Hematologic Malignancies   

Do you consider supportive transfusions, and if so, have you been successful with keeping patients on hospice while receiving transfusions? Do you us...

New data suggests monoclonal gammopathies can be associated with thrombotic events. Is your practice changing to include monoclonal gammopathy evaluat...

Patient with long standing history of HLAB27 associated uveitis on adalimumab and new diagnosis of CLL.  

Hgb is 8 and platelets 10. A very small PNH clone (0.08%) detected. No evidence of hemolysis. No response to steroids. All other anemia/thrombocytopen...

Can you elaborate on reasons for a non-quantifiable SPEP and how does one follow the paraprotein?

Can you explain when would you consider light chain amyloidosis work up with fat pad biopsy?

Bone marrow biopsy does not meet criteria for MDS and no other identifiable cause of the cytopenias.

Are there specific guidelines for managing this patient population?

For example, how do you address tendency to "over-order" these tests in patients with common aches/pains but no structural abnormalities on advanced i...

Work-up was performed for isolated anemia which resolved to >11 g/dl after the reversible cause was treated.

Would you do a 24-hour urine and echocardiogram in all of these patients? Cardiac biomarkers, PT/PTT, or any other such blood tests?

Would a negative NGS eliminate the possibility of MDS? Is bone marrow biopsy indicated in a patient with pancytopenia with a negative NGS panel?

E.g. a patient with monoclonal protein with mild light chain ratio elevation. Do we need to get a BM biopsy in all such patients?

Peripheral blood flow shows prominent NK cell population but marrow aspiration/bx shows normocellular marrow with trilineage hematopoiesis. 

e.g. IS < 0.002% by qPCR

Is a repeatedly abnormal serum immunofixation all it takes for MGUS?

What if there are no cardiovascular risk factors?  Are VKAs preferred or can DOACs be used?

Are there other supportive care interventions that would otherwise be covered by hospice?

Specifically, are there strategies you use to 1) empower patients to participate in decision-making and 2) reassure patients who may be skeptical?

Do you use specific tools or take into account certain factors when considering treatment options for older adults?

Bulky adenopathy compressed bilateral ureters, CrCl < 30, post stent placement, but renal function has plateaued

Technically, you can have up to 55% of larger cells circulating and still be called CLL.