Hematology

Operational model and value proposition for multidisciplinary CHIP clinics

CHIP clinics provide a multidisciplinary framework for evaluation, risk assessment, trial referral, and registry creation for clonal hematopoiesis. The authors propose workflows for patient identification, team composition, and operational elements adaptable to academic and community settings. CHIP clinics enable preventive hematology activities and prospective real-world risk assessment tied to curated biorepositories. Translational impact is promising but depends on longer-term natural history data and emerging therapies. 1

Phase 2 monotherapy cancer trials show worse average efficacy than phase 3

Across 130 phase 2 and 52 phase 3 monotherapy arms, pooled objective response rates were 7% versus 24%, respectively. Median PFS was shorter in phase 2 (3.23 months vs 5.43 months) and median OS was also shorter. Grade 3–4 drug-related adverse events were at least as common in phase 2 (30%) as in phase 3 (25%). The authors conclude phase 2 monotherapy exposure is primarily justified as research rather than therapeutic care. 2

International PBM guidelines agree on restrictive transfusion thresholds but vary elsewhere

This review analysed 40 national and institutional PBM guidelines across two decades. Most guidelines endorse restrictive transfusion, commonly using a threshold of Hb 7 g/dL or lower in many settings. Substantial variability exists in strategies to reduce diagnostic blood loss and in national standardisation efforts. The authors call for harmonisation and multidisciplinary coordination to expand safe PBM adoption. 3