Hematology&nbsp;&nbsp;&nbsp;

For patients with microcytosis MCV 75-79 and normal Hb, low TIBC, and normal ferritin do you always rule out thalassemia?

What else would you consider in your differential?

What is the role of CNS prophylaxis in a healthy patient in their 60s with a large DLBCL of the cranium/dura with brain parenchymal invasion?

Good performance score, 7 cm in size, CSF cytology is negative, MRI complete spine is negative. Would you consider any additional systemic therapy mod...

Would you anticoagulate a patient with an asymptomatic gonadal vein thrombosis on CT scan, found on surveillance imaging for colorectal cancer?

Would you consider radiation therapy before chemotherapy in a patient with stage I-II high-grade B-cell lymphoma presenting with a large necrotic skin lesion?

Elderly patient with large fungating necrotic breast mass positive for high grade BCL and a solitary hypermetabolic ipsilateral axillary node. Medical...

Would you consider complement inhibitor therapy or immunosuppressive therapy (e.g. cyclosporine, corticosteroids) for a patient with a PNH clone and early MDS who presents with pancytopenia?

If blood counts are being checked during concurrent chemoradiation, is there a number at which point you would recommend a radiation treatment break?

For example, concerning throbocytopenia or neutropenia during anal cancer treatment with concurrent mitomycin/5FU, or other pelvic malignancies treate...

Do you repeat images in patients with venous thrombosis to inform decision about duration of anticoagulation?

E.g. pulmonary embolism, portal vein thrombosis, cerebral venous sinus thrombosis

Do you recommend starting an antiplatelet for primary prophylaxis in post splenectomy thrombocytosis given there is some increased risk of venous thrombosis?

If so, what platelet count threshold would you use? Would age impact your decision? Would you do a bone marrow to rule out primary MPD in adults if th...

How would you treat DLBCL of the terminal ileum in an otherwise healthy patient?

What is the optimal age at which a patient with sickle cell disease should undergo allogeneic stem cell transplant?

What is your ferritin threshold to prescribe iron to female adolescent athletes who have symptomatic iron deficiency without anemia?

What is the ideal approach for female adolescent athletes if they have complaints of fatigue and dizziness and are diagnosed with mild iron deficiency...

Would you recommend adding a TKI to a pediatric regimen for a AYA B-ALL patient with IKZF1 mutation?

How do you approach an ITP patient who responds very well to steroids but the response is short-lived?

How would you counsel the patient if he/she wants to continue on steroids?

For CLL patients with high-risk cytogenetics on ibrutinib who develop a cardiac event such as an MI, would you continue ibrutinib?

Would you continue ibrutinib even if they are placed on anti-platelet therapy such as clopidogrel or ticagrelor? When do you switch to an altern...

Is there a role to continue aspirin in patients with myeloproliferative disorders who have never had a thrombotic event that are starting DOAC for stroke prophylaxis with newly diagnosed atrial fibrillation?

What is your approach to curative-intent therapy for a young, fit patient with newly-diagnosed monomorphic epitheliotropic intestinal T cell lymphoma (MEITL)?

Do you incorporate PEG-asparaginase or brentuximab vedotin (for CD30-expressing malignant cells) into anthracycline-based induction regimens? Do you c...

How do you approach a cervical node biopsy-proven follicular lymphoma in situ in a symptomatic patient with night sweats and PET findings of low SUV uptake throughout the body?

Would you biopsy another site or treat the patient?

Would you continue warfarin anticoagulation in patients with unprovoked DVT if switching to low-dose DOAC is cost-prohibitive?

How do you manage a patient with JAK2+ ET without history of thrombosis during pregnancy?

Does history of miscarriage affect your treatment decision?

Would you consider antiphospholipid syndrome to be a contraindication for checkpoint inhibitor immunotherapy?

How do you differentiate between JAK2 positive ET and PV when peripheral blood shows erythrocytosis and thrombocytosis?

Concordant low EPO level and bone marrow with megakaryocyte hyperplasia

In light of the TRIANGLE data at ASH, how are you now approaching a transplant-eligible patient with a new Dx of agressive mantle cell lymphoma?

Are you adding ibrutinib? Should we add ibrutinib to NORDIC? Still referring to transplant?

How would you manage a transplant-eligible patient with DLBCL who relapsed 6-12 months following a CR1 to R-CHOP and then attained a CR2 to platinum-based salvage chemoimmunotherapy?

How do you choose between CAR-T and autoSCT, for example?

What is your approach to treating early stage EBV-positive diffuse large B-cell lymphoma of the elderly after a CR to systemic therapy?

This is a recently described entity with poor prognosis, so even with a CR after RCHOPx6 cycles, is your bias to push for ISRT due to EBV being poor p...

When, if ever, would you consider deep venous thrombosis prophylaxis for patients with advanced epithelial ovarian cancer undergoing neoadjuvant chemotherapy?

In your practice, what is the proportion of patients receiving neoadjuvant chemotherapy who are diagnosed with VTE? Does this differ from patients rec...

What dose constraints do you use when treating gastric MALT or DLBCL with radiation therapy?

How do you perform fertility counseling for a patient with a duplication of one of the alpha genes and their partner who has a beta chain point mutation?

That is, extra copy of one of the alpha genes resulting in an atypical alpha thalassemia for the patient, and beta thalassemia heterozygous carrier fo...

For a patient with diffuse large B-cell lymphoma of the testicle, do you irradiate the contralateral testicle alone or do you recommend radiation to the lymphatics and remaining testicle?

How do you approach treatment for a fit patient with unmutated CLL who has progressed after BTKi and venetoclax containing regimens in the first and second line?

Would you ever consider using ibrutinib in CLL patients who have received first line acalabrutinib and then progressed?

How do you manage bruising in patients on ibrutinib?

7 Answers available

What would be your next step in workup for a patient with IgG Kappa Monoclonal protein detected on SPEP and free lambda light chains found in the urine, with chronic diarrhea for 3 years and concern for GI amyloidosis?

Do you check beta 2 microglobulin in patients with MGUS?

Does it assist in prognosis in any way?

What precautions do you take prior to CABG in a patient with sickle cell trait?

Please comment on temperature recommendations and role of exchange transfusion.

Based on recently published data from COG ANHL12P1, how will you use crizotinib in pediatric and AYA patients with ALK+ anaplastic large cell lymphoma?

How would the risk of VTE associated with crizotinib affect your decision? Should we consider using crizotinib in combination with brentuximab?

Do you use anticoagulation in cancer patients who develop an unprovoked superficial vein thrombosis?

If so, do you treat for a limited period of time or indefinitely?

In sickle cell patients with continued pain crises despite hydroxyurea, how do we sequence the use of newer agents?

While L-glutamine has minimal side effects and would likely be added after hydrea, how do you decide between the use of voxelotor and crizanlizumab?

How do you approach low to moderate titer of APLS when working up unprovoked DVT if it is persistent on repeat testing?

Would you consider using DOACs in a young patient with SLE and Libman-Sacks endocarditis, who is negative for APS?

Do you switch from imatinib to another TKI in patients with chronic phase CML who develop renal insufficiency?

There are conflicting reports whether it contributes to renal insufficiency. If you do switch, what is your preferred TKI in this scenario?

Can acalabrutinib be used after ibrutinib failure in relapsed/refractory mantle cell lymphoma?

Or would you sequence a different BTKi?

Do you screen for VWD in all women with menorrhagia severe enough to cause iron deficiency anemia?

How do you manage anemia in a patient with myelofibrosis and hemochromatosis?

Patient on JAK2i, ESA, transfusion dependent

Based on the ASC4MORE trial, would you add asciminib to imatinib if patients don’t achieve deep molecular remission at 1 year?

Do you recommend prophylactic anticoagulation to pregnant women undergoing chemotherapy for breast cancer?

Since both pregnancy and cancer are risk factors for VTE, is there data to guide when or if we should prophylactically anticoagulate? If so, what shou...

How long do you continue treatment with imatinib in a patient with chronic eosinophilic leukemia who achieves remission?

If indefinite treatment is recommended, is there an optimal maintenance dose?

What is the treatment approach if an AML patient receiving azacitidine/venetoclax is later found to have FLT3 and IDH2 mutations?

How do you manage a patient with progressive cerebellar ataxia and positive cardiolipin antibodies?

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

For a patient with MM progressing on a daratumumab-based regimen, is it preferable to entirely switch drug class or is another monoclonal antibody such as isatuximab an acceptable next step?

How would you manage anti-platelet therapy in patients presenting with ischemic stroke and have a history of von Willebrand disease?

How would you approach therapy for a transplant-eligible patient with peripheral T cell lymphoma NOS who experiences early relapse after CHOEP, but achieves remission to salvage therapy?

Would you still go to auto or consider allo?

How should elevated PT of unclear etiology and significance be evaluated?

In the absence of concerning bleeding or thrombosis, family history of coagulopathy, current anticoagulant use, or malnutrition

Do you typically see peripheral neuropathy in patients with castleman syndrome?

What is your first line strategy for TP53 mutant AML?

What would you use for a maintenance regimen after high dose chemotherapy and autologous stem cell transplant for a patient with 17p-deleted multiple myeloma?

How would treat a patient with good performance status with PTCL-NOS found to have leptomeningeal disease during treatment course with CHOEP?

Would you intercalate HD-MTX with her CHOEP?

How would you counsel a patient with active SLE on treatment, low to moderate level of one of the APLS antibodies, and remote history of provoked blood clot regarding perioperative anticoagulation?

Is SLE-related APLS managed differently in terms of anticoagulation?

How would you manage a patient with erythrocytosis of unknown cause in pregnancy?

MPN work-up negative

How do you manage a patient with a nonspecific platelet function disorder and heterozygous protein C deficiency during pregnancy?

Specifically - patient who had mild aggregation defect with ADP which corrected in third trimester of pregnancy. Would it be appropriate or necessary ...

How would you approach a low to moderate titer of one of the APLS antibodies in a patient with a strong family history but no personal history of thrombosis?

Although testing was not indicated, what do u do with these results? Other hypercoagulability work up negative

How would you treat lymphoplasmacytic lymphoma (LPL) with a non-IgM paraprotein?

Does your treatment approach differ from Waldenstrom's Macroglobulinemia? Does the presence/absence of a MYD88 L265P and/or CXCR4 mutation change you...

How do you manage occlusive bilateral retinal vasculitis with isolated lupus anticoagulant positivity?

What is your preferred BTK inhibitor for patients with relapsed/refractory mantle cell lymphoma?

How do you generally think about sequencing treatment among available options? Would your choice be affected by a patient's eligibility for transplan...

What's the role of ibrutinib and venetoclax in CLL in light of data emerging from ASH 2022?

Do you offer IVIG to myeloma patients with recurrent infections?

Do you have a certain immunoglobulin level which you would use to determine this?

Do you send an antiphospholipid antibody panel routinely for all patients with an unprovoked thrombus?

What is your preferred frontline treatment for CLL in young patients < 50 years old?

What are your top takeaways from ASH 2022?

8 Answers available

Would you start anticoagulation in a patient with a history of CVA 1 year ago and high risk APL profile who was never started on anticoagulation, but is now presenting for follow up and without recurrent thrombotic events?

The patient has no known history of autoimmune disease.

Would you restart prophylactic anticoagulation in a patient with a history of unprovoked PE who received short term anticoagulation with a prior physician?

E.g. low dose DOAC

Is rituximab for refractory ITP contraindicated in the setting of an active COVID infection, particularly in a patient with asymptomatic COVID?

Would you discontinue anticoagulation in patients with antiphospholipid antibody syndrome, who have a remote history of thrombotic events and are now negative for pathogenic antiphospholipid antibodies?

Would the answer differ if the index event was arterial vs venous?

How do you interpret elevations in ESR and CRP in the setting of increased BMI?

How do you approach anticoagulation in the setting of HIT and thrombocytopenia?

I.e. platelet count <30. Would your management change if HIT were only suspected rather than confirmed?

How do you approach the workup for a patient with persistently elevated inflammatory markers (CRP and ESR) whose history and exam do not point to a clear cause?

How will you treat a young man with recurrent cryptogenic strokes with no identifiable cause, with MTHFR A1298C homozygous mutation and normal homocysteine level?

Does stopping anagrelide affect fibrosis in patients with ET who develop post-ET myelofibrosis?

Are there any possible scenarios where you would do phlebotomies for heterozygous hemochromatosis?

How would you treat a patient with chronic phase CML who could not tolerate nilotinib due to G4 thrombocytopenia despite sequential dose reductions?

How would you approach a patient with low grade follicular lymphoma (stage IE) of the breast who presents with local recurrence 1 year s/p lumpectomy?

She was on surveillance after lumpectomy. No prior radiation therapy. What dose/fractionation?

Is there any role in continuing apixaban in a patient with occlusion of the right internal jugular vein with chronic postthrombotic change to prevent a recurrent DVT?

Previous provoking factors resolved (CVC, malignancy, etc)

What salvage chemotherapy, if any, would you recommend for a patient with primary refractory DLBCL who progressed after two cycles of R-CHOP?

Do you anticipate a paradigm shift in first line treatment of multiple myeloma from RVD to immune therapy with CAR-T/bispecifics?

If so, when do you think this might occur?

Do you discontinue or adjust azathioprine when a patient develops elevated MCV after starting it?

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?

How do you advise patients with sickle cell disease on contraception?

Do you advise against combination OCPs?

Do you do prophylactic LP/IT chemotherapy in high risk APML prior to starting consolidation?

When and how do we do cytoreduction in CLL?

Would you consider thrombophilia testing in a pregnant patient with VTE?

If work-up is sent and the patient is found to have a persistently positive antiphospholipid antibody, particularly lupus anticoagulant, would you con...

How do you titrate hydroxyurea in the management of myeloproliferative neoplasms?

What parameters/goals/targets do you use? Do you treat PV, ET, and MF differently?

What is your approach to CMML-MDS in an older patient with low risk disease who is becoming transfusion dependent?

Would you use a trial of dexamethasone for a patient with thrombocytopenia?

For hypogammaglobulinemia as a complication of successful treatment, do you empirically start prophylaxis with either 400 mg/kg monthly for IVIG or 100 mg/kg weekly for subcutaneous immune globulin?

Would you consider clearing a patient with essential thrombocytosis for a kidney donation?

How would you approach management of bleeding risk and factor VIII replacement in a patient with severe hemophilia A undergoing stem cell transplant?

Do you typically recommend four factor prothrombin complex concentrate versus fresh frozen plasma for INR correction in patients with vitamin K antagonist associated spontaneous ICH?

Do you use GCSF for a patient with MDS with excess blasts and neutropenia?

If so, how do you incorporate GCSF into treatment of these patients?

What is your simulation setup and dose fractionation for DLBCL of the hand with Deauville 4 residual disease following R-CHOP?

What is your perioperative approach for a patient with severe hemophilia?

What type, dosage, and duration of treatment do you use? How does your practice change when there is an inhibitor?

How would you work up a mildly neutropenic patient (ANC >800) with family history of neutropenia and personal history of occasional mouth sore?

What are indications to order gene mutation studies (e.g. ELANE) and how would it help the patient?

How would you approach a young patient with a history of APLS and VTE, desiring hormone replacement therapy after oophorectomy?

Currently on nonwarfarin therapeutic anticoagulation

How would you manage IVF using ovarian stimulation in a woman with a prior estrogen related thrombotic event?

For a patient with PE undergoing procedures like port placement in the first month, how do you manage anticoagulation?

What is your preferred agent (DOAC, warfarin, enoxaparin), and is periprocedural bridging necessary?

How do you manage prophylactic antimicrobial medications in patients who undergo ATG/cyclosporine/eltrombopag induction for severe aplastic anemia?

What would you recommend within the first year after ATG and thereafter if still maintained on cyclosporine?

What is your approach to BK hemorrhagic cystitis not responding to cidofovir?

How would you manage a patient with new renal failure and mild anemia in the setting of a moderate M-Spike and low kappa/lambda ratio, but with negative PET and bone marrow with <10% plasma cells?

How would you approach mantle cell lymphoma in very elderly patients?

What is the appropriate management of arthralgias associated with bosutinib?

Which patients with acute promyelocytic leukemia do you consider maintenance after completing consolidation?

What is the recommended radiation treatment volume for a patient with orbital DLBCL who achieved a CR to chemotherapy?

When would you treat the entire orbit versus partial orbit? One patient has medial rectus involvement and another has only conjunctival involvement. I...

How do you work up a young patient with increasing ferritin and normal TSAT without infectious, inflammatory, or liver disorders?

Ferritin uptrending >1000, no additional lab abnormalities. HFE wildtype. Too young for age-appropriate cancer screening. Asymptomatic except fatig...

What is the optimal management of a patient needing surgical clearance for a knee replacement with VWF Ag and factor VIII between 40-50 and no bleeding history?

How do you utilize p53 NGS testing in your treatment planning for patients with CLL?

What VAF burden would be considered significant prognostically or for treatment decisions?

In a patient with Type I von Willebrand disease with history of VTE and heavy menses, would tranexamic acid be a treatment option?

Is thrombotic risk too significant? Patient failed OCPs.

Would you stop hydroxyurea for thrombocytosis in a prostate patient receiving radiation?

Do you recommend hydroxyurea in patients with sickle cell disease with hereditary persistence of fetal hemoglobin who have recurrent vaso-occlusive crises requiring hospital admission?

If hydroxyurea modifies the course of sickle cell disease by increasing fetal hemoglobin, is there any benefit to using it in patients with fetal hemo...

Do you stop hydroxyurea or switch to an alternative therapy in a male patient with controlled Hb SC disease who is interested in having children?

When can abdominal surgery be safely performed for presumptive ovarian cancer in a patient with recent pulmonary emboli?

(Normal oxygenation and echo)

What is the treatment of choice for mixed phenotype ALL?

What are the differences in approach to B lymphoid/myeloid and T lymphoid/myeloid MPAL?

Can APLS cause a false positive HIT ELISA?

If so, is there one type of antibody that is more likely to cause this false positive test?

Would you require biopsy of both orbits or is unilateral biopsy adequate for a patient with suspected bilateral orbital MALT lymphoma?

Imaging studies (MRI and PET) show bilateral disease

At what ferritin threshold would a patient with anemia of inflammation or malignancy no longer benefit from iron supplementation for functional iron deficiency?

For example, if TSAT is less than 20% but ferritin is over 200.

What would be the main indications for opting for biosimilars over an original biologic, outside of insurance barriers?

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

Do you offer anticoagulation to patients with prior antiphospholipid antibodies detected in pregnancy without a history of pregnancy loss or thrombosis?

What is the risk of pregnancy loss in absence of anticoagulation? What would you suggest if the patient had anticoagulation in prior pregnancies and r...

How do you workup splenomegaly related to possible hematologic etiology in the absence of abnormal blood counts, adenopathy or severe constitutional symptoms?

For instance, evaluation by primary care and GI without other etiology for splenomegaly

Do you recommend continuous antibiotic prophylaxis for patients on complement inhibitors such as eculizumab?

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

Should post-transplant cyclophosphamide be utilized for all matched unrelated donor peripheral blood stem cell transplants for hematologic malignancy?

If not, how do you choose GVHD prophylaxis regimen? Is there a preference?

How would you confirm the diagnosis of splenic marginal zone lymphoma without utilizing splenic biopsy or splenectomy?

How do you choose bridging therapy prior to CAR-T leukapheresis?

Are there agents (eg. bendamustine) or modalities to avoid? Does washout times prior to collection vary between modalities?

Do you treat secondary erythrocytosis caused by SGLT2 inhibitor?

Based on recent data would you consider adding ATRA to low dose rituximab for steroid refractory ITP?

Wu et al., PMID 34665865

For a patient who has core binding factor AML but also a small FLT3-ITD mutation detected, do you proceed with allo transplant or only HiDAC consolidation after achieving CR from induction chemotherapy?

How do you manage MPN patients with acquired VWD in the perioperative setting?

Please specify your approach in elective and emergency surgical situations

Other than B12 repletion, is there any further treatment or work-up indicated in pernicious anemia with positive parietal cell antibodies?

How would you approach cytopenias 5 weeks after initial dosing in a young patient with MDS treated with Azacitadine as a bridge to transplant?

E.g. would you dose-reduce or continue at same dose? Baseline ANC was in the normal range

Do you hold histone deacetylase (HDAC) inhibitors for patients receiving palliative radiation therapy for cutaneous lymphomas?

If so, how long before/after radiation?

Is there a role for IL2-receptor antagonists and TNF-alpha inhibitors in cytokine release syndrome as a complication of CAR-T or immunotherapy?

How would you treat a patient with two concurrent plasmacytomas whose bone marrow showed no evidence of multiple myeloma and has no other MM defining features?

Normal CBC, CMP, SPEP, serum light chains, and FISH. Young otherwise fit patient.

How do you approach work-up for a patient suspected for monoclonal gammopathy of renal significance for whom renal biopsy is contraindicated?

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?

What is your approach to using medications that can cause bone marrow suppression in SLE patients who have persistent leukopenia?

When considering the use of DOACs in APLS, does the number of positive APLS antibodies influence your decision?

Would you continue venetoclax indefinitely/until disease progression in patients treated with upfront venetoclax for TP53 mutated CLL?

When do you stop trying to eradicate an acquired factor VIII inhibitor?

Patient with high titer acquired FVIII inhibitor with no causative etiology. Bleeding is well-controlled on emicizumab, but inhibitor has failed...

How would you treat a patient with recurrent DLBCL 15 years after definitive treatment of initial de novo disease with R-CHOP?

How do you manage and/or prevent ruxolitinib withdrawal syndrome?

What aspirin dose do you favor for thrombotic prophylaxis in myeloproliferative neoplasms?

81 mg vs 162 mg

Would you give IV iron for low TSAT in patients with MDS anemia who are transfusion independent but on an ESA?

i.e. similar to CKD anemia?

How long would you consider the use of low-dose aspirin in a patient with SLE and high risk aPL profile (without a clinical event)?

When do you consider iron chelation in elderly patients with transfusion-dependent MDS?

What is your threshold to diagnose light chain MGUS with only a slight elevation in the light chain ratio, in a patient without other CRAB symptoms and no M spike?

When would you consider a bone marrow biopsy?

What would your radiation field be for a 7.5 cm DLBCL involving the tibia (with pretibial soft tissue involvement) after CR to R-CHOP x6?

Complete response was achieved after cycle 3. What extent of bone would you include?

Will you use or have you been using the IPSS-M as the primary way to risk-stratify patients with MDS to determine use of hypomethylating agents?

Will you be using the IPSS-M in place of the IPSS-R? How will you be using IPSS-M in practice?

Would you continue ruxolitinib in combination with HMA plus venetoclax in myelofibrosis at the time of transformation to AML?

In antiphospholipid syndrome with recurrent strokes, would you consider adding antiplatelets to warfarin?

Also how would you manage this perioperatively?

6 Answers available

Do you recommend long term anticoagulation for all patients with first time unprovoked VTE?

Do you consider discontinuing maintenance therapy in transplant-ineligible patients with Multiple Myeloma?

Other than in the setting of disease progression or significant treatment-related adverse event?

Would you recommend an allogenic stem cell transplant in an older patient > 50 with Ph negative acute lymphoblastic leukemia who is MRD negative after induction?

Does your answer change based on clinical or molecular risk factors, and if so how? Does your answer change if MRD status after induction is unknown?

Do you recommend IVIg and/or cytoreduction for patients with IgM MGUS with reciprocal depression in IgG and recurrent infections?

Infection is not part of the criteria for starting treatment both in UpToDate and in NCCN guidelines.

What recommendations do you have for a transgender female patient with history of prothrombin gene mutation who is interested in starting gender affirming hormone therapy?

The patient has no personal history of VTE, but has positive family history of VTE. Any prophylactic anticoagulation options? How would manage...

Is concurrent intrathecal therapy necessary with HD-MTX for CNS lymphoma?

How do you determine whether to add intrathecal chemotherapy in patients with +CSF? Would your approach change for primary vs secondary CNS lymphoma?

Do you hold IV iron in the setting of active infection?

How do you manage a DOAC if interested in testing for lupus anticoagulant?

Significant history of autoimmune diseases and DVT in family, recent PE/DVT for a month

Do you routinely send NGS testing from bone marrow samples in patients with unexplained cytopenia or cytoses?

For instance, if clonal hematopoiesis of indeterminate potential (CHIP) suspected

What is the recommended management approach in regard to diagnostic evaluation and treatment for patients with homocystinuria and cerebral thrombosis?

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

How would you approach an early stage II unfavorable Hodgkins lymphoma following 6 cycles ABVD with persistent Deauville 5 with negative biopsy?

iPET2 and iPET4 showed Deauville 5 response. CT biopsy after 4 cycles was negative. Patient is currently scheduled for 2 additional cycles of ABVD.

How would you approach a bulky 9 cm DLBCL of the axilla following an excisional biopsy to negative margins?

Would you treat as bulky or non-bulky? Is ISRT indicated? Biopsy was performed because there was concern for soft tissue sarcoma.

How would you work up a patient with cutaneous mastocytosis?

Is a BM biopsy a must when there is skin involvement? If tryptase level is mildly elevated but less than 20 would you recommend a BM biopsy?

In patients with severe hemophilia A on emicizumab for prophylaxis, in case of noncompliance leading to a lapse of more than 2-3 months off therapy, do you reload with emicizumab?

In a patient identified as having APLS because of recurrent pregnancy loss without history of thrombosis, but now has a new DVT/PE during pregnancy despite use of enoxaparin—for how long would you recommend anticoagulation?

Is it time limited since it may have been triggered by the pregnancy or is it indefinite since it is APLS associated?

When using daratumumab in the setting of post-transplant red cell aplasia or post-transplant immune-mediated cytopenias, do you hold the drug for certain ANC parameters?

What is the preferred immunosuppressive modality for patients with an acquired factor 8 inhibitor?

In patients who develop a VTE, what conditions do you consider as persistent, provoking risk factors, and at what point are they controlled enough to stop anticoagulation?

I.e., what constitutes well-controlled cancer, IBD, nephrotic syndrome, etc. What other diseases do you put in this category (obesity, autoimmune dise...

How does your surveillance for DLBCL change given the new role of CAR-T in 2nd line treatment?

How do you assess if a patient may be a candidate for CAR-T cell therapy?

What are your recommendations for a male patient who was recently started on imatinib and wants to conceive?

What is the role of radiation therapy in recurrent Rosai-Dorfman disease after surgical resection, which manifests as many cutaneous lesions on the arms and buttocks?

Does the fact that the patient is on methotrexate alter your choice?

What are your triggers for BM biopsy in polycythemia vera?

What workup and initial treatment should be considered for suspected autoimmune myelofibrosis?

What is the best approach for patients with DLBCL with early relapse (< 6 months) after initially attaining a CR with 6 cycles RCHOP?

Does this differ for a patient who had a longer remission before relapse?

How do you prepare patients with DLBCL on the potential need for cellular therapies after progression on first line regimens?

When is this discussed? What are the common/less common toxicities you advise patients on? Are there best practices for coordination with referring on...

How do you incorporate CAR-T cell therapy for DLBCL in transplant-eligible patients?

Given the results of ZUMA-7, TRANSFORM, and BELINDA - how does this inform your current practice? What are the currently approved indications for CAR-...

How soon do you anticipate response to cyclosporine in red cell aplasia and what cyclosporine trough levels do you target?

How would you work up and manage persistent lymphopenia in an asymptomatic patient?

ALC<200

Do you consider travel as a risk factor for DVTs in the absence of any other underlying predisposing factors?

i.e. long car rides or plane rides

How would you manage an incidental catheter-related thrombosis in a functioning dialysis catheter?

- Dialysis catheter used for hemodialysis- RIJ thrombus in dialysis catheter was incidentally found- Patient asymptomatic with no prior history of VTE...

What is the benefit of cytoreduction with Hydroxyurea for patients with newly diagnosed chronic phase CML with a WBC count >100 prior to the initiation of a TKI?

Do you offer iron supplementation to a non-anemic adolescent athlete with a low ferritin?

What platelet threshold, if any, is your goal for cytoreduction in essential thrombocythemia?

How do you treat a young woman of child bearing age group diagnosed with primary CNS lymphoma?

The CALGB regimen is quite complicated.

Is an elevated CRP an expected finding in an otherwise healthy patient with hemoglobin S - alpha thalassemia?

CRP 39 mg/L (normal < 10) and normal ESR

How would you manage relapsed DLBCL in a patient who received second line CD19 CART treatment?

If a patient had a grade 2 infusion reaction to initial dose of IV Rituximab, can you give subcutaneous Rituximab for cycle 2 or continue with IV Rituximab?

Would you add Daratumumab to upfront treatment of multiple myeloma in a patient with tetraploidy on FISH?

How would you manage someone with antithrombin deficiency who has recurrent VTE on a DOAC?

APLA syndrome, obesity, non compliance ruled out and prefers another oral anticoagulation. Is higher dose of rivaroxaban or apixaban an option?

Would you consider anifrolumab in the management of hematologic manifestations in SLE?

How do you choose which BTK inhibitor to use in NHL?

Does the safety profile impact your choice significantly? Does your first choice vary by disease histology?

How do you approach treating a patient with IgM-AL amyloidosis?

Given the rarity of this diagnosis (5-7% of all AL amyloidosis cases), and the prognostic and clinical differences when compared to non IgM-AL am...

What is your first line of therapy for refractory Hodgkin lymphoma in an AYA patient?

What factors do you look at while deciding between a daratumumab-based quadruplet induction versus standard triplet induction such as VRd for newly diagnosed MM?

Which, if any, young/fit intermediate-risk AML patients would you not offer allogeneic transplant to in MRD- CR1?

How does the presence of concurrent infections or wound issues affect your choice and timing of induction in patients with AML or MDS with excess blasts?

Are there any differences in your approach to therapy for secondary versus primary myelofibrosis?

Secondary MF such as post-PV, for example. Do you apply the same prognostic scoring systems?

Does normal methylmalonic acid levels absolutely rule out vitamin B12 deficiency?

What is your preferred first line regimen for myeloma with severe renal impairment, either on or off dialysis?

For primary CNS lymphoma, when do you refer for whole brain radiation therapy (WBRT)?

My experience has been that patients can be neurologically devastated years out from WBRT. In Medical Oncology practice at my institution, we do not r...

How do you define bulky disease for Hodgkin's lymphoma which is outside the mediastinum?

Do you use a cutoff of 10 cm? Do you measure the size of the largest node or measure the largest conglomerate or measure the total length of the entir...

In transplant-eligible, fit patients with primary refractory myeloma, what is the optimal timing for stem cell collection?

We know the longer we expose patients to lenalidomide, the harder collection will be. Would you collect now or switch to an alternative regimen to ach...

In someone with an asymptomatic JAK2 V617 mutated and BCR/ABL negative MPN with a steadily rising WBC, when do you decide to start cytoreductive therapy and which agent(s) do you recommend?

No evidence of palpable splenomegaly, normal hematocrit and platelet count

How do you approach the decision to pursue early versus delayed autologous stem cell transplantation in newly diagnosed multiple myeloma?

Do you always initiate hypercoagulable work up in a patient with recurrent stroke?

If so, what would you consider ordering?

In a patient with a bleeding disorder, how would one approach anticoagulation during active COVID infection?

Bleeding disorder such as vWD

In patients with CML on imatinib and newly diagnosed breast cancer now requiring radiation therapy, should we hold imatinib?

The said patient has been on Imatinib for 2.5 years and is In MMR. Last rt-PCR was 0.04.

In a patient with sickle cell disease on hydroxyurea who is planning to have a family, for how long should they be off the drug before trying to conceive?

Are there situations where you would start treatment for cardiac amyloid in a patient with amyloid seen on biopsy, but still pending mass spectrometry results?

E.g. in a patient with tenuous cardiac function, would starting treatment several weeks earlier potentially improve outcomes?

How do you manage a patient with a history of high-risk leukemia who has increasing loss of donor chimerism in the post-transplant setting in the absence of disease relapse?

How does graft function play into your decision making? How do you utilize post allogeneic transplant chimerism in clinical practice? Do you obta...

How would you treat a patient with blastoid mantle cell lymphoma with hepatic involvement causing significantly elevated bilirubin?

What criteria is needed in relapsed/refractory B-cell ALL to choose CAR-T therapy over conventional stem cell transplant as destination therapy?

What are your top takeaways in Hematologic Malignancies from ASCO 2022?

What were your “top 3” presentations/studies coming out of the meeting this year and how will it impact your own clinical practice? ...

Would you recommend allogeneic stem cell transplantation for consolidation in a patient with follicular lymphoma who relapsed within 13 months of initial chemo-immunotherapy?

What is the optimal treatment for a fit, elderly patient with NGC diffuse large B cell lymphoma that recurred about 1 year after dose-attenuated R-CHOP?

Would you include midostaurin in induction and consolidation for patients with good-risk AML w/ NPM1 mutation and FLT3-ITD (<0.5)?

How would you treat gray zone lymphoma which initially achieved a CR after 2 cycles of DA-R-EPOCH, but end-of-treatment PET demonstrates progression with new sites of biopsy-proven disease?

At what platelet count would you feel comfortable dosing aspirin 81 mg for coronary artery disease in a patient with ITP?

Presuming strong indication for ASA - eg history of NSTEMI

How do you counsel patients with elevated factor VIII levels for their thrombosis risk?

Should we stop checking factor VIII levels as part of thrombosis workup?

For patients with multiple myeloma, when using Lenalidomide or Pomalidomide, how do you approach dose adjustment based on patient tolerance?

In a patient with multiple myeloma on lenalidomide who develops COVID-19 and is going to receive Paxlovid treatment, would you stop lenalidomide for the duration of Paxlovid treatment?

How would you approach protein S deficiency found on hypercoagulability work-up in a patient with a post-operative central retinal vein occlusion?

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 interpret elevations in antiphospholipid antibodies that are lower than Sapporo criteria?

(e.g. beta 2 glycoprotein IgM > 20 but <40)

How has the virtual aspect of tumor boards impacted their educational quality in the Covid-19 era?

Would you include the entire hardware as part of ISRT for a patient with Stage IE DLBCL of the distal femur treated with upfront prophylactic nailing for impending fracture, who had a CR to chemotherapy?

In this case, initial tumor was 9.5 cm craniocaudal but hardware spans the entire femur.

Are BTK inhibitors safe to use in patients with severe renal failure?

eg. eGFR < 30 ml

Is there any benefit to transplant patients with Ph+ ALL who have achieved MRD-negativity?

Would you give antithrombin concentrate for surgical VTE prophylaxis in case of congenital AT deficiency?

To what extent does the degree of thrombocytopenia correlate with the severity of cirrhosis?

Do you avoid using tafasitamab in germinal center subtype diffuse large B-cell lymphoma?

What is your approach to pediatric or AYA patients with B-cell ALL who relapse after CD-19 CAR-T?

How do you approach treatment for a patient with hypoplastic MDS who is not eligible for transplant?

How do you manage patients who develop minor antigen antibodies and require multiple blood transfusions?

e.g. K, Fya, s, etc

At this time, how are you using MRD testing for clinical management of patients with multiple myeloma?

How do you manage a patient with sickle cell disease during pregnancy?

How long after starting anticoagulation would you remove an IVC filter in a patient with a DVT presenting with stroke and PFO which is now closed?

How do you manage real-time release of pathology and radiology results to oncology patients following enaction of the CURES act?

Would you offer consolidation RT to a young woman with bulky mediastinal DLBCL who achieved early and persistent CR to RCHOP on PET?

For primary MZL of the breast, do you do whole breast to 24 Gy or ISRT?

For patients receiving outpatient venetoclax/azacitidine who develop profound neutropenia with ANC <200, do you admit for monitoring during the nadir in the absence of fever?

If not, what instructions do you give to patients regarding checking temperature at home/return precautions?

How do you determine duration of anticoagulation for an ovarian vein thrombosis following a provoking event?

How do you approach IVIG replacement for pediatric patients with low IgG during treatment for hematologic malignancies?

Do you routinely check IgG levels during therapy, if not indicated by a study protocol?

Would you consider CAR-T therapy without autologous transplant in a patient with multiple myeloma whose best response to induction therapy is a partial response?

What radiation dose do you typically use for relapsed DLBCL following 6 cycles of R-CHOP?

Do you routinely offer antiviral prophylaxis for patients receiving chemoimmunotherapy?

If so, what regimen do you utilize?

What is your approach to treating newly diagnosed plasma cell leukemia?

Would you anticoagulate recurrent venous thromboembolism in a patient with Ehlers Danlos syndrome?

How would the approach differ if the patient had a significant bleeding phenotype vs only minor bruising and mucosal bleeding?

What is your approach to a patient who has an ischemic stroke while on clopidogrel despite strict compliance and normal results on clopidogrel response assay?

In a patient diagnosed with Multiple Myeloma, is there a role for 24-hour UPEP prior to treatment?

Does measuring serum free-light chains make a 24-hour UPEP unnecessary?

How do you sequence therapy in an older patient with newly-diagnosed blastoid mantle cell lymphoma with a 17p deletion?

What are your recommendations for management of patients with familial polycythemia due to EPOR mutation during pregnancy?

What is your institution's practice/guidelines for considering a reduced-intensity (RIC) over a myeloablative (MAC) conditioning regimen?

Do you recommend the use of dexamethasone and anakinra as upfront treatment in a pediatric patient with secondary HLH (nonrheumatic) who is too ill to tolerate etoposide?

This type of etoposide sparing therapy has been previously described in a case series at https://pubmed.ncbi.nlm.nih.gov/32725881/

Would you retry rituximab in steroid refractory warm autoimmune hemolytic anemia which responded to rituximab before?

Last rituximab 6 months ago

For a patient with concurrent diagnoses of Hodgkin Lymphoma and Light Chain Myeloma complicated by Myeloma Kidney, how would you approach treatment?

What agents would have sufficient efficacy overlap to treat both?

What are the alternatives to anticoagulation in an individual with an atrial thrombus and absolute contraindications to anticoagulation?

How would you manage a patient with essential thrombocythemia and persistent pruritus despite adequate control of CBC with hydroxyurea and aspirin?

ET is JAK2+

How does evidence of cerebral amyloid angiopathy/microbleeds affect choices for secondary stroke prevention in patients with a history of ischemic stroke and atrial fibrillation?

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

Would you recommend consolidative radiation therapy for advanced stage bulky Hodgkin's lymphoma with a delayed complete response after 6 cycles of A-AVD chemotherapy?

Initial tumor size:18 cm. Partial response was achieved after cycle 2 and cycle 6 of chemotherapy. Complete response (Deauville 2, size: 6 cm) was ach...

When and how do you initiate therapeutic phlebotomy for patients with hereditary hemochromatosis without evidence of end-organ injury?

How would you approach treating patients with RA refractory to cDMARDs and a prior history of MALT lymphoma?

How do you differentiate atopic dermatitis from mycosis fungoides histologically?

When consolidating DLBCL with radiotherapy, do you treat all originally involved sites, or just initially bulky and partial responder sites?

Does this change depending on stage?

How long do you give systemic therapies or skin directed therapies to work before changing treatments in patients with diffuse skin limited mycoses fungoides?

Do you have a preferred sequence of therapies for diffuse skin limited MF?

How would you approach the treatment of cytopenia related to NK cell LGL leukemia?

When would you opt for a chemotherapy free approach in the first line treatment for hairy cell leukemia?

What would you consider as contra-indications to Cladribine?

Would you give a TPO agonist for thrombocytopenia in alcoholic cirrhosis?

Would you check vitamin B6 routinely in the work up of anemia?

Are there best practices or data regarding the use of open notes among oncology patients?

What is the impact among patients and providers? Has your documentation been adjusted now that patients can readily review?

How do you approach heparin management in patients who have suprathetherapeutic Xa levels on minimal heparin?

Do you repeat antiphospholipid antibody testing in a patient that previously met criteria for APLS?

If so, how long after diagnosis do you do so?

Does R-CHOP provide durable remission in low-risk pediatric Burkitt or Burkitt-like lymphoma?

What is your recommended management algorithm for bleeding associated with an acquired factor VIII inhibitor?

What would be your approach to initial treatment of a patient with standard-risk myeloma unwilling to undergo autologous stem cell transplant, if practicing in a resource-limited setting?

How do you interpret a Deauville score of 3 on PET when performing mid-treatment assessments in patients with Hodgkin lymphoma?

Are there situations in which a Deauville 3 would cause you to escalate therapy?

For relapsed/refractory myeloma, how long of a disease-free interval from first autologous transplant do you recommend before considering a second autologous transplant?

When do you consider plasma exchange for multiorgan failure in a patient with sickle cell disease?

How do you manage recurrent portal vein thromboses in a patient with JAK2+ PV on therapeutic anticoagulation and appropriate cytoreduction?

Recurrent thromboses despite therapeutic enoxaparin. Other hypercoagulable work-up negative.

How would you qualify and treat a patient with neutropenia, anemia, and abnormal NK cell population with normal trilineage marrow maturation?

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

What induction combination(s) would be appropriate for newly diagnosed standard cytogenetic risk multiple myeloma who have a transplanted kidney?

Would you avoid imid's given reported association with transplant rejection?

For patients with mild CKD, how do you decide between zoledronic acid and denosumab for bone protection in patients with multiple myeloma?

For pts w/ eGFR between 30-60

What would be a reasonable radiation approach and dose for a patient with multiple myeloma with brain involvement?

Should a pregnant woman who is heterozygous for factor V Leiden who has never had a thrombotic event receive prophylactic anticoagulation?

Does 4G/5G polymorphism in the plasminogen activator inhibitor (PAI-1) gene increase the risk of thrombosis?

In the absence of a VTE would you consider prophylaxis after a surgical procedure? Often non-hematologists order this testing but we are consulted for...

Does potential longterm risk for leukemia influence your decision for using hydroxyurea in young patients with myeloproliferative neoplasms?

Would pegylated interferon be preferred?

Do you recommend routine use of Evusheld for pre-exposure prophylaxis for patients on immunosuppression?

Does treatment with B-cell depletion and/or negative anti-spike antibody status despite COVID mRNA vaccination influence your decision?

Are there any situations you would recommend prophylactic anticoagulation for a patient with Factor V heterozygosity?

FVL heterozygotes are often treated similarly to the general population. Aside from avoiding other VTE risk factors, are there situations where prophy...

What treatment considerations do you make for elderly patients with relapsed/refractory follicular lymphoma?

Are you more inclined to use non cytotoxic regimens such as R2 or PI3K inhibitors?

When would you consider an umbilical cord blood transplant over a haploidentical transplant with post-transplant cyclophosphamide, or using a desensitization protocol for high donor-specific antibodies?

In which platelet function disorders would you consider use of Novoseven as opposed to platelet transfusion?

Are there particular clinical scenarios that would affect your decision?

What is the role of splenectomy versus systemic therapy in splenic marginal zone lymphoma?

How do you approach very treatment-refractory ITP?

Such as the case in which a patient is unresponsive to steroids, IVIG, TPO-agonist, rituximab, splenectomy, and even fostamitinib.

How have you been counseling patients with sickle cell regarding a 3rd COVID vaccine?

Would you consider using HMA in management of polycythemia vera?

i.e. treatment-refractory PV, prior to progression to PMF or AML

Should we recommend the COVID-19 booster vaccine to patients who had a DVT or any other complications such as hemolytic anemia or thrombocytopenia from prior vaccine doses?

Do you find IgA isotypes of anti-beta2-glycoprotein antibodies and anticardiolipin antibodies to be clinically useful in the evaluation for APS?

Do you routinely check IgA anticardiolipin and beta-2 glycoprotein antibody IgA in your practice? And how would a positive result change your manageme...

In a patient with a heterozygous prothrombin gene mutation who has COVID with minimal symptoms, do you recommend prophylactic and/or therapeutic anticoagulation?

When would you add daratumumab to a PI/IMiD/dex backbone for first-line treatment of transplant-eligible multiple myeloma?

Are the early results of CASSIOPEIA (Abst 8003) from ASCO 2019 practice changing? What about the GRIFFIN results in 2020?

How would you approach a patient with early-stage orbital MALT lymphoma with high proliferative index?

Is antiplatelet or anticoagulant therapy preferred for the secondary prophylaxis of cryptogenic stroke in a patient with underlying malignancy?

How do you manage drug-induced thrombocytopenia when the implicated drug is essential?

e.g. DITP from eptifibatide after a cardiac intervention

For patients with myeloma on an IMiD, how do you decide on the dosages of aspirin or anticoagulants in VTE prophylaxis ?

Do you modify the aspirin dose based off the lenalidomide dose? Do you ever use higher dose aspirin in lieu of an anticoagulant? The NCCN guidelines s...

What is your preferred anticoagulant for acute portal vein thrombosis?

How does cirrhosis and/or underlying thrombophilia affect your decision?

For treatment of ITP, what would you add to dexamethasone to achieve the fastest recovery in a patient waiting for a procedure?

IVIG, TPO, or other agents?

Would you use new DOAC loading dose or start with maintenance dosing for a stable patient on existing DOAC who needs to switch brand due to insurance/formulary reasons?

Conversion tables suggest starting the new drug with the next dose but do not seem to answer this question (i.e. if switching from rivaroxaban 20 mg d...

For multiple myeloma patients with vertebral lesions requiring palliative radiation (e.g. 20-30 Gy in 10fx), do you treat concurrently with modern systemic myeloma agents such as lenalidomide and bortezomib?

Which systemic agents would you recommend holding during RT?

Is it reasonable to treat a solitary plasmacytoma of the lung parenchyma with SBRT?

What dose/fractionation?

How do you treat primary refractory diffuse large B cell lymphoma in elderly patients with good performance status?

When would you consider stopping chronic transfusion therapy in a sickle cell patient with history of abnormal TCDs but no stroke?

What are non-clinical trial options to treat high-risk MDS in a transplant ineligible patient, after progression on hypomethylating agents?

How would you manage an in-field small volume recurrence of early-stage favorable Hodgkin Lymphoma treated previously with 2 cycles of ABVD and 20Gy?

If re-irradiation, what dose would you use?

Do you give an etoposide-based regimen/more aggressive therapy for lymphoma-associated HLH, such as da-EPOCH-R over R-CHOP?

What about changing standard regimens for TCL with HLH?

Do you ever consider treatment outside of the peripartum period in a patient with a history of obstetric APS?

i.e. obstretric APS without thrombosis or SLE

How do you manage severe thrombocytopenia due to splenomegaly and bone marrow involvement in CLL when starting obinituzumab and venetoclax?

How should one manage a patient with leukocytosis and borderline detectable BCR-ABL without other clinical features of CML such as basophilia or splenomegaly?

e.g. IS < 0.002% by qPCR

What is your treatment of choice for triple class refractory multiple myeloma?

CAR-T (any specific preference of product?) vs bispecific antibodies vs any other specific agents not previously utilized?

Are there any alternative, hypofractionated RT courses for patients with DLBCL that can be used during the COVID-19 pandemic?

How do you approach relapsed idiopathic HLH?

How will you use Pola-R-CHP in the frontline treatment of DLBCL?

Given the POLARIX study data presented at ASH 2021, will this replace R-CHOP as the standard of care therapy in your practice? If not, how will y...

How does one interpret persistently positive lambda light chains on serum immunofixation but without measurable serum monoclonal protein and a normal light chains and ratio?

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

What options are available for patients with relapsed/refractory AL amyloidosis after Dara-CyBorD, other than clinical trial?

Do you adjust the dose of ruxolitinib in primary myelofibrosis based on hemoglobin?

For lymphoma, how long after chemotherapy can you wait to start consolidative radiation therapy?

In situations when we are waiting for insurance clearance or due to other logistical reasons.

How would you approach a resected solitary osseous plasmacytoma?

Plasmacytoma of 6th rib s/p resection. Negative multiple myeloma work-up.

What are your considerations for peri-operative anticoagulation in patients with a mechanical heart valve undergoing a major noncardiac surgery?

Please comment on bridging.

What are contraindications for growth factors in patients with hematologic malignancies?

Do you routinely check platelet counts after COVID-19 vaccines in patients with chronic ITP?

Does variable allele frequency (VAF) of JAK mutation affect your clinical decision-making in MPN in any scenario?

Does VAF <1% make you want to do a BM biopsy for confirmation?

Does testing for elevated serum homocysteine have any relevance in thrombophilia management?

What should be done with a high level?

In young patients with essential thrombocythemia and early significant atherosclerotic disease but no thrombotic history, would you consider the addition of cytoreductive therapy?

Would the presence of JAK2 versus CALR versus MPL influence this decision? What if there are other risk factors for cardiovascular disease?

How do you counsel male-to-female transgender patients on the VTE risk of hormonal therapy?

Are you comfortable using DOACs in obese patients with VTE?

Which patients with smoldering myeloma do you treat?

How would you manage a patient with JAK2-positive PV who is not responding to hydroxyurea or IFN-alpha for cytoreduction?

This is in the setting of a patient who is now on ruxolitinib with rising leukocytosis and thrombocytosis, but cannot be on aspirin due to recent blee...

Now that ropeginterferon is approved for PV, how do you select patients for this therapy?

How would you approach older patients who are not fit or frail with stage 1 favorable classical Hodgkin lymphoma?

Is there any role for radiation therapy alone?

What is your approach to a patient with an advanced stage diffuse large B-cell lymphoma treated with chemotherapy alone (with a PET CR) who then develops an isolated CNS relapse?

If the patient cannot tolerate methotrexate or further chemotherapy, how effective is radiation therapy (e.g. WBRT) in rendering the patient disease-f...

What is your experience managing myelosuppression from busulfan, prescribed for PV?

What is the role for consolidative ISRT for patients with stage III follicular lymphoma following a good response to systemic therapy?

How would one alter therapy in a transplant-ineligible AL amyloidosis with less than a complete response to six cycles of Dara-CyBorD?

Would you continue with daratumumab maintenance per ANDROMEDA or switch regimen?

How do you approach transplant eligible myeloma patients with a partial or minimal response to treatment with 3-4 cycles of RVD?

After 3-4 cycles of RVD, would you automatically take the patient to transplant if he has achieved at least a partial response, or is there any benefi...

Do you approach the diagnosis and treatment of HIT patients differently in the outpatient setting or in a resource-limited community setting?

For example, for outpatients or resource-limited settings with a moderate probability 4-T score (but low clinical suspicion), would you ever consider ...

How would you approach a patient with gastric MALT lymphoma who has CREST syndrome?

Would chemotherapy be preferred over RT?

How do you manage HIT in a patient with high bleeding risk?

e.g. in the setting of using prophylactic heparin in the past but now requiring therapeutic anticoagulation

How would you manage an asymptomatic elderly frail patient with newly diagnosed mantle cell lymphoma with TP53 mutation?

Ki67 = 90% with multiple small nodes on PET scan and normal CBC

How do you manage a patient with superficial venous thrombosis with close proximity (<3 cm) to deep veins and an inherited thrombophilia ?

Would you offer indefinite anticoagulation if the event is unprovoked and the patient has low bleeding risk?

Is there a role for phlebotomy in secondary polycythemia?

Aside from addressing the underlying case, is there a role for phlebotomy in secondary polycythemia such as in COPD or post-renal transplant erythrocy...

What is your typical workup for a patient with a spontaneous renal infarct?

Please also discuss the type and duration of anticoagulation.

How do you manage a patient with transfusion-dependent MDS with concurrent hemochromatosis requiring phlebotomy?

In what situations would you offer salvage radiotherapy for relapsed/refractory DLBCL?

NCCN only recommends palliative ISRT for non-transplant eligible patients with refractory/relapsed DLBCL

What radiation dose and fractionation is appropriate for hairy cell leukemia presenting as an isolated skeletal lesion, where systemic treatment is not recommended?

The dosing in the literature has a huge range.

In patients with high-risk polycythemia vera with a history of thrombosis, should aspirin be used in addition to indefinite anticoagulation and cytoreduction for prevention of recurrent thrombosis?

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

How do you approach patients with underlying psychiatric disorders who refuse CML treatment due to not believing their diagnosis?

How would you manage a patient with history of follicular lymphoma treated with Bendamustine-Rituximab who now has a new FDG avid lesion that is biopsy proven CD30 positive CD20 negative DLBCL?

In patients with thrombocytosis with negative MPN workup from peripheral blood and bone marrow, is there a role for daily 81mg aspirin or other treatment?

Does discovery of clonal hematopoiesis on liquid biopsy for solid tumors change your treatment approach in terms of which chemotherapy to offer for the solid tumor?

Is there experience/reports of using voxelotor in sickle cell patients who are Jehovah Witnesses with few crises but who have fatigue and/or dyspnea?

Also is there value in using voxelotor for the purpose of reducing hemolysis, and if so what parameters do you use to determine when to initiate voxel...

Would you re-challenge a patient with refractory multiple myeloma with carfilzomib who responded well but developed grade 3 heart failure and subsequently recovered the EF upon holding carfilzomib?

If you do recommend resuming carfilzomib, what dose and frequency would you use?

Do you routinely check for copper deficiency as part of workup for bicytopenia with leukopenia/anemia or pancytopenia?

Is there a role for radiation therapy in the treatment of a lymphoproliferative disorder involving the orbit?

If so, what dose and fractionation would you recommend?

What is the typical time course of cytopenias after CAR-T therapy, and how do you treat them?

What is your preferred approach for patients with anti-phospholipid syndrome with recurrent thrombosis on coumadin and LMWH?

What's the optimal management of stage IA nodal ATLL in a young fit patient?

Patient in mid-30s with no major medical history presented with isolated left neck swelling. Incisional biopsy w/ HTLV1/2 associated ATLL, Ki67 of >...

How would you approach a patient with vitreoretinal lymphoma without CNS or systemic involvement?

What would be your RT volumes and dose?

How would you approach moderate neutropenia (ANC < 1000) in a solid organ transplant recipient?

Is there a particular sequence you would adjust contributing antirejection or antimicrobial medications? Is the use of G-CSF appropriate and at what c...

Does cytoreductive therapy in high risk PV reduce thrombotic events because of better normalization of blood counts as compared to phlebotomy, or through some other mechanism?

Are there any circumstances where you consider repeating CT Angiogram Chest after 3-6 months of anticoagulation for pulmonary embolism?

Is prophylactic anticoagulation indicated in patients with frequent ulcerative colitis flares?

If so, what agent(s) do you prefer?

Do you recommend work up for POEMS and/or amyloidosis for IgM monoclonal gammopathies associated with neuropathy?

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

What is your escalation strategy for chronic GvHD?

How does belumosudil now fit in your approach to steroid refractory chronic graft-versus-host disease?

What is the role of hydroxyurea in variant sickle cell genotypes?

Hydroxyurea is demonstrated to reduce complications and improve long-term outcomes in severe genotypes HbSS and sickle beta0 thalassemia. What clinica...

How do you diagnose sickle hepatopathy?

What is your standard workup and treatment for an incidentally-noted splanchnic vein thrombosis?

What is your duration of anticoagulation?

In what circumstances would you give G-CSF to a patient with severe neutropenia and HLH?

How do you approach conversations regarding discontinuation of transfusions in patients with advanced hematologic malignancies who are otherwise appropriate for hospice?

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

What is your approach to a patient with positive antiphospholipid antibodies who otherwise do not meet clinical criteria for APS?

What if the patient is triple-positive or has continued seropositivity on repeat lab testing? What is the appropriate interval of monitoring and does ...

How would you approach early stage unfavorable classical Hodgkin lymphoma with metabolic CR apart from a single residual positive node after 6 cycles of ABVD?

Would you move straight to second-line systemic therapy or first attempt consolidative ISRT/boost, or employ both? Assume node is biopsy-proven.

Do you utilize D-dimer to inform anticoagulation duration in the treatment of VTE?

Provoked or unprovoked VTE: Do you use D-Dimer (or even repeat imaging to reassess residual clot) in any capacity to guide anticoagulation duration? E...

When is a lumbar puncture indicated in a lymphoma staging work up for a pediatric or AYA patient?

Is an LP only recommended in the setting of particular subtypes of lymphoma or symptoms of CNS disease?

How would you manage VTE in a patient with bleeding disorder such as hemophilia?

Have you used anticoagulants other than coumadin? Or is that the only appropriate agent given monitoring is based on PT/INR?

In your practice, do you usually check MMA and B12 simultaneously or start with B12 levels and check MMA only if indeterminate?

For young patients with smoldering multiple myeloma who wish to be treated with lenalidomide, how do you go about harvesting their cells for an autologous transplant?

Insurance won't pay for harvesting if the transplant is not done within a year.

Do you recommend COVID vaccination in patients with antiphospholipid antibody positivity or other prothrombotic states not on anti-coagulation?

Would you extrapolate results from ELEVATE-RR study to favor use of acalabrutinib as first-line therapy in treatment-naive CLL?

Does this data change your preferred first line treatment regimens when considering other options such as mAb combos, cytotoxic chemotherapy?

Do you find ELEVATE-RR data and study design compelling to start preferentially using acalabrutinib over ibrutinib?

Is the non-inferiority margin of 1.429 sufficient, how was this selected? Is the open label (rather than blinded) study design of any concern? Is th...

Do you routinely offer fungal prophylaxis for patients on BTK inhibitors?

Can experts comment on fungal pneumonia risk with individual BTK inhibitors as seen in ELEVATE-RR and whether this impacts their management decisions?

What is your approach to CLL in patients with atrial fibrillation and/or on anticoagulation?

Do you feel comfortable with BTK inhibitors in these patients? In ELEVATE-RR patients on a/c were excluded, and rate of atrial fibrillation in the ac...

Given results of the ELEVATE-RR study, would you consider use of acalabrutinib in all patients with previously treated CLL, or restrict it to certain patient populations?

Such as patients with specific underlying cardiovascular risk factors or other medical comorbidities?

How would you manage a patient with acquired von Willebrand disease who requires DAPT for arterial disease?

In the absence of symptoms would you still treat high risk myelofibrosis if transplant ineligible?

Is leukocytosis and thrombocytosis alone an indication for treatment?

How do you approach the initial dosing of carfilzomib for patients with relapsed multiple myeloma?

Is the therapeutic purpose of the proteasome inhibitor to maximize total dosage per week or number of infusions per week?

Would you treat iron deficiency in post PV myelofibrosis if anemia is the predominant concern?

In a patient with progressive thrombocytosis but negative MPN mutations on peripheral blood, what are your diagnostic and treatment recommendations?

Do you ever recheck JAK2/CALR/MPL/BCR-ABL? Would you recommend a bone marrow biopsy? Is cytoreductive therapy indicated?

When do you check for EPOR gene mutations in your workup for erythrocytosis, and if found, how do you manage it?

Is there a role for aspirin or hydroxyurea? Do you perform phlebotomy, and if so, what goals?

For frail patients with cardiac co-morbidities and relapsed CLL with high cytogenetic risk, what are some considerations for using continuous acalabrutinib over fixed duration therapies such as venetoclax/rituximab?

How do you diagnose MDS in a patient with equivocal morphological findings?

In the case of subtle single lineage dysplasia with normal cytogenetics, do you routinely perform NGS testing for CHIP-type clonal mutations? Do you ...

Do you routinely offer a bisphosphonate or denosumab to multiple myeloma patients without skeletal lesions?

Recommendations in guidelines are discordant (ASCO vs NCCN vs UptoDate).

What hematologic conditions are contraindications for a COVID vaccine?

How would you manage a patient with type 1 cryoglobulinemia secondary to MGUS?

What if the patient is no longer responding to steroids?

Would you use aspirin 81 mg for VTE prophylaxis in patients on adjuvant tamoxifen/SERMs?

Is there data that it actually helps?

Do you consider low-dose aspirin for primary thromboprophylaxis in patients with high-risk antiphospholipid antibody profiles?

While low-dose aspirin for primary thrombosis prevention in aPL without APS is not typically recommended outside cardiovascular prevention guidelines ...

How do you counsel patients referred for abnormal light chain ratio when individual light chains are in normal range?

What is your preferred maintenance strategy for high risk multiple myeloma?

What regimen would you offer a young patient with T-cell ALL who recurred a short time after allo-transplant and was initially treated with CALGB10403?

Especially with the current drug shortage of nelarabine.

Would you start TKI therapy in a patient with new diagnosis of T-ALL without BCR-ABL gene rearrangement on FISH but found to have very low level p190 transcript on RT-PCR?

How do you approach management of sickle cell patients who mistrust Western medicine and prefer naturopathic therapies?

While building a trusting patient-physician relationship, what therapies could be discussed that may be aligned with naturopathic medicine? (i.e. L-gl...

How would you manage a CLL patient who experienced severe infusion reactions with rituximab and has exhausted all other options?

Is it safe to challenge with other CD20 monoclonal antibodies such as obinutuzumab?

What is the anticoagulation recommendation for a chronic DVT?

How would you approach a young person with JAK2 V617F positive essential thrombocytosis with otherwise low risk features?

Would you get bone marrow biopsy periodically? Would your approach change based off specific age or platelet count?

Would you routinely use G-CSF prophylaxis in a CMML patient for decitabine-related neutropenia?

In the rare setting of enoxaparin injection-induced abdominal wall hematoma in patients requiring long-term anticoagulation, what is your timeline for restarting anticoagulation?

Would appreciate expert opinion on when to reimage and when to restart anticoagulation depending on findings.

Would you require pre-RT dental evaluation and clearance for a patient who is being treated with ISRT to Waldeyer's ring/BOT area to 30 - 36Gy?

Should patients with active multiple myeloma and other gammopathies be routinely vaccinated against herpes zoster?

If yes would you delay initiation of antineoplastic therapy to allow time for the vaccine to start acting?

What is the role, if any, for next generation sequencing testing in patients with suspected MPN who test negative for commonly identified mutations such as JAK2, CALR, MPL, and BCR-ABL?

How would you manage symptomatic iron deficiency in patients with PV on frequent phlebotomies?

Is this a reason to start hydrea? Would you give oral iron after adequate control on hydrea?

Do you recommend anticoagulation for a splenic infarct in patients with myelofibrosis and splenomegaly?

What is the maximum pRBC volume you can transfuse when performing a manual exchange transfusion in an adult-sized patient with sickle cell disease?

Do you discontinue anti-hormonal therapy if a high-risk ER+ HER2- localized breast cancer patient develops blood clots on anti-hormonal therapy?

How would you approach a patient who is intolerant of AI and develops thrombosis while on SERM?

What would you recommend for a stage I follicular lymphoma of the bone?

Would your recommendation change based on grade and/or location (weight-bearing vs non weight-bearing bone)?

How do you approach treatment of vasculitis in a sickle cell disease patient?

There are multiple difficulties that could be seen: steroids can precipitate a sickle cell crisis, vasculitis and sickle cell can produce similar clin...

How do you approach monitoring for lymphoproliferative disease in Sjogren's patients?

Would you offer RT to a patient with a stage I low grade follicular lymphoma in the groin/upper thigh (7 cm) s/p complete excision with negative margins?

Would your recommendations change if the mass were significantly smaller, say 1-2 cm, and was completely excised with negative margins?

How often should you repeat iron testing in patients with hemochromatosis, not on phlebotomy?

Patient with ferritin level <1000 ng/mL and no evidence of end-organ damage

How soon after a VTE would you feel comfortable with a patient undergoing an elective surgery?

While there are many factors involving:- type (DVT vs PE, unprovoked vs provoked) and severity of venous thromboembolism (VTE) size- duration of antic...

How do you counsel patients with newly diagnosed transplant-ineligible multiple myeloma on the expectations of treatment in terms of disease control, duration of therapy, monitoring and follow up?

How do you approach an isolated T-cell gene arrangement found in the setting of persistent hypereosinophilia?

If all work-up including peripheral flow, bone marrow biopsy, PET-CT returns negative, what additional management (if any) would be recommended?

What level of 24h urine M protein do you consider to define active myeloma in a patient with renal insufficiency, proteinuria and monoclonal gammopathy?

When do you start treatment in this case?

What would be your preferred second line treatment for a frail elderly patient progressing on Rd?

Do you use premedications (acetaminophen, diphenhydramine) before pRBC and plt transfusions to prevent febrile nonhemolytic transfusion reactions and allergic reactions?

Does manipulation of blood products (leukoreduction, irradiated) affect your approach? There is growing evidence that routine premedication (at least ...

Would you extend the duration of anticoagulation in patients with a provoked DVT, but evidence of residual clot at 3 months?

While follow up ultrasound is not usually recommended in provoked DVT, it often is done either for other reasons or by other physicians. Would this in...

Under what circumstances would you consider anticoagulation in a young female patient with persistently elevated factor XI activity?

While this is a known risk factor for venous [Meijers et al NEJM 2000] and potentially arterial [Yang et al, Am J Clin Pathol 2006] thrombosis, it is ...

Would you offer a complement inhibitor to a minimally symptomatic PNH patient with mild non-transfusion dependent hemolytic anemia?

What is your perioperative approach to holding and restarting hydroxyurea in patients with essential thrombocythemia?

Are there any special considerations when evaluating patients with non-malignant hematologic or immunodeficiency disorders for allogeneic transplant?

Are there major differences in standard conditioning and/or GVHD prophylaxis regimens utilized? Does the non-relapse mortality different significantl...

What regimen would you recommend for a younger, fit, transplant eligible patient with relapsed IDH1 positive AML?

With what agents can you replace PPIs if they cause thrombocytopenia?

How would you optimally manage a patient with a MDS/MPN overlap syndrome who has both transfusion-dependent anemia and marked thrombocytosis?

Would this change with someone who has a history of thrombosis (e.g. DVT/PE, MI, CVA)? Would this change with someone who is more fit vs more frail?

Should platelet transfusions be considered for anti-platelet agent reversal in patients with major bleeding?

Should assessing for a MTHFR mutation be part of the thrombophilia evaluation in a patient presenting with a thrombus?

How would you approach immunosuppression for patients with severe aplastic anemia who are not transplant or ATG candidates?

Such as patients who are frail, elderly, renally impaired? Would you consider sirolimus over cyclosporine or tacrolimus for safer nephrotoxicity prof...

How long do you continue caplacizumab in relapsed refractory TTP?

How often do you monitor ADAMTS-13 levels off therapy?

Are there any reasons to consider a prolonged course of steroids with taper over a shorter course of pulsed steroids in the treatment of ITP?

For example, do we prefer one regimen over the other in patients with a bleeding history or who have relapsed after a lengthy remission?

Can you use other iron formulations if a patient develops Stevens-Johnson Syndrome with ferumoxytol?

How do you determine when to use a maintenance regimen vs continuous 3-drug regimen in a transplant-ineligible MM patient after response to first line therapy?

How is this impacted by patient features, cytogenetics/disease biology, depth of response, or other factors? What would compel you to continue 3 drugs...

What clinical factors impact your upfront treatment decisions in transplant-ineligible MM?

How do you factor in patient age, frailty, patients with underlying organ dysfunction, or other clinical features? Do you still consider CyBorD or R...

How often do you follow ferritin and organ iron-deposition in a patient who has known hereditary hemochromatosis, but no current evidence of iron overload?

e.g. a genetic mutation picked up through a family member

Is there any role for iron chelation in a patient with iatrogenic transfusion-induced iron overload such as in patients with end-stage kidney or liver disease?

Does transplant eligibility make a difference for management?

What is your preferred first line treatment regimen for patients with untreated transplant-ineligible MM?

Do you opt for VRd, DaraRD, CyBorD or another regimen? How would this change for a patient with high risk cytogenetics?

When, if ever, would you choose a two-drug regimen instead of three drug regimen first line in patients with transplant-ineligible Myeloma?

What factors besides disease progression would lead you to de-intensify or change MM therapy for a patient with ongoing response?

In your experience, do certain regimens have more cumulative toxicity, financial impact, or patient convenience factors?

How do you manage testosterone replacement therapy-induced erythrocytosis?

Do you recommend therapeutic phlebotomy to a certain Hct goal? Any strong evidence for thromboembolic risk related to erythrocytosis or if this is mit...

Do you routinely obtain bone marrow biopsy in newly diagnosed autoimmune hemolytic anemia when working up potential underlying etiologies?

What is the optimal initial therapy and management of Erdheim-Chester disease without actionable mutations such as BRAF or MAPK-ERK pathway alterations?

What strategies have you found to be most effective in engaging PCPs in a primary-care or shared-care model of survivorship for pediatric and AYA patients who will receive ongoing care in their communities away from their primary oncology treatment site?

In follow up to @Jacqueline Casillas presentation at ASCO 2021 regarding models of survivorship care delivery for AYA patients.

With new data showing similar outcomes of mismatched unrelated donor and haploidentical related donor allogeneic transplants using post transplant cyclophosphamide, how does one decide which donor is optimal?

If given both options, which donor would one prefer: haploidentical related donor or 7/8 mismatched unrelated donor using post transplant cyclophospha...

How do you advise a patient with VTE on indefinite anticoagulants regarding the Ad26.COV2.S Johnson & Johnson/Janssen COVID vaccine?

When do you consider re-treatment with lenalidomide in later line therapy for relapsed multiple myeloma?

Are there scenarios where you would use a higher dose of lenalidomide in a novel doublet or triplet (eg. relapse on lenalidomide maintenance)?

How do you counsel patients on the risk of thromboembolic complications with use of immunotherapy in NSCLC?

Given recent data in Blood (Moik et al, 2021), and the potentially overlapping risks with other clinical factors associated with NSCLC. Will you alte...

Would you consider bone marrow transplant in a pediatric patient with recurrent HLH with no identified exogenous trigger or HLH-associated mutation?

How do you approach evaluation of pulmonary vein thrombosis?

Is there any difference between anticoagulants in this clinical context (e.g. anti-Xa inhibitors vs warfarin vs LMWH)?

How would you approach chronic isolated severe non-cyclic neutropenia with negative bone marrow and rheumatologic work-up?

Is there a role for empiric antibiotics if there is history of opportunistic infection?

How often do you monitor thiamine levels in a myelofibrosis patient taking fedratinib?

What further genetic testing would you perform on a pediatric patient with cyclic neutropenia who is negative for the most common associated mutations?

With a strong family history

How do you approach the treatment of drug-induced thrombotic microangiopathy?

When do you consider initiating eculizumab?

Do you consider splenic response as adequate to judge efficacy of JAK2 inhibitors in myeloproliferative disorders?

What is the transfusion management of a sickle cell patient during pregnancy?

What are your target goals during transfusion, either prophylactically or during acute complication? Does your management change between vaginal deliv...

Is there a role for anti-fibrinolytic agents in patients with hyperfibrinolytic disseminated intravascular coagulation?

The use of anti-fibrinolytics is typically contraindicated in DIC, but does it have benefit in DIC states characterized by hyperfibrinolysis?

Is there a role for frontline combination therapy with a hypomethylating agent plus venetoclax for high risk MDS?

Would you consider allogeneic stem cell transplant for a newly diagnosed patient with favorable risk AML who had residual disease after initial therapy that included the need for re-induction?

Is there an absolute IgM level, in an asymptomatic patient on surveillance that initiation of therapy would be considered for Waldenstrom's macroglobulinemia?

Does the rate of progression of IgM influence your decision?

Would you recommend use of ESA for anemia of kidney disease in the setting of metastatic solid tumor malignancy?

What is your approach to platelet transfusion in heparin induced thrombocytopenia?

Does having a concurrent consumptive process e.g. DIC change your management?

Is there a risk of increased side effects with combined radiation and ibrutinib therapy?

Would you change your radiation therapy treatment dose or volume if you needed to treat a chloroma? If a patient had a separate cancer (e.g. skin canc...

In patients with autoimmune cytopenias, is there any reservation for COVID vaccination?

While benefits outweigh known harms and limited data, do you worry about vaccination in patients with a history of or active autoimmune cytopenias (e....

How do you approach the use of low-dose aspirin for primary prevention in non-pregnant patients with SLE and positive aPL antibodies, without clinical criteria for APS?

Do you follow the 2019 EULAR Guidelines that SLE patients with asymptomatic, positive aPL should be on low-dose ASA?

How would you evaluate a patient with an isolated high RBC count but with a normal hemoglobin and hematocrit?

Would you consider this type of patient as having polycythemia?

How do you approach transfusing a patient with sickle cell disease who has a history of hyperhemolysis?

Do you offer maintenance rituximab in transplant ineligible patients with mantle cell lymphoma?

Are there any subsets of patients that you're more inclined to offer maintenance?

When (if ever) do you check for anti-platelet antibodies for workup of thrombocytopenia?

Do you offer iron supplementation to a patient with iron studies that are normal (including normal ferritin) except for low iron saturation?

What is the potential differential diagnoses for low iron saturation?

In patients with a history of HIT, how do you counsel them on the use of the AstraZeneca vaccine given reports of unusual thrombosis and association with PF4/heparin antibodies?

AstraZeneca may cause PF4 antibodies leading to vaccine-induced prothrombotic immune thrombocytopenia (VIPIT).

What additional testing, if any, should be performed for an adolescent patient with heavy menstrual bleeding and a negative von Willebrand disease evaluation?

How do you counsel patients on JAK inhibitors about the risk of venous thromboembolism, MACE, and cancer?

Would you consider use of upfront BV plus nivolumab to treat Hodgkin Lymphoma in elderly patients unable to receive standard chemotherapy?

Are there other regimens you employ for patients unsuitable for standard chemotherapy?

Do you check pertussis serologies when sending labs for antiphospholipid syndrome?

How do you treat a low-grade B-cell lymphoma with plasmacytic differentiation (Waldenstrom's) confined to the CNS?

How would you approach treatment of a bulky stage II DLBCL in a patient >80 with a contraindication to anthracyclines but otherwise good performance status?

When can defibrotide be discontinued before the 21-day treatment course is completed in a pediatric patient with SOS?

Do you always treat with the full 21-day treatment course, or can defibrotide be stopped if certain criteria are met sooner?

In a patient with breakthrough VTE on rivaroxaban, would you switch to apixaban or an agent with a different mechanism of action?

Assuming the patient is a candidate for all anticoagulation options (no mechanical valve, antiphospholipid syndrome, patient-specific contraindication...

Would you consider adding midostaurin to azacitadine in elderly patients with newly diagnosed AML with FLT3-ITD mutations in the frontline setting?

How do you approach therapy for a fit adult with relapsed AML with CNS involvement after allogeneic stem cell transplantation?

Is Ommaya placement with CNS-directed therapy preferred to intrathecal or cranial irradiation? How do you interweave this therapy with systemic therap...

What would be the ideal patient to receive selinexor-based therapy over other options for penta-refractory multiple myeloma?

Excluding clinical trials

How do you choose your systemic treatment for primary mediastinal grey zone lymphomas?

Do you prefer a cHL chemotherapy backbone or PMBL chemotherapy backbone?

What workup do you perform to evaluate for underlying triggers/associated conditions in a pediatric patient with autoimmune hemolytic anemia?

Is it appropriate to substitute vincristine for vinblastine in ABVD for systemic therapy of Hodgkins lymphoma?

Given nationwide shortage in vinblastine, several of my patients under active therapy are facing delays in their therapies. Is it appropriate to subst...

Should patients receive thrombophilia testing in the setting of a provoked VTE secondary to hormonal therapy/OCPs?

While thrombophilia testing is not routinely recommended prior to starting OCPs, how about after the development of a VTE?

How would you manage a patient with antiphospholipid syndrome in the setting of severe steroid-refractory thrombocytopenia?

Especially in a triple-positive patient with an acute ischemic stroke who may have urgency for anticoagulation with high bleeding risk and severe thro...

How do you risk stratify complex karyotype in newly diagnosed multiple myeloma in the absence of specific high-risk cytogenetic abnormalities?

Would you initiate chemoimmunotherapy (e.g. RCHOP) in a symptomatic patient with DLBCL who tested positive for COVID19?

How would you manage a stage IE DLBCL of the stomach, non-germinal center type by IHC, and Ki-67 of 70%, but negative for double/triple hit by FISH?

Would you use R-CHOP or a more intensive chemotherapy regimen? Would you consolidate with radiation therapy after 3 cycles or use systemic thera...

Would you ever consider prophylactic anticoagulation in patients with CKD requiring ESA therapy?

While the CKD population is at high thrombotic and bleeding risk, would you consider anticoagulating a patient prophylactically if they had a history ...

How do you treat refractory cold agglutinin disease?

The patient who has not responded to steroids, rituximab/bendamustine, and splenectomy?

Is there a role for prophylactic tranexamic acid in patients with hematologic malignancy with chemotherapy-induced thrombocytopenia?

Would you recommend stem cell transplant or gene therapy for a patient with CML and sickle cell disease currently on imatinib with worsening anemia?

What is the best way to monitor intraoperative heparin use in a patient with factor XII deficiency?

In a patient with severe factor XII deficiency with a baseline prolonged PTT, what is the best method to monitor their ACT or heparin levels when on c...

Does your treatment approach for NK/T cell lymphoma of the nasal cavity differ depending on the volume and extent of disease?

How do you approach systemic therapy options? What are your recommended volumes?

When do you refer AYA patients with newly diagnosed severe aplastic anemia for transplant?

Would you give a trial of IST first or immediately refer for SCT if the patient has matched siblings?

How do you approach patients with a history of lymphoma in remission who are in need of immunosuppressive (e.g. TNF blockers, 6MP) or other therapies (e.g. JAK inhibitors) for autoimmune disease that have been linked with the development of lymphoma?

How do you approach the treatment of ITP in a pregnant patient who did not respond to prednisone?

Would you consider high-dose dexamethasone (deliberating adverse effects of antenatal steroids) or move to next-line therapies?

How can healthcare providers better serve as allies of the sickle cell community?

Has your medical practice taken any steps either in community outreach or within the clinic to show support for this medically vulnerable population, ...

How do you decide between CPX-351 and HMA + Venetoclax in treating transplant eligible AML-MRC?

What could explain discordant iron studies?

For a patient with low ferritin, but high TSAT?

How do you workup erythrocytosis with a normal or elevated serum erythropoietin?

When would you recommend using a DOAC in a pediatric patient with VTE?

Do you generally reduce DOAC dosing for extended anticoagulation in patients with first unprovoked VTE?

Ref: EINSTEIN-CHOICE and AMPLIFY-EXT Would you approach this differently in patients with inherited thrombophilias?

What are the current official guidelines regarding COVID-19 vaccination for patients with cancer or for hematologic conditions?

Do you account for the effect of coffee on platelet aggregation studies?

Is a patient with secondary myeloid sarcoma a candidate for hematopoietic stem cell transplant?

When are you recommending bone marrow transplant recipients receive the SARS-CoV-2 vaccine?

Does your recommendation differ between autologous and allogeneic transplants? Does your recommendation differ in allogeneic transplant recipients wh...

Why are autoantibodies not often detected on monoclonal gammopathy assays (SPEP/IFE, quantitiative immunoglobulins)?

For example, in cold agglutinin disease or AIHA, antibodies can be detected via DAT, but are often not observed on assays for monoclonal gammopathies.

How would you time COVID-19 vaccination with someone on R-CHOP chemotherapy?

How would you manage a patient with Stage IVB DLBCL with refractory disease in the retroperitoneum and spleen after 6 cycles of RCHOP?

Would you offer refractory doses (40-50 Gy) to the RPnodes and send for splenectomy? Or would you offer refractory doses to both RP nodes and spleen?&...

How would you approach the treatment of patients with von Willebrand disease or hemophilia A previously managed with intranasal DDAVP during the recall?

During the Stimate recall, how are we performing DDAVP challenges for newly diagnosed hemophilia A or von Willebrand disease?

What is your preferred oral iron formulation and dosing for treatment of iron deficiency anemia?

Are most places administering oral iron as once daily or every other day dosing due to upregulation of hepicidin receptors following oral iron adminis...

Is there an equivalent test for serum viscosity in sickle cell disease?

How many years of oral antibiotics prophylaxis do you recommend for a teenager with hereditary spherocytosis post-splenectomy?

There is no uniform guideline in the literature. AAP recommends until 5 years old or 1-year post-splenectomy. Some for 5 years post-splectomy.

Is there a role for G-CSF treatment for SLE patients with persistent neutropenia?

Do you routinely refer young patients with iron deficiency anemia for GI evaluation?

In low-risk patients (age < 40) or patients with very obvious causes of blood loss or iron deficiency (menorrhagia, pregnancy), do you routinely pe...

How do you approach unresectable or borderline resectable symptomatic nasal/paranasal Rosai-Dorfman disease?

Are there effective therapy options that do not include steroids?

Would you offer rituximab maintenance for 2 years after a successful response to induction in a patient with splenic marginal zone lymphoma?

When do you consider splenectomy? Is there a role for splenic radiation in non-surgical candidates?

How do you counsel patients who are candidates for a clinical trial regarding their options?

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

Is there any benefit in continuing VRd instead of VR as maintenance therapy in transplant ineligible multiple myeloma?

In which patients with atypical HUS would you consider eculizumab discontinuation?

Given the high cost of eculizumab, are there patient characteristics that inform which patients, if any, should be on indefinite therapy versus a time...

How do you manage a delayed hemolytic transfusion reaction in a patient with sickle cell disease?

How do you manage an uncomplicated DHTFR versus a hyperhemolysis?

How would you approach a patient presenting with pancytopenia and splenomegaly whose bone marrow biopsy is morphologically normal but has a positive Philadelphia chromosome in bone marrow as well as peripheral blood?

When do you utilize lenalidomide in patients with MDS without del(5q)?

Are there particular mutations (eg SF3B1) or syndromes (eg MDS/MPN overlaps such as MDS/MPN-RS-T) where you are more apt to using lenalidomide?

What is your threshold for pursuing bone marrow biopsy in a lupus patient with cytopenias?

For incidentally found stage I indolent non-Hodgkin's lymphoma in young patients, which subtypes would more strongly warrant a consideration for curative-intent radiation?

For instance, if the tissue came back SLL, Waldenstrom's, follicular lymphoma, or even nodular lymphocyte-predominant Hodgkin lymphoma, would any or a...

How do you approach the management of a patient with symptomatic iron deficiency anemia who is intolerant of iron?

Such as a patient who cannot tolerate oral iron and has had a anaphylaxis to intravenous iron

What is the target ferritin level for patients with hereditary hemochromatosis and signs of end-organ damage?

For example, a patient with hypogonadism unless it matters which organ is involved. Are other markers of iron storage useful in guiding therapy?

How do you approach anticoagulation in patients with catastrophic antiphospholipid syndrome and thrombocytopenia?

When would you consider splenectomy or other immunosuppressive/cytotoxic therapy for steroid-refractory warm autoimmune hemolytic anemia?

For example, in a patient who is steroid-refractory, requiring regular transfusion, and has not had response to rituximab after several weeks.

Would you consider just treating radiographic residual disease (as opposed to all original sites of disease involvement, per ILROG guidelines) in a patient with bulky early-stage Hodgkin's lymphoma of the mediastinum?

For example, in a young patient where standard fields would be very large and you want to minimize toxicity

What are your thoughts on adding mycophenolate to steroids in the first line treatment of ITP based on the results of the FLIGHT trial?

Presented at ASH: FLIGHT trial

Would you consider splenectomy for an early stage l/ll primary splenic diffuse large B cell lymphoma followed by R-CHOP?

An otherwise healthy patient with spleen only diffuse large B cell lymphoma with mild spleenomegaly, Spleenectomy plus Rchop or Rchop plus RT?

For which rituximab infusion reaction symptoms do you consider it safe to re-challenge in the office with adjusted rates and pre-medications?

Would you offer treatment for asymptomatic CLL with WBC of ~300k or greater, high risk cytogenetics, or doubling time of 6-12 months?

What are your indications for pursuing a rheumatologic workup in a pediatric patient with ITP?

If so, what additional testing do you send?

How would you manage a patient with PV or ET who is experiencing breakthrough thrombosis?

For example, a patient on cytoreductive therapy and aspirin BID, but suffers an arterial event, or a patient who is already on therapeutic anticoagula...

Would you add chemotherapy to a TKI in treating an elderly patient with de novo CML blast crisis?

When would you perform a thrombophilia workup in a pediatric patient presenting with VTE?

Should venous thrombosis in a patient with Behcet syndrome be treated with both immunosuppression and anticoagulation?

How would you manage OCPs in a patient who develops a VTE while on treatment?

In a patient with a medical or personal indication to induce oligomenorrhea/amenorrhea, how would you manage OCP therapy if a patient develops a VTE d...

Would you place an IVC filter in a patient with an acute PE and an absolute contraindication for anticoagulation, but negative imaging for proximal DVT?

How do you handle hypogammaglobulinemia detected in patients prior to maintenance rituximab infusion?

Is there a role for anti-neutrophil antibody testing in the workup of neutropenia?

If autoimmune neutropenia already suspected, is this test informative or unnecessary?

Do hemoglobin S levels always correlate with SCD phenotype?

What is the lowest level you have seen with uncomplicated or complicated crises?

How do you decide between blinatumomab or traditional chemotherapy in combination with TKI for upfront treatment of adult patients with Ph + ALL?

Is there currently a role for adding venetoclax to a hypomethylating agent (HMA) after failure of single-agent HMA therapy in MDS?

Can results from emerging AML data be extrapolated to high risk MDS populations? Is there data to guide the choice of continuing the HMA in combinati...

What is your approach for treating transplant-ineligible patients with relapsed blastic plasmacytoid dendritic cell neoplasm (BPDCN) who have progressed on tagraxofusp?

How do you decide to transition a patient with stable PNH on eculizumab to extended half-life ravulizumab?

What is your approach to VTE prophylaxis following hematopoietic stem cell transplant?

What would be your choice of therapy in a fit patient with relapsed CLL previously treated with bendamustine and rituximab who does not want BTK inhibitor therapy?

Relapsed disease occurred 3.5 years after initial treatment

How do you approach diagnosing a patient with Iron Refractory Iron Deficiency Anemia (IRIDA)?

Do you go straight to TMPRSS2 genetic testing or what other lab testing (e.g. hepcidin) could be helpful?

What is your preferred formulation of parenteral iron?

There are various formulations of intravenous iron; each with varying costs, test dose requirement, elemental dose, and number or time of infusions ne...

How would you manage CML first-line second generation TKI with a best response of MMR 4, but now with a loss of MMR with more than one log response loss but still in complete cytogenetic remission and mutation panel negative?

What would be your choice for re-induction in a young patient with FLT3+ refractory AML after 7+3 induction therapy with no FLT3 mutation on the day 14 marrow?

Are there patients who can forgo anticoagulation with asymptomatic, incidentally discovered subsegmental pulmonary embolism?

If there are a low-risk patients who can be monitored, how would you do so? If unprovoked, would you consider stopping anticoagulation?

How would you manage acquired von Willebrand syndrome secondary to a myeloproliferative neoplasm in a patient who is already on anticoagulation?

Individuals with MPNs may be at higher risk for thrombosis and be placed on antiplatelet therapy or even anticoagulation because of prior thrombosis. ...

What is the optimal VTE prophylaxis for hospitalized patients with COVID-19?

Should we use a different dose in critically ill patients in the ICU? When should we consider intermediate-dose anticoagulation?

What is the optimal management of a patient with refractory TTP who has had poor response to plasma exchange, steroids, rituximab, especially when caplacizumab is unavailable?

How would you treat a de novo CLL with WBC of 1,000,000 and no overt signs of leukostasis?

Is there any role for post chemotherapy (R CHOP x 6) radiation therapy after a splenectomy for a stage IE diffuse large B-cell lymphoma involving only the spleen?

What if it is a young patient?

How do you manage VTE in the setting of persistent severe thrombocytopenia?

Is there a preferred strategy of transfusional support versus reduced-dose anticoagulation during the duration of thrombocytopenia?

What would you recommend for a patient with bilateral conjunctival MALT (without systemic disease)?

In this scenario, is systemic treatment better given bilateral involvement? In a patient who has already had cataract surgery and is not at risk for c...

How would you treat a stage IE diffuse large B-cell lymphoma of the adrenal gland in an elderly patient who is not a candidate for systemic therapy?

What CTV margins do you use for indolent advanced stage lymphoma treated with palliative radiation alone?

Would you forgo consolidation radiotherapy for a patient with stage 1EA diffuse large B cell lymphoma of the stomach who presented with a perforated ulcer?

What dose do you use to palliate multiple myeloma in a vertebral body?

Does your dose recommendation change if a patient has cord compression or has undergone surgery? There is a range of doses in the ILROG guidelin...

Would you consider holding treatment with hypomethylating agents and venetoclax in elderly with AML who achieve CR and are MRD negative?

Do you routinely prophylactically anticoagulate patients undergoing systemic chemotherapy outside of the perioperative period?

How do you approach treatment in a patient with a solitary plasmacytoma with minimal marrow involvement (< 10% clonal plasma cells)?

Is there any data justifying the use of systemic therapy over localized therapy (e.g. radiation or surgery) in this situation prior to a progression e...

How would you treat an adult patient with T-cell lymphoblastic lymphoma with FGFR1 rearrangement and co-exisiting myeloproliferative neoplasm?

For a patient with previously relapsed TTP but in clinical remission, what is the role of rituximab in treating asymptomatic ADAMTS13 deficiency to prevent relapse?

Rituximab has entered the treatment algorithm in the first-line setting for the initial treatment of TTP. However, in remission, the role of adjuvant ...

What is the role of RT for a patient with double-hit DLBCL and a single site of relapse who can no longer tolerate chemotherapy?

Is there any role for direct oral anticoagulants in the treatment of antiphospholipid syndrome?

What if this was "triple-negative" antiphospholipid syndrome?

How often do you utilize soluble transferrin receptor or hepcidin testing in the diagnosis of ambiguous iron deficiency, such as with concomitant anemia of chronic disease?

Does recent iron intake affect the iron panel, and if so, do you often order fasting labs in practice?

Would you anticoagulate a patient with an isolated arterial thrombosis in the setting of an inherited thrombophilia?

Does your opinion change based on the specific underlying inherited thrombophilia? The original case was a central retinal artery occlusion in a patie...

How do you evaluate an isolated prolonged aPTT in patients?

Especially in a patient without hemophilia or thrombosis history?

What therapy do you usually choose in patients with previously treated follicular lymphoma who experience early relapse (< 2 years)?

How do you approach CNS prophylaxis in double-hit lymphoma patients?

Do you only give intrathecal chemotherapy or systemic therapy?

What maintenance treatment would you recommend for Ph positive ALL following Hyper-CVAD, transplant eligible or ineligible?

What is the role of radiation in a patient with stage IV DLBCL with bilateral testicular involvement?

Under what circumstances do you consider double autologous stem cell transplants for patients with multiple myeloma?

Do you rebiopsy grade 1-2 follicular lymphoma if SUV is high by PET?

What are the scenarios in which a rebiopsy is warranted for follicular lymphoma?

Would you start a patient with sickle cell disease and COVID-19 on prophylactic anticoagulation?

Would you recommend anticoagulation for patients with partial false lumen thrombosis in type B aortic dissection?

Would you offer this routinely or only if specific complications arise, such as distal emboli?

Do you offer enasidenib with azacitadine in AML with an IDH2 mutation for patients ineligible for intensive induction chemotherapy?

Does the absence of an OS benefit in the AG221-AML-005 presented at ASCO 2020 deter you from this strategy?

Are there any special considerations for treating CML in the very elderly, greater than 85 years old?

When would you consider transplant for a patient with a bone marrow failure syndrome (FA, DC, etc.)?

How would you treat a young patient with symptomatic Rosai-Dorfman disease who has recurrent, life-threatening pericardial and pleural effusions?

CT scans show omental and pelvic disease.

How do you manage thrombocytopenia when radiating the spleen?

At what point would you recommend transfusion? At what point would you stop radiation?

Is there a role for ruxolitinib in essential thrombocythemia?

In patients who are intolerant to hydroxyurea, anagrelide and interferon

When do you get a bone marrow biopsy for likely essential thrombocytosis?

Is there any benefit to getting it prior to starting cytoreduction?

What frontline therapy would you offer for a patient who is elderly or unfit for standard induction therapy with both IDH-2 and FLT-3 ITD mutations?

How would you approach treatment in an otherwise young, fit patient with transformed AML currently in remission with a plan for transplant and was found to have an invasive fungal infection not amenable to resection upon recovery from induction?

Would you consider “bridging” therapy with something like an HMA?

Do you recommend that children with sickle cell disease refrain from returning to school during the COVID-19 pandemic?

How do you adjust the dose of Ibrutinib in hepatic dysfunction, particularly if disease related?

Would you consider adding Enasidinib to frontline combination therapy with HMA and Venetoclax in a patient with newly diagnosed AML with IDH2 mutation that is >75 or unfit for standard induction therapy?

Do you use bevacizumab in patients with history of VTE (DVT/PE) who are stable on anticoagulation?

Would it make a difference if the VTE diagnosis occurs during bevacizumab therapy or whether it preceded the cancer diagnosis?

During induction therapy for acute leukemia, when do you decide to discontinue the antimicrobial prophylaxis?

Is it at neutrophil recovery, at documentation of CR on bone marrow biopsy, or is there a different point in time?

How would you approach re-irradiation to a localized DLBCL of the lower extremity?

The patient received R-EPOCH followed by consolidative RT (36 Gy in 18 fractions) approximately one year ago and was subsequently salvaged with RICE.

What are the options of induction treatment of young AML patients who are on CRRT, continuous renal replacement therapy ?

How do you approach the treatment of patients with an e14a3 (b3a3) BCR-ABL fusion in chronic phase CML?

How would you manage a patient with severe aplastic anemia and a large PNH clone?

For pre-menopausal female patients who present with acute leukemia in need of urgent anti-neoplastic therapy, what is your preferred approach in effort to preserve fertility?

Does acute leukemia sub-type affect your decision?

How would you evaluate a pediatric patient referred to rule out cancer due to an isolated significantly elevated vitamin B12 level?

Assuming CBC w/ different and complete metabolic panel are within normal limits, what (if any) further evaluation or management is needed?

Do you offer adjuvant chemoimmunotherapy after IFRT for Stage I to II low grade follicular lymphoma?

TROG 99.03 showed nearly 20% improved PFS at 10 years with chemoimmunotherapy despite 31/75 patients assigned R-CVP vs 44/75 assigned CVP without ritu...

When during ALL induction therapy are you checking for MRD?

Do you hold maintenance lenalidomide or bortezomib for a patient who needs a surgery?

For example, for joing replacement surgery? Do you hold the revlimid for certain about of time before and after?

What's your preferred management for a newly diagnosed chronic phase CML with concurrent thrombocytopenia?

How long after discontinuation of TKI (for complete remission) would you feel it is safe for a patient with CML to consider pregnancy?

Would you choose a different anti-CD20 antibody in early relapsed (< 6 months) DLBCL treated with rituximab?

Is there a preference for obinutuzumab over rituximab in early relapsed DLBCL, or in primary refractory disease?

What dose and fractionation do you use to palliate mycosis fungoides lesions?

There seems to be a wide variety of palliative doses used in clinical practice (8 Gy x 1, 2 Gy x2, and 20 Gy in 10 fx). Do you have a preferred ...

Would you recommend prophylactic cranial irradiation (PCI) for a teenager with a T cell acute lymphoblastic leukemia in remission?

If so, what dose would you recommend?

What is your approach to advanced Hodgkin Lymphoma when bleomycin is contraindicated and infectious complications arise with A-AVD?

How do you manage severe lenalidomide-associated drug rash in a transplant-eligible patient with multiple myeloma?

Would your approach change based on the type of reaction (eg. Stevens-Johnson syndrome vs DRESS)? How would you address maintenance (if any) post-tra...

What is your preferred induction regimen for primary CNS lymphoma in a young patient?

Do you ever discontinue ibrutinib in patients with CLL who have a good response?

For instance, would you discontinue when there is resolution of adenopathy and normalization of counts? If so, do you overlap ibrutinib with other the...

What factors do you consider when choosing between a 1st and 2nd generation TKI in a newly diagnosed CML patient?

How long would you wait after a cycle of IT MTX to treat a spinal lesion causing cord compression in a patient with stage IV DLBCL?

Do you prefer hyper-CVAD or the CALGB 9111 protocol for high intensity remission induction treatment in Ph-negative ALL patients?

The NCCN recommends both regimens.

How do you determine whether to treat a young adult with stage IA Hodgkin Lymphoma with the adult or pediatric treatment paradigm?

At what age would you treat an early stage hodgkins lymphoma patient with ABVD + RT (adult treatment) vs OEPA x 2 or AV-PC x 3 (pediatric paradigm)?&n...

Do you routinely prescribe anticoagulation for patients on active chemotherapy?

Would you consider giving ESA for anemia secondary to chronic kidney disease in a patient with follicular lymphoma in remission and on rituximab maintenance?

How do you decide on the modality of consolidative treatment after a CR in primary CNS lymphoma patients treated with a high-dose methotrexate regimen?

How do you decide between WBRT, maintenance chemotherapy, or stem cell transplantation?

Would you stop current immunosuppressive therapy or delay starting immunosuppressive therapy in a patient with aplastic anemia who has been infected with COVID-19?

Would you recommend anticoagulation prophylaxis for a pediatric patient admitted with COVID-19?

Are patients with bleeding disorders receiving plasma-derived products at increased risk of acquiring COVID-19?

Should patients with bleeding disorders increase their home supplies of clotting factors foreseeing a possible shortage of product availability due to COVID-19?

How would you manage a patient with sickle cell disease who is infected with COVID-19?

How do you assess whether an early-stage Hodgkin's patient is unfavorable?

The unfavorable risk factors for stage I-II Classic Hodgkin's Lymphoma differ depending on the cooperative group (GHSG, EORTC, NCCN), which criteria d...

Would you give CNS prophylaxis to a patient with Waldeyer's ring diffuse large B cell lymphoma if it is not triple or double hit ?

Risk of CNS relapse in a reported series is less than 5%.

How would you approach primary CNS lymphoma in an elderly patient over 80 years old?

How does your approach differ when managing a "triple hit" versus a "double hit" or "double expressor" lymphoma?

Given the rarity of DLBCL with MYC/BCL2/BCL6 rearrangements, do you approach this disease differently than DLBCL with MYC/BCL2 or BCL6 rearrangement, ...

Do you include gemtuzumab ozogamicin for any of your newly diagnosed AML patients who are candidates for 7+3 induction chemotherapy?

Or do you consider addition of this agent in the re-induction setting for refractory disease?

Do you have preferred regimens for young patients (<30 y/o) with early stage DLBCL?

Guidelines indicate RCHOPx3 +RT as category I and RCHOP x 6 below that; long term f/u for SWOG 8736 showed similar PFS and OS. Do you have and approac...

What is your recommendations for vaccines to prevent shingles in CLL patients?

When do you use post chemotherapy XRT in advanced (stage 3 and 4) large B cell lymphoma who obtain CR by PET scan and what dose?

Do the potential late effects offset any benefit of mediastinal XRT in a young patient with bulky disease?

Would you consider using daratumumab in the first line setting for non-transplant eligible multiple myeloma?

To me, the recent NEJM study is flawed in that the control arm did not have maintenance treatment while the experimental arm used maintenance Dar...

What is your approach to a patient with systemic AL amyloidosis who has achieved a hematologic response but not an organ response with CyBorD?

Would you proceed to autologous transplant, or switch to an alternate regimen (eg. daratumumab-based) first? Would the type or degree of organ involv...

How do you approach a patient with IgM monoclonal gammopathy associated with severe neuropathy of unclear etiology?

Do you perform biomarker-based screening for AL amyloidosis in patients with newly diagnosed MGUS?

If so, what is your approach to laboratory and clinical testing?

When do you consider cytoreduction in patients with Essential Thrombocytosis?

In a patient with no evidence of bleeding, do you use a platelet cutoff? Do you utilize genomic testing (eg CALR, MPL, JAK2, etc.) to decide on cytore...

How do you approach the workup and initial treatment of systemic AL amyloidosis?

Once a tissue biopsy has confirmed light chain amyloid, what additional tests do you perform as part of a standard workup? In whom should treatment b...

Why do we immediately perform CNS staging with a LP at diagnosis of ALL when the risk of seeding is highest with a high lymphoblast count?

How long do you treat recurrent classical Hodgkin lymphoma with brentuximab/nivolumab if the patient does not want to proceed to BMT?

How would you manage a patient with minimal residual disease (<1% of CD25 positive cells) six months after completing therapy with 2-CDA for Hairy Cell Leukemia?

What dosing schedule of cladribine do you use for newly diagnosed hairy cell leukemia in need of treatment?

Can a rituxumab biosimilar be used for a high grade lymphoma?

How do you manage patients who develop de novo or recurrent skin cancers (SCC or BCC) while on lenalidomide?

Do these events mandate discontinuation of lenalidomide therapy or switching to a different agent? Can appropriate therapy for these skin cancers be r...

What is the preferred approach for giving high dose methotrexate in double or triple hit lymphomas being treated with dA-EPOCH-R?

What volumes do you treat for ISRT for extranodal DLBCL?

For a stage IAE DLBCL (in this case, of the oral cavity) that was completely excised, s/p R-CHOP, is the ISRT target volume just the preop volume plus...

Do you consider discontinuing brentuximab in stage III-IV classical Hodgkin lymphoma patients on AVD+brentuximab who have a good response to 2 cycles?

(ie Deuvelle criteria 1-3) Is it appropriate to discontinue brentuximab like you would with bleomycin?

Would you offer consolidative RT to a patient with early stage, non-bulky, high-grade non-Hodgkin's lymphoma of the orbit after 6 cycles of RCHOP + IT chemotherapy?

How do you approach maintenance therapy for relapsed follicular lymphoma?

Specifically, do you consider repeating maintenance therapy after second line therapy if a patient had already received 2 years of maintenance rituxim...

How do you manage DLBCL in patients with previous anthracycline exposure?

If a young and otherwise healthy patient with normal echocardiogram and no other cardiac risk factors needs treatment for DLBCL, but has previously re...

What would be your choice for treatment for an HIV positive patient with no detectable viral load with CD20 negative and CD30 positive DLBCL?

What is your approach in a transplant-eligible patient with relapsed classical Hodgkin lymphoma who has an area of refractory disease after salvage chemotherapy?

Would you still proceed to high-dose therapy and autologous SCT? Would you incorporate radiation pre- or post- transplant? Or offer additional salvag...

Would you offer maintenance lenalidomide or rituximab in a patient with DLBCL transformed from a marginal zone lymphoma in a young, fit patient?

Would you offer next-line systemic therapy to a patient with LGL leukemia with chronic severe neutropenia, who has had treatment failure with methotrexate, cyclophosphamide, cyclosporine, and danazol?

If the patient has not experienced significant infectious complications? If so, what agent?

Would you recommend scrotal RT in a patient with stage IV primary testicular lymphoma with CNS involvement after CR to RCHOP and MTX?

What dose and volume would you treat in a patient with diffuse large B-cell lymphoma confined to the stomach after complete response to R-CHOP?

How would your dose and/or volume change if the patient refuses chemotherapy?

Do you alter your management of Stage I-II DLBCL if it's double or triple hit?

Specifically, do you utilize 3 cycles of chemo with ISRT or 6 cycles? Do you use R-EPOCH or R-CHOP in these cases?

Do you ever start with lower than standard doses of TKIs when initiating treatment for chronic phase CML?

For instance, do you ever start with dasatinib 50 mg daily? Are there any titration schedules that you follow?

What positions and immobilization strategies do you use to minimize breast and heart dose when treating axillary and mediastinal nodes in young women with large breasts who require consolidative radiation (ISRT) for Hodgkins lympoma?

Any experience treating patients prone with openings for both breasts, no minimize breast overlap with axilla and mediastinum?

Would you recommend consolidative radiation therapy to an isolated frontal dural MALT lymphoma after complete response to chemotherapy?

Do you recommend lenalidomide for high risk smoldering multiple myeloma?

Given the PFS benefit seen in the most recent ECOG-ACRIN, and the prior study of Rd showing an OS benefit, is your practice to put any high-risk SMM p...

How do you treat a composite NHL of various subtypes?

e.g. mixed indolent/aggressive NHL, mixed NHL/HL? Is there a definitive way to discern composite from transformation? NCCN does not list recommendatio...

What dosing regimen of carfilzomib do you use in the front line setting for high risk transplant-eligible multiple myeloma?

In a patient with Waldenstrom's macroglobulinemia doing well and feeling better on ibrutinib & rituximab, but with a rising IgM, do you switch treatment or continue?

Can we ever observe newly diagnosed chronic phase CML patients and not immediately start them on therapy?

if so, are there specific cytogenetic, molecular, clinical, or hematologic factors that you take into consideration?

Are you de-escalating treatment for favorable risk Stage I-II DLBCL patients to 4 cycles of R- CHOP with 2 additional rituximab cycles?

Have you changed your practice based off the FLYER trial presented at ASH 2018?

What is the role of consolidative RT to initially bulky sites (>8cm) in a patient with stage III triple hit lymphoma who has tolerated only 4 cycles of DA-EPOCH-R?

The patient is not a transplant candidate due to multiple co-morbidities. Some of the sites in question have had a complete response and other have ha...

How would you approach treatment of DLBCL in a patient on hemodialysis?

How would you handle high risk features (eg double hit) with the limitations of dialysis?

What dose and fractionation would you recommend for a localized primary bone marginal zone lymphoma?

The patient has no bone marrow involvement.

Is there a role at this time for chemo-immunotherapy in the upfront treatment of classic Hodgkin lymphoma?

Although not approved, for example, are you every using AVD-nivolumab?

What is your preferred maintenance therapy in young, fit patients with de novo plasma cell leukemia who achieve complete response after autologous stem cell transplantation?

When treating DLBCL with induction therapy with R-CHOP, if after 2 cycles, you have a mixed response on PET, would you consider that treatment failure or would you continue R-CHOP?

How would you treat an elderly fit patient with stage IE DLBCL (single skin lesion)?

Would you give 3 cycles of RCHOP followed by consolidative IFRT or 6 cycles of R-mini CHOP? Is there a role for 3 cycles of R-mini CHOP followed by IF...

What is your first line treatment of choice for advanced (stage IIIA) follicular lymphoma, histologic grade 1-2 in an otherwise young healthy patient in 2019?

Assuming the patient has an indication for treatment.

How would you manage a CML patient with a T315I mutation that developed severe abdominal pain requiring hospitalization after starting ponatinib 45 mg?

Thrombosis was ruled out and no etiology was found. Would you start ponatinib back at a lower dose, transition to omacetaxine or begin transplan...

For patients who have exceptionally long responses to HMA with high risk MDS or AML and not candidate for more aggressive therapy/transplant, do you consider treatment holidays or spacing out doses into longer intervals?

How do you treat a gastric plasmacytoma which is not amenable to radiation?

For a patient with relapsed FLT3 positive AML on HMA and venetoclax, is there ever a role for the addition of midostaurin to the treatment regimen to improve response rate?

With the recent FDA approvals of Venetoclax and Glasdegib in AML, is one generally preferred over the other for elderly and/or unfit patients in combination with a hypomethylating agent/low-dose cytarabine?

In a newly diagnosed elderly patient with AML who harbors an IDH1 mutation, would you treat with upfront with ivosidenib or would you proceed with venetoclax and HMA as your first line treatment?

Is a very rapidly rising WBC count ever an indication for the upfront treatment of CLL?

Assuming there are no other indications at the moment.

What is your approach for bulky stage I primary mediastinal B-cell lymphoma in a patient with a positive post-chemotherapy PET-CT (residual mass and Deauville 5)?

Some specific questions: Would you recommend repeat biopsy to confirm residual disease? How would your recommendations vary if the patient had pre...

Do you use absolute WBC count or doubling time to determine whether to start treatment for early stage CLL?

Would this affect your decision regardless of the stage and symptoms?

What is your approach to the decision to use CPX-351 or standard 7+3 for de novo AML?

Do you await molecular and cytogenetic results prior to initiating therapy, or does age and function status primarily drive your choice?

What is your preferred TKI and dosing for AYAs or adult patients with Ph+ ALL?

NCCN does not list any preferences for the TKIs in their guidelines.

Which imaging modalities and schedule do you use to follow stage I-II follicular lymphoma that was treated with radiotherapy alone?

Would you offer chestwall RT after capsultectomy+explant for an implant-related ALCL?

If the breast was previously radiated 15 years ago, would that change your decision? If there was residual lymphoma on cytology of a chronic se...

For inpatient treatment of lymphoma and ALL, can rituximab be delayed?

I.e., Can day 2 Rituximab (RCHOP) or day 6 Rituximab (DA-EPOCH, Hyper CVAD) be given? Or should only Day 1 Rituximab be used with chemoimmunotherapy i...

What would you recommend for a stage I diffuse large B cell lymphoma (IPI 0-1) involving a single lymph node that is completely removed with an excisional biopsy?

Would you recommend RCHOP x 3-6 or RCHOP x 3 + ISRT? If you end up doing ISRT, would your target be any different than the principles that guide...

How do you approach front line treatment for TP53 mutated mantle cell lymphoma?

Since some prior studies (eg. Eskelund et al. Blood 2017 130:1903-10.) have shown intensive chemoimmunotherapy does not overcome the ad...

What is the role (if any) for Rituximab in a patient with CD20+, Philadelphia chromosome positive ALL?

What would be the preferred chemotherapy regimen in elderly patients with advanced stage classical Hodgkin Lymphoma and contraindication to doxorubicin and bleomycin?

When would you use AVD + brentuximab instead of ABVD for newly diagnosed stage 3 or 4 Hodgkin lymphoma?

Since ECHELON-1 trial showed an improvement in PFS (but not OS), are there any situations where you would replace bleomycin with brentuximab...

What factors do you consider when interpreting post treatment PET Deauville scores for patients treated with chemotherapy for classical Hodgkin Lymphoma?

Is your scoring based on SUV uptake vs the subjective interpretation of the radiologist? How do you go about reconciling Deauville scoring when there ...

What dose/fractionation do you like to use for palliation of bulky LAD from CLL/SLL?

When do you offer consolidative tandem autologous stem cell transplantation for high-risk multiple myeloma?

For example - Would you offer tandem transplantation in a young, fit patient in a CR after first transplant, but with MRD detectable?

How do you approach CNS prophylaxis in patients with DLBCL?

Would you follow an algorithm such as the one proposed by Hall et al? How do you decide between intrathecal chemotherapy vs systemic therapy with HD-...

What is the role of salvage radiation therapy in patients with locally recurrent Hodgkin lymphoma after an autologous stem cell transplant?

Should consolidation autologous stem cell transplant be considered for de novo follicular lymphoma transformation to DLBCL after achieving a PR with R-CHOP x 6 cycles, if residual disease showed original indolent follicular lymphoma?

For an otherwise healthy individual, what would be your front line choice for de novo Richter’s transformation?

Pathology is clear this is not a concurrent DLBCL and is indeed transformed CLL

Would using Obinutuzumab and Venetoclax second line after Bendamutine and Rituximab be a reasonable option for a patient with IGHV-unmutated CLL?

How do you dose midostaurin in patients with AML who need azole antifungal prophylaxis?

FDA package insert lists posaconazole as strong cyp3A4 inhibitor and states to consider other therapies.

How much later after starting a hypomethylating agent in an elderly patient with AML being treated in the upfront setting can venetoclax be started?

Can it be added after 2 or 3 cycles of HMA?

Can post op RT be omitted in a surgically repaired pathological fracture site in multiple myeloma if the patient will receive systemic therapy?

Do you make diagnostic lumbar puncture part of routine work up for newly diagnosed AML if patient is asymptomatic?

Does presenting total white blood cell count affect your decision? Does myeloid subtype affect your decision?

Why are hypomethylating agents as single agents not approved yet by FDA for treatment of AML (technically off-label)?

How would you treat low grade follicular lymphoma with diffuse epidural involvement? Would you give intratheracal or high dose systemic methotrexate in addition to systemic chemoimmunotherapy?

How would you approach treatment in an older (>65), but fit patient with intermediate-risk AML, but with MRD persistence after induction with 7+3?

How might your decision change if the patient had a suitable 10/10 donor? How about if the patient had a targetable molecular mutation such as IDH2?

How would you manage a patient with a MALT lymphoma (H. Pylori negative) found incidentally in the surgical specimen at the time of sleeve gastrectomy?

Repeat EGD and additional biopsies of the stomach were all negative for MALT lymphoma and H. Pylori. A CT of the C/A/P was done showing no evidence of...

What stage is bilateral orbital/conjunctival NHL (limited only to the bilateral orbit/conjunctiva)?

How early have you been able to detect a response with CAR-T in patients with relapsed DLBCL?

With recent measles outbreaks occurring in the US, would you consider offering multiple myeloma patients s/p ASCT on maintenance treatment vaccination, or an alternate means of immunity?

Although the MMR vaccine is contraindicated in immunosuppressed patients on anticancer treatment according to CDC/ACIP and IDSA guidelines, data on sa...

What are the factors that convince you to not immediately treat mantle cell lymphoma and to follow a course of "active surveillance"?

Is there a specific Ki67 percentage? P53-negativity?

How do you manage classical early stage Hodgkin lymphoma patients when an ESR is not checked as part of their workup?

For example, would you go ahead with 20 Gy of ISRT if medical oncology has already treated a stage I-IIA patient with 2 cycles of ABVD meeting all oth...

How long after high-dose IV methothrexate for chemo-refractory CNS lymphoma do you wait before giving brain radiation?

If they are symptomatic do you relax that time interval? Do you ever consider partial brain radiation instead of whole brain to minimize neurotoxicity...

How would you manage a patient with primary CNS lymphoma who is not a candidate for high-dose methotrexate?

In a patient who absolutely cannot receive chemotherapy due to impaired performance status, what dose would you use for WBRT and what dose would you u...

What is your preferred chemotherapy regimen for a fit younger patient with mantle cell lymphoma?

What recommendations do you make regarding the use of biologics for uncontrolled Crohn's disease in patient's who have a history of DLBCL that developed while on infliximab and azathioprine and whose lymphoma is essentially cured?

I have received inquiry from a patient's gastroenterologist regarding use of Entyvio or Stelara in such a situation.

Would detection of an adverse cytogenetic marker such as dup(1q) alone in the setting of MGUS satisfy criteria for a diagnosis of multiple myeloma?

Do you routinely order double-hit assessment in cutaneous DLBCL?

How would you treat a patient with a refractory primary splenic marginal zone lymphoma with symptomatic splenomegaly (20 cm) and a mild pancytopenia?

Prior trials of systemic therapy including alkylating agents and rituximab have failed and the patient is medically inoperable with no history of Hepa...

In staging Hodgkin's lymphoma, would you identify a PET+ bony focus as disease when there are no associated bone changes on CT and a biopsy was not obtained?

The staging bone marrow biopsy was negative. The staging manual simply states "bone involvement is identified using appropriate imaging studies."...

In transplant-eligible, fit patients with multiple myeloma who have an inadequate response to front-line therapy, what regimen would you choose for second-line?

Given the recent results presented from the Griffin trial, would you choose a daratumumab-based regimen (eg. D-VRd) over other salvage options (V...

What volume and dose would you use for a Stage I MALT lymphoma of the lung?

Would you use a similar dose and fractionation as gastric MALT (30Gy in 1.5 Gy fractions)?

With new data now available for use of brentuximab in ALK positive, CD30 anaplastic large cell lymphoma, what is your first line regimen?

What CTV margins should be used with early stage favorable Hodgkin's Lymphoma in the illiac chain if they had a complete response on PET after 2 cycles of ABVD?

Should prechemo PET positive disease from bowel or other structures be carved out?

In a patient with high risk acute promyelocytic leukemia, when do you consider ATRA+ATO with GO vs ATRA+ATO with idarubicin?

How do you approach fit patients with quickly relapsed Hodgkin lymphoma (disease-free interval less than or equal to one year) after 6 cycles of ABVD and radiation therapy?

Would the site of disease relapse play a role in your decision (i.e. isolated lymph node recurrence versus failure at primary site of disease)?

What is your preferred first-line therapy for a patient with standard risk multiple myeloma?

Has the recent data presented at ASH affected your choice of regimen? Would your choice differ between transplant-eligible and transplant-ineligible ...

Will you offer Ibrutinib and Rituximab for untreated patients with CLL without a 17p deletion?

Shanafelt et al. recently presented results from the phase III E1912 study at ASH 2018. Will you still utilize FCR as first-line or now use Ritux...

Is there a role for assessing measurable/minimal residual disease (MRD) in multiple myeloma at this time?

Would MRD assessments affect your clinical decision making for MM patients outside of a clinical trial?

Do you recommend using DIBH for young adults with Hodgkin lymphoma who require mediastinal RT?

Which regimen do you prefer for patients with newly diagnosed DLBCL that are not candidates for doxorubicin secondary to low ejection fraction?

Do you use etoposide-based regimens such as R-CEPP? How about substitution with liposomal doxorubicin?

In which patients with early-stage favorable Hodgkin's lymphoma, if any, would you consider omitting consolidation RT after ABVD chemotherapy?

What is your standard dose for total skin irradiation in a mycosis fungoides patient?

Do you generally always boost the scalp and/or soles even if those sites are not involved with disease?

How would you manage a primary dural low-grade lymphoma?

Would you consider observation following surgical resection with negative margins? Would you recommend WBRT and/or ISRT? What would be your preferred ...

When do you choose to give CyBorD over RVd in a newly diagnosed myeloma patient?

Specifically, what regimen would you choose in a patient with new renal failure but not requiring dialysis?

What is your approach to choosing a conditioning regimen for allogeneic transplant in AML?

What factors influence your decision (patient/disease characteristics, additional agents added to induction chemotherapy, CR1 or later, etc)?

How do you approach incidentally diagnosed mantle cell lymphoma found on a routine screening colonoscopy?

How do you approach the treatment of hairy cell leukemia with inadequate response to front line therapy?

If a patient obtains a PR or less to front line cladribine, what factors help you chose between a second course of cladribine, an alternative pur...

How would you treat a younger patient with relapsed mantle cell lymphoma after treatment with hyperCVAD?

How about if disease is found in the CSF?

What is your general approach to post-allogeneic HSCT maintenance therapy for AML?

When is it warranted to utilize targeted therapies for known mutations (eg. midostaurin or an alternative TKI for FLT3 mutations, ivosidenib for ...

How do you utilize lenalidomide maintenance in non-transplant eligible myeloma?

Does the choice of initial induction regimen affect your decision for when to employ lenalidomide maintenance? Are there situations where you would c...

What is your approach to CMV prophylaxis in the post-allogeneic stem cell transplant setting?

Are you routinely using letermovir as CMV prophylaxis in high-risk patients? Any special considerations with its use versus other antiviral agents? ...

What is your alternative first line approach to follicular lymphoma that requires treatment if initial treatment with BR leads to significant neutropenia despite G-CSF?

Would you consider switching regimens?

How would you treat an elderly, transplant-ineligible patient with recurrent DLBCL?

Would you treat differently for de novo disease vs disease arising from large cell transformation of an indolent NHL?

What is your approach to treating limited stage DLBCL of the colon?

Does isolated del(5q) have the same prognostic implications for post-PV secondary myelofibrosis as it does in MDS?

Given the rarity of this in MF, is it still predictive of response to lenalidomide therapy?

What is the role for maintenance lenalidomide in elderly patients with DLBCL?

Does their candidacy for autologous HSCT affect your decision to use maintenance lenalidomide?

Would you offer scrotal radiation to a patient with a stage IIE bilateral testicular DLBCL treated with a bilateral orchiectomy and chemotherapy?

The patient had a bilateral orchiectomy (pathology demonstrated no invasion of the tunica) followed by R-CHOP x 6 and IT Mtx with a PET CR in a para-a...

What is your preferred treatment to ameliorate bone pain from G-CSF?

Do you routinely add eight extra rituximab doses to six cycles of R-CHOP in elderly patients with DLBCL treated with miniR-CHOP as done in SMARTE-R-CHOP-14 trial ?

What is your preferred first line treatment for patients with high risk MDS who are not candidates for transplant?

What is an appropriate dose for definitive radiation of a stage IE EBV+ polymorphic B-cell lymphoproliferative disorder?

The patient is a 75 yo immunocompetent man who has a history of inverted papilloma of the sinuses and presented with a new lesion in the right maxilla...

Would you use alternative management in a chronic phase CML with a 3 way translocation between chromosome 9, 22 and 7?

Does anything need to be done if hyperlymphocytosis (i.e. ALC > 300K) develops in a CLL patient just starting ibrutinib?

If you decide to discontinue TKI after prolonged molecular remission in CML, how often would you follow the BCR/ABL after discontinuation?

How would you treat an older patient with newly diagnosed B-ALL and significant cardiac and neurological co-morbidities?

What is your preferred approach to therapy in transplant ineligible multiple myeloma initially treated with CyBorD owing to acute renal failure, after achieving a VGPR (+IFE alone) with continued mild-moderate renal impairment?

Would you change to an alternative triplet therapy, or switch to maintenance therapy? Are there variations in depth of response short of CR that woul...

Does CD5 positivity by itself in DLBCL pose a high risk of CNS recurrence and necessitate CNS prophylaxis?

In classical hodgkin's lymphoma patients with a postive PET after 2 cycles, are you routinely transitioning to escalated BEACOPP?

Does the more recent data regarding the continued utility of brentuximab vedotin and the utility of PD-1 inhibitors factor in to your reasoning at all...

What are some preferred steroid sparing regimens for untreated multiple myeloma patients who have type 1 diabetes mellitus?

What is your experience with liposomal-encapsulated daunorubicin and cytarabine (CPX-351) for first line treatment of therapy-related AML or AML with myelodysplasia-related changes in elderly patients?

Do you have experience administering these agents in the outpatient setting?

Do you have a preferred strategy for front line induction therapy in DLBCL patients who have asymptomatic depressed ejection fraction and thus concern about anthracycline dosing?

Is there a situation where you would use a purine analogue in combination with rituximab for the frontline line treatment of normal variant Hairy Cell Leukemia?

Could one make a case for addition of Rituxinab frontline to increase the chances of a complete remission and even maybe achieve MRD-negative status ?

What is your approach to treating relapsed subcutaneous panniculitis-like T-cell lymphoma?

Does it differ from the treatment of other relapsed peripheral T-cell lymphomas? Are there any clinical trials or case series focused on SPTCL? Is t...

What is the best strategy after initial treatment with hypomethylating agents for high grade myelodysplatic syndromes, mainly for responders who became transfusion independent?

Do we continue the hypomethylating agent indefinitely?

Do you routinely do imaging on patients to look for intrathoracic or abdominal lymphadenopathy in newly diagnosed patients with CLL?

How are you making the diagnosis of chronic lymphocytic leukemia transforming to prolymphocytic leukemia?

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

What is your preferred approach to the treatment of transplant ineligible multiple myeloma that has been treated with a triplet regimen and reached a plateau phase?

Would you observe until progression or would you place the patient on maintenance?

What is the best dose to treat splenomegaly with pancytonenia in the setting of myelofibrosis?

Would you use 10 Gy in 1 Gy per fraction as mentioned in a litterature review in Pubmed?

What are your radiotherapy recommendations for a unilateral primary intraocular large B-cell lymphoma following high-dose methotrexate and rituximab?

What factors influence your choice to treat as well as dose and target?

How would you approach a patient with smoldering myeloma that has a quickly rising and very high M-spike (6 g/dL range)?

Once you decide to begin treatment, any special precautions you would use for protein levels starting that high.

Would you treat a patient with definitive local XRT without systemic therapy if he/she presents with pathology showing a PTCL NOS from a small (1.5 cm) lesion of the skin of the chin?

The patient does have significant weight loss, drenching night sweats, but no evidence of other involved sites on PET, thorough skin exam, and has nor...

When would you consider treating a testicular relapse with definitive radiation in a child with ALL?

What is an appropriate dose for nodular lymphocyte predominant, stage 1 Hodgkin lymphoma following nodal excision?

In the case of an excised groin node with no residual disease and no chemotherapy in a young adult patient, how large should the fields be? Is it requ...

How do you approach previously treated grade 1 follicular lymphoma now with transformation to a large cell lymphoma?

What chemotherapy regimen would you recommend for a patient with symptomatic cutaneous B cell lymphoma?

Assuming that the involved area is too widespread for RT. Would you try single agent rituximab first? Or obinutuzumab? What if rituximab alone gave on...

Would you use Ibrutinib plus Venetoclax as second line therapy in relapsed/refractory mantle cell lymphoma?

The recent NEJM phase II trial http://www.nejm.org/doi/full/10.1056/NEJMoa1715519?query=featured_home looked at a small cohort of 24 patients and show...

Do you give 3 or 4 cycles of HiDAC during consolidation for good/intermediate-risk AML without an available allotransplant donor?

How do you choose between 3 and 4?

How would you approach a completely resected DLBCL of the appendix if PET scan and bone marrow biopsy suggest no other disease?

Would you consolidate marginal zone lymphoma transformed to a high grade B-cell lymphoma with a stem cell transplant?

the MZL was untreated in the past prior to transformation. Do these patients have a higher risk of recurrence post CR as opposed to patients with de ...

How do you approach small lymphocytic lymphoma that does not have a leukemic phase. Do you follow treatment guidelines for indolent lymphoma or CLL?

How do you get 17p testing on someone with only lymphadenopathy

For multiple myeloma, is 8 Gy in 1 fraction an appropriate palliative dose, although this histology was excluded from trials examining a single fraction?

What dose of radiotherapy do you use for low volume Castleman's disease?

I have a patient with low volume disease of Castleman's disease with cervical lymphadenopathy and tonsillar hyperplasia that is suspicious but not bio...

How do you manage patients with primary refractory Hodgkin lymphoma?

If a patient has an increase in PET avidity between the PET/CT done after 2 cycles of ABVD and after completion of chemo, how would you proceed? Would...

Do you think there will be a role for duvelisib in the treatment of relapsed/refractory chronic lymphocytic leukemia?

Specifically, in patients that had progression or developed toxicity on ibrutinib? Idelalisib is very toxic and venetoclax a labor-intensive drug to g...

When do you combine hypomethylating agents with venetoclax or gemtuzumab ozogamicin in elderly patients with AML who are ineligible for intensive chemotherapy?

Even though Venetoclax is not FDA-approved yet, assuming you can get it off label? 1. Gemtuzumab: What dose/schedule and which HMA? 2. Venetoclax: W...

How would you approach a Follicular grade 1-2 NHL found on a terminal ileum biopsy with otherwise negative EGD and colonoscopy and contrast enhanced CT scan?

Would you consider resection? Or maybe anti-CD20 monoclonal antibody?

What is your threshold for transfusing platelets in an asymptomatic patient after autologous stem cell transplant?

My practice had always been to transfuse for plts < 10, but the recent ASCO guideline change suggests that in the post-autoSCT setting it is ...

Would you consider aggressive presentation of multiple squamous cell carcinomas of the skin an indication for treatment of CLL?

In the absence of any other classic CLL indications for treatment.

Do you have any concerns about enhanced radiation toxicity with any of the novel agents used to treat multiple myeloma?

How do you follow patients after radiation treatment for orbital MALT lymphoma?

Does your follow-up differ depending on the dose you used (e.g. boom boom vs. 24 Gy)? Do you routinely image? If so, do you use MRI or PET...

What growth factor would you use with A+AVD, if any at all?

If filgrastim, how many days would you give? Pegfilgrastim is often not covered by payers if given less than 14 days before chemotherapy.

How would you treat a diffuse CNS myeloid sarcoma (aka chloroma/granulocytic sarcoma) without evidence of blood or bone marrow involvement?

The patient has no medical problems and no history of leukemia/MDS. Biopsy of the filum terminale and arachnoid confirmed a myeloid sarcoma and MRI sh...

When treating a patient with multiple myeloma with bortezomib, how do you decide between subcutaneous vs intravenous dosing?

Subq has been shown to have lower risk of neuropathy. Is there any reason to use weekly IV still?

What would you choose as a first line therapy for a patient with CLL who is asymptomatic with Rai Stage 4 with bulky adenopathy and organomegaly?

Would it change your management if patient if IgVH mutated?

How would you treat a fit, newly diagnosed, high-risk multiple myeloma patient with multiple poor risk factors and circulating plasma cells?

In a patient with multiple poor risk features including TP53 mutation, 1q amplification, stage III, and circulating plasma cells, would you consider a...

Do you prefer a chemo-radiation combination or chemotherapy followed by sequential radiation approach for early stage NK/T-cell lymphoma?

When do you consider re-starting treatment for a patient with relapsed myeloma?

For example, how significant does the M protein have to increase for you to begin a conversation about new therapy?

For Hodgkin lymphoma patients with initial splenic involvement, do you ever include the pre-chemotherapy involved spleen as part of your consolidative ISRT treatment after a CR?

If the patient had a CR by PET/CT after 2 cycles of ABVD and received 6 cycles of ABVD would you recommended consolidating only the bulky disease and ...

How do you choose among regimens for relapsed refractory myeloma?

Specifically, to you lean towards elotuzumab or a daratumumab-based regimen?

For a MALT of the eyelid, do you treat the entire conjunctiva reflection as well, or just the eyelid?

What technique do you use (IMRT vs direct electrons w bolus)? The ILROG paper on extranodal NHL says "For tumors confined to the conjunctiva or...

How do you choose between azacitidine and decitabine when deciding to treat a patient with MDS with a hypomethylating agent?

Can RT to non-bulky sites be omitted in an early stage (stage I or II) classical Hodgkin's lymphoma case with a CR by PET/CT?

If a patient will receive a total of 4 cycles ABVD and has a CR by PET/CT after cycle 2, can RT be omitted to non-bulky sites to avoid toxicity?

Is a CLL FISH panel sufficient to aid in treatment decisions in CLL or is p53 sequence analysis also needed?

How do you approach the development of an LGL clone in a NHL patient actively getting therapy?

What is your preferred dosing and schedule for interferon in pregnant CML patients?

Given the sensitivity and prognostic value of the serum free light chain ratio for light chain multiple myeloma, do you continue to check urine studies?

In multiple myeloma patients on bortezomib and dexamethasone, who develop HZV reactivation while on HZV prophylaxis, do you stop bortezomib/dexamethasone permanently?

Is venetoclax expected to be useful in patients with refractory CLL/SLL who do not have Del(17p)?

How would you treat stage 3 lymphocyte-predominant Hodgkin Lymphoma that is CD20 negative ?

Are there any indications on advanced stage Hodgkins disease that one might consider stopping the bleomycin after first two cycles?

Specifically I am thinking if a PET scan shows complete response, would it be reasonable to stop bleomycin and continue AVD?

For elderly patients who cannot tolerate chemotherapy, is radiation alone an option for a stage IA favorable classical Hodgkin lymphoma?

What dose and volumes would you use?

For male patients in chronic phase CML on a TKI and not yet in a MMR, is there a preferred amount of time spent in a MMR before discontinuing TKI therapy to conceive or bank sperm ?

Drug information indicates a patient may need 3-4 months off TKI. This seems like a long time off drug. Would a MMR of a certain duration make it less...

What is the preferred regimen for testicular lymphoma with de novo symptomatic CNS involvement and systemic disease at the time of presentation ?

If a patient with myeloma develops a symptomatic DVT or PE while on an immunomodulatory drug such as lenalidomide, would you stop the IMiD?

Would you ever give another IMiD?

How do you manage rituximab-induced neutropenia?

Specifically when given as a single agent. Any role for G-CSF?

What is the role of radiation treatment of stage IA ALK negative anaplastic large cell lymphoma?

PET/CT/bone marrow biopsy negative for evidence of distant disease. Following 4 cycles of combination chemotherapy with no evidence of progressive dis...

What is your approach to the upfront treatment of anaplastic large cell lymphoma, ALK positive, with low IPI score in a young person?

With the advent of many new agents, any thought to initial therapy different from CHOP or CHOEP?

How would you approach a chronic phase CML patient who is responding to second generation TKI but not yet in molecular remission and is now pregnant?

What dose/fractionation schedule should be used for adjuvant RT after surgical decompression of a spinal cord compression from multiple myeloma osseous lesions?

What is the optimal regimen for advanced stage Nodular Lymphocyte Predominant Hodgkin Lymphoma?

For early stage indolent NHL (low grade follicular, MALT) involving midline structures of the head and neck (ie base of tongue, soft palate) how do you apply the concepts of ISRT?

For example: would you treat the entire Waldeyer's ring? For a stage II patient who also has cervical lymph node involvement on one side, do you...

How do you manage the development of neuropathy in patients receiving bortezomib for multiple myeloma?

At what point is the neuropathy a contraindication to further bortezomib therapy?

Does rituximab + lenalidomide have a role in advanced follicular lymphoma?

Although bendamustine + rituximab is a standard option for advanced follicular lymphoma when treatment is required, does the regimen rituximab + lenal...

How do you manage a patient who has developed a symptomatic pleural effusion while on dasatinib?

Specifically, can you rechallenge after the effusion has resolved (e.g. therapeutic thoracentesis)? If so, how long do you wait to rechallenge (especi...

Has the combination of daratumumab, bortezomib, and dexamethasone been tried for the treatment of plasma cell leukemia?

When starting a patient on a tyrosine kinase inhibitor for chronic phase CML, which drug do you choose upfront?

Imatinib, or a second-generation TKI? Are there specific factors that make you choose one over the other?

What is the risk of breast cancer that you quote to young women with early stage Hodgkin's lymphoma receiving involved field/site radiation therapy?

We often see young women with favorable, early stage disease in the mediastinum who have had a complete response to chemotherapy. With current smaller...

Do you use anti-microbial prophylaxis when you prescribe ibrutinib?

If so, do you use antivirals and/or antibiotics? Does it matter if the patient has mantle cell lymphoma, CLL, or Waldenstrom's macroglobulinemia?

Should we continue to offer consolidative radiation for early stage, non-bulky Hodgkin's disease for individuals who have had a complete response (Deauville 1 or 2) after chemotherapy by PET?

How have the results of the UK RAPID study (Radford et al NEJM 2015) changed your practice?

Is there any data to support to use of Brentuximab in the up-front setting in the treatment of Hodgkin lymphomas?

After induction therapy for acute promyelocytic leukemia with arsenic trioxide and ATRA, at what point do you start consolidation?

Specifically, do you just wait for count recovery? Do you check for morphologic or molecular remission at all during this time?

Do you choose to include or omit growth factor support in the treatment of Hodgkins lymphoma?

When determining treatment approach to newly-diagnosed follicular lymphoma (e.g. watchful waiting vs chemotherapy), do you take the intensity of the SUV measurements on PET into account?

How do you manage severe cytarabine syndrome in AML patients (manifesting as severe hypotension, fevers, rash, myalgias)?

Do you re-challenge them? If so, what pre-medications do you give? Do you dose reduce the cytarabine? Or do you switch another regimen?

What is your preferred approach to a patient with newly diagnosed primary mediastinal B-cell lymphoma in the upfront setting?

Specifically, is there still a role for dd RCHOP followed by ICE, or do you recommend DA-R-EPOCH for all patients?

Does radiation improve bone health and allow for healing of a pathological fracture in a patient with multiple myeloma refusing surgery?

What is the best evidence to support or refute this?

How would you define your radiation treatment volume for a primary diffuse large B-cell lymphoma of the L4 vertebral body that had a complete response to chemotherapy?

Would you include one vertebral body above and below the involved vertebral body? Is IMRT appropriate in order to reduce dose to small bowel? What oth...

For patients with stage 1A-E extra nodal marginal zone lymphoma that has been completely excised, would you still consider radiation?

NCCN guidelines suggest XRT as standard of care for this stage of disease. However, occasionally patients have their tumors completely excised when un...

How would you treat a young man with refractory AML after HIDAC induction who developed cerebellar toxicity to HIDAC and previously received doxorubicin (300 mg/m2) for lymphoma?

What re-induction regimen without cytarabine or an anthracycline is likely to be most effective?

Which chemotherapy regimen would you choose for a female adolescent with favorable prognosis stage I-II Classical Hodgkin lymphoma, assuming the patient prefers not to do IFRT if the initial PET response is good?

How would you manage a localized low grade follicular lymphoma diagnosed shortly after a patient had a CR to an aggressive treatment regimen for DLBCL?

If a patient had recently completed R-EPOCH x 6 cycles, would you change your dose for a low grade follicular lymphoma?

Is it appropriate to treat a Stage IE DLBCL of the cervix with close followup if a CR is achieved after 4 cycles of R-CHOP followed by a hysterectomy omitting RT?

Is surgery an adequate treatment for Stage IE DLBCL of the cervix?

What is the best treatment management of low grade early stage follicular lymphoma of the mesentery?

If the mesentery is widely involved with small lesions would this change your management? What if the patient was symptomatic?

What is the recommended initial treatment for spinal cord compression due to non-Hodgkin lymphoma (e.g. diffuse large B-cell lymphoma)?

When treating with radiation therapy, what dose-fractionation do you typically utilize?

Should FISH studies be repeated when CLL patients under active surveillance have progressive disease warranting treatment?

What is the utility of repeating FISH studies to evaluate for clonal evolution if FISH studies were done at diagnosis?

When treating a patient with classic early stage diffuse large B-cell lymphoma (Stage I/II), when is it appropriate for patients to receive 3 versus 6 cycles of R-CHOP chemotherapy when the treatment is followed by ISRT?

The NCCN guidelines recommend all patients receive 3 cycles RCHOP followed by ISRT unless they have bulky disease greater than 7.5 cm. However, are th...

Do you routinely offer consolidation RT to sites of previous bulky disease in stage III and IV Hodgkin's lymphoma who have a complete metabolic response on restaging PET/CT following 6 cycles of ABVD?

In what situations would you feel comfortable omitting RT to bulky disease in stage III/IV Hodgkin's lymphoma?

Is there any data on an effective RT regimen (dose/fractionation) for inducing an abscopal effect using a PD-1 inhibitor in refractory Hodgkin's lymphoma?

How would you treat Classic Hodgkin's lymphoma when the nodal sites are non-contiguous?

With the field moving more toward ISRT/ INRT, and conformal radiation, would you generate separate PTV for initial nodal involvements that are within ...

Given the improved ability to spare heart, kidney and liver, should IMRT be the standard of care for gastric MALT lymphoma (despite the low dose needed to effectively treat these patients)?

If so, what data should be presented to insurance companies to cover the cost?

When would you consider testicular RT prior to TBI for BMT?

What dose do you recommend?

Would you irradiate all borderline suspicious lymph node regions on PET/CT in stage IIA nodular lymphocyte predominant Hodgkin's lymphoma treated with ISRT alone?

When nodal regions not amenable to biopsy but are enlarged without significant SUV uptake, should they be treated as involed and recieve RT?

Should whole brain radiation therapy and orbital radiation therapy be administered in situations of ocular B-cell lymphoma recurrence 2 years after primary CNS lymphoma treated with intrathecal methotrexate and no prior cranial irradiation?

How would you treat a pediatric patient with Stage IVB Hodkin lymphoma who still has persistent PET+ disease after dose-escalated chemotherapy?

After ABVE-PC X4 and Ifos/vinorelbine x 2 per AHOD 0831 (and is unable to have these sites biopsied), what dose would you treat to and what volume wou...

What are your current recommendations for treatment of symptomatic splenomegaly in the setting of myelofibrosis when splenectomy is not an option?

Is there a preferred low dose splenic irradiation regimine?

What is the best management of a lacrimal gland MALToma?

When radiation therapy is utilized, what should the radiation therapy treatment fields include and what imaging studies should be completed to assist ...

Is there a role for radiation therapy after chemotherapy for localized anaplastic large cell lymphoma?

If so, should involved site radiation thearpy (ISRT) or involved field radiation therapy (IFRT) be used for the radiation therapy treatment fields? Wo...

Do you omit consolidative RT in pediatric patients with intermediate risk, non-bulky Hodgkin lymphoma who have a rapid early response to chemotherapy?

Are the results of AHOD0031 practice changing?

What is the role of radiation consolidation after chemotherapy for residual splenic involvement in follicular lymphoma?

What dose do you feel comfortable treating the entire circumference of an extremity to before you are concerned about chronic toxicity?

When the disease (in this case, lymphoma) involves almost all of the entire muscle compartment of the distal lower extremity, what is a safe dose? I'm...

In treating with total body irradiation, how should the lung blocks be drawn and what dose should the lung receive?

In drawing the lung blocks approximately 1 cm in from the chest wall, diaphragm and mediastinum, should the blocks stop underneath the clavicle o...

Is there a role for consolidation radiation in a patient with stage I low grade follicular lymphoma treated with chemotherapy?

If a patient with stage I, low grade follicular lymphoma achieves a complete response after rituxan and treanda is there any role for consolidative ra...

In Stage I-II primary mediastinal B-cell lymphoma (PMBL), bulky or non-bulky, is post-chemotherapy radiotherapy still standard in patients with a complete response to CHOP-R chemotherapy?

What is the best radiation dose to treat primary cutaneous B cell lymphoma?

Specifically for marginal zone or follicle center?

What is the best treatment volume and dose for a marginal zone orbital lymphoma?

Is it necessary to treat the whole orbit or is conformal treatment ok?

What is the appropriate treatment for marginal zone lymphoma of the parotid following surgery?

After a nerve sparing parotidectomy, would you offer postoperative radiotherapy? If so, what volume and dose? Would it change your management if the p...

Is it acceptable to treat pediatric Hodgkin's lymphoma with an involved nodal field outside the setting of a clinical trial?

What is the treatment volume for primary breast lymphoma?

In a patient with Stage IE DLBCL, is your treatment volume postchemo ISRT or whole breast? Would you consolidate if a lumpectomy was performed prior t...

In treating early stage follicular lymphoma with RT, do you approach grade 3 disease any differently than grade 1-2?

Would you prescribe to a higher dose? Treat with wider margins? Encourage the use of systemic therapy?

What is the appropriate RT dose for an advanced stage follicular lymphoma?

Hoskin et al (Lancet Oncology 2014) suggest 24Gy/12fx is more effect RT dose compared to 4Gy.

Is IMRT preferred over 3D conformal RT for lymphoma of the head and neck?

Is there a benefit to IMRT when we treat to relatively low doses (as compared to squamous cell cancers of the head and neck)?

Can you observe low grade follicular lymphoma if the involved node(s) have been surgically removed?

Is it time to start incorporating involved site irradiation for all lymphomas?

Or is it more appropriate for certain sites/stages/histologies?

What is the appropriate dose of radiation for a primary osseous non-Hodgkin's lymphoma?

Specifically, for a diffuse large B cell lymphoma of the femur?

Is it preferable to simulate pediatric Hodgkin's lymphoma patients with arms up or akimbo?

It seems that with the arms up, you get better lung blocking but with arms akimbo, you might have a lower dose to the humeral head.

What is the difference between involved node and involved site irradiation?