Hematology

Digital bedside guideline platform linked to shorter LOS after pediatric allo-HCT

Single-center, three-era cohort of first pediatric allogeneic HCTs compared pre-platform (n=200), wash-in (n=111), and sustained-use (n=78) eras. Sustained-use was associated with 14% shorter LOS versus pre-platform (adjusted ratio 0.858; p=0.018), with mean LOS 45.74 days in sustained-use. There was a trend toward lower non-relapse mortality after adjustment (adjusted SHR strengthened to 0.193-0.212 in sensitivity models). No signal of increased ICU admission or 30-day readmission was observed in the sustained-use era. 1

EASIX-driven stratification predicts bleeding and early death in APL-like AML

Multicenter analysis of newly diagnosed APLL showed log2-EASIX markedly higher than other AML and correlated with thrombomodulin (r=0.80). High log2-EASIX independently associated with major bleeding (OR 5.61) and higher early-death incidence across cohorts. High-risk APLL treated with standard venetoclax+HMA had worse early outcomes, while a modified VEN-HMA with reduced venetoclax initiation improved early outcomes (P=0.036). Authors propose rapid EASIX-based risk stratification to identify patients who may need an optimized induction strategy. 2

Hydroxyurea reduced vaso-occlusive composite events in adults with HbSC

Retrospective single-center pre-post study included 75 patients in effectiveness analysis after HU initiation. Hydroxyurea reduced mean annual vaso-occlusive composite events by 56% (from 0.57 to 0.25; Δ = -0.32; p=0.0015). Haematological adverse events were common but mostly mild (thrombocytopenia 32.7%, neutropenia 23.6%, leukopenia 20.9%). Non-haematological harms were infrequent and asymptomatic (bilirubin elevation 10.9%), with no clinical hepatotoxicity reported. 3