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Leukemia

Different Subtypes of Acute Myeloid Leukemia Create Both Clinical and Research Challenges

Acute myeloid leukemia (AML) is the most common leukemia in adults. Each year, about 20,000 Americans will be diagnosed with AML, and roughly 10,000 people in this country will die of the disease. AML progresses quickly, and unless treatment begins soon and is effective , the prognosis is grim....

leukemia

Blinatumomab After Failure of TKI Treatment in B-Precursor Acute Lymphoblastic Leukemia

In a phase II trial reported in the Journal of Clinical Oncology, Martinelli et al found that blinatumomab (Blincyto) produced complete responses in patients with relapsed/refractory Philadelphia chromosome–positive (Ph+) B-precursor acute lymphoblastic leukemia (ALL) progressing after...

leukemia

Mercaptopurine Ingestion Habits and Risk of Relapse in Children With Acute Lymphoblastic Leukemia

In a report from the Children’s Oncology Group Study AALL03N1 published in the Journal of Clinical Oncology, Landier et al found no association between oral mercaptopurine ingestion habits in children with acute lymphoblastic leukemia and risk of relapse after adjustment for medication...

Leukemia
Cost of Care

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

Association of DNA Thioguanine Nucleotide Concentration and Outcome During Maintenance Therapy for Childhood ALL

In a substudy of a European phase III trial (Nordic Society of Pediatric Hematology and Oncology ALL2008) reported in The Lancet Oncology, Nygaard Nielsen et al found that higher leukocyte DNA-incorporated thioguanine nucleotide (DNA-TGN) levels were associated with an improved relapse-free...

leukemia

Benefit of Imatinib in Chronic Myeloid Leukemia Persists Long Term in IRIS Trial

Long-term follow-up of patients with chronic myeloid leukemia (CML) randomized to imatinib in the IRIS trial was reported by Hochhaus et al in The New England Journal of Medicine. In the open-label crossover-design trial, 1,106 patients with CML were randomized to receive imatinib at 400 mg/d (n = ...

leukemia

Blinatumomab vs Chemotherapy in Advanced Acute Lymphoblastic Leukemia

In the phase III TOWER trial reported in The New England Journal of Medicine, Kantarjian et al found that blinatumomab (Blincyto) treatment improved overall survival vs chemotherapy in heavily pretreated patients with B-cell precursor acute lymphoblastic leukemia (ALL). Blinatumomab received...

leukemia

Clofarabine-Based Consolidation in Younger Patients With Acute Myeloid Leukemia in First Remission

In a French phase II trial reported in the Journal of Clinical Oncology, Thomas et al found that clofarabine-based consolidation may provide improved relapse-free survival vs conventional high-dose cytarabine in postremission treatment in younger patients with acute myeloid leukemia (AML) and no...

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

Adding Idelalisib to Bendamustine/Rituximab in Relapsed or Refractory Chronic Lymphocytic Leukemia

As reported by Zelenetz et al in The Lancet Oncology, an interim analysis of a phase III trial has shown the superiority of adding the phosphoinositide-3-kinase δ inhibitor idelalisib (Zydelig) to bendamustine/rituximab (Rituxan) in patients with relapsed or refractory chronic lymphocytic...

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...

leukemia

High Financial Burden for CML Patients Enrolled in Medicare Part D Receiving Targeted Oral Therapy

In a study reported in the Journal of Oncology Practice, Shen et al found that more than three-quarters of patients receiving targeted oral therapy for chronic myeloid leukemia (CML) reached the catastrophic phase of the Medicare Part D benefit within the calendar year of starting such treatment....

leukemia

Diagnosis and Management of AML in Adults: 2017 European LeukemiaNet Recommendations From an International Expert Panel

An international panel of experts has released updated evidence-based and expert opinion–based recommendations for the diagnosis and treatment of acute myeloid leukemia (AML) in adults. The recommendations were issued by the European LeukemiaNet (ELN) and published by Döhner et al in...

leukemia

Three Genetic Alterations Identified in Non–Down Syndrome Pediatric Acute Megakaryoblastic Leukemia

Research led by St. Jude Children’s Research Hospital has identified three genetic alterations to help identify high-risk pediatric patients with acute megakaryoblastic leukemia (AMKL) who may benefit from allogeneic stem cell transplants. The study, published by de Rooij et al in Nature...

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

Venetoclax Plus Rituximab Studied in Relapsed or Refractory Chronic Lymphocytic Leukemia

In a phase Ib study reported in The Lancet Oncology, Seymour et al found that the combination of the BCL2 inhibitor venetoclax (Venclexta) and the anti-CD20 monoclonal antibody rituximab (Rituxan) was highly active in patients with relapsed or refractory chronic lymphocytic leukemia...

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

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.

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