Great question, wish I knew!
We offer our patients innovative, state-of-the-art therapies - but sometimes just pulling up a chair and having a good talk is what can make the greatest impact
If you are immunocompromised or otherwise high risk, right now it seems best to “hunker down” as best you can. Having unmasked contact with people with recent “negative” tests still has some risk as things can evolve….
I have said to many patients over the years that while you may miss/modify one important family holiday (e.g. being in the hospital) it is with the goal of sharing many more in the future....seems like similar approach very relevant now for many of us....
State laws restricting out of state video visits without licensure are absurd and frankly abusive to patients - at a point where some patients want to drive out of their home state to do a video visit from their car in a parking lot in another location where it is “legal”….
Two patients meeting in clinic for first time - one local, one lives several states away - patient 1 offers to have patient 2 stay at her house to ease the burden - amazing how patients come together to try to help each other through things
I treat patients with
#lymphoma
. There are several FDA-approved drugs for lymphoma that I have never treated a patient with, & some others I have rarely used. That said, I am glad that they ALL are available if/when my patients and I - together - decide they are a good option.
Patient with mantle cell
#lymphoma
.....over 12 year history, 2 lines of treatment on trials, doing well....never has had chemotherapy....the world is changing....
The terms “shows promise” and “promising” in regard to a new drug or treatment regimen are non-scientific and frankly useless. Real advances don’t need to be described in this way, the data tell the story.
With respect to hard work of all involved in these lymphoma CAR-T studies, and importance of data to the community, if they going to be presented over and over at every meeting there should be a clear description of what is new/incremental info and time frame that is new
#ASCO18
Just recorded the
#ASH19
#LeonardList
edition of our
@WeillCornell
#CancerCast
podcast highlighting 10 key
#lymphoma
abstracts - next week the episode (with my commentary on these + 5 bonus extra pod-only abstracts) will drop and the 10 day twitter countdown will begin!
Seems like a higher percentage of the people in the room at the start of the
#lymphoma
#CLL
session at
#ASCO22
could have stayed in the room to hear the presentations on the important issue of healthcare disparities in these conditions
Manuscript now online
@JCO_ASCO
AUGMENT: A Phase III Study of Lenalidomide Plus Rituximab Versus Placebo Plus Rituximab in Relapsed or Refractory Indolent Lymphoma
Just saw a mantle cell lymphoma patient diagnosed 10 years ago - still in remission from our initial therapy on a clinical trial...he and his wife reminisced about all (good) that has happened in their life during that time...
The
#ASH21
#LeonardList
high impact
#lymphoma
abstract list is finalized & under tight security (my backpack)! Countdown daily 12/1 to 12/10 or listen to the
#cancercast
podcast review (with 5 extra bonus selections) recorded & expected to drop on 12/1.
A patient brings us fresh-picked blueberries, my physician assistant turns them into muffins, I eat - we are truly a multidisciplinary collaborative team in our clinic (excuse my purple fingers)
Patient with recurrent follicular lymphoma doing well on current treatment: “Maybe I should have had this back at the beginning” - the drug hadn’t yet been developed 15 years ago when she was diagnosed - shows the benefits of progress we are making!
Think about the fact that despite the flaws of the US Postal Service, any person can - for 55 cents - have an envelope and contents delivered across the country a few days later door to door. This is impressive, important and should be protected and not messed around with.
Today I had to tell 2 patients requesting a telemedicine consult that I am unable because I am not licensed in their home states. And this is good why???
Over 100
#ASH19
@ASH_hematology
abstracts identified by keyword search “real world” - are the others from the “unreal world” ? And do abstracts from authors working at major academic referral centers and pharma companies represent the “real world”?
After about 20 years of work in “cell of origin directed” strategies in upfront and relapsed DLBCL
#lymphoma
it seems like the newest advances are “cell of origin agnostic” - there are important lessons here….
As a community in lymphoma, we should be embarrassed by the lack/limitations of quality of life data available on treatments - it is pretty sad that we cannot currently provide solid data to guide choices - we need to do better and collaborate w experts with novel tools
#ASCO18
Those who care about progress for patients and advances in treatment need to be aware of the staffing challenges in clinical research programs across the country - that can be marginally funded in the best of times - multiple strategies needed to support studies of new therapies
Diffuse large B cell
#lymphoma
therapy is improving (and getting more complicated)! Clinical trials are the engine! Greater participation and faster enrollment are the keys to rapid progress and saving/improving more lives!
#ASH21
My editorial comments in
@JCO_ASCO
on the PHOENIX study of Ibrutinib + R-CHOP in Diffuse Large B Cell
#Lymphoma
:De-Cell-eration in Therapy for Diffuse Large B-Cell Lymphoma | Journal of Clinical Oncology
So the CAR-T debate of which works better/is less toxic is now going to be rivaled by the bispecific antibody debate of which works better/is less toxic....
#ASH20
Kudos to everyone who did the hard work (and the patients who participated) for the studies to be presented at
#ASH21
- most importantly to advance knowledge and patient care - participating in research is the way to improve outcomes
One of several exciting bispecific antibodies for B cell lymphoma - seems likely that a few years from now many more patients will be receiving bispecifics than CAR-T....
Six new physicians recently added to the Heme/Med Onc team
@WeillCornell
@nyphospital
- we are growing and expanding our clinical and research programs under
@DrMhidalgo
- exciting progress!
Key point-for clinical trials in follicular & DLBCL
#lymphoma
there is NO NEED to do BM biopsies to assess response! Changes response in <1% of enrolled pts. Lets do patient friendly trials & do BM bx only if needed for valid clinical/correl science reasons!
#LeonardList
#ASH18
Now for
#LeonardList
key
#ASH18
#lymphoma
abstract number 8 - 1605 Rutherford
@drsarahruth
- Bone marrow biopsies do not meaningfully change response assessments in follicular and DLBCL
#lymphoma
clinical trials (from GALLIUM and GOYA studies) w/2600 pts
Happy to see a follicular
#lymphoma
patient today in clinic who I have cared for over 20 years (since I was a brand new attending)! Made us both feel old, but both aiming for the next 20 plus years!
If a doctor can have a serious conversation with a patient and family through 2 masks and a face shield, a football coach can keep his cloth mask up to scream at a referee...
Pretty soon we should be comparing bispecific ab (alone or in combo) randomized vs CAR-T (w/crossover) in a number of
#lymphoma
settings….though I expect biases (in both directions) may preclude such depending on the situation
#ASH21
One of the best things about an in person scientific meeting is being able to turn to insightful and respected colleagues nearby and ask “what do you think of that study?” - here’s hoping for a healthy dose of those exchanges in some form at
#ASH21
Black Friday: The annual day when hematologists overwhelm barbershops and hair salons to get their pre
#ASH18
haircuts (ok it may extend over a few days but lots get pre-ASH cuts - see if you can guess at the meeting....)
So we had the pre-
#ASH18
haircut, the busy meeting, and now the cycle continues with.... wait for it....the post-ASH respiratory virus (fostered by air travel) ....no doubt there are plenty of them out there...or coming soon...🙁
@ASH_hematology
Patients are sick of hearing about, thinking about, worrying about and dealing with concerns about measles. It is ridiculous that we are at this point. Totally avoidable. The amount of energy that has had to be devoted to this issue could be better spent on many other things.
Seeing a patient in mid 80s who I have followed (never treated) for 2 years (over 9 visits) with an asymptomatic DLBCL that hasn't progressed (she smartly declined rx). Me: "See you in 6 months" Her: "If you don't see me it means I died" So much to learn from this encounter....
I had a headache this am. Took ibuprofen. I know it has possible side effects, sometimes serious. My headache got better. Not sure if it was due to the ibuprofen or if it would have gotten better anyway. No OS benefit. No formal QOL analysis. I’m glad ibuprofen is available.
Seems unlikely every B cell lymphoma patient will ultimately get a CAR-T, but seems more likely that every B cell lymphoma patient will get a bispecific antibody.....
#ASH20
Tomorrow begins
#LeonardList
twitter countdown of 10 top
#ASH18
lymphoma abstracts - BUT anyone wanting to hear my comments on the full
#LeonardList
(+ 5 podcast-only bonus picks) they are now live on
#CancerCast
- feedback welcome via twitter
#LeonardList
Despite our challenges, frustrations, disappointments and anger - it is important to keep in mind that there are a lot of people working hard in different ways to make the world better - and lots of opportunities for all of us to do so - big and small
Over 25 years after the important publication by Margaret Shipp and colleagues of the International Prognostic Index (IPI), we now have reached a point where we will treat Diffuse Large B Cell
#lymphoma
patients differently based on their IPI scores
#ASH21
I need a haircut! We’re launching the
#HairstylesForHeroes
campaign to support
#WCMDeptOfMed
junior faculty & trainees. I’ll sport a crazy hairstyle (? mullet, mohawk, dye) once we meet our fundraising goal. Donate & help spread awareness.
#TogetherWithWCM
Would be reasonable to run randomized or pragmatic trial of now standard EHR (eg Epic) vs streamlined version w less detail (fewer checkboxes largely for billing) w/endpoints of clinical outcomes, patient satisfaction & MD/RN/provider QOL
@cuttingforstone
Remember my first day as intern/on call night. 30 yrs ago today. To my resident’s horror I “renewed” my patients’ orders by d/cing every medication & reordered them all. Thought was the way to do it. That night I lost my papers w/everyone’s sign out info. Days of the giants.
Just finalized the
#ASH20
#LeonardList
of top 10
#lymphoma
abstracts - lots of great studies - daily annual countdown starts wednesday & we just recorded
#Cancercast
podcast to post soon with 5 additional bonus selections & my comments. Looking forward to feedback and dialogue!
In clinic today post
#ASH21
- what is crystal clear on new data on diffuse large B cell
#lymphoma
is that often choice not "crystal clear" - pts don't fit into neat boxes/algorithms - good care requires a patient-centered discussion & wisdom in applying data to individuals