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13 Jan, 5 tweets, 1 min read
All FDA Antibody Drug Conjugates Heme Malig
Tweetorial
#Goodman_heme

Antibody+Linker+Chemo/toxin
MOA
FDA approvals (trial)
tox (last tweet)

Gemtuzumab ozogamicin
anti-CD33+calicheamicin (DNA breaker)
Frontline AML+7+3 (ALFA,AML15)
Pediatric induction (AAML0531)
RR AML mono-Rx
Brentuximab vedotin
anti-CD30+MMAE (microtubule polym inh)
Frontline HL BV+AVD (ECHELON 1, no OS)
RR HL BV mono-Rx
High risk HL post-ASCT maint (AETHERA,I don't rec)
Frontline CD30+ PTCL BV+CHP (ECHELON2, +OS)
RR systemic anaplastic large cell lymphoma
RR CTCL/cALCL (ALCANZA)
Inotuzumab ozogamicin
anti-CD22+MMAE (+calicheamicin (DNA breaker)
RR B-ALL mono-Rx (INO-VATE, +OS)

Belantamab mafodotin
anti-BCMA+MMAF (microtubule poly inh)
RR multiple myeloma mono-RX (DREAMM-2)
Moxetumomab pasudotox-tdfk
anti-CD22+PE38 (pseudomonas toxin that inhibits EF2)
RR hairy cel leukemia mono-Rx

Polatuzumab vedotin
anti-CD79b+MMAE (microtubule polym inh)
RR DLBC PV+BR (RCT phase II, +OS)
Important Toxicity

Gemtuzumab ozogamicin = VOD
Brentuximab vedotin = Neuropathy
Inotuzumab ozogamicin = VOD
Belantamab mafodotin = Blindness (keratopathy)
Moxetumomab pasudotox-tdfk = HUS+capillary leak
Polatuzumab vedotin = Neuropathy

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More from @AaronGoodman33

Aaron Goodman Profile picture
1 Jan
Cold Blood (short Tweetorial)
#Goodman_heme

3 confusing diseases

1. Cold agglutinin disease
2. Cryoglobulinemia
3. Paroxysmal cold hemoglobinuria

Two of these disease are seen often on both the heme consult service and boards.
Cold Agglutinin Disease

Hemolytic anemia precipitated by cold
Monoclonal IgM binds RBCs (I antigen), agglutination, and fixes complement in cold->hemolysis
DAT+ for C3 and - for IgG
Associated with IgM gammopathies/LPL
Polyclonal form after Mycoplasma infection
Rx = Rituximab
Cryoglobulinemia = precipitate at cold temp

I:
MPGN, palpable purpura
Monoclonal IgG/IgM
LPL, MGUS, myeloma, CLL

II:
Meltzer's triad = palpable purpura, arthralgias, weakness
Mononeuritis multiplex
Monoclonal IgM + polyclonal IgG
HCV, HIV

III:
Polyclonal IgM+IgG
Autoimmune dz
Read 5 tweets
Aaron Goodman Profile picture
31 Dec 20
Early stage DLBCL Tweetorial of all key trials from a presentation I just gave
#Goodman_heme
See last slide/Tweet for my conclusions

SWOG 8736:
>18 years
Bulk (>10 cm) allowed
CHOPx 3+IFRT vs. CHOP x 3 +IFRT
OS⬆️with IFRT but no difference in OS with extended f/u

18 year f/u Image
ECOG 1484
>16 years
Bulk (>10 cm) allowed
CHOP x 8 if CR (by CT) randomized to IFRT vs observation
DFS improved with IFRT
No difference in OS Image
GELA/LNH 93-1
No adverse risk factors on aaIPI
Age <60 years
Bulk (> 10 cm) allowed
ACVBP x 3 vs CHOP x 3 + IFRT
EFS and OS improved with chemo alone
Very young favorable group but chemo alone works! Image
Read 9 tweets
Aaron Goodman Profile picture
22 Dec 20
I had a 1 hour Zoom meeting so I thought I go big
(Tweetorial 1/10)
#Goodman_heme

t(8;14) = MYC-IgH = BL
t(2;8) = IgK-MYC = BL
t(8;22) = MYC-IgH = BL
t(14;18) = IgH-BCL2 = FL
t(2;18) = IgK-BCL2 = FL
t(18;22) = BLC2-IgL = FL
t(11;14) = CCND1-IgH = MCL
t(11;18) = API2-MALT1 = MZL H. pylori-
t(2;5) = NPM1-ALK = ALCL ALK+
t(6;7) = DUSP22-FRAH7H = ALCL ALK-
iso7q = HSTCL
inv(14) = t(14;14) = MTCP1 = T-PLL
t(X;14) = TCL1 = T-PLL
del(11q) = ATM = CLL (intermediate)
del(13q) = RB1 = CLL (good)
+12 = CLL (good)
9p24.1 amp = PDL1/PDL2/JAK2 = Hodgkin
t(11;14) = CCND1-IgH = Myeloma (standard risk), AL amyloid, plasma cell leukemia
Trisomies 3,5,7,9,11,15,19,21 (odd chromosomes) = Myeloma (standard risk)
t(6;14) = CCND3-IgH = Myeloma (standard risk)
Read 10 tweets

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