What are your top takeaways in Classical Hematology from ASH 2025?

My top 3 takeaways in classical hematology:

1) ITP - much controversy at the education program session about the draft 2025 guidelines, where TPO mimetic + steroids is going to be recommended in the front line. There does not appear to be compelling new data that supports the revision of this guideline since the last guideline was issued.

Ianalumab + TPO (VAYHIT2 and NEJM article) appears to have an impressive response in the late-breaking abstract session, and a new mechanism of action is always ...

Distinguishing true iron deficiency from inflammatory changes on iron parameters is still difficult.

From the PARADIGM trial, we are still searching for the best way to induce remission in fit AML patients. There are still many unanswered questions, despite the exciting EFS outcomes in this trial.

This is tough - I tend to attend various talks, not only at BH. Here are some interesting immediate recollections:

• Certainly, a potential game-changer is replacing 7 + 3 with venetoclax + azac.
• I learned that once you diagnose bleeding of unknown cause (BDUC), the diagnosis rarely changes, and the prognosis appears to be good.
• The plenary session on IV iron for treatment of acute infections in hospitalized patients was disgraceful and is bound to do a lot of damage.
• Avoid the combined use of an...

The first and third are clinical practice-changing studies on the prevention of kidney disease. SGLT2 inhibitors will become very important in SCD. The second is on a promising new drug.

1. Renin-angiotensin-aldosterone system inhibitors exacerbate anemia in sickle cell disease
2. Phase I study of the histone deacetylase inhibitor panobinostat in sickle cell disease
3. Dapagliflozin for treatment of sickle cell nephropathy: A multi-centre experience

The tranexamic acid is important for consultative hematology.