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:
- Full-dose anticoagulation with platelet support.
- Half-dose in moderate bleeding risk.
- 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:
- Light contrast: more daylight, less artificial light at night. Natural light can be 100× brighter than indoor lighting.
- Meal timing: eat within the first 8–10 hours after waking, finish dinner ≥3 hours before bed.
- 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.”
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