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Hematologic Malignancies
Leukemia
Lymphoma
Multiple Myeloma

Selected Hematology Abstracts From the 2016 ASCO Annual Meeting

Here are several abstracts selected from the proceedings of the 2016 ASCO Annual Meeting, focusing on clinical trials on therapeutics in different types of leukemia, multiple myeloma, follicular lymphoma, and central nervous system (CNS) lymphoma. For full details of these study abstracts, visit...

leukemia

Juno Therapeutics to Resume JCAR015 Phase II ROCKET Trial After FDA Clinical Hold

Juno Therapeutics, Inc, announced on July 12, 2016, that the U.S. Food and Drug Administration (FDA) has removed the clinical hold on the phase II clinical trial of JCAR015 (known as the ROCKET trial) in adult patients with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL). Under the ...

leukemia

Shorter Remission Telomere Length Associated With Prolonged Neutropenia After Pediatric AML Treatment

In a study reported in the Journal of Clinical Oncology, Gerbing et al found that prolonged posttreatment neutropenia was associated with shorter chromosomal telomere length in pediatric patients receiving chemotherapy for acute myeloid leukemia (AML). Study Details The study included 53 patients ...

Leukemia

Increased Risk for Cardiovascular Events Seen in Patients With CML Taking Tyrosine Kinase Inhibitors

Although tyrosine kinase inhibitors have dramatically increased survival for patients with chronic myeloid leukemia (CML), continuous administration of these drugs may elicit long-term toxicity, including cardiovascular adverse events. To investigate the incidence of vascular events in patients...

leukemia

Relapse of Leukemia After Bone Marrow Transplantation: Cytomegalovirus Infection Has No Protective Effect

Recent studies on a small number of patients with leukemia treated with bone marrow transplantation have suggested that the presence of the common cytomegalovirus (CMV) in patients or their donors may protect against relapse or even death after the transplant. A large international study published...

Leukemia

CAR T-Cell Dose Refinement May Reduce Cytokine-Release Syndrome in Patients With Advanced Acute Lymphoblastic Leukemia

Chimeric antigen receptor (CAR) T-cell therapy has been effective in adults and children with advanced acute lymphoblastic leukemia (ALL), but along with efficacy, the treatment can stimulate cytokine-­release syndrome, which can be deadly if it goes unrecognized and untreated. Adjusting the dose...

Geriatric Oncology
Supportive Care
Leukemia

Assessment of Fitness, Function, and Quality of Life Essential in Treatment of Older Patients With CLL

Significant progress has been made in the past 2 decades in the care of patients with chronic lymphocytic leukemia (CLL). Recently, the therapeutic armamentarium has expanded for such patients with the introduction of new targeted agents. CLL is predominantly a disease of the elderly, with a...

hematologic malignancies
leukemia

Genomic Classification and Outcome in Acute Myeloid Leukemia

As reported in The New England Journal of Medicine, Papaemmanuil et al have identified 11 genomic subgroups in acute myeloid leukemia (AML) associated with distinct diagnostic features and clinical outcomes. AML Subgroups The study included analysis of driver mutations in 111 cancer genes and...

hematologic malignancies
leukemia

Study Finds Inotuzumab Ozogamicin Improves Outcomes vs Standard Therapy in Relapsed/Refractory ALL

In a phase III trial reported in The New England Journal of Medicine, Kantarjian et al found that treatment with the antibody-drug conjugate inotuzumab ozogamicin resulted in a greater complete remission rate and improved overall survival vs standard therapy in patients with relapsed/refractory...

hematologic malignancies
leukemia

Increased Risk for Cardiovascular Events Seen in Patients With CML Taking Tyrosine Kinase Inhibitors

Although tyrosine kinase inhibitors have dramatically increased survival for patients with chronic myeloid leukemia (CML), continuous administration of these drugs may elicit long-term toxicity, including cardiovascular adverse events. To investigate the incidence of vascular events in patients...

leukemia
lymphoma

Sagar Lonial, MD, and Andrew Zelenetz, MD, PhD, on MCL, DLBCL, CLL: How Much Rituximab Is Enough?

Sagar Lonial, MD, of Emory University School of Medicine, and Andrew D. Zelenetz, MD, PhD, of Memorial Sloan Kettering Cancer Center, discuss newly reported findings on rituximab maintenance therapy in hematologic malignancies (Abstracts 7503, 7504, and 7505).

Leukemia

Seattle Children’s Reports Promising Early Results With Immunotherapy in Relapsed ALL

Seattle Children’s announced that 39 of 42 patients treated in a phase I clinical trial using genetically reprogrammed T cells to treat relapsed or refractory acute lymphoblastic leukemia (ALL) have achieved complete remission, showing no detectable leukemia cells. Phase II of this trial, known as...

leukemia
cost of care

ASCO 2016: Patients With Cancer With ACA Policies Swiftly Reach Out-of-Pocket Caps

Duke Cancer Institute researchers have found that a hypothetical leukemia patient buying the life-extending drug therapy for his condition would reach his annual out-of-pocket maximum in a month on most of the bronze policies and half of the silver policies offered through the Affordable Care Act...

leukemia

First-Line Fludarabine, Cyclophosphamide, and Rituximab vs Bendamustine/Rituximab in Advanced CLL

In a European phase III noninferiority trial reported in The Lancet Oncology, Eichhorst et al found that progression-free survival was better with standard first-line fludarabine/cyclophosphamide/rituximab vs bendamustine/rituximab in fit patients with advanced chronic lymphocytic leukemia (CLL)...

hematologic malignancies
leukemia

5-Year Results of DASISION Trial of Dasatinib vs Imatinib in CML

As reported in the Journal of Clinical Oncology by Cortes et al, the final 5-year results of the DASISION trial support the safety and efficacy of dasatinib (Sprycel) as first-line treatment in patients with chronic myeloid leukemia (CML) in chronic phase. Initial results in the trial led to...

hematologic malignancies
leukemia

International Prognostic Index for Patients With Chronic Lymphocytic Leukemia

The International Chronic Lymphocytic Leukemia–International Prognostic Index (CLL-IPI) working group has developed an IPI for patients with chronic lymphocytic leukemia based on a meta-analysis of individual patient data, as reported in The Lancet Oncology. Study Details The meta-analysis...

Leukemia

Venetoclax for Previously Treated Chronic Lymphocytic Leukemia With 17p Deletion

On April 11, 2016, venetoclax ­(Venclexta) was approved for treatment of patients with chronic lymphocytic leukemia (CLL) with 17p deletion, as detected by a U.S. Food and Drug Administration (FDA)-approved test, who have received at least one prior therapy.1,2 The accelerated approval was based...

Supportive Care
Leukemia

Recent Reports on Treatment for Leukemias, Sinusoidal Obstruction Syndrome, and Graft-vs-Host Disease

In this installment of Hematology Expert Review, I will summarize five studies from the recent literature addressing important questions about leukemias and their treatment, anticoagulant therapy with the new agent defibrotide (Defitelio), and the use of antilymphocyte globulin to prevent chronic...

Cost of Care
Leukemia

The Arrival of Generic Imatinib Into the U.S. Market: An Educational Event

Imatinib mesylate (Gleevec), a Bcr-Abl tyrosine kinase inhibitor, is approved therapy for chronic myeloid leukemia (CML) in the United States. Imatinib is a miraculous drug that results in a normal functional lifespan in most patients with CML who can afford and comply with the treatment and who ...

hematologic malignancies
leukemia

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

In a phase II study reported in The Lancet Oncology, Stilgenbauer et al found that the BCL2 inhibitor venetoclax (Venclexta) produced a high response rate in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) with the 17p deletion (del [17p]). The study supported the recent...

leukemia

Risk Factors for Acute Pancreatitis in Children/Young Adults With Acute Lymphoblastic Leukemia

In a study reported in the Journal of Clinical Oncology, Liu et al found that Native American ancestry, older age, higher cumulative dose of asparaginase, and a rare variant of the CPA2 gene increased risk for pancreatitis in children/young adults with acute lymphoblastic leukemia (ALL). Study...

leukemia

Benefit of Dexamethasone and High-Dose Methotrexate in Children/Young Adults With High-Risk B-Acute Lymphoblastic Leukemia

As reported by Larsen et al in the Journal of Clinical Oncology, final data from the Children’s Oncology Group (COG) AALL0232 trial indicate that the event-free survival benefit of high-dose methotrexate was maintained in children/young adults with high-risk B-acute lymphoblastic leukemia....

leukemia

FDA Grants sBLA for Blinatumomab in Pediatric Patients With Ph–Negative Relapsed/Refractory B-Cell Precursor ALL

Amgen announced on May 3 that the U.S. Food and Drug Administration (FDA) has accepted for priority review the supplemental Biologics License Application (sBLA) for blinatumomab (Blincyto) to include new data supporting the treatment of pediatric and adolescent patients with Philadelphia...

hematologic malignancies
leukemia

Donor Epstein-Barr Virus Status Affects Risk for Graft-vs-Host Disease but Not Survival in Acute Leukemia After HSCT

Positive donor Epstein-Barr virus (EBV) serostatus increases the risk for graft-vs-host disease but does not affect relapse-free or overall survival among patients with acute leukemia receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT), according to a study from the Acute...

Leukemia

Potential Biomarker for Carfilzomib Activity in CLL

Carfilzomib (Kyprolis) is active in B-cell neoplasms but exhibits heterogeneous activity in chronic lymphocytic leukemia (CLL) samples. As reported in Clinical Cancer Research, Lamothe and colleagues examined the mechanism by which carfilzomib induces CLL cell death. In studies using CLL patient...

Leukemia

City of Hope Awarded NCI Research Grant for Potential Acute Myeloid Leukemia Drug

A City of Hope research team led by Steven T. Rosen, MD, City of Hope’s Provost and Chief Scientific Officer, has been awarded a $2.3 million Research Project Grant (R01) from the National Cancer Institute (NCI) to fund studies associated with a phase I/II clinical trial in relapsed/refractory...

leukemia

FDA Approves Venetoclax for Chronic Lymphocytic Leukemia With 17p Deletion

On April 11, 2016, the U.S. Food and Drug Administration (FDA) approved venetoclax (Venclexta) for the treatment of patients with chronic lymphocytic leukemia (CLL) with 17p deletion, as detected by an FDA-approved test, who have received at least one prior therapy. Venetoclax is the first...

Lymphoma
Leukemia

Selected Abstracts From 2015 ASH Annual Meeting: Part 4

Here is the final installment of selected abstracts from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, focusing on Hodgkin lymphoma, follicular lymphoma, diffuse large B-cell lymphoma, and chronic lymphocytic leukemia. For other selected abstracts...

leukemia

Jeffrey Jones, MD, MPH, on Chronic Lymphocytic Leukemia: Optimizing Treatment With New Agents

Jeffrey Jones, MD, MPH, of the Ohio State University Comprehensive Cancer Center, discusses the use of small molecule inhibitors in developing an individualized treatment plan for patients with CLL.

leukemia

Jerald Radich, MD, on Chronic Myeloid Leukemia: Managing Advanced-Phase Disease

Jerald P. Radich, MD, of the Fred Hutchinson Cancer Research Center, discusses ways to prevent advanced-phase chronic myeloid leukemia through adherence to prescribed treatment and routine monitoring of disease burden.

Leukemia

Minimal Residual Disease in AML: Worth Looking?

As summarized in this issue of The ASCO Post, Ivey and colleagues demonstrated that assessing for NPM1-mutated gene transcripts by reverse-transcriptase quantitative polymerase chain reaction assay is a feasible approach for measuring minimal residual disease after acute myeloid leukemia (AML)...

Leukemia

Minimal Residual Disease Identified by NPM1 Mutation Is a Powerful Marker for Poorer Outcome in Standard-Risk AML

In a study reported in The New England Journal of Medicine, Adam Ivey, MSc, from Guy’s Hospital, London, and colleagues found that a leukemia-specific marker consisting of mutation in the gene encoding nucleophosmin (NPM1) can be used to identify minimal residual disease in peripheral blood in...

Leukemia

Two Types of Asparaginase Compared in Newly Diagnosed Childhood Acute Lymphoblastic Leukemia

Intravenous pegylated (PEG) Escherichia coli (E coli) asparaginase was associated with similar toxicity and efficacy compared with intramuscular native E coli L-asparaginase in children with newly diagnosed acute lymphoblastic leukemia, according to the results of a phase III trial (DFCI 05-001).1 ...

Leukemia

Chronic Lymphocytic Leukemia: The Golden Drug Only for Golden Agers?

As reviewed in this issue of The ASCO Post, Burger and colleagues recently reported findings of the RESONATE-2 trial of ibrutinib (Imbruvica) vs chlorambucil (Leukeran) as initial therapy for elderly patients with chronic lymphocytic leukemia (CLL).1 The study met its primary endpoint of...

Leukemia
Lymphoma

First-Line Ibrutinib Improves Progression-Free and Overall Survival vs Chlorambucil in Older Patients With Chronic Lymphocytic Leukemia

As reported in The New England Journal of Medicine and at the 2015 American Society of Hematology Annual Meeting, Jan A. Burger, MD, PhD, and colleagues found that first-line treatment with the oral Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) improved progression-free and overall...

breast cancer
leukemia
lung cancer

Specific Form of CYP3A7 Gene Associated With Poor Outcomes for Patients With Several Cancer Types

Among patients with breast cancer, lung cancer, or chronic lymphocytic leukemia (CLL), those who had a specific form of the CYP3A7 gene (CYP3A7*1C) had worse outcomes compared with those who did not have CYP3A7*1C. This may be related to how the patients metabolize the therapeutics used to treat...

hematologic malignancies
leukemia

Increasing the Dose of Obinutuzumab Monotherapy Raised the Response Rate

A randomized phase II study in symptomatic, untreated patients with chronic lymphocytic leukemia (CLL) found an increased overall response rate with obinutuzumab (Gazyva) at a 2,000 mg vs 1,000 dose. In addition, the “data demonstrate that obinutuzumab produces a higher response rate in...

leukemia

Adding Targeted Therapy to Chemoimmunotherapy in Patients With Chronic Lymphocytic Leukemia: Questions as to Optimal Strategy Remain

The HELIOS study is an international phase III trial of bendamustine (Treanda) plus rituximab (Rituxan) in combination with ibrutinib (Imbruvica) vs placebo in patients with previously treated chronic lymphocytic leukemia. As reported by Chanan-Khan in The Lancet Oncology1 and reviewed in this...

leukemia

Children With Leukemia From High-Poverty Areas More Likely to Suffer Early Relapse

Among children with acute lymphoblastic leukemia (ALL), the most common pediatric cancer, those who live in high-poverty areas are substantially more likely to suffer early relapse than other patients, despite having received the same treatment, according to new research from Dana-Farber/Boston...

leukemia

Minimal Residual Disease Identified by NPM1 Mutation May Be Prognostic Marker for Poorer Outcome in Standard-Risk AML

In a study reported in The New England Journal of Medicine, Ivey et al found that a leukemia-specific marker consisting of a mutation in the gene encoding nucleophosmin (NPM1) can be used to identify minimal residual disease in peripheral blood in standard-risk acute myeloid leukemia (AML), with...

leukemia

Ofatumumab for Extended Treatment of Patients With Recurrent or Progressive Chronic Lymphocytic Leukemia

On January 19, 2016, ofatumumab (Arzerra) was approved for extended treatment of patients in complete or partial response after at least two lines of therapy for recurrent or progressive chronic lymphocytic leukemia (CLL).1,2 Ofatumumab was previously approved for treatment of untreated patients...

leukemia
issues in oncology

Inherited Genetic Variations That Lead to Severe Drug Toxicity in Pediatric Leukemia Discovered

An international research team has determined how inherited gene variations lead to severe drug toxicity that may threaten chances for a cure in children with leukemia. St. Jude Children’s Research Hospital scientists led the study, results of which set the stage to expand the use of a...

leukemia
lymphoma

Younger T Cells May Improve Immunotherapy for Pediatric Cancer

Pediatric oncologists from The Children’s Hospital of Philadelphia (CHOP) have investigated techniques to improve and broaden a novel personalized cell therapy to treat children with cancer. The researchers say that a patient’s outcome may be improved if clinicians select specific...

leukemia
lymphoma
survivorship

Reduction in Late Mortality in Childhood Cancer Survivors in the Childhood Cancer Survivor Study Cohort

In a study reported in The New England Journal of Medicine, Armstrong et al found that late mortality decreased over time among 5-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort. The reduction is consistent with efforts during recent decades to modify treatment with ...

leukemia

FDA Approves Ofatumumab for Patients With Chronic Lymphocytic Leukemia in Complete or Partial Response

The U.S. Food and Drug Administration (FDA) has approved ofatumumab (Arzerra), a CD20-directed cytolytic monoclonal antibody, for extended treatment of patients who are in complete or partial response after at least two lines of therapy for recurrent or progressive chronic lymphocytic leukemia...

leukemia
issues in oncology

New Assay Detects Persistent Disease in Leukemia Patients Thought to Be in Remission

The outcomes of chronic myeloid leukemia (CML) have dramatically improved as the result of tyrosine kinase inhibitor treatment. Use of a tyrosine kinase inhibitor regimen can lower the blood CML biomarker to levels imperceptible by current detection methods. For patients in “molecular...

leukemia

Bone Loss Associated With Leukemia Therapy Occurs Sooner Than Previously Thought

Investigators at Children’s Hospital Los Angeles (CHLA) have found that significant bone loss occurs during the first month of chemotherapy for acute lymphoblastic leukemia (ALL), which is far earlier than previously assumed. Results of the study were published by Orgel et al in the...

breast cancer
hematologic malignancies
leukemia
sarcoma

Increased Breast Cancer Risk Reported in Childhood Sarcoma and Leukemia Survivors With No History of Chest Radiotherapy

In an analysis of the Childhood Cancer Survivor Study reported in the Journal of Clinical Oncology, Henderson et al found that childhood survivors of sarcoma and leukemia with no history of chest radiotherapy were at an increased risk of breast cancer. Increased Risk The study included data from...

leukemia
lymphoma

Matthew Lunning, DO, on Ublituximab Plus TGR-1202 in Lymphoma

Matthew Lunning, DO, of the University of Nebraska Medical Center, on abstract 801, “Ublituximab, a Novel Glycoengineered Anti-CD20 Monoclonal Antibody, in Combination with TGR-1202, a Next-Generation Once Daily PI3kδ Inhibitor, Demonstrates Activity in Heavily Pretreated and High-Risk Chronic Lymphocytic Leukemia and B-Cell Lymphoma.”

leukemia
lymphoma

Julie M. Vose, MD, MBA, FASCO, on Ublituximab Plus TGR-1202 in Lymphoma

Julie M. Vose, MD, MBA, FASCO, of the University of Nebraska Medical Center, offers her thoughts on abstract 801, “Ublituximab, a Novel Glycoengineered Anti-CD20 Monoclonal Antibody, in Combination With TGR-1202, a Next-Generation Once-Daily PI3kδ Inhibitor, Demonstrates Activity in Heavily Pretreated and High-Risk Chronic Lymphocytic Leukemia and B-Cell Lymphoma,” presented by Matthew A. Lunning, DO.

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