Health AI Central
Peer-Reviewed Publication
Nat Med2026;32(9):3224-3234.September 1, 2026Journal Article

Clinical decision support in hematological malignancies using a case-grounded AI agent.

Julian Zoller1,2,3,4, Michael Kalz1,2,3,4, Xuewei Wu5,6, Sven Cuntz1,2,3,4, Linus Kruk7, Niklas Kehl1,2,3,4, Julius J Michel1,2,3,4, Cornelius Funk1,2,3,4, Sarah Richter2, Tobias Tix7, David Sedloev2, Jonathan Naboschni1,2,3,4, Jan H Frenking2, Silvia Barbosa5, Oliver L Saldanha5,8, Alanna Kirschner1,2,3,4, Anna D Metzler1,2,3,4, Antonia Schach1,2,3,4, René Onken1,2,3,4, Tim R Wagner1,2,3,4, Martin Dugas2,9, Andreas Trumpp3,4, Martin Dreyling7, Michael von Bergwelt-Baildon7, Kai Rejeski7, Tim Sauer2, Peter Dreger2, Marc S Raab2, Carsten Müller-Tidow2, Jakob N Kather5,8,10,11, Mirco J Friedrich12,13,14,15
1JRG Hematology and Immune Engineering, German Cancer Research Center (DKFZ), Heidelberg, Germany.
2Medical Faculty, University of Heidelberg and Department of Hematology, Oncology and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany.
3Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM), Heidelberg, Germany.
4German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany.
5Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany.
6Department of Radiology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
7Department of Medicine III-Hematology/Oncology, LMU University Hospital, LMU Munich, Munich, Germany.
8Else Kroener Fresenius Center for Digital Health, Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany.
9Medical Faculty, Heidelberg University, Institute of Medical Informatics, Heidelberg, Germany.
10Department of Medicine I, Faculty of Medicine, TUD Dresden University of Technology, Dresden, Germany.
11Pathology and Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
12JRG Hematology and Immune Engineering, German Cancer Research Center (DKFZ), Heidelberg, Germany. mirco.friedrich@dkfz.de.
13Medical Faculty, University of Heidelberg and Department of Hematology, Oncology and Rheumatology, Heidelberg University Hospital, Heidelberg, Germany. mirco.friedrich@dkfz.de.
14Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM), Heidelberg, Germany. mirco.friedrich@dkfz.de.
15German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany. mirco.friedrich@dkfz.de.
PubMed PMC DOI PDF

Abstract

Multidisciplinary tumor boards integrate longitudinal treatment histories, molecular profiling and rapidly evolving evidence to guide decisions in hematological malignancies, yet access to this level of subspecialty deliberation is increasingly uneven. Here we develop HemaGuide, a locally deployable, modular large language model agent that converts unstructured clinical documents into structured c…

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