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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

ASH 2016: Children With Down Syndrome and ALL Fare as Well as Other Children Treated on ALL Consortium Protocols

Despite an elevated risk of toxicity from chemotherapy, children with Down syndrome and acute lymphoblastic leukemia (ALL) did not experience higher rates of relapse or treatment-related mortality compared with other children treated on Dana-Farber Cancer Institute ALL Consortium Protocols,...

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

ASH 2016: IKZF1 Gene Mutations Found to Increase Hereditary Risk for Acute Lymphocytic Leukemia in Children

A late-breaking abstract being presented by Churchman et al during the 58th American Society of Hematology (ASH) Annual Meeting & Exposition in San Diego (Abstract LBA-2) identifies inherited genetic mutations in the gene IKZF1 that confer a higher likelihood of developing pediatric...

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

ASH 2016: Interim Analysis Shows Adding Lenalidomide Maintenance Therapy to Chemoimmunotherapy Prolongs Progression-Free Survival in High-Risk CLL

The combined use of genetic markers and minimal residual disease assessment (MRD) has made it easier to identify chronic lymphocytic leukemia (CLL) patients likely to have a poor outcome after receiving frontline chemoimmunotherapy. Interim results from the phase III German CLL M1 study presented...

leukemia

ASH 2016: CD19-Targeting CAR T-Cell Immunotherapy Yields High Response Rates in Treatment-Resistant CLL

In a small, early phase trial, a high percentage of patients who had exhausted most traditional treatments for chronic lymphocytic leukemia (CLL) saw their tumors shrink or even disappear after an infusion of a highly targeted, experimental chimeric antigen receptor (CAR) T-cell immunotherapy...

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.

leukemia

ASH 2016: Patients With CML and Stable Molecular Responses May Be Able to Safely Decrease the Dose of Their Tyrosine Kinase Inhibitor

A study led by researchers at the University of Liverpool presented by Clark et al at the 58th American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 938) suggests many patients with chronic myeloid leukemia (CML) may be able to safely reduce tyrosine kinase inhibitor side...

leukemia

ASH 2016: Cessation of Tyrosine Kinase Inhibitor Treatment in Chronic Myeloid Leukemia Patients With Deep Molecular Response

In one of the largest-ever trials to assess the safety of stopping tyrosine kinase inhibitor therapy—the Euro-Ski trial—about half of 821 patients with chronic myeloid leukemia (CML) showed no evidence of relapse 2 years after treatment cessation, suggesting that some patients can...

leukemia

ASH 2016: Phase I Trial of Vadastuximab Talirine in Combination With 7+3 Induction Therapy for Patients With AML

In a clinical trial presented by Erba et al at the 58th American Society of Hematology (ASH) AnnualMeeting & Exposition (Abstract 211), vadastuximab talirine was found to be safe when used in combination with standard chemotherapy treatment for patients with acute myeloid leukemia (AML). The...

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

ASH 2016: Biomarker May Predict Which Patients Previously Treated for Cancer Will Develop Highly Fatal Form of Leukemia

Patients successfully treated for breast, colon, and other cancers can go on to develop an often-fatal form of leukemia, sometimes years after completion of treatment, due to a genetic mutation leading to secondary malignancies known as therapy-related myeloid neoplasms. A study conducted by...

leukemia

ASH 2016: New CAR T-Cell Therapy Holds Promise for Children and Young Adults With Hard-to-Treat ALL in Phase I Trial

Children and young adults with relapsed or refractory acute lymphoblastic leukemia (ALL) who receive chimeric antigen receptor (CAR) T-cell therapy targeting CD22, a protein found on the surface of leukemic cells, appear to mount a clinical response and, in some cases, achieve remission....

leukemia

ASH 2016: New Chemotherapy Delivery Method Improves Survival After Bone Marrow Transplant in Older Patients With AML

A new analysis presented by Lancet et al at the 58th American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 906) found older patients with acute myeloid leukemia (AML) survived longer after receiving an allogeneic stem cell transplant if they were first treated with the...

leukemia

High Frequency and Poor Outcome of Philadelphia Chromosome–Like ALL Reported in Adults

In a study reported in the Journal of Clinical Oncology, Roberts et al found a high frequency of Philadelphia chromosome (Ph)–like acute lymphoblastic leukemia (ALL) in adults with B-cell ALL and poorer outcome with conventional therapy in these patients. Frequency of Disease The frequency...

leukemia

FDA Grants Full Approval and Label Update for Ponatinib in CML and ALL

The U.S. Food and Drug Administration (FDA) has granted ponatinib (Iclusig) full approval for the treatment of adult patients with chronic-phase, accelerated-phase, or blast-phase chronic myeloid leukemia (CML) or Philadelphia chromosome–positive acute lymphoblastic leukemia (ALL) for whom no ...

leukemia

Projected Financial Burden of Targeted Therapies for Chronic Lymphocytic Leukemia

In an analysis reported in the Journal of Clinical Oncology, Chen et al predicted that an increase in the number of patients living with chronic lymphocytic leukemia (CLL) due to improved treatment with oral targeted therapies will be accompanied by a markedly increased overall cost to patients and ...

leukemia

Postinduction Minimal Residual Disease Predicts Outcome and Benefit From ASCT 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). The study...

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

Association of T-Cell CD62L Expression and Molecular Response to Tyrosine Kinase Inhibitor Therapy in Early Chronic-Phase CML

Higher baseline levels of T-cell expression of CD62L (L-selectin) were associated with a greater likelihood of molecular response to nilotinib (Tasigna) in early chronic-phase chronic myeloid leukemia (CML), according to a report by Sopper et al in the Journal of Clinical Oncology. The study...

leukemia

Study Describes Genetic Model of Pro-B ALL

After nearly 2 decades of unsuccessful attempts, researchers from the University of Chicago Medicine and the Cincinnati Children's Hospital Medical Center have created the first mouse model for the most common form of infant leukemia. Their discovery, reported by Lin et al in Cancer Cell, could...

leukemia

Improved Outcomes Reported With 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...

leukemia

Researchers Reveal Genomic Landscape of Core-Binding Factor Acute Myeloid Leukemia

An international team of researchers from the St. Jude Children’s Research Hospital–Washington University Pediatric Cancer Genome Project has completed a detailed map of the genomic landscape for core-binding factor acute myeloid leukemia (CBF-AML). The work reveals differences in the...

leukemia

French Trial Shows Addition of Androgen Maintenance Improves Survival in Elderly Patients With Acute Myeloid Leukemia

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. In the open-label trial, 330 patients with de novo AML or...

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

Delayed Initiation of Tyrosine Kinase Inhibitors Reported in Medicare Patients With Chronic Myeloid Leukemia

In a study using Surveillance, Epidemiology, and End Results (SEER)-Medicaid data reported in the Journal of Clinical Oncology, Winn et al found that 68% of Medicare patients with chronic myeloid leukemia (CML) initiated tyrosine kinase inhibitor treatment within 180 days after diagnosis. Factors...

leukemia

Study Indicates 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 Etienne et al, long-term follow-up in the French Stop Imatinib (STIM1) study indicates imatinib can be safely stopped in patients with chronic myeloid leukemia (CML) with undetectable minimal residual disease sustained for at least 2 years. Study...

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...

leukemia

Phase II Trial Shows Benefit of Ibrutinib in Relapsed/Refractory CLL With 17p Deletion

O’Brien et al found further evidence of the benefit of ibrutinib (Imbruvica) in relapsed/refractory chronic lymphocytic leukemia (CLL) with the 17p deletion, according to an extended analysis of the phase II RESONATE-17 trial reported in The Lancet Oncology. Ibrutinib currently is approved...

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...

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