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.
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.
24 Aug 2026
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.
20 Jul 2026
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.
19 Jun 2026
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.
20 May 2026
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.
20 Apr 2026
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.
19 Mar 2026
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.
20 Feb 2026
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.
20 Jan 2026
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
Professors Robin Foà, Filippo Milano, and Sabina Chiaretti examine a phase 3 trial that uses Ponatinib and Blinatumomab to treat Philadelphia-positive acute lymphoblastic leukemia without chemotherapy, improving remission rates and event-free survival in this interview.
3 Dec 2025
The New Era of CLL Therapy: From Chemo-Free Strategies to Fixed-Duration Regimens - A dialogue Between Robin Foà, Filippo Milano and Mazyar Shadman
Dr. Mazyar Shadman discusses the shift in CLL therapy from chemo-immunotherapy to targeted agents with Professor Robin Foà and Dr. Filippo Milano, highlighting the importance of tailoring treatment to individual patient needs in this interview.
27 Oct 2025
Acute Myeloid Leukemia: Progress, Plateau, and the Path Ahead – A Dialogue Between Prof. Robin Foà, Dr. Filippo Milano and Dr. Fred Appelbaum
Dr. Fred Appelbaum discusses the challenges and progress in treating acute myeloid leukemia with Professor Robin Foà and Dr. Filippo Milano, highlighting the impact of Venetoclax and the complexities of transplantation in this interview.
25 Aug 2025
Ph-Positive Acute Lymphoblastic Leukemia, 25 Years of Progress – A Dialogue Between Prof. Robin Foà and Dr. 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.
21 Jul 2025
Evolving Strategies in ALL: CAR-T Cells, MRD, and the Decline of Transplant – A Dialogue Between Prof. Robin Foà and Dr. Filippo Milano
Professor Robin Foà and Dr. Filippo Milano discuss evolving strategies in acute lymphoblastic leukemia treatment, highlighting CAR-T cell therapy, minimal residual disease monitoring, and the decline of transplantation in this interview.
12 Jun 2025
Transplant as Immunotherapy: The PTCy Revolution, GVHD Control, and the New Era of Allogeneic SCT – A Dialogue Between Prof. Robin Foà and Dr. Filippo Milano
Professor Robin Foà and Dr. Filippo Milano discuss the revolutionary impact of post-transplant cyclophosphamide in allogeneic stem cell transplantation, which reduces graft-versus-host disease and expands donor options, in this interview episode.
12 May 2025
Understanding CAR-T Resistance: Biology, Persistence, and the Pathways to Failure – A Dialogue Between Prof. Robin Foà, Dr. Filippo Milano, and Dr. Marco 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.
9 Apr 2025
CAR-T in Multiple Myeloma: Balancing Innovation, Toxicity, and Access – A Dialogue Between Prof. Robin Foà, Dr. Filippo Milano and Dr. 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.
11 Mar 2025
CAR-T Cells: Navigating the Landscape of Access, Sustainability, and Innovation - A Dialogue Between Prof. Robin Foà and Dr. 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.
26 Feb 2025
Gene Therapy: Innovation Meets Access Challenges – A Dialogue Between Prof. Robin Foà and Dr. 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.
26 Feb 2025
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.
Who has been a guest on Hematology Pills
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Robin Foà
Filippo Milano
Sabina Chiaretti
Professor Robin Foà
Dr Filippo Milano
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