Hematology   

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

Labs with normal PT, but prolonged PTT (47 sec, ULN 40 sec) that does not correct on immediate mix. Lupus anticoagulant negative (DRVVT and hexagonal ...

Do you generally recommend anti-diarrheals, dietary modifications, or consider this an unacceptable side effect and move to other therapies? 

Thrombophilia testing, including JAK2 is negative. When would you stop anticoagulation?

E.g., a patient with newly diagnosed CIDP who is wheelchair-bound.

Should some patients get 325 mg instead of 81mg at least for a certain amount of time, such as patients in the acute phase of ischemic stroke or patie...

Considering the short half-life, at what point would it be deemed too late to administer any reversal agent, and to consider withholding it?

In light of ANNEXA-I RCT results: Connolly et al., PMID 38749032.

Are there specific mass features that would influence your treatment decision?

Is there utility when classic inflammatory markers (ESR,CRP) or disease specific markers (C3, C4, dsDNA) do not correlate with patients disease activi...

When would you consider using anticoagulation and for how long?

Is there any evidence supporting the use of heparin boluses?

The ASH 2020 guidelines have "recommended that adults with HbSS or HbSβ0 thalassemia be screened at least once for silent cerebral infarcts even ...

In FRAIL-AF, switching VKA therapy to a NOAC was associated with higher risk of bleeding in elderly, frail patients. 

In FRAIL-AF, participants were switched from VKA to dabigatran, rivaroxaban, apixaban, and edoxaban.

Would you continue KEYNOTE-522 neoadjuvant therapy? The patient has a PMH of sarcoidosis with no stroke risk factors. No residual deficits. 

Also how would you manage this perioperatively?

The patient has no known history of autoimmune disease.

Are there any instances where you would prefer a biosimilar rather than the reference product? 

Regimen currently 25 mg lenalidomide D1-21 of D28 day cycles, Daratumumab 16 mg/kg every 2 weeks.

Do you wait 12 weeks for confirmation to begin treatment if patient is declining?

When it seems fairly certain that this is a drug effect is it something that can just be monitored or requires a change in approach?

Do you just use antibiotic prophylaxis if therapy is started prior to meningococcal vaccination?

Do we prophylactically place patients on anticoagulation after one episode? Besides MRI/MRV brain, are there other diagnostic imaging that should b...

If so, what would you consider ordering?

In the setting of no personal or family history and no other risk factors for thrombosis, is systemic anticoagulation warranted if local treatments (e...

How do you approach secondary stroke prevention for patients with ischemic stroke, atrial fibrillation, and signs of cerebral amyloid angiopathy/micro...

e.g. DITP from eptifibatide after a cardiac intervention

Can you expand on this by sharing exactly what this routine workup should include? What additional tests outside of evaluating for POEMS and amyloidos...