Hematology Pills

Mattioli Health

Hematology Pills is a new format based on monthly discussions between Prof. Robin Foà (Rome) and Dr. Filippo Milano (Seattle). Each episode explores the latest breakthroughs in gene therapy, immunotherapy, and clinical innovation, while addressing also ethical and practical challenges that shape the field. Our podcast offers a clear and compelling look at the evolving landscape of blood disorders and treatments for hematologists, researchers and healthcare professionals. Stay informed, inspired, and connected with Hematology Pills – a source off hematology updates, one episode at a time.

Play

Open in

19 episodes
monthly
Avg 21 min
English

Episodes 19

Newest Oldest Longest

All19 Unplayed19 In progress0 Played0

S1 · E18
September 18 · 22 min
Beyond the Storm: Preventing and Managing CAR-T Toxicities – A Dialogue Between Robin Foà, Filippo Milano and Jordan Gauthier
In this episode, Prof. Robin Foà and Prof. Filippo Milano are joined by Dr. Jordan Gauthier, Associate Professor at the Fred Hutchinson Cancer Center and an internationally recognized expert in the management of CAR-T cell toxicities. The conversation explores how the field has evolved from acautious, reactive approach to immune-related complications toward proactive, biomarker-guided prevention—an evolution essential to extending the safe use ofCAR-T therapy beyond major academic centers. The discussion retraces the paradigm shift in corticosteroid management, from the early Seattle trials of 2012–2017, when high-dose steroids were withheld out of fear of compromising CAR-T efficacy, to current evidenceshowing that early intervention mitigates toxicity without blunting antitumor activity. The speakers also examine the growing role of risk biomarkers—including CRP, ferritin, LDH, and pre-treatment thrombocytopenia—alongside emerging evidence on host genetic variants in T-cell function genes that may predispose patients to more severe complications. A significant part of the conversation addresses the pharmacological management of severe or steroid-refractory neurotoxicity, focusing on high-dose intravenous Anakinra and its role in facilitating corticosteroid weaning, as well as the ongoing investigation of JAK-STAT inhibitors such as itacitinib as alternative strategies. The speakers also discuss a distinct and less understood clinical entity: late-onset neurological toxicities (NINTS) associated with anti-BCMA CAR-T products such as ciltacabtagene autoleucel, includingcranial nerve palsies and Guillain-Barré-like syndromes, and the hypotheses behind their unique pathogenesis. Looking at the broader clinical landscape, the conversation turns to thegrowing demand for cellular therapies and the structuralchallenges—particularly hospital bed availability and long-term care logistics—that limit expanded access, alongside the value of multidisciplinary immunotoxicity meetings in managing complex cases. A rigorous and timely conversation on how deepening our understanding of CAR-T toxicities is paving the way for safer, more accessible immunotherapy.
S1 · E17
August 24 · 30 min
Fifty Years of Hematopathology: From Morphology to AI
In this episode, Prof. Robin Foà and Dr. Filippo Milano arejoined by Prof. Stefano Pileri, one of the world's leading hematopathologistsand a key contributor to the WHO Classification of Hematolymphoid Tumors. Inspired by his recent book, Where do we come from? What are we? Where are we going? A journey through theevolution of Pathological Anatomy over the last half century, the conversation retraces the remarkable evolution of hematopathology—from the era of purely morphological diagnosis to the integration of molecular technologies and artificial intelligence. The discussion explores the milestones that transformed the field, including the introduction of immunohistochemistry, the discovery ofdisease-defining biomarkers such as CD30, and the transition toward molecular diagnostics and next-generation sequencing. These advances have progressively reduced diagnostic subjectivity while enabling increasingly precise disease classification and the development of targeted therapies. A central theme of the episode is the growing need for highly specialized reference centers. As diagnostic techniques become more sophisticated, accurate pathological assessment has become essential not only for selecting the most appropriate therapy but also for avoiding unnecessary treatments and optimizing healthcare resources. The speakers also emphasize the importance of multidisciplinary collaboration, where pathologists and clinicians combine increasingly complex biological data to guide patient care. Looking to the future, the discussion turns to digital pathology, tele pathology, and artificial intelligence. While AI promises to improve standardization and diagnostic consistency, it is seen as a tool that will support—rather than replace—the expertise and clinical judgment of experienced pathologists. A thoughtful conversation on how technological innovation has transformed hematopathology and how it will continue to shape precision medicine in the years ahead.
S1 · E16
July 20 · 24 min
From CML to AML: Precision Medicine, Global Access, and the Future of Leukemia Care – A Dialogue Between Robin Foà, Filippo Milano and Jerald Radich
In this episode, Prof. Robin Foà, Dr. Filippo Milano, and Dr. Jerald Radich revisit the extraordinary journey of chronic myeloid leukemia (CML), one of the greatest success stories in modern hematology and the disease that transformed precision medicine from concept to clinical reality. The discussion retraces the evolution of CML treatment, from an era when bone marrow transplantation represented the only curative option to the revolutionary introduction of tyrosine kinase inhibitors (TKIs), which have dramatically changed the natural history of the disease. Today, most patients receiving TKI therapy can expect a life expectancy comparable to that of the general population, making CML the prototype of targeted cancer therapy. The conversation also highlights the global impact of scientific innovation through the partnership with The Max Foundation, an initiative that has expanded access to molecular diagnostics and lifelong TKI treatment for tens of thousands of patients in low- and middle-income countries. By combining innovative diagnostic strategies with worldwide collaboration, the program has demonstrated that precision medicine can become a global reality rather than a privilege limited to high-income healthcare systems. Looking toward the future, the episode explores MyeloMatch, the largest precision medicine trial ever conducted in acute myeloid leukemia (AML). By integrating rapid molecular profiling, next-generation sequencing, and targeted therapies, the initiative aims to redefine frontline AML treatment while advancing increasingly sensitive measurable residual disease (MRD) assessment. The discussion examines both the promise and the challenges of applying precision medicine to a biologically complex disease such as AML, where molecular diversity continues to shape prognosis and therapeutic decision-making. A compelling conversation on how decades of scientific discovery have reshaped leukemia care—demonstrating how precision medicine, global collaboration, and molecular innovation continue to redefine the future of hematology.
S1 · E15
June 19 · 22 min
The Next Chapter of Cord Blood Transplantation: Harnessing Immune Responses to Improve Transplant Outcomes – A dialogue between Robin Foà and Filippo Milano
In this episode, Prof. Robin Foà and Prof. Filippo Milano reflect on a groundbreaking phase two study out of Seattle that introduces a novel and highly effective approach to cord blood transplantation. Unlike traditional double cord blood transplants, which have historically been hindered by severe complications when T-cells from both units interact, this new methodology overcomes these major disadvantages to reshape patient outcomes. The conversation delves into the biological mechanics of this pioneering technique. Prof. Milano details how his research team successfully combined a single matched cord blood unit with an off-the-shelf product made from a pool of six to eight different units. By meticulously CD34-selecting and expanding these pooled cells for 14 days on a Notch platform, they created a therapeutic product rich in CD34 and monocytic cells, yet completely lacking T-cells. A major theme of the discussion is the striking clinical success of this trial. Among approximately 30 patients, the approach yielded a 96% overall survival rate and a remarkable 0% incidence of acute grade 3 and 4 Graft-Versus-Host Disease (GVHD). Beyond survival metrics, the episode explores a fascinating biological phenomenon observed between day 7 and 10 post-transplant: a massive spike in active CD8 lymphocytes. Single-cell RNA sequencing revealed that these monoclonal cells originated from the matched unit, reacting to the mixed HLA of the pooled product. Prof. Milano highlights ongoing research using mouse models to see if this immune response can be predictably directed to enhance the Graft-Versus-Leukemia (GVL) effect, which would be especially beneficial for patients with active disease. The debate then turns to the broader structural challenges facing the field today. With the overall number of cord blood transplants declining and public banks shrinking—even halting collections in major cities like New York—Prof. Milano strongly advocates for the preservation of this critical resource. Cord blood remains a vital, immediately available, pre-typed stem cell source, a readiness that proves essential during unexpected global emergencies like pandemics. As the episode closes, the speakers look ahead to the future, discussing plans to test this pooled cell product in mismatched related haploidentical transplants. This dialogue is a candid examination of both scientific ingenuity and systemic challenges—a reminder that persistent innovation and dedicated research continue to push the boundaries of what is possible in the field of hematopoietic stem cell transplantation.
S1 · E14
May 20 · 27 min
Ph+ ALL without chemotherapy: when TKIs reshape the immune response – A dialogue between Robin Foà, Filippo Milano e Michela Ansuinelli
In this episode, Prof. Robin Foà and Dr. Filippo Milano explore the evolving treatment landscape of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL), focusing on the transition from intensive chemotherapy and transplantation toward targeted therapies combined with immunotherapy. What emerges from the discussion is not only a new therapeutic strategy, but a deeper understanding of how these treatments profoundly reshape the immune system. The conversation centers on the biological effects of combining tyrosine kinase inhibitors with blinatumomab, revealing unexpected patterns of immune activation. Patients treated with Dasatinib showed significant expansion of T cells and NK cells, while the addition of blinatumomab further enhanced immune responses and reduced immunosuppressive regulatory T cells. Particularly striking was the observation that patients achieving early complete molecular responses also displayed the strongest immune modulation, suggesting a direct link between immune activation and clinical outcome. The episode also examines the differences between Dasatinib and Ponatinib. While Dasatinib appears to induce a broad quantitative immune response, Ponatinib seems to act more through qualitative and phenotypic changes, promoting maturation and functional activity of immune effector cells. These findings highlight how different TKIs may interact with the immune system in distinct ways, opening new perspectives for individualized treatment strategies. Looking ahead, the discussion expands to the broader role of the tumor microenvironment, checkpoint inhibition, and CAR-T cell therapy, emphasizing how future advances in Ph+ ALL will increasingly depend on understanding the dialogue between leukemia cells and host immunity at the single-cell level. A thoughtful exploration of how targeted therapy and immunotherapy are redefining the concept of leukemia treatment—moving beyond disease control toward immune-driven eradication of residual disease.
S1 · E13
April 20 · 23 min
AI in Hematology and Beyond: Transforming Diagnostics, Research, and Care – A dialogue between Robin Foà and Filippo Milano
In this episode, Prof. Robin Foà and Dr. Filippo Milano explore the rapidly expanding role of Artificial Intelligence in medicine, reflecting on a transformation that feels both inevitable and profound. Much like past technological revolutions, AI is already reshaping daily clinical practice—supporting communication, improving academic writing, and streamlining routine tasks—while quietly redefining how physicians interact with information. The discussion moves into concrete clinical applications, from radiology and pathology to hematology, where AI is accelerating diagnostics and enhancing the analysis of complex biological data. Large-scale projects and global datasets are becoming accessible through machine learning, while real-time tools are beginning to assist physicians directly during patient encounters. These advances raise the possibility of more efficient care, improved outcomes, and more precise decision-making. Yet, alongside these opportunities, important concerns emerge. The reliability of AI-generated information, risks to academic integrity, and the protection of sensitive patient data all require careful consideration. Above all, the conversation returns to a central question: how will AI influence the human dimension of medicine? While technology can augment clinical reasoning, the empathy, trust, and personal connection between doctor and patient remain irreplaceable. A balanced and thought-provoking dialogue on the promises and limits of AI—where innovation must evolve hand in hand with responsibility.
S1 · E12
March 19 · 26 min
Iron Biology Unveiled: Hepcidin, Erythroferrone and the Modern Understanding of Iron Metabolism – A dialogue between Robin Foà, Filippo Milano e Clara Camaschella
In this episode, Prof. Robin Foà and Dr. Filippo Milano are joined by Dr. Clara Camaschella to explore the evolution of iron metabolism, tracing one of the most elegant and coherent stories in modern hematology. From the early conceptual models of iron regulation to the molecular breakthroughs that defined the field, the discussion reflects on what has been described as a true “golden age” of iron biology. The conversation revisits the fundamental principles of iron homeostasis, highlighting the central role of recycling over absorption and the absence of a regulated excretory pathway—features that make systemic control both essential and uniquely complex. From the pioneering work of Clement Finch to the discovery of HFE and the unraveling of genetic heterogeneity, the speakers guide listeners through the key milestones that shaped current understanding. At the heart of the episode is the discovery of hepcidin, the master regulator of iron metabolism, and the mechanisms that govern its interaction with ferroportin. The dialogue also explores the role of erythroferrone in linking erythropoiesis to iron availability, providing a molecular explanation for long-standing physiological hypotheses and shedding light on conditions such as thalassemia. Despite these advances, therapeutic strategies remain rooted in traditional approaches such as phlebotomy, raising important questions about the translation of molecular insights into clinical practice. Looking ahead, the discussion expands toward emerging fields including ferroptosis, immunity, and the role of iron in cardiovascular biology. A rich and reflective journey through discovery, this episode captures both the clarity and the complexity of iron metabolism—an essential system where biology, genetics, and clinical medicine converge.
S1 · E11
February 20 · 29 min
The Cost of Progress: Funding, Pharma, and the Future of Hematology – A dialogue between Robin Foà e Filippo Milano
In this episode, Prof. Robin Foà and Dr. Filippo Milano reflect on a striking paradox: while research has revolutionized hematology over the past decades, the sustainability of this progress is now in question. Innovation has transformed patient outcomes, yet rising costs and shrinking public funding threaten to slow the pace of discovery. The discussion highlights the growing crisis of academic support, from declining NIH grant success rates in the United States to shifting governmental priorities in Europe. As public investment contracts, the pharmaceutical industry has taken a leading role in driving research—reshaping priorities toward larger markets and increasing the financial burden of clinical trials. At the same time, the soaring costs of advanced diagnostics, such as next-generation sequencing and measurable residual disease monitoring, risk widening disparities in access to care across countries. Philanthropy emerges as a crucial, though complex, pillar sustaining research—whether through major private donations in the US or collective funding models like AIRC in Italy. The episode closes with a sober reflection on how geopolitical tensions further fragment scientific collaboration, reminding us that progress in hematology depends not only on discovery, but on shared commitment and global cooperation. A thoughtful and timely conversation on the future of innovation in our field.
S1 · E10
January 20 · 24 min
From chemotherapy to targeted precision: A paradigm shift in the frontline treatment of Ph+ ALL - A dialogue between Robin Foà, Filippo Milano and Sabina Chiaretti
In this episode, Prof. Robin Foà, Prof. Filippo Milano and Prof. Sabina Chiaretti explore the first results of a worldwide randomized phase 3 trial that challenges a long-standing paradigm in adult Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL): the necessity of frontline chemotherapy. The discussion focuses on a direct comparison between a fully chemo-free strategy—combining Ponatinib and Blinatumomab—and the conventional standard of care based on Imatinib plus chemotherapy. The trial enrolled 236 patients with no upper age limit and introduced age-adapted dosing of Ponatinib alongside strictly biology-driven criteria for allogeneic transplantation, based on molecular response, ABL1 mutations, and the Ikaros-plus genotype. Intensified central nervous system prophylaxis addressed the historically high risk of CNS relapse in this disease. The speakers highlight the superiority of the chemo-free arm, which achieved higher hematological and molecular remission rates, improved event-free survival, and a marked reduction in the need for transplantation. These benefits were accompanied by better tolerability, with fewer severe adverse events and no excess cardiovascular toxicity compared with chemotherapy. Looking ahead, the episode reflects on the broader clinical implications of these findings, particularly for elderly patients and those unfit for intensive therapy. The discussion also opens the door to the possibility of long-term treatment-free remission in patients achieving deep and durable molecular responses, while acknowledging ongoing challenges in global access to advanced diagnostics and targeted therapies. A concise yet in-depth conversation on how precision medicine is reshaping the future of Ph+ ALL—moving the field closer to effective, chemotherapy-free frontline care.
S1 · E9
Dec 3, 2025 · 22 min
The New Era of CLL Therapy: From Chemo-Free Strategies to Fixed-Duration Regimens - A dialogue Between Robin Foà, Filippo Milano and Mazyar Shadman
In this episode, Prof. Robin Foà and Dr. Filippo Milano sit down with Dr. Mazyar Shadman, a leading voice in immunotherapy and one of the foremost experts in chronic lymphocytic leukemia (CLL). Together, they explore how rapidly—and profoundly—the therapeutic landscape of CLL has transformed, moving away from chemo-immunotherapy toward a new era defined entirely by targeted agents. The conversation opens with a reflection on the radical shift that has occurred in frontline management. Where fludarabine-based regimens once dominated the care of younger and fit patients, the field has now embraced treatments that no longer rely on chemotherapy at all. Randomized studies consistently show improved progression-free survival—and in some cases overall survival—making targeted therapies the undisputed standard in countries where access is guaranteed. Against this backdrop, the speakers examine the evolving first-line strategies: continuous BTK inhibition; fixed-duration venetoclax plus obinutuzumab; and the fully oral combination of ibrutinib and venetoclax. The recent CLL17 trial, a plenary abstract at ASH, provides one of the first head-to-head comparisons among these approaches. Early results suggest that fixed-duration treatments are not inferior to continuous BTK inhibition, underscoring how meaningful “time off therapy” has become for both patients and clinicians. A central theme of the episode is the complexity behind treatment selection. Age, comorbidities, logistical constraints, and patient preference all interplay—yet Dr. Shadman emphasizes that even in older individuals, therapeutic choices should not be dictated by age alone. For some, the simplicity of a continuous oral regimen is preferable; for others, the goal of achieving deep remission and eventually stopping therapy is paramount. Prognostic markers, particularly TP53 disruption, continue to inform expectations and guide nuanced discussions around the trade-offs between durability and freedom from treatment. The dialogue then turns to measurable residual disease (MRD). Although MRD negativity remains an important biological milestone, Dr. Shadman cautions against extending therapy beyond predefined durations solely to chase deeper responses—except in selected high-risk settings. Ongoing studies like CLL18 may soon clarify whether MRD-guided strategies can outperform fixed-duration regimens. One of the most challenging areas discussed is the management of double-refractory CLL. CAR-T cell therapy, while transformative in other lymphoid malignancies, has delivered only modest long-term outcomes in CLL. Early referral is critical, ideally while patients are beginning treatment with the non-covalent BTK inhibitor pirtobrutinib. Real-world data suggest that cytoreduction and disease control before CAR-T may be key to improving responses. Allogeneic transplant, though reserved for the most refractory cases, remains a necessary option for younger patients when CAR-T is not accessible or feasible. In closing, the speakers reflect on the ultimate goal of therapy—whether cure or functional cure—and how this must be tailored to the individual sitting in front of the clinician. For some, decades of remission represent success; for others, especially the very elderly, sustained disease control may be an equally meaningful outcome. Yet global inequities remain stark: while some countries benefit from cutting-edge targeted agents, many regions still rely on chemotherapy due to economic constraints. This episode offers a thoughtful, forward-looking examination of where CLL therapy stands today—an arena shaped by scientific progress, clinical judgment, and the persistent drive to offer patients treatments that are not only effective but also aligned with their lives and priorities.
S1 · E8
Oct 27, 2025 · 22 min
Acute Myeloid Leukemia: Progress, Plateau, and the Path Ahead – A Dialogue Between Robin Foà, Filippo Milano and Fred Appelbaum
In this episode, Prof. Robin Foà and Dr. Filippo Milano are joined by Dr. Fred Appelbaum from the Fred Hutchinson Cancer Center to reflect on the persistent challenges and evolving landscape of acute myeloid leukemia (AML). Unlike other hematologic malignancies that have seen major therapeutic revolutions, AML remains bound to the traditional 7+3 regimen, a reminder of how complex its biology truly is. The conversation delves into the biological roots of AML, emphasizing that the disease originates in the myeloid stem cell—an essential element of hematopoiesis that cannot be eradicated without profound consequences. This fundamental limitation has slowed progress compared with CML, CLL, or ALL, where targeted therapies have reshaped outcomes. Dr. Appelbaum reflects on the need to understand the molecular journey from normal stem cells to leukemic clones, envisioning future treatments capable of selectively eliminating malignant mutations while preserving healthy hematopoiesis. A major theme of the discussion is the impact of Venetoclax, which has transformed induction therapy for elderly patients, offering higher remission rates and better tolerability. Yet, the question remains whether this improvement translates into cure or simply extends survival. Dr. Milano highlights its role as a bridge to transplant, while both he and Prof. Foà note the growing challenge of Venetoclax resistance and the need for more durable solutions. The debate then turns to the role of transplantation in intermediate-risk AML. When should patients undergo transplant in first remission (CR1), and how should minimal residual disease (MRD) guide this decision? While studies suggest comparable outcomes between early and delayed transplantation, the practical reality is more nuanced, depending on MRD status, patient age, and access to specialized centers. Prof. Foà voices caution about relying on non-standardized, in-house MRD assays, stressing the ethical and clinical importance of centralized and validated methodologies. Throughout the discussion, the speakers underscore how scientific progress in AML remains uneven—marked by breakthroughs like Venetoclax but constrained by the disease’s intrinsic biology. As the episode closes, they draw inspiration from the success story of acute promyelocytic leukemia (APL), once one of the deadliest forms of AML and now often cured without chemotherapy or transplant. This dialogue is a candid examination of both frustration and hope—a reminder that even in areas where progress has lagged, persistent research and collaboration continue to push the boundaries of what is possible in the treatment of AML.
S1 · E7
Aug 25, 2025 · 20 min
Ph-Positive Acute Lymphoblastic Leukemia, 25 Years of Progress – A Dialogue Between Robin Foà and Filippo Milano
In this episode, Prof. Robin Foà and Dr. Filippo Milano look back on twenty-five years of remarkable progress in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). Once regarded as one of the most devastating hematologic malignancies, with prognosis considered among the worst in oncology, Ph+ ALL has undergone a dramatic transformation thanks to targeted therapies and innovative treatment strategies. The conversation traces the pioneering decision to replace intensive chemotherapy with tyrosine kinase inhibitors and steroids, a bold approach that opened the way to higher remission rates and better tolerability, especially for older patients. From the early use of Imatinib to the evolution toward second- and third-generation TKIs, this paradigm shift has steadily improved outcomes and reshaped clinical practice. The discussion also highlights the D-ALBA study, where Dasatinib combined with Blinatumomab marked a new era by eliminating both induction and consolidation chemotherapy while achieving durable survival in the majority of patients. Foà and Milano explore how minimal residual disease monitoring has become central to guiding therapy and reconsidering the role of transplant, once seen as the only curative option. They also reflect on the challenges that remain, including unequal access to modern therapies and the need for standardized laboratory infrastructures worldwide. While CAR-T cells play an expanding role in other leukemias, their use in Ph+ ALL remains limited in the frontline setting, reinforcing the centrality of TKIs and immunotherapy as the foundation of treatment. This dialogue is both a scientific journey and a story of hope, showing how determined research, clinical innovation, and international collaboration have turned a disease once defined by despair into one where cure is now a realistic possibility for many patients.
#6
Jul 21, 2025 · 14 min
Evolving Strategies in ALL: CAR-T Cells, MRD, and the Decline of Transplant – A Dialogue Between Robin Foà and Filippo Milano
In this episode, we delve into the evolving landscape of Acute Lymphoblastic Leukemia (ALL) treatment, with a focus on cutting-edge therapies and their impact on patient outcomes. We explore the rapid integration of CAR T-cell therapy, now being used earlier in treatment and its effects on survival rates. The discussion also addresses the shifting role of allogeneic transplantation, particularly in light of the economic and clinical advantages of newer therapies. We highlight the importance of minimal residual disease (MRD) monitoring and its ability to guide treatment decisions, potentially sparing patients from invasive procedures. Additionally, we examine the transformative effects of immunotherapies like blinatumomab and inotuzumab, and their role in reducing the reliance on traditional chemotherapy and transplantation. As the field continues to evolve, we consider the future of ALL treatment, including the challenges posed by economic constraints and the move toward personalized medicine. Tune in for an in-depth analysis of these groundbreaking advances in ALL therapy and their potential to redefine treatment paradigms.
S1 · E5
Jun 12, 2025 · 17 min
Transplant as Immunotherapy: The PTCy Revolution, GVHD Control, and the New Era of Allogeneic SCT – A Dialogue Between Robin Foà and Filippo Milano
In this episode, we delve into the transformative changes in allogeneic stem cell transplantation (SCT), a treatment once seen as a last resort for patients but now experiencing a renaissance. Despite the rise of therapies like immunotherapy and CAR-T cells, SCT continues to evolve and remains crucial, particularly with recent breakthroughs. A key focus of the discussion is the introduction of post-transplant cyclophosphamide (PTCy), a groundbreaking advancement in SCT that significantly reduces the incidence of graft-versus-host disease (GVHD), a major complication. PTCy has shown extremely low rates of both acute and chronic GVHD in randomized clinical trials, a major shift from traditional immunosuppressive therapies. While concerns were raised about the potential for increased relapse due to the elimination of reactive T-cells, studies have shown no evidence of an increased relapse risk, making PTCy a game changer. The use of PTCy has also expanded the donor pool, enabling the use of alternative donors such as mismatched relatives and haploidentical donors, which was unthinkable just five years ago. This expansion addresses the global challenge of finding compatible donors, especially for patients from underrepresented ethnic backgrounds or regions with poorly organized donor registries. Additionally, SCT is now being reconsidered as a first-line treatment for several hematologic conditions, thanks to reduced toxicity and the possibility of minimizing pre-transplant chemotherapy. This has also made SCT an option for patients over 75, although careful cardiological evaluation is essential due to potential heart risks associated with cyclophosphamide. Despite the rise of novel therapies, SCT remains a cornerstone in the treatment of acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), particularly for older patients. With advancements in post-transplant care and a better understanding of the microbiome’s influence, SCT will continue to play a pivotal role in treating these diseases. Listen to learn more about how SCT is evolving, maintaining its relevance, and offering hope to patients worldwide.
May 12, 2025 · 22 min
Understanding CAR-T Resistance: Biology, Persistence, and the Pathways to Failure – A Dialogue Between Robin Foà, Filippo Milano, andMarco Ruella
In this episode of Hematology Pills, Dr. Marco Ruella, Prof. Robin Foà, and Dr. Filippo Milano dive into the challenges of CAR T-cell therapy resistance. They explore key resistance mechanisms, including T-cell dysfunction, the tumor microenvironment, and antigen loss, such as CD19 in relapsed ALL. Dr. Ruella discusses promising strategies to overcome these hurdles, like dual-targeting approaches, and highlights the importance of improving CAR T-cell product quality and monitoring in clinical settings. The episode also touches on the inflammatory side effects, like cytokine release syndrome (CRS) and neurotoxicity (ICANS), and their potential for enhancing the anti-tumor effect. Tune in for a deep dive into the future of CAR T-cell therapies and their evolving role in cancer treatment.
S1 · E4
Apr 9, 2025 · 22 min
CAR-T in Multiple Myeloma: Balancing Innovation, Toxicity, and Access – A Dialogue Between Robin Foà, Filippo Milano and Rahul Banerjee
In this episode of Hematology Pills, Professor Robin Foà speaks with Dr. Filippo Milano and Dr. Rahul Banerjee about the current role of CAR-T cell therapy in the treatment of multiple myeloma. The discussion touches on key aspects such as therapeutic potential, toxicity management, and the practical issues related to access. Aimed at clinicians and healthcare professionals, the episode provides a clear overview of both opportunities and limitations of this evolving approach.
Mar 11, 2025 · 20 min
CAR-T Cells: Navigating the Landscape of Access, Sustainability, and Innovation - A Dialogue Between Robin Foà and Filippo Milano
Join Prof. Robin Foà (Sapienza University of Rome) and Dr.Filippo Milano (Fred Hutchinson Cancer Center, Seattle) as they explore the evolving landscape of CAR-T cell therapies. This episode of Hematology Pills offers concise yet profound insights into the challenges and opportunities surrounding CAR-T treatments, from access and sustainability to innovation and clinical advancements.With a focus on real-world applications, the discussion highlights key issues such as treatment accessibility, cost-effectiveness, long-term outcomes, and the future of CAR-T in autoimmune diseases.
S1 · E2
Feb 26, 2025 · 21 min
Gene Therapy: Innovation Meets Access Challenges – A Dialogue Between Robin Foà and Filippo Milano
In the inaugural episode of our hematology podcast, Professor Robin Foà(Emeritus Professor of Hematology, Sapienza University of Rome) and Dr. Filippo Milano (Associate Professor, Fred Hutchinson Cancer Center, Seattle) explore the groundbreaking advances in gene therapy and the pressing ethical dilemmas surrounding patient access. From the high costs and insurance hurdles in the U.S. to the impact on underserved populations, this discussion sheds light into the complex landscape of innovative treatments and equitable care. Join us for a thought-provoking conversation that bridges scientific innovation and real-world challenges in hematology.
S1 · E1
Feb 26, 2025 · 2 min
Hematology Pills. Insights into Gene and Immunotherapy - Teaser
Join Prof. Robin Foà (Sapienza University of Rome) and Dr. Filippo Milano (Fred Hutchinson Cancer Center, Seattle) as they explore the cutting-edge world of hematology. Hematology Pills offers concise yet profound insights into innovative treatments like gene and immunotherapy, transforming patient care and reshaping the future of hematology. Aimed at specialists and researchers, this podcast is your gateway to some of the latest advancements and expert perspectives in the field.

Showing 1–19 of 19 episodes