https://xitter.cf/t.co/VdrXEe1Kb2 Official Journal of PHO Chapter of Indian Academy of Pediatrics https://xitter.cf/t.co/PZDsoC5jKD
Joined June 2019
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Pediatric Hematology Oncology Journal retweeted
Soon, radiology residents will replace radiology AI models.
Pedrini et al (2026) looked at 3 months' worth of CT scans (2,153) interpreted by an on-call resident. 15.4% of them had intracranial hemorrhage (ICH).
The residents had a sensitivity of 96.4% and specificity of 99.6%. The same studies were given to directly to a commercial AI software, which generated heatmaps. The results and heatmaps were separately evaluated as part of the research protocol (aka not available at interpretation time) with sensitivity of 84% and specificity of 94.4%. Performance by AI improved with multiple hemorrhagic types or sites, but did not outperform the resident.
Of 12 FN reports by residents, 6 would have been caught by the model; the attending that overread the preliminary report obviously found all 12.
AI mislabeled 101 cases as FP for ICH. If these were autonomously read, this would have likely led to increased length of stay, follow-up imaging, or inappropriate treatment changes, including discontinuation or non-administration of thrombolytic therapy in patients with ischemia.
The study authors note that the AI FP "typically would not cause confusion with ICH for radiologists interpreting CT scans, as they are easily recognized as various hyperdense intracranial abnormalities not related to ICH."
Take-home points: 1) Clinical deployment studies are increasingly important for medical AI. The commercial model used here was good and well-validated. 2) Perhaps you should hire a Swiss radiology resident to read all your ICH cases, they seem pretty good.
link.springer.com/article/10…
When one rare tumor wasn’t rare enough, this toddler said 'Let’s make it a case report'
Synchronous ERMS + ACC + germline CBL mutation = genetics keeping pediatric oncology on its toes.
Moral: If a kid brings two tumors to clinic, always invite genetics to the party #GeneticsWins
This systematic review by Dana Ashkenazi Lustig and colleagues from Israel speaks about the spontaneous resolution of LCH lesions. Proposed mechanisms include biopsy-induced inflammatory
system modulation, apoptosis via the Fas/Fas-L pathway, & disruption of the MAPK signalling
BRAF V600E mutations. Nanoparticle-based delivery of targeted
agents, like anti-BCL2 or cytokine inhibitors, represents an emerging therapeutic strategy. Have you noticed this phenomenon in your practice? Give your inputs in comments #pediatriclch #langerhanscellhistiocytosis
Krisha Savla and colleagues from Tata Memorial Hospital, Mumbai have described their findings about the nutritional status of children with acute leukemias receiving chemotherapy at their centre. Details of the findings in comments.
In this cohort, 37.5 % of children classified as malnourished.
At end of Rx, 5.3 % were severely & 22.6 %
were moderately malnourished, 8.2 % were overweight & 6.7 %
were obese
Improvement in the status could be attributed to effective nutritional interventions, supportive care
sciencedirect.com/science/ar…
This interesting article written by Maya Et al describes the diagnostic algorithm in CNS leukemias, CNS directed therapy in ALL, management of CNS disease at relapse, role of newer agents and immunotherapies, CNS directed treatment in ALL and AML.
Pediatric Hematology Oncology Journal retweeted
@kidzcancerdoc amazing to think this was only 15 years ago, how awareness is changing in India, but there are now gaps to fill in support for physicians, especially in smaller centers... #childhoodcancer #India #mapping #icci #cankids #pediatriconcology
Read this with a report on triple negative thrombocytosis (apparently group 4) in 2025 issue of PHOJ #thrombocytosis #children #PHOJ
TNT (Triple-Negative Thrombocytosis) Treatment Algorithm —
Proposed by BJHaem, Godfrey et al. — shown at the 3rd Kuwait Hematology Conference
🧬 First question: Clonal or non-clonal?
🔍 Second question: Megakaryocyte atypia or not?
➡️ These 2 answers place every patient into 1 of 4 treatment pathways.
⸻
🟥 1) Clonal marker + Megakaryocyte atypia
Triple-Negative ET with clonal marker (cTNT-ET / ITAM-C)
• Age ≥60 or refractory symptoms or cardiovascular RFs → Aspirin if no bleeding risk
• Age ≥60, prior vascular event, persistent Plt ≥1500×10⁹/L, or refractory symptoms → Consider cytoreduction
• Monitor for evolution toward PMF/MDS/other MPN
⸻
🟧 2) Non-clonal + Megakaryocyte atypia
ITAM (Idiopathic thrombocytosis with atypical megakaryocytes / TN-ET without clonal markers)
• Age ≥60, symptoms, or CV risk → Consider aspirin
• Age ≥60, prior vascular event, Plt ≥1500×10⁹/L, or multiple CV RFs → Consider cytoreduction
• Monitor carefully for transformation; marrow should be repeated if phenotype changes
⸻
🟦 3) Clonal marker + No megakaryocyte atypia
CTUS (Clonal thrombocytosis of undetermined significance)
• Age ≥60 or symptoms or CV RFs → Could consider cytoreduction (case-by-case)
• Aspirin can be considered depending on risk profile and Plt count
• Monitor for evolution to ET/MPN
⸻
🟩 4) Non-clonal + No megakaryocyte atypia
ITUS (Idiopathic thrombocytosis of undetermined significance)
• Usually benign course
• Annual FBC monitoring
• Aspirin only if another indication (e.g., CV risk)
• Cytoreduction not recommended
⸻
Key Factors That Determine Treatment
1️⃣ Clonal or non-clonal?
2️⃣ Megakaryocyte atypia present or absent?
3️⃣ Age ≥60?
4️⃣ Symptoms?
5️⃣ Thrombosis history?
6️⃣ Cardiovascular risk factors?
7️⃣ Platelet count?
⸻
#MPN #TNT #TripleNegativeET #ET #CTUS #ITUS #Thrombocytosis #Hematology #NGS #KuwaitHematologyConference #SOHO25 #EmiratesHematologySociety
Bedside clinical skills have been diminished by an overreliance on technology. A new Review Article presents educational strategies for reinvigorating the bedside encounter and shows how much can be learned from it.
Read the review “Strategies to Reinvigorate the Bedside Clinical Encounter,” the latest in the Medical Education series, by Brian T. Garibaldi, MD, MEHP, and Stephen W. Russell, MD, from @NUFeinbergMed and the University of Alabama at Birmingham (@UABNews): nej.md/4nUirnP
ALT Review Article | Medical Education Strategies to Reinvigorate the Bedside Clinical Encounter An illustration describing a scenario with a patient, a resident, and a medical educator
Pediatric Hematology Oncology Journal retweeted
#ScienceSaturday
❓ What controls whether T cells keep fighting or get tired?
➡️ A recent study in Nature Immunology reveals that a protein called SATB1 acts like a “brake” on CD8 T cells, the immune system’s cancer-fighting soldiers.
➡️ During chronic infections or #cancer, T cells can become exhausted over time. This research shows that SATB1 controls how fast T cells multiply and how strongly they attack tumors. When SATB1 levels are high, T cells stay balanced but may hold back their attack. When SATB1 is removed, T cells expand faster and fight harder, especially when combined with immunotherapy, though they may tire sooner.
➡️ Importantly, blocking #SATB1 improved tumor control and boosted the power of checkpoint inhibitors in preclinical models, suggesting a promising new strategy to enhance cancer immunotherapy.
🌟 Congratulations to the study authors at the University of Melbourne, Peter Doherty Institute, University Hospital Bonn, Peter MacCallum Cancer Center, and collaborators for deepening our understanding of T cell biology and uncovering a potential way to make immunotherapies even more effective. @UniMelb @TheDohertyInst @UniklinikBonn @PeterMacCC @NaturePortfolio
🔗 Read more: doi.org/10.1038/s41590-025-0…
Pediatric Hematology Oncology Journal retweeted
An interesting insight as to how bone mets stay protected!
Pediatric Hematology Oncology Journal retweeted
CHI3L3+ immature neutrophils inhibit anti-tumor immunity and impede immune checkpoint blockade therapy in bone metastases dlvr.it/TNjd8P
Pediatric Hematology Oncology Journal retweeted
Hypogamma after CART or bispecifics needs aggressive IgG replacement.
A 52-year-old man with a history of splenectomy and hypogammaglobulinemia after CAR T-cell therapy for lymphoma 3 years earlier was admitted with septic shock. Encapsulated diplococci were seen in 20% of neutrophils.
Read the full case details in the Images in Clinical Medicine article “Pneumococcal Sepsis in a Patient with Asplenia and Hypogammaglobulinemia,” from @RushUniversity: nej.md/4oap9GL
ALT Images in Clinical Medicine Pneumococcal Sepsis in a Patient with Asplenia and Hypogammaglobulinemia Panel A: Encapsulated diplococci seen in 20% of neutrophils on a peripheral-blood smear. Panels B and C: Multiorgan dysfunction and purpura fulminans of the nose and fingers developed.
Pediatric Hematology Oncology Journal retweeted
For our focus issue on innate immunity, Ruochan Chen, Daolin Tang and colleagues discuss damage-associated molecular pattern (DAMP) release upon cell death and downstream immune pathways. dlvr.it/TNjpPs
Pediatric Hematology Oncology Journal retweeted
New #JITC article: O-GlcNAc transferase promotes immune evasion and immunotherapy resistance in uterine corpus endometrial cancer by targeting the glucocorticoid receptor bit.ly/438LM6i
