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Mikhail Fominykh: What I Read This Week
Mikhail Fominykh/LinkedIn
Nov 8, 2025, 01:40

Mikhail Fominykh: What I Read This Week

Mikhail Fominykh, Assistant Professor at Semey Medical University, shared on LinkedIn:

”What I Read This Week | Issue №20

This week — three papers: on managing thrombosis in cancer patients with thrombocytopenia, the circadian science of sleep, and long-term results from the AGILE trial in IDH1-mutated AML.

1. Anticoagulant therapy in patients with cancer and thrombocytopenia
J Thromb Thrombolysis, 2025 | [DOI: 10.1007/s11239-025-03188-x]

  • Thrombocytopenia doesn’t protect from thrombosis — and vice versa.
  • When PLT <50×10⁹/L, three strategies are possible:
    1. Full-dose anticoagulation with platelet support.
    2. Half-dose in moderate bleeding risk.
    3. Temporary hold when PLT <25×10⁹/L.
  • LMWH remains the standard, though DOACs can be considered in moderate thrombocytopenia.
  • In acute VTE (<30 days), maintaining anticoagulation at PLT ≥40–50×10⁹/L is preferred.\

Thrombocytopenia is not a reason to stop anticoagulation — it’s a reason to treat with more precision.

2. Better sleep through science
Nature, 2025 | [DOI: 10.1038/d41586-025-03148-8]

  • Circadian physiology defines three pillars of healthy sleep:
    1. Light contrast: more daylight, less artificial light at night. Natural light can be 100× brighter than indoor lighting.
    2. Meal timing: eat within the first 8–10 hours after waking, finish dinner ≥3 hours before bed.
    3. Consistency: regular sleep–wake rhythm matters more than total duration.
  • Modern habits — artificial light, late meals, and “social jet lag” — disrupt internal clocks and accelerate aging.

It’s not the number of hours, but alignment with your biological rhythm that defines restorative sleep and longevity.

3. Long-term results from the AGILE study of azacitidine plus ivosidenib vs placebo in newly diagnosed IDH1-mutated AML
Blood Advances, 2025 | [DOI: 10.1182/bloodadvances.2025016399]

  • 3-year follow-up confirms sustained benefit of ivosidenib + azacitidine in newly diagnosed IDH1-mutated AML patients unfit for intensive chemotherapy.
  • Median OS: 29.3 months vs 7.9 months (HR 0.42; p < 0.0001).
  • Transfusion independence: 54% vs 17%.
  • Deep MRD negativity (<0.1%) in 30% of patients, correlating with longer survival.
  • Favorable safety profile with manageable toxicity; no new safety signals.

Ivosidenib + azacitidine marks the first targeted doublet to deliver durable benefit for elderly and unfit AML patients with IDH1 mutation.

Question of the week: Which topic resonates more with you — clinical decision-making, circadian biology, or targeted therapy?

Follow for more weekly literature highlights and practice-oriented insights in hematology and oncology.”

Stay updated with Hemostasis Today.

AGILE study AGILE Trial AML anticoagulant Blood Advances Circadian Physiology Health Hematology Hemostasis Today Medicine Mikhail Fominykh Nature thrombocytopenia thrombosis VTE
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