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Hematologic Malignancies
Leukemia

Financial Burden of Targeted Oral Therapy for Patients With Chronic Myeloid Leukemia

In a study reported in the Journal of Oncology Practice, Chan Shen, PhD, of The University of Texas MD Anderson Cancer Center, and colleagues found that more than three-quarters of patients receiving targeted oral therapy for chronic myeloid leukemia (CML) reached the catastrophic phase of the...

Leukemia

Study Finds Children, Parents Overreport Adherence to Leukemia Treatment

New research suggests that young patients with acute lymphocytic leukemia (ALL)—the most common type of pediatric cancer—and their parents are likely to report to their physician that they took more of their anticancer medication than they actually did. The study, published by Landier et al in...

Leukemia

Phase II Studies Evaluate New Approaches in Richter Transformation

Despite advances in treating chronic lymphocytic leukemia (CLL), the 5% to 10% of patients who develop Richter transformation continue to have poor outcomes. For these patients, median progression-free survival is approximately 6 months, and median overall survival is about 8 months. Phase II...

leukemia
issues in oncology

Children, Parents Overreport Leukemia Treatment Adherence

New research suggests that young patients with acute lymphocytic leukemia (ALL) and their parents are likely to report to their physician that they took more of their anticancer medication than they actually did. The study, published by Landier et al in Blood, found that 84% of patients with ALL...

Leukemia

Postinduction MRD Predicts Outcome From Transplantation in NPM1-Mutant AML

In an analysis of a French trial reported in the Journal of Clinical Oncology, Balsat et al found that postinduction minimal residual disease was predictive of outcome and benefit from allogeneic stem cell transplantation (ASCT) in patients with NPM1-mutant acute myeloid leukemia (AML). Nicolas...

Leukemia

Retinoic Acid and Arsenic Trioxide vs Retinoic Acid and Chemotherapy in APL

As reported in the Journal of Clinical Oncology by Platzbecker et al, the final results of the Italian-German phase III APL0406 trial indicate that the combination of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO [Trisenox]) is associated with better outcomes than standard ATRA plus...

Geriatric Oncology
Leukemia

Androgen Maintenance in Elderly Patients With AML

The addition of norethandrolone as maintenance therapy improved survival in patients aged ≥ 60 years with acute myeloid leukemia (AML), according to a French phase III trial reported in the Journal of Clinical Oncology by Pigneux et al. Norbert Ifrah, MD, of CHU d’Angers, France, is the...

Leukemia

I’m Learning to Live With Chronic Cancer

I was feeling a bit more tired than usual as the Christmas holidays approached in December 2012, but I chocked it up to the frenetic pace of the season and keeping up with caring for my two young children, ages 4 and 12. I had none of the other typical warning signs of chronic myeloid leukemia...

Leukemia

Diamonds Are Forever, Tyrosine Kinase Inhibitors Are Not?

Sir Donald Munger: “You have been on holiday, I understand. Relaxing, I hope?” James Bond: “Oh, hardly relaxing, but most satisfying.” (Diamonds Are Forever) As tyrosine kinase inhibitors became the mainstay of therapy for patients with chronic myeloid leukemia (CML), our assumption has been that...

Leukemia

Safety of Stopping Imatinib in CML With Undetectable Minimal Residual Disease for at Least 2 Years

As reported in the Journal of Clinical Oncology by Gabriel Etienne, MD, PhD, of the Institut Bergonié, Bordeaux, and colleagues, long-term follow-up in the French Stop Imatinib (STIM1) study indicates that imatinib can be safely stopped in patients with chronic myeloid leukemia (CML) with...

Leukemia

Expert Point of View: Richard Furman, MD

“These results are interesting, important, and relevant for maintenance post chemotherapy, but if we are not using chemotherapy, they may not be relevant,” said Richard Furman, MD, of Weill Cornell Medical College, New York Presbyterian Hospital, New York. He said that newer drugs such as...

Leukemia

Lenalidomide Maintenance Extends Progression-Free Survival in CLL

Lenalidomide (Revlimid), a cornerstone of therapy for multiple myeloma in the modern era, is making headway as maintenance therapy in chronic lymphocytic leukemia (CLL). Separate phase III studies presented at the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition showed...

Leukemia

Treating the Whole Person

Twenty-five years ago, I was a physically fit woman of 45 in training to run a marathon, which had been a lifelong goal. I was feeling fine and had no hint of the illness that would nearly take my life and has forever changed it. While ramping up to go the 26.2-mile distance, I decided to have a...

Leukemia

Expert Point of View: Armand Keating, MD

“This study shows that a great deal of innovation can come from existing knowledge. The 7+3 regimen has been around since I was an intern,” admitted Armand Keating, MD, of the University of Toronto and Princess Margaret Hospital, Toronto, Ontario, Canada. “Using the liposomal formulation of...

Leukemia

CPX-351 Improves Survival Post Transplant in Older High-Risk Patients With Acute Myeloid Leukemia

Induction therapy with the experimental chemotherapy called CPX-351—a liposomal formulation of cytarabine and daunorubicin—outperformed standard “7+3” cytarabine plus daunorubicin by extending survival in older high-risk patients with acute myeloid leukemia (AML) who subsequently underwent...

Leukemia

Expert Point of View: Mikkael A. Sekeres, MD, MS

Mikkael A. Sekeres, MD, MS, Director of the Leukemia Program at the Cleveland Clinic Taussig Cancer Center in Ohio, commented on vadastuximab talirine in newly diagnosed acute myeloid leukemia (AML). He noted that the drug is similar to gemtuzumab ozogamicin, another antibody-drug conjugate that...

Leukemia

Vadastuximab Talirine Shows Early Promise in Newly Diagnosed Acute Myeloid Leukemia

The investigational CD33-directed antibody-drug conjugate vadastuximab talirine yielded high overall and complete response rates when combined with standard “7+3” chemotherapy for patients newly diagnosed with acute myeloid leukemia.1 Results from this phase Ib study were presented at the 2016...

Leukemia

Expert Point of View: Amir T. Fathi, MD

“In the past few years, there has been increased reporting of other, less traditional, response criteria in acute myeloid leukemia (AML), including morphologic leukemia-free state, partial response, and complete remission [or complete response] with incomplete recovery. There is some concern that...

Leukemia

Achieving Complete Response Is Key to Improving Survival in Older Patients With AML

The importance of achieving complete response after intensive therapy in older adults with acute myeloid leukemia (AML) was confirmed in a follow-up analysis of the E2906 North American Intergroup trial.1 Patients in complete response had superior survival in this landmark analysis. This finding...

Leukemia

Expert Point of View: Mikkael Sekeres, MD

In his practice, Mikkael Sekeres, MD, of the Cleveland Clinic Foundation, has not initiated dose reductions of tyrosine kinase inhibitors, but “anecdotally, my patients tell me that they have reduced the dose. Many of them cannot afford to continue treatment indefinitely, and some have side...

Leukemia

Reducing Doses and Stopping Tyrosine Kinase Inhibitors Gain Favor in Chronic Myeloid Leukemia

Tyrosine kinase inhibitors, such as imatinib, nilotinib (Tasigna), and dasatinib (Sprycel), have revolutionized the treatment of chronic myeloid leukemia (CML). A substantial percentage of patients achieve deep and meaningful remissions on these agents. More recently, partly driven by patients’ and ...

Leukemia

Expert Point of View: Stephen P. Hunger, MD

Stephen P. Hunger, MD, Chief of the Division of Pediatric Oncology and Director of the Center for Childhood Cancer Research at The Children’s Hospital of Philadelphia, and the Jeffrey E. Perelman Distinguished Chair in the Department of Pediatrics at the University of Pennsylvania, Philadelphia,...

Leukemia

Reduced-Intensity Chemotherapy Leads to More Relapses in Childhood ALL

Children with acute lymphoblastic leukemia (ALL) considered at standard risk for relapse should continue to receive standard-intensity regimens, according to findings from the international randomized AIEOP-BFM ALL 2000 trial.1 A reduced-intensity treatment for children with ALL considered to have ...

leukemia
lymphoma

ASH 2016: Ibrutinib and TGR-1202 Combination Yields Encouraging Results in Patients With Relapsed Forms of Leukemia or Lymphoma

A combination of two targeted agents has demonstrated safety as well as encouraging signs of effectiveness in a phase I clinical trial in patients with relapsed or hard-to-treat chronic lymphocytic leukemia (CLL) or mantle cell lymphoma (MCL). Davids et al reported the findings at the 58th American ...

leukemia

Martin Schrappe, MD, on Childhood ALL: Study Results on Reducing Treatment Burden (German Language Version)

Martin Schrappe, MD, of Christian-Albrechts University Kiel, discusses in German study findings on reduced intensity delayed intensification in standard-risk patients defined by minimal residual disease in childhood acute lymphoblastic leukemia (Abstract 4).

leukemia

Julie Vose, MD, MBA, and Anjali Advani, MD, on AML: Results of Two Trials on Vadastuximab Talirine

Julie Vose, MD, MBA, of the University of Nebraska Medical Center, and Anjali Advani, MD, of the Cleveland Clinic, discuss study findings on vadastuximab talirine as monotherapy and, in another trial, vadastuximab talirine plus hypomethylating agents in older patients with AML (Abstracts 590, 591).

leukemia

Julie Vose, MD, MBA, and Mhairi Copland, MB, ChB, PhD, on CML: Data From the British DESTINY Study

Julie Vose, MD, MBA, of the University of Nebraska Medical Center, and Mhairi Copland, MB, ChB, PhD, of the Paul O’Gorman Leukaemia Research Centre at the University of Glasgow, discuss decreasing the dose of tyrosine kinase inhibitors in CML patients with stable molecular responses (Abstract 938).

leukemia

Harry P. Erba, MD, PhD, on AML: Early Study Results on Vadastuximab Talirine

Harry P. Erba, MD, PhD, of the University of Alabama at Birmingham, discusses phase Ib findings on vadastuximab talirine in combination with 7+3 induction therapy for patients with newly diagnosed AML (Abstract 211).

leukemia

Jeffrey E. Lancet, MD, on AML: Subgroup Analysis of a Phase III Trial

Jeffrey E. Lancet, MD, of the H. Lee Moffitt Cancer Center and Research Institute, discusses study findings on survival following allogeneic hematopoietic cell transplantation in older, high-risk acute myeloid leukemia patients initially treated with CPX-351 liposome injection vs standard cytarabine and daunorubicin (Abstract 906).

leukemia

Terry J. Fry, MD, on ALL: MRD and CAR Therapy

Terry J. Fry, MD, of the Pediatric Oncology Branch of the National Cancer Institute, discusses minimal residual disease–negative complete remissions following anti-CD22 chimeric antigen receptor in children and young adults with relapsed/refractory acute lymphoblastic leukemia (Abstract 650).

leukemia

Martin Schrappe, MD, on Childhood ALL: Study Results on Reducing Treatment Burden

Martin Schrappe, MD, of Christian-Albrechts University Kiel, discusses study findings on reduced intensity delayed intensification in standard-risk patients defined by minimal residual disease in childhood acute lymphoblastic leukemia (Abstract 4).

leukemia
survivorship

Smita Bhatia, MD, MPH, and Jessica Wu, BA, on CML: A Report From the Bone Marrow Transplant Survivor Study

Smita Bhatia, MD, MPH, and Jessica Wu, BA, both of the University of Alabama at Birmingham, discuss long-term morbidity and mortality experienced by chronic myeloid leukemia patients after allogeneic hematopoietic cell transplantation (Abstract 823).

leukemia

Syed A. Abutalib, MD, and Nelli Bejanyan, MD, on Adult ALL and Consolidation Chemotherapy: Results From a CIBMTR Study

Syed A. Abutalib, MD, of the Cancer Treatment Centers of America, and Nelli Bejanyan, MD, of the University of Minnesota, discuss findings from a study conducted by the Center for International Blood and Marrow Transplant Research on treatment for ALL patients, with an available donor, undergoing myeloablative allogeneic hematopoietic cell transplantation in first complete remission (Abstract 684).

leukemia

Andrew D. Zelenetz, MD, on CLL: Emerging Treatments

Andrew D. Zelenetz, MD, of the Memorial Sloan Kettering Cancer Center, discusses novel treatments for chronic lymphocytic leukemia, touching specifically on the Gilead 115 trial.

leukemia

Jose F. Leis, MD, PhD, and Sagar Lonial, MD, on CLL: Ibrutinib Insights

Jose F. Leis, MD, PhD, of the Mayo Clinic, and Sagar Lonial, MD, of Emory University, discuss a session on CLL treatment (excluding transplantation): ibrutinib resistance, transformation, and cellular therapy.

hematologic malignancies
leukemia
issues in oncology

ASH 2016: Study Shows Patients Traditionally Ineligible for Studies May Benefit From Trial Participation

Patients who potentially could benefit most from participation in clinical trials due to poor prognoses often are not included based on eligibility criteria, such as existing medical illnesses. A novel study at The University of Texas MD Anderson Cancer Center revealed some patients with acute...

Leukemia

Gleevec Is Saving My Life but at a Cost

Like many patients in the chronic phase of chronic myeloid leukemia (CML), my cancer was discovered during a routine physical, when an off-the-chart white blood cell count signaled a serious problem that my primary care physician attributed to unspecified internal bleeding. Fortunately for me, my...

Leukemia

Minimal Residual Disease Assessment and Prediction of Outcome in CLL Responders

Assessment of minimal residual disease was associated with improved prediction of outcome in responders, as well as complete responders, in patients with chronic lymphocytic leukemia (CLL) who respond to treatment. Kovacs et al reported these findings, which are based on an analysis of two phase...

Leukemia

Venetoclax Monotherapy Safe and Clinically Active in Acute Myelogenous Leukemia

A phase II study has found venetoclax (Venclexta) to be clinically active in patients with high-risk relapsed/refractory acute myelogenous leukemia (AML) or those unfit for intensive chemotherapy, with an overall response rate of 19% and a tolerable safety profile. The study results, which were...

Leukemia

Donor Selection for HLA-Matched Hematopoietic Cell Transplantation

Question 1: Which statement about donor selection for allogeneic hematopoietic cell transplant is correct? Correct Answer: C. If a donor is available, the genotypic identity between the patient and his brother should be established by typing the patient’s parents; if this is not possible, the...

Leukemia

Donor Selection for HLA-Matched Hematopoietic Cell Transplantation

Case Study A 33-year-old white male is diagnosed with acute myeloid leukemia (AML) with complex cytogenetics. A decision is made in favor of performing allogeneic hematopoietic cell transplantation in first complete remission. The patient has a 35-year-old brother who is healthy and motivated to...

Leukemia

Susan M. O’Brien, MD, Embraces the Challenge of Balancing Patient Care With Clinical Trial Investigation

Susan M. O’Brien, MD, one of the nation’s foremost leukemia experts, told The ASCO Post that she wanted to become a doctor since her earliest memories. “The idea of being able to help sick people always appealed to me,” said Dr. O’Brien, who was born in Manhattan but spent her formative years in...

hematologic malignancies
leukemia

Improved Event-Free Survival With Addition of Rituximab to Chemotherapy in B-Lineage Adult ALL

In the phase III GRAALL-2005 trial reported in The New England Journal of Medicine, Maury et al found that the addition of rituximab (Rituxan) to standard chemotherapy resulted in improved event-free survival in adult patients with B-lineage acute lymphoblastic leukemia (ALL). Study Details In...

Leukemia

Clinical Trials Actively Recruiting Patients With Acute Lymphoblastic Leukemia

Phase I Study Title: Phase Ib Study of Nivolumab and Dasatinib in Patients With Relapsed/Refractory Philadelphia Chromosome–Positive Acute Lymphoblastic Leukemia (Ph+ ALL) Study Type: Phase I/interventional/single-group assignment Study Sponsor and Collaborators: Northwestern University, National...

Leukemia

FDA Approves Blinatumomab for Use in Pediatric Patients With Ph-Negative Relapsed or Refractory B-Cell Precursor ALL

The U.S. Food and Drug Administration (FDA) has approved the supplemental Biologics License Application (sBLA) for blinatumomab (Blincyto) to include new data supporting the treatment of pediatric patients with Philadelphia chromosome (Ph)-negative relapsed or refractory B-cell precursor acute...

Leukemia

FDA Approves Ofatumumab in Combination With Fludarabine and Cyclophosphamide for Relapsed CLL

The U.S. Food and Drug Administration (FDA) has approved a supplemental Biologics License Application for the use of ofatumumab (Arzerra) in combination with fludarabine and cyclophosphamide for the treatment of patients with relapsed chronic lymphocytic leukemia (CLL). The application, which...

leukemia
issues in oncology

Adolescent Girls With Leukemia May Not Be Screened for Pregnancy Before Beginning Chemotherapy

A new study indicates that adolescent females with acute leukemia have low rates of pregnancy screening prior to receiving chemotherapy that can cause birth defects. These findings were published by Rao et al in Cancer. Although many chemotherapy drugs can cause birth defects, there are no...

Leukemia

Venetoclax Produces High Response Rate in Relapsed or Refractory CLL With 17p Deletion

In a pivotal phase II study reported in The Lancet Oncology, Stephan Stilgenbauer, MD, of Ulm University, Germany, and colleagues found that the BCL2 inhibitor venetoclax (ABT-199) produced a high response rate in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) with the 17p ...

hematologic malignancies
leukemia

Is Extramedullary Disease at Diagnosis Prognostic in Adult Acute Myeloid Leukemia?

The presence of extramedullary disease at acute myeloid leukemia (AML) diagnosis was not an independent prognostic factor for worse survival, based on an analysis of data from the Eastern Cooperative Oncology Group–American College of Radiology Imaging Network (ECOG-ACRIN) reported by Ganzel...

Hematologic Malignancies
Leukemia
Lymphoma
Multiple Myeloma

Roundup of Selected Abstracts in Multiple Myeloma, Acute and Chronic Leukemia, and Advanced Lymphoma

In June 2016, the European Hematology Association Congress convened in Copenhagen, Denmark. The educational and scientific program highlighted state-of-the-art clinical practice and the latest findings in hematology research. The ASCO Post brings its readers brief summaries of some of the important ...

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