This ASH 2025 conference video features expert perspectives on newly published ASH guidelines for the treatment of newly diagnosed older adults with acute myeloid leukemia (AML). Discussion focuses on individualized treatment selection, molecular risk–informed decision-making, assessment of transplant eligibility, and the role of supportive and end-of-life care.

The video also reviews real-world evidence evaluating anti-inflammatory approaches for the management of immune effector cell–associated neurotoxicity syndrome (ICANS) following CAR T-cell therapy, highlighting evolving strategies to address this challenging toxicity in clinical practice.

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The FDA recently approved daratumumab and hyaluronidase-fihj (subcutaneous CD38 antibody) in combination with bortezomib, lenalidomide, and dexamethasone (VRd) for induction and consolidation in newly diagnosed multiple myeloma (MM) patients eligible for autologous stem cell transplant (ASCT). The approval was based on clinical trial results (NCT03710603) that demonstrated a significant reduction in disease progression or death by 60% with CD38-VRd compared to VRd alone. Common adverse reactions included neuropathy, fatigue, and upper respiratory infections, among others. The efficacy and tolerability of CD38 antibodies continue to expand their role in optimizing MM treatment outcomes.

How does the addition of CD38 antibodies reshape the treatment landscape for transplant-eligible multiple myeloma patients? What factors should clinicians consider when selecting induction therapies for this patient population?

Low blood cell counts are a frequent and serious concern during cancer care, often due to chemotherapy, the cancer itself, or comorbid conditions. These include anemia (low red cells), neutropenia (low white cells), and thrombocytopenia (low platelets). If unaddressed, they may cause fatigue, infections, bleeding, and treatment delays—all of which can impact outcomes and quality of life.

Anemia may cause fatigue, breathlessness, and palpitations. Monitoring hemoglobin, hematocrit, iron studies, vitamin B12, and renal function helps guide therapy. Management includes iron supplementation, red cell transfusions, or drugs that stimulate red blood cell production.

Neutropenia impairs immune defense and raises infection risk. Febrile neutropenia—fever accompanied by low white cell count—is an oncologic emergency. Risk assessment, patient education, and use of white cell growth factors are key to prevention and treatment.

Thrombocytopenia increases bleeding risk and may present as bruising, petechiae, or prolonged bleeding. It can result from marrow suppression, infection, or medication. Management includes platelet monitoring, transfusions, or medications that boost platelet production.

NCCN Guidelines emphasize early intervention and regular monitoring. Knowing when and how to act supports uninterrupted cancer treatment and patient safety. A multidisciplinary approach enhances treatment outcomes and overall care experience.

What proactive steps can patients take to detect low blood cell counts early, especially when symptoms are not yet apparent? What clinical indicators or patient factors influence your decision to modify chemotherapy regimens in the presence of cytopenia?