Tanya Wildes MD Profile picture
Dec 7, 2019 5 tweets 4 min read Read on X
Abs 268: @HiraSMian presents data on >5700 pts with MM from Canadian registry with some good/some sobering news for #geriheme pts:
1. ASCT use rising
2. 60% of older pts get a novel drug
3. 20% 1-yr mortality
4. 30% of older patients received NO MYELOMA TREATMENT
#ASH19
Even with universal coverage, older pts, lower SES or more comorbidities less likely to be treated for myeloma #mmsm #geriheme #ASH19 ImageImage
High 1-yr mortality for older pts with myeloma who don’t receive treatment. We saw similar rate untreated in SEER- Medicare database. #geriheme ncbi.nlm.nih.gov/m/pubmed/29429… Image
Will be curious to hear hypotheses about why the plateau? Payor or provider factors? Image
13% of pts over age 65 get ASCT... have to check but I think it is single digit % in US in >65. Image

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More from @tanyawildes

Sep 23, 2020
I have done the academically unfathomable:

I am resigning my faculty position without another job lined up. While I am 100% confident in my decision, I am also 100% sad.

This did not have to happen. #womeninmedicine 1/
I am not burned out. I love what I do. I love my patients and I love my research. I am not quitting my calling. I am being brave enough to be CEO of my own life. @RUBraveEnough 2/
Why? “Alignment between your career & your core values produces satisfaction, a sense of happiness & fulfillment. A misalignment can cause can everything from minor problems to major disruptions.” 3a/
Read 12 tweets
Dec 9, 2019
Abs 694: Dr Puiz presents GEM-Claridex trial of Rd vs Clarithromycin-RD. Got to witness Sweet moment at end when her mentor @mvmateos flashed her the “Great job, my protege!” smile we all need to see ❤️ ImageImage
GEM-Clarieex provides another cautionary tale about a myeloma regimen that is more effective but more toxic in older patients #geriheme....
Very inclusive with pts into their 90s. Significantly greater CR, >=VGPR rates. We should celebrate 🎉 right? But.... ImageImage
Read 5 tweets
Dec 8, 2019
Blown away by rising star @mwschoen's masterful storytelling of how he is trying to understand and eradicate racial disparities in myeloma treatment and outcomes...
file:///var/folders/mw/0w9f93f97wscrp764dmz0k900000gp/T/com.apple.iChat/Messages/Transfers/IMG_6462.jpeg #ASH19 Image
@mwschoen Dr. Schoen walks us through a hypothesis that renal impairment and racial differences in estimating renal function may impact treatment and outcome: 1) Pts with renal dies less likely to receive lenalidomide. Image
@mwschoen 2) Black veterans have higher creatinine but better GFR... if clinician only looks at creatinine, may err in understanding pts renal function. Image
Read 6 tweets
Dec 7, 2019
Here's my #gerihemelist for #ASH19 Saturday...
Abs 2209, Poster today: 1/3 of pts with "good" PS were frail; Frail pts with AML had 50% 100-day mortality! ash.confex.com/ash/2019/webpr…
Abs 1563, poster today: In SEER-Medicare analysis of 2800 older adults with Hodgkin Lymphoma (1999-2014), 1/4 received NO treatment.

#ASH19 #geriheme ash.confex.com/ash/2019/webpr…
Read 4 tweets
Dec 7, 2019
Abstract 67: all new patients with blood cancer age >=75 screened for frailty; participants randomized to receive geriatric consultation. Outcomes: feasibility, 1-yr OS, acute care utilization, goals of care discussion. ash.confex.com/ash/2019/webpr…
86% participated in RCT, but some patients worried that geriatric consultation would make them ineligible for treatment. Just heard this same observation from another #geriheme MD on the opposite side of the country just last night! @ROlinMD
@ROlinMD Outcomes: OS not improved (Abel says geriatrics is not magic!) but geriatric consultation did increase documented goals-of-care conversations. #geriheme #gerionc #ASH19
Read 4 tweets
Dec 2, 2019
My top 8 #ASH19 #geriheme #myeloma abstracts....
1. 2 out of 5 real-world myeloma patients ineligible for clinical trials; 75% of frail patients ineligible.
ash.confex.com/ash/2019/webpr…
#GeriHemeList
2. Response rates in frail patients similar to those in intermediate or fit transplant-ineligible NDMM patients
ash.confex.com/ash/2019/webpr…
#GeriHemeList
Read 9 tweets

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