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Showing 101 - 150Dactinomycin Produces Durable Response in Patient With NPM1-Mutant AML
As reported by Falini et al in a letter to The New England Journal of Medicine, dactinomycin treatment resulted in morphologic and molecular complete remission ongoing at 14 months in a patient with NPM1-mutant acute myeloid leukemia (AML). NPM1-mutated AML may account for one-third of AML in...
Ofatumumab Maintenance Improves Progression-Free Survival in Responders to Second- or Third-Line CLL Treatment
In an interim analysis of the phase III PROLONG trial reported in The Lancet Oncology, van Oers et al found that maintenance therapy with ofatumumab (Arzerra) prolonged progression-free survival vs observation in patients with chronic lymphocytic leukemia in complete or partial remission after...
Study Explores Link Between Allele Expression and Risk of Graft-vs-Host Disease in Transplant Recipients
In a study reported in The New England Journal of Medicine, Petersdorf et al found a greater risk of acute graft-vs-host disease among hematopoietic cell transplant recipients with the high-expression rs9277534G allele linked to mismatched HLA-DPB1 who received transplants from donors with the...
Persistent Leukemia-Associated Mutations After Induction Therapy Predict Poorer Outcome in AML
In a study reported in JAMA, Klco et al found that persistence of leukemia-associated mutations in ≥ 5% of bone marrow cells at remission predicted poorer outcome among patients with acute myeloid leukemia (AML), including those with intermediate-risk disease. Study Details In the study,...
BRAF Inhibition Successful in Relapsed/Refractory BRAF V600E–Mutant Hairy Cell Leukemia
In two phase II studies reported in The New England Journal of Medicine, Tiacci et al found that the BRAF inhibitor vemurafenib (Zelboraf) produced responses in nearly all patients with BRAF V600E–positive hairy cell leukemia who relapsed after treatment with a purine analog or who had...
No Difference in Overall Survival With Addition of Quinolone Derivative Vosaroxin to Cytarabine in Relapsed or Refractory AML
In a phase III VALOR trial reported in The Lancet Oncology, Ravandi et al found that the addition of the quinolone derivative vosaroxin to cytarabine did not significantly improve overall survival in patients with relapsed or refractory acute myeloid leukemia (AML). However, differences favoring...
Long-Term Follow-Up Suggests No Detrimental Survival Effect of Dexrazoxane in Pediatric Patients With Leukemia or Lymphoma
In an analysis of Children’s Oncology Group (COG) trials reported in the Journal of Clinical Oncology, Chow et al found that dexrazoxane use did not appear to be associated with poorer survival among pediatric patients with leukemia or lymphoma in long-term follow-up. Study Details The...
DNMT3A Mutations Predict Poorer Outcome in Younger Adults With AML Irrespective of NPM1 Genotype, but Type of Mutation Matters
In a UK study reported in the Journal of Clinical Oncology, Gale et al found that presence of DNMT3A mutations was associated with poorer prognosis in young adults with cytogenetic intermediate-risk acute myeloid leukemia (AML) irrespective of the presence of NPM1 mutation. Poorer outcome was found ...
Addition of Ofatumumab to Chlorambucil Increases Progression-Free Survival in Previously Untreated CLL Patients Who Are Not Candidates for Fludarabine
In the phase III COMPLEMENT 1 trial reported in The Lancet, Hillmen et al found that the addition of the anti-CD20 antibody ofatumumab (Arzerra) to chlorambucil (Leukeran) increased progression-free survival among patients with chronic lymphocytic leukemia (CLL) who were not considered candidates...
Single-Center Experience Indicates Relatively Good Prognosis After Allogeneic Stem Cell Transplantation Failure in CLL
In a retrospective single-center study reported in Journal of Clinical Oncology, Rozovski and colleagues found that chronic lymphocytic leukemia (CLL) patients with disease progression after allogeneic stem cell transplantation had a relatively good prognosis, with apparent benefit of salvage...
Less Than 95% Adherence to Mercaptopurine Maintenance Associated With Nearly Threefold Increased Risk of Relapse in Pediatric ALL
In a Children’s Oncology Group study (COG-AALL03N1) reported in JAMA Oncology, Bhatia et al found that < 95% adherence to mercaptopurine treatment was associated with a nearly threefold increase in the risk of relapse in children with acute lymphoblastic leukemia (ALL). Among adherent...
No Improvement in Complete Remission Rate With Cytarabine Plus Amonafide L-Malate vs Daunorubicin in Secondary AML
In a phase III trial reported in the Journal of Clinical Oncology, Stone et al found that the combination of cytarabine and amonafide L-malate, a DNA intercalator and non–ATP-dependent topoisomerase II inhibitor, did not improve complete remission rate compared with cytarabine plus...
No Difference in Event-Free Survival With Stem Cell Transplantation Using Matched Unrelated vs Sibling Donor Grafts in Children With ALL
In a European trial (Berlin-Frankfurt-Muenster study group trial ALL-SCT-BFM 2003) reported in the Journal of Clinical Oncology, Peters et al found no difference in event-free survival with stem cell transplantation using matched unrelated vs sibling donors in pediatric patients with high-risk...
Factors in Ibrutinib Discontinuation in Patients With Chronic Lymphocytic Leukemia
In a single-center study reported in JAMA Oncology, Maddocks et al found that Richter’s transformation accounted for early progression-related discontinuation of ibrutinib (Imbruvica) in patients with chronic lymphocytic leukemia (CLL) and that CLL progression but not Richter’s...
Ibrutinib Active in Previously Untreated and Relapsed/Refractory CLL With TP53 Aberrations
In a phase II study reported in The Lancet Oncology, Farooqui et al found that single-agent ibrutinib (Imbruvica) had good activity in patients with previously untreated or relapse/refractory chronic lymphocytic leukemia (CLL) with TP53 aberrations. Study Details In this single-arm trial, 51...
Allogeneic Stem Cell Transplantation Prolongs Recurrence-Free Survival in NPM1-Mutant AML
In an analysis of the Study Alliance Leukemia (SAL) AML 2003 trial reported in the Journal of Clinical Oncology, Röllig et al found that allogeneic stem cell transplantation significantly prolonged recurrence-free survival in patients with NPM1-mutant acute myeloid leukemia (AML). NPM1...
Bispecific CD19-Directed CD3 T-Cell Engager Blinatumomab Active in Adults With Relapsed/Refractory B-Cell Precursor ALL
In a phase II study reported in The Lancet Oncology, Topp et al found that the bispecific CD19-directed CD3 T-cell engager (BiTE) blinatumomab (Blincyto) was highly active in adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL). Blinatumomab binds to CD19 expressed ...
Anti-CD19 Bispecific T Cell Engager Blinatumomab Shows Activity in Relapsed/Refractory B-Precursor ALL
In a phase II study reported in the Journal of Clinical Oncology, Topp et al found that the bispecific T-cell engager (BiTE) antibody blinatumomab produced a high response rate in patients with relapsed or refractory B-precursor acute lymphoblastic leukemia (ALL). BiTEs induce a transient cytolytic ...
CD19-Directed CAR T Cells Produce Sustained Remission in Relapsed/Refractory ALL
In a study reported in The New England Journal of Medicine, Maude et al reported achieving sustained remissions in children and adults with relapsed/refractory acute lymphoblastic leukemia (ALL) using autologous CD19-targeted chimeric antigen receptor (CAR)-modified T cells. Study Details In the...
New Findings in Acute Promyelocytic Leukemia
Three studies reported in the Journal of Clinical Oncology provide information on maintenance treatment with the synthetic retinoid tamibarotene in acute promyelocytic leukemia, potential implications of QT interval prolongation related to arsenic trioxide (Trisenox), and potential health-related...
Promising Activity of Ibrutinib Plus Rituximab in High-Risk CLL
In a phase II trial reported in The Lancet Oncology, Burger et al found that the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) showed promising activity and an encouraging safety profile in patients with previously treated or untreated high-risk chronic lymphocytic leukemia (CLL)....
Adding Gemtuzumab Ozogamicin to Chemotherapy Improves Event-Free Survival but Not Overall Survival in Children and Adolescents With De Novo AML
In a Children’s Oncology Group phase III trial reported in the Journal of Clinical Oncology, Gamis et al found that the addition of gemtuzumab ozogamicin (Mylotarg), an immunoconjugate targeting CD33, resulted in significantly prolonged event-free survival but not overall survival when added...
Musculoskeletal Pain May Be Sign of Potential Tyrosine Kinase Inhibitor Withdrawal Syndrome in CML
In a letter to the Journal of Clinical Oncology, Richter et al describe a potential tyrosine kinase inhibitor withdrawal syndrome characterized by musculoskeletal pain after stopping tyrosine kinase inhibitor treatment for chronic myeloid leukemia (CML). Onset After Tyrosine Kinase Inhibitor...
Minimal Residual Disease–Based Risk-Directed Therapy Is Effective in Children With BCR-ABL1–Like B-Cell ALL
BCR-ABL1–like acute lymphoblastic leukemia (ALL), a recently identified B-cell ALL subtype associated with poor outcome, has a gene-expression profile similar to BCR-ABL1–positive disease without the presence of the BCR-ABL1 fusion protein. In a retrospective analysis reported in the...
Excess Risk of Chronic Late Effects of Treatment in Children With Standard-Risk ALL
Given the changes in treatment of children with acute lymphoblastic leukemia (ALL), the risk of late effects in those treated with current protocols may be different from that in children treated decades ago. In a study of survivors of childhood standard-risk ALL reported in The Lancet Oncology,...
Event-Free Survival Benefit, Greater Toxicity of Augmented Postremission Therapy for Children/Young Adults With High-Risk Acute Lymphoblastic Leukemia
In a UK phase III trial (UKALL 2003) reported in The Lancet Oncology, Vora et al found that augmented postremission therapy provided an event-free survival benefit at the cost of increased toxicity in children and young adults with clinical standard- or intermediate-risk but minimal residual...
First-Line Lenalidomide Plus Rituximab Is Safe and Effective in Older and Younger CLL Patients, Phase II Study Shows
The combination of lenalidomide (Revlimid) and rituximab (Rituxan) has shown synergistic activity in chronic lymphocytic leukemia (CLL) preclinical models. In a CLL Research Consortium phase II study of the combination in treatment-naive patients reported in the Journal of Clinical Oncology, James...
Ibrutinib Resistance Mutations Identified in CLL Patients
Ibrutinib is an irreversible inhibitor of Bruton’s tyrosine kinase that was recently approved for treatment of chronic lymphocytic leukemia (CLL) patients who have received at least one prior therapy. A small proportion of CLL patients have been observed to relapse during ibrutinib treatment, ...
No Overall Survival Improvement With Elacytarabine vs Investigator Choice in Patients With Relapsed/Refractory AML
Current treatment options for relapsed/refractory acute myeloid leukemia (AML), which carries a very poor prognosis, are generally ineffective. In a phase III trial (CLAVELA) reported in the Journal of Clinical Oncology, Roboz et al found that elacytarabine, a novel elaidic acid ester of...
Mutations Associated With Arsenic Resistance in Acute Promyelocytic Leukemia
In a letter to The New England Journal of Medicine, Zhu et al described identification of resistance mutations in acute promyelocytic leukemia patients receiving arsenic trioxide (Trisenox) and all-trans retinoic acid (ATRA) therapy. The direct-binding targets of arsenic trioxide in the...
Good Prognosis for High-Risk Ph-Negative ALL With Chemotherapy After Early Cytologic Response and Low Minimal Residual Disease Level on Flow Cytometry
In a Spanish trial (PETHEMA ALL-AR-03) reported in the Journal of Clinical Oncology, Ribera et al found high disease-free and overall survival rates with delayed consolidation and maintenance chemotherapy in high-risk Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL)...
Novel Prognostic Indices Validated for Cytogenetically Normal Acute Myeloid Leukemia
Cytogenetically normal acute myeloid leukemia (AML) is the largest and most heterogeneous cytogenetic AML subgroup. As reported in the Journal of Clinical Oncology, Pastore et al have developed a widely applicable prognostic model for cytogenetically normal AML that combines established patient and ...
IGH@ Translocations Are Prevalent in Teenagers and Young Adults With Acute Lymphoblastic Leukemia
In a study reported in the Journal of Clinical Oncology, Russell et al found that immunoglobulin heavy chain (IGH@) translocations were present in a substantial proportion of younger patients with acute lymphoblastic leukemia (ALL), including those with B-cell precursor ALL. However, IGH@...
Prolonged Administration of Azacitidine Improves Response in Myelodysplasia, Less So in Combination With Entinostat
In the phase II US Leukemia Intergroup Trial E1905 reported in the Journal of Clinical Oncology, Prebet et al found that prolonged administration of lower-dose azacitidine produced a high response rate in patients with myelodysplastic syndrome or acute myeloid leukemia (AML) with myelodysplastic...
Phase II Study Suggests Benefit of Adding Rituximab to Chlorambucil in First-Line Treatment for Chronic Lymphocytic Leukemia
In a UK phase II study reported in the Journal of Clinical Oncology, Hillmen et al assessed the safety and activity of adding rituximab (Rituxan) to chlorambucil (Leukeran) in first-line treatment of chronic lymphocytic leukemia (CLL). Such a regimen may be an alternative to fludarabine-based...
Methotrexate-Induced Neurotoxicity Does Not Preclude Rechallenge in Children With ALL
In a study reported in the Journal of Clinical Oncology, Bhojwani et al from St. Jude Children’s Research Hospital assessed clinical, pharmacokinetic, and genetic risk factors for methotrexate-related clinical neurotoxicity and asymptomatic leukoencephalopathy in children with acute...
Use of Intravenous Pegaspargase in Adapted Pediatric Regimen Is Feasible in Adults With Newly Diagnosed ALL
Asparaginase treatment, standard in pediatric acute lymphoblastic leukemia (ALL) regimens, is excluded or used for shorter durations in treatment of adults with ALL due to risk of toxicity. In a study reported in Journal of Clinical Oncology, Douer et al evaluated a pegaspargase (Oncaspar) dosing...
CD49d-Positivity Is the Strongest Flow Cytometry–Based Predictor of Overall Survival in CLL
In a study reported in the Journal of Clinical Oncology, Bulian et al found that CD49d-positive chronic lymphocytic leukemia (CLL) patients have significantly poorer overall survival and treatment-free survival and that CD49d status is the strongest flow cytometry–based predictor of overall...
Alternative Mechanism of Action Suggested for Vemurafenib in Hairy Cell Leukemia With BRAF V600E Mutation
The finding that the BRAF V600E mutation is present in nearly all cases of hairy cell leukemia has resulted in the use of BRAF inhibitors to treat chemotherapy-resistant disease, with good responses to vemurafenib (Zelboraf) being observed. BRAF inhibition has been thought to result in...
Adding Idelalisib to Rituximab Improves Progression-Free and Overall Survival in Patients With Difficult-to-Treat, Relapsed CLL
Use of standard chemotherapy is difficult in patients with relapsed chronic lymphocytic leukemia (CLL) who have significant coexisting medical conditions. In a phase III trial reported in The New England Journal of Medicine, Furman et al found that the combination of idelalisib, an oral inhibitor...
Advanced Rai Stage Predicts Poor Outcome of Skin Cancer in CLL
Chronic lymphocytic leukemia (CLL) is associated with increased risk of skin cancer. In a study reported in JAMA Dermatology, Velez et al attempted to determine whether progression of CLL indicated by advanced Rai stage is associated with worse skin cancer outcomes. They found that risk of death...
Seven-Gene Score Incorporating Methylation and Expression Distinguishes AML Risk Groups
In a study reported in the Journal of Clinical Oncology, Marcucci et al assessed whether including epigenetic changes—ie, DNA methylation—as molecular risk factors could improve risk stratification in acute myeloid leukemia (AML). They found that a seven-gene score integrating DNA...
Superior Progression-Free Survival With Obinutuzumab/Chlorambucil vs Rituximab/Chlorambucil in Previously Untreated CLL With Coexisting Conditions
Obinutuzumab (Gazyva) is a glycoengineered type 2 anti-CD20 antibody that appears to exhibit increased activity against chronic lymphocytic leukemia cells (CLL), with increased antibody-dependent cellular cytotoxicity and reduced complement-dependent cytotoxicity, compared with rituximab (Rituxan). ...
Ibrutinib Promising as Initial Therapy for Elderly Patients With CLL in Phase IB/II Trial
Chemoimmunotherapy has produced improved response and survival in young patients with chronic lymphocytic leukemia (CLL), but its use in elderly patients has been limited by myelosuppression and infection. In a phase IB/II study reported in The Lancet Oncology, O’Brien et al assessed the use...
Good Results Using Loss of Major Molecular Response as Criterion for Restarting Tyrosine Kinase Inhibitor Therapy in CML
Many patients with chronic-phase chronic myelogenous leukemia (CML) in complete molecular response have molecular relapse after discontinuation of imatinib (Gleevec) treatment. In a French multicenter observational study reported in the Journal of Clinical Oncology, Rousselot et al assessed the...
Higher Copayment Associated With Greater Discontinuation of and Nonadherence to Tyrosine Kinase Inhibitor Treatment in CML
The availability of the tyrosine kinase inhibitor imatinib (Gleevec) has dramatically increased survival in chronic myeloid leukemia (CML). Nonadherence to therapy with imatinib and other tyrosine kinase inhibitors is associated with disease progression and treatment resistance. In a study reported ...
Matched-Pairs Analysis Shows Better Survival With Allogeneic Transplantation vs Conventional Chemotherapy in Postremission Therapy for AML
In a prospective matched-pairs analysis reported in the Journal of Clinical Oncology, Stelljes et al in the German AML Cooperative Group compared outcomes with allogeneic stem cell transplantation vs conventional postremission chemotherapy in patients aged < 60 years with acute myeloid leukemia...
Survival Benefit With High-Dose Cytarabine Induction in AML Patients Aged < 46 Years
In a European Organisation for Research and Treatment of Cancer (EORTC) and Gruppo Italiano Malattie Ematologiche dell’ Adulto (GIMEMA) phase III trial (AML-12) reported in Journal of Clinical Oncology, Willemze et al compared induction regimens containing high-dose or standard-dose...
Persistent Significant Neurocognitive Impairment in Adult Survivors of Childhood Acute Lymphoblastic Leukemia
In a study reported in the Journal of Clinical Oncology, Kevin R. Krill, PhD, and colleagues from St. Jude Children’s Research Hospital assessed neurocognitive function in adult survivors of childhood acute lymphoblastic leukemia (ALL). They found pervasive significant impairment across...
Novel Oncogenetic Classifier Identifies Low- and High-Risk Patients With Adult T-Cell Acute Lymphoblastic Leukemia
The Group for Research in Adult Acute Lymphoblastic Leukemia (GRAALL) recently reported significantly better outcome in T-cell acute lymphoblastic leukemia (ALL) harboring NOTCH1 or FBXW7 (N/F) mutations, although relapse was still observed in one-third of patients with N/F-mutated T-cell ALL. In a ...
