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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...

leukemia

Early Studies Examine Response of CML-Initiating Cells to Ezh2 Inhibition

Although targeted drugs like imatinib (Gleevec) have revolutionized the treatment of chronic myelogenous leukemia (CML), patients generally must take them for the rest of their lives and may cease benefiting from them over time. New research conducted by scientists at Dana-Farber Cancer Institute...

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...

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

Study Finds Minimal Residual Disease Assessment Improves 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...

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 ...

leukemia

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

Genmab A/S announced today that 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...

Leukemia

Clinical Trials Actively Recruiting Patients With Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on chronic lymphocytic leukemia. These studies are investigating multiple combination chemotherapies; regimens for relapsed and/or refractory disease; the role of inhibitors;...

Leukemia

Inotuzumab Ozogamicin Improves Outcomes vs Standard Therapy in Relapsed/Refractory Acute Lymphoblastic Leukemia

In a phase III trial reported in The New England Journal of Medicine, Hagop M. Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, and colleagues found that treatment with the antibody-drug conjugate inotuzumab ozogamicin resulted in a greater complete remission rate and improved ...

Leukemia

Pediatric Regimen Yields Improved Survival for Adults With ALL

Arisk-stratified analysis of the Nordic Society for Pediatric Hematology and Oncology (NOPHO) protocol ALL2008 showed almost identical outcomes in adults and children aged 1 to 45 years with Philadelphia-negative acute lymphoblastic leukemia (ALL). Nina Toft, MD, of the Herlev University Hospital...

Leukemia

New Upfront Treatment Algorithm Emerges for Chronic Lymphocytic Leukemia

According to Susan M. O’Brien, MD, an expert in the treatment of chronic lymphocytic leukemia (CLL), novel agents and new data on patient subsets have led to a new upfront treatment algorithm for this malignancy. Speaking at the 2016 Pan Pacific Lymphoma Conference in Koloa, Hawaii, Dr. O’Brien...

Leukemia

Inotuzumab Ozogamicin Shows Clear Benefit in Acute Lymphoblastic Leukemia

In patients with relapsed/refractory acute lymphoblastic leukemia (ALL), the antibody-drug conjugate inotuzumab ozogamicin produced significantly more complete remissions and was a better bridge to transplant than treatment by physician’s choice, according to the final results of a phase III trial...

hematologic malignancies
leukemia

Study Finds Venetoclax Monotherapy Safe and Clinically Active in AML

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

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; clinicaltrials.gov identifier NCT02535364) in adult patients with relapsed or refractory B-cell...

leukemia

Study Evaluates Chronic Graft-vs-Host Disease Burden and Complications in Patients Receiving Bone Marrow Transplants

A University of Colorado Cancer Center study compared outcomes of leukemia patients receiving bone marrow transplants from 2009 to 2014, finding that 3 years post transplant, the incidence of severe chronic graft-vs-host disease was significantly higher in patients who had received transplants from ...

Survivorship
Leukemia
Lymphoma

My Commitment to Helping Other Survivors of Childhood Cancers

When I was diagnosed with acute lymphocytic leukemia (ALL) at the age of 2 in 1974, not much was known about the cancer or the side effects of its treatment. Too young to understand what was happening to me, the burden fell to my parents and older sibling to protect and care for me. For more than...

Leukemia

Clinical Trials Actively Recruiting Patients With Acute Myeloid Leukemia

Phase I/II Study Title: A Phase I-II Randomized Trial of a Combination of ­Nintedanib/Placebo in Combination With Induction Chemotherapy for Patients With Refractory or First-Relapse AML Study Type: Phase I/II/interventional/parallel assignment Study Sponsor and Collaborators: Yale University,...

Leukemia

Genomic Classification and Outcome in Acute Myeloid Leukemia

As reported in The New England Journal of Medicine, Elli Papaemmanuil, PhD, of the Cancer Genome Project, Wellcome Trust Sanger Institute, and colleagues have identified 11 genomic subgroups in acute myeloid leukemia (AML) associated with distinct diagnostic features and clinical outcomes. AML...

leukemia
lymphoma

Susan M. O’Brien, MD, on ALL/Lymphoma: Upfront and Salvage Treatments in Older Patients

Susan M. O’Brien, MD, of the University of California, Irvine, discusses the challenges of treating older patients with acute lymphoblastic leukemia and lymphoma, and the positive results with newer regimens using blinatumomab and inotuzumab.

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...

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