The Fellow on Call: The Heme/Onc Podcast

This week we kick off a two-part update to our CLL series, covering what has changed in frontline management since our original episodes. Using the case of a 68-year-old man with newly diagnosed, symptomatic CLL, we revisit the essential steps before treatment: confirming an indication to treat, ruling out Richter's transformation, and risk stratification, with the history behind FISH cytogenetics, IGHV status, and the CLL-IPI. We then trace how continuous BTK inhibitors and fixed-duration venetoclax-obinutuzumab displaced chemoimmunotherapy, before digging into the trials reshaping practice in 2026: AMPLIFY, SEQUOIA Arm D, and CLL17. Along the way, we cover the open questions for TP53-aberrant disease and why MRD, although prognostic, is not yet a reliable guide for treatment decisions with novel agents. If you haven’t done so, be sure to check out our original CLL Series, as these updates will draw on concepts covered previously! **This episode is sponsored by The Lymphoma, Leukemia and Myeloma Congress! To learn more and register for the meeting, click here! Be sure to use our SPECIAL TFOC code TFOC40 to save 40% off registration. ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week the Head and Neck series turns to what happens when local therapy isn't enough — recurrent, relapsed, and metastatic disease. Using the case of a woman with a laryngeal cancer recurrence, we work through the first and most important question (recurrence versus second primary), the workup and biomarkers that steer therapy, local salvage options, the CPS-driven first-line systemic algorithm, second-line and beyond, the distinct world of nasopharyngeal cancer, oligometastatic disease, and the central role of early palliative and supportive care. As always, if you haven't heard the earlier episodes in this series, start there first. **This episode is sponsored by Primum! Sign up for your free account at primum.co/fellows ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week the Head and Neck series turns to radiation oncology, with guest Dr. David Palma, a Professor and Radiation Oncologist at the Verspeeten Family Cancer Centre and professor at the Schulich School of Medicine and Dentistry, Western University (London, Ontario). A clinician-scientist who splits his time between clinical-trials research and treating head and neck and lung cancers, David walks us through how radiation actually works and gets planned, the de-escalation question, PET after treatment, larynx preservation, re-irradiation, oligometastatic disease, and the proton-versus-photon debate - all with some of the best analogies we've had on the show. **This episode is sponsored by Primum! Sign up for your free account at primum.co/fellows ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week, we are so excited to share the third episode of our Career Development Series episodes, developed in partnership with The American Society of Hematology, The ASH Trainee Council, and Hematopoiesis! For years, our listeners have reached out to our show asking for guidance to help navigate their careers. We are so excited to be partnering with an amazing organization like ASH to help make this happen! This week, we interview Hanny Al-Samkari, MD as he shares his insights on what constitutes clinical research, what a career in clinical research might look like, and how trainees can get involved in clinical research. ** This episode is created in partnership with The American Society of Hematology ( https://www.hematology.org/ ), The ASH Trainee Council ( https://www.hematology.org/education/trainees/fellows/trainee-council ), and Hematopoiesis ( https://www.hematology.org/education/trainees/fellows/hematopoiesis ) ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

Throughout this series, we have discussed how multidisciplinary the management of head and neck cancer is and the critical role that our surgical colleagues play in the management of this disease. This week, we welcome Dr. Michael Topf, Associate Professor for Associate Professor of Otolaryngology-Head and Neck Surgery at Vanderbilt University Medical Center to our show to share with us how he determines which patients are appropriate for surgery, what his approach is, and so much more. It’s rare that we get insights into the factors that our surgery colleagues think about when determining surgical candidacy and surgical approaches and so get ready for an incredibly informative conversation! Another high yield episode you do not to miss! **This episode is sponsored by Primum! Sign up for your free account at primum.co/fellows ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week we get into treatment. Building on Part 1's (episode 158: https://www.thefellowoncall.com/tfocpodcast/hncintro ) workup and staging, we walk through three cases to highlight the important distinguishing details: an oral cavity cancer, a locally advanced oropharynx cancer, and a larynx cancer. Content: - Approach to locoregional oral, oropharynx, and larynx cancers - How we arrived at the current dosing paradigms for chemotherapy for chemoRT - Is there a role for induction therapy? - What are the data for immunotherapy in this space? - High risk factors and why they matter **This episode is sponsored by Primum! Sign up for your free account at primum.co/fellows ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week, we kick off our Head and Neck Cancer series. Using the case of a man with a painless neck mass, we build a framework for the whole series. Content: - Why head and neck cancer is really two distinct diseases - The biology behind HPV-associated oropharyngeal cancer - How to work up a neck mass and hunt for an unknown primary - The cervical lymph node levels, and AJCC 8th edition staging - How "Stage IV" does not mean metastatic in HPV-positive disease **This episode is sponsored by Primum! Sign up for your free account at primum.co/fellows ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week, we put everything we talked about in our ITP series together and talk about how we manage ITP in complicated patient scenarios. Through a case-based discussion, we discuss how to we would approach each of these complicated scenarios. If you haven’t done so already, be sure to check out episodes 155 and 156! Content: - ITP management in pregnancy - ITP management in a patient with new VTE - ITP management in a patient with acute bleeding - Refractory thrombocytopenia management despite multiple lines of therapy - ITP management in a patient with TPO-RA side effect intolerance ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week, we move to the relapsed/refractory ITP setting, focusing on what options are available to patients after their initial treatment with steroids ± IVIg, which we discussed in Episode 155. If you have not done so already, definitely listen to that episode as we build on the topics discussed here today! Content: - What are options after steroids? - How to counsel patients on options? - Is there a correct way to sequence available options? ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week, we go back to Classical Hematology! We previously discussed the initial workup and management of ITP in Episode 009, but now it’s time to dig deeper. What do we do once we make the diagnosis? How do we approach management when we have a new diagnosis? Content: - Refresher on diagnosis of ITP - Response criteria - What warrants a hospital admission vs. outpatient management? - What is our approach to initial inpatient management? - When is it safe to discharge a patient from the hospital? ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week, we are so excited to share the second episode of our Career Development Series episodes, developed in partnership with The American Society of Hematology, The ASH Trainee Council, and Hematopoiesis! For years, our listeners have reached out to our show asking for guidance to help navigate their careers. We are so excited to be partnering with an amazing organization like ASH to help make this happen! With fellowship application season around the corner, we thought that this was the perfect time to understand what program directors are looking for in their applicants. This time, we welcome Dr. Alice Ma, Hematology/Oncology Fellowship Director at UNC, and Dr. Gerald Hsu, Hematology/Oncology Fellowship Director at UCSF. Along with our guest hosts, Nick and Claire, we ask the tough questions that all of wish we could ask but never could. This is an episode you do not want to miss! ** This episode is created in partnership with The American Society of Hematology ( https://www.hematology.org/ ), The ASH Trainee Council ( https://www.hematology.org/education/trainees/fellows/trainee-council ), and Hematopoiesis ( https://www.hematology.org/education/trainees/fellows/hematopoiesis ) ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

Therapy, Maintenance, and Relapsed/Refractory Sequencing This week, we kick off the first of our myeloma capstone roundtable discussions with two experts who treat myeloma every single day. We welcome back Dr. Manni Mohyuddin from the Huntsman Cancer Institute at the University of Utah, and introduce a new friend of the show, Dr. Adeel Khan from UT Southwestern. In part two, we cover three practical and rapidly evolving topics: the role of MRD testing in guiding treatment decisions, how to individualize maintenance therapy in 2026, and how to approach sequencing of CAR-T and bispecific therapies in the relapsed/refractory setting. In this week’s show notes, we summarize the key thoughts about how our experts think about approach to their patients. If you have not already done so, be sure to check out Part 1 of this discussion! Content: - What are the practical implications of MRD-testing in myeloma treatment? - How do we think about maintenance therapy in the present day? - What therapies are on the horizon? - How do we approach management of younger patients with relapsed/refractory disease? - How do we approach bridging therapy? ** This episode is sponsored by Primum! To learn more, sign up for your free account, and to ask questions to Primum experts, visit primum.co/fellows . As a special bonus, one of our guests, Dr. Mohyuddin, is an expert on Primum ready for your questions! ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week, we kick off the first of our myeloma capstone roundtable discussions with two experts who treat myeloma every single day. We welcome back Dr. Manni Mohyuddin from the Huntsman Cancer Institute at the University of Utah, and introduce a new friend of the show, Dr. Adeel Khan from UT Southwestern. In part one, we tackle two highly practical topics: the AQUILA trial and its real-world implications for smoldering myeloma management, and how to approach frontline therapy in the older myeloma patient. In this week’s show notes, we summarize the key thoughts about how our experts think about approach to their patients. Stay tuned for part 2 of this discussion next week! Content: - How do our experts approach the management of smoldering multiple myeloma in light of the AQUILA study - What is our experts' approach to older patients with newly diagnosed multiple myeloma ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

In this week’s episode, we continue our journey through the relapsed/refractory myeloma space, with a focus on the role of bispecific T-cell engagers. Another incredibly important conversation that is so important in the current treatment landscape and one that you don’t want to miss. If you haven’t done so already, be sure to check out our CAR T episode. Content: - What are bispecific T-cell engagers? - How are they different than CAR T? - A discussion of the pivotal MajesTEC-3 trial (NEJM 2025) - What are key side effects? - How to sequence CAR T vs. bispecific T-cell engagers? ** This episode is sponsored by The Lymphoma, Leukemia and Myeloma Congress! To learn more and register for the meeting, visit llmcongress.com/podcast ! Be sure to use our special TFOC code TFOC40 to save 40% off registration. ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

In this week’s episode, we take a practical dive into the relapsed/refractory myeloma space, with a focus on the role of CAR T therapy for relapsed/refractory. In our next episode, we will continue on with a discussion on bispecific agents! This is a conversation that is so important in the current treatment landscape and one that you don’t want to miss. Content: - What are treatment options for patients with relapsed/refractory multiple myeloma (R/R MM)? - What is CAR T therapy? And what role does it play in R/R MM? - What are the available options for CAR T for R/R MM? - What are the toxicity profiles of available agents? - How to choose between the options? ** This episode is sponsored by The Lymphoma, Leukemia and Myeloma Congress! To learn more and register for the meeting, visit llmcongress.com/podcast ! Be sure to use our special TFOC code TFOC40 to save 40% off registration. ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week, we turn our attention to what we do in the maintenance setting for management of myeloma. At this point, our patient has gone through initial therapy; for patients who are able to undergo a transplant, we have consolidated their disease with a transplant; and now, we want to maintain that response using a lower dose of therapy, all while trying to minimize toxicity and maximize the patient’s quality of life. We discuss this in detail in this week’s episode! Content: - Why is lenolidomide (revlimid) our current standard of care? - What data do we have to add anti CD38 antibodies? - How is MRD being considered in this space? ** This episode is sponsored by Primum! To learn more, sign up for your free account, and to ask questions to Primum experts, visit primum.co/fellows ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

Throughout this series, we have discussed that for eligible patients, the current standard of care is to take patients for autologous stem cell transplant as consolidation for their multiple myeloma. In this reboot episode, we sit down with two incredible hematologists who specialize in transplant to discuss the real-life decision-making that goes into evaluating each patient. We are so excited to welcome two special guests this week, Dr. Shonali Midha and Dr. Amar Kelkar, joining us from the Dana-Farber Cancer Institute in Boston! Content: - What goes into determining if a patient is transplant eligible? - What counseling is provided to patients? - Approach to melphalan dosing - How does apheresis work? - What agents are used to help mobilize stem cells? - How many stem cells do we need to collect? - Does how much therapy one has received affect their collection? - Is there still a role for transplant in today's world? - Is there a role for an "MRD-adapted" approach to treatment? - Is there a role for a second transplant in patients who have relapsed? - Is there a role for allogeneic stem cell transplants in myeloma? A huge THANK YOU to our guests, Dr. Shonali Midha and Dr. Amar Kelkar, both of the Dana-Farber Cancer Institute! ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week, we discuss the role of the “consolidation” phase of treatment in multiple myeloma, focusing on three key trials: IFM 2009, DETERMINATION, and the MIDAS Trial. Content: - What is the role of autologous stem cell transplant in the management of multiple myeloma? - How did we get to our current standards of care? - How is minimal residual disease (MRD) fitting into our treatment paradigm? ** This episode is sponsored by Primum! To learn more, sign up for your free account, and to ask questions to Primum experts, visit primum.co/fellows ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week, we are so excited to share the first of our Career Development Series episodes, developed in partnership with The American Society of Hematology , The ASH Trainee Council, and Hematopoiesis! For years, our listeners have reached out to our show asking for guidance to help navigate their careers. We are so excited to be partnering with an amazing organization like ASH to help make this happen! This time, we welcome two amazing guests, Dr. Hetty Carraway, Director of the Leukemia Program and the Vice Chair of Strategy and Enterprise Development at the Taussig Cancer Institute at The Cleveland Clinic, and Dr. Alfred Lee, Chief of Classical Hematology at Yale School of Medicine, for our inaugural episode where we discuss the importance of mentorship and ask them all the questions most of us have always wondered but are too afraid to ask our mentors. A MUST listen for all trainees! ** This episode is created in partnership with The American Society of Hematology ( hematology.org ), The ASH Trainee Council ( https://www.hematology.org/education/trainees/fellows/trainee-council ), and Hematopoeisis ( https://www.hematology.org/education/trainees/fellows/hematopoiesis ) ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube

This week, we begin our discussion about treatment of multiple myeloma, focusing on the first-line setting. Once again, a lot has changed in this space over the last few years, most notably the standards of care (now quadruplet regimens instead of triplet regimens!). We break down the data and how to help you practically approach your treatment planning for your patient with newly diagnosed multiple myeloma. Content: - What are the phases of treatment for multiple myeloma - What are our current treatment standards of care? - How do we select the agents to include in our first-line regimens? - How do we stratify patients into quadruplet vs. triplet eligible? What about transplant eligible vs. ineligible? ** This episode is sponsored by Primum! To learn more, sign up for your free account, and to ask questions to Primum experts, visit primum.co/fellows ** Want to review the show notes for this episode and others? Check out our website. Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Youtube