I'm Mikkael Sekeres. I'm chief of the division of hematology and professor of medicine at the Sylvester Comprehensive Cancer Center, University of Miami. We had a terrific team who got together to write the 2025 American Society of Hematology guidelines for treating newly diagnosed older adults with acute myeloid leukemia. This included obviously people who were experts in treating and doing research in leukemia, but also experts in geriatric oncology and in palliative care and in methodology.We had a very elaborate team to make sure that we had a structured and rigorous process for developing these guidelines.Most importantly, we also included on our panel two patients, two people who were older who had acute myeloid leukemia. And I think both tragically and poignantly, one of those patients passed away right after we submitted these guidelines for publication in Blood Advances.So, it emphasized just how important a topic this is and how real it is to not only the patients we treat, but also the patients who helped write these guidelines. We included nine recommendations in our new guidelines. And like I said, we wanted these to mirror the important conversations that occur between a healthcare provider and a patient.So, we start with the most basic of questions. And that is, should an older adult with acute myeloid leukemia be treated at all? And we concluded, yes, they should. Actually, the data that are out there support that we treat people as opposed to recommending that they go on palliative care alone.We then go through questions about whether patients should get traditional inpatient chemotherapy versus the other chemotherapy I mentioned that was based on a hypomethylating agent or low dose cytarabine, whether they should get those drugs alone or in combination with other drugs, how patients who have specific genetic mutations in their leukemia, such as the IDH mutations or FLT3, should optimally be treated, whether patients who have particularly higher risk leukemia based on their genetics should undergo a bone marrow transplant or not.So, we came down recommending that patients get combinations of therapies, so either azacitidine and venetoclax, or for example, for patients who have an IDH1 mutation, azacitidine and ivosidenib, or azacitidine and venetoclax. We also came down recommending that patients undergo transplantation if they do have higher risk genetics with their leukemia. And we end with a recommendation that I'm particularly proud of, and that is for patients at the end of life who are no longer receiving therapy for their leukemia and have enrolled onto end-of-life care or hospice, whether they should continue to receive blood and platelet transfusions or not. And this is actually legislation that's being considered by Congress right now. These are recommendations based on the latest data and are very up to date.So, we strongly recommend that clinicians adopt these recommendations, many of which address the questions that clinicians are facing every single day with their patients and in real time over the course of their patient's illness. High-dose Anakinra to Treat Refractory Immune Effector Cell-Associated Neurotoxicity Syndrome in CAR T-cell Therapy RecipientsHello, my name is Emily Liang and I am an incoming assistant professor in the Bone Marrow Transplant and Immunotherapy Group at Fred Hutch Cancer Center and University of Washington in Seattle, Washington. My project investigated the efficacy of anakinra, an anti-inflammatory medication, to treat neurologic side effects after CAR T-cell therapy.So, CAR T-cell therapy, or Chimeric Antigen Receptor T-cell therapy, has really revolutionized treatments for patients with blood cancers.However, it has also brought a landscape of unique side effects, including what we call immune effector cell-associated neurotoxicity syndrome, or ICANS. And ICANS refers to neurologic side effects that can happen from CAR T-cell therapy, ranging from headaches and confusion to seizures and even coma.So, this project included 101 patients who had received CAR T-cell therapy, who had developed ICANS,These patients who received anakinra had either ICANS that were not responding to corticosteroids, which was our standard first line treatment for ICANS, and/or they had severe ICANS that required upfront treatment with anakinra. These patients had all types of blood cancers ranging from non-Hodgkin lymphoma to acute lymphoblastic leukemia to multiple myeloma. The major endpoints that we looked at in this study were threefold. First, we looked at treatment failure, which is basically, you know, after anakinra was started for ICANS, when did the patient or if the patient required additional therapy beyond anakinra?Second, we also looked at ICANS resolution. So, when did ICANS resolve after anakinra was started, if it did resolve?And lastly, we defined a new definition that we called significant neurologic improvement, which we defined as at least a two-grade improvement in ICANS after anakinra was started.What we found was encouraging. Anakinra produced significant neurologic improvement within 72 hours in about 40% of patients and roughly 70% of patients did not require additional therapy beyond anakinra.In addition, ICANS tended to resolve around eight days after anakinra was started. And these results suggest that anakinra is a viable and effective treatment option for ICANS when corticosteroids are insufficient.And then in terms of next steps going forward from this project are to ideally conduct randomized controlled studies where we can more definitively evaluate the efficacy of anakinra and understand its optimal dosing administration and patient selection.And more broadly, you know this study contributes to the field of CAR T-cell therapy because we are really trying to move from a reactive management approach of these side effects to a more proactive precision guided and personalized approach to manage these side effects and improve the safety of CAR T-cell therapy.