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Hematologic Malignancies
Survivorship
Gastrointestinal Cancer
Lymphoma
Leukemia
Myelodysplastic Syndromes

Risk of Subsequent Gastrointestinal Tract Malignancies After Blood or Marrow Transplantation

In a study reported in JAMA Oncology, McDonald et al found that receipt of blood or marrow transplantation (BMT) was associated with an increased risk of subsequent malignant neoplasms of the gastrointestinal (GI) tract. As stated by the investigators, “Survivors of BMT are at increased risk of...

Leukemia

Undaunted

Soon after my marriage, in 2003, I noticed swelling in the glands around my throat. Although I otherwise felt fine, I went to see my primary care physician for a checkup and a blood test. The results of the test showed that I had an abnormally high number of lymphocytes circulating in my...

Leukemia

Expert Point of View: Jaime A. Suarez-Londono, MD

Jaime A. Suarez-Londono, MD, a medical oncologist at NYU Langone’s Perlmutter Cancer Center and Assistant Professor of Medicine at NYU Grossman School of Medicine, said the results of the ASAP study provide a basis for discussion with the transplant team. “The landscape of treatment of acute...

Leukemia

Intensive Remission Induction Chemotherapy vs Less Intensive Approach Prior to Transplant for Relapsed/Refractory AML

Intensive salvage therapy with the goal of achieving complete remission prior to allogeneic hematopoietic cell transplantation (alloHCT) may not be necessary in some patients with relapsed or refractory acute myeloid leukemia (AML), according to the results of the phase III ASAP trial presented at...

Leukemia
Issues in Oncology

The Influence of Structural Racism and Poverty on Outcomes in Leukemia

In the United States, Black American patients with acute myeloid leukemia (AML) have notably worse survival outcomes compared to White patients. In addition, Black patients are less likely to receive intensive chemotherapy and undergo allogeneic stem cell transplants. Many researchers have reported ...

Leukemia

Olutasidenib for Relapsed or Refractory Acute Myeloid Leukemia With a Susceptible IDH1 Mutation

On December 1, 2022, the IDH1 inhibitor olutasidenib was approved for the treatment of adults with relapsed or refractory acute myeloid leukemia with a susceptible IDH1 mutation, as detected by a U.S. Food and Drug Administration (FDA)-approved test.1 The FDA simultaneously approved the Abbott...

Leukemia
Lymphoma

FDA Approves Zanubrutinib for CLL or SLL

On January 19, the U.S. Food and Drug Administration (FDA) approved the kinase inhibitor zanubrutinib (Brukinsa) for the treatment of patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). SEQUOIA Trial: Treatment-Naive Patients Efficacy in treatment-naive patients...

Leukemia
Lymphoma

Is Zanubrutinib Poised to Become a New Standard of Care in Relapsed or Refractory CLL and SLL?

The next-generation Bruton’s tyrosine kinase (BTK) inhibitor zanubrutinib demonstrated superior progression-free survival compared with ibrutinib, with an improved cardiac safety profile, in the first head-to-head comparison between these two BTK inhibitors in relapsed or refractory chronic...

Leukemia

CLL2-GIVe Trial: Regimen of Obinutuzumab, Ibrutinib, and Venetoclax Effective in High-Risk CLL

The first-line combination of obinutuzumab, ibrutinib, and venetoclax appears to be effective in treating high-risk chronic lymphocytic leukemia (CLL), according to data presented at the 2022 American Society of Hematology (ASH) Annual Meeting and Exposition.1 Results of the CLL2-GIVe trial, which...

Leukemia

Studies Explore Novel Triplet Combinations in Acute Myeloid Leukemia

Two separate studies presented at the 2022 American Society of Hematology (ASH) Annual Meeting and Exposition provide preliminary evidence that triplet combinations may have a role in the treatment of acute myeloid leukemia (AML). Both triplets were based on the addition of a third drug to standard ...

Leukemia
Immunotherapy

Blinatumomab Improves Survival in MRD-Negative, B-Cell ALL

The standard of care could be changing for adults with newly diagnosed BCR-ABL–negative B-lineage acute lymphoblastic leukemia (ALL) who achieve measurable residual disease (MRD) negativity after induction chemotherapy. In the phase III E1910 trial by the ECOG-ACRIN Cancer Research Group, an...

Leukemia

Ruxolitinib Demonstrates Clinical Activity in a Phase II Trial of Chronic Myelomonocytic Leukemia

In a phase II trial, treatment with the JAK2 inhibitor ruxolitinib resulted in clinical activity in two-thirds of patients with chronic myelomonocytic leukemia (CMML) with splenomegaly or an otherwise high disease symptom burden. The magnitude of symptomatic benefit was similar to that observed in...

Leukemia

New Scoring System Measures Inflammation Levels, May Improve Risk Stratification in AML

Researchers have discovered that severe inflammation may weaken the body’s ability to kill cancerous blood cells in patients with acute myeloid leukemia (AML), according to a new study published by Lasry et al in Nature Cancer. With bone marrow samples from 20 adults and 22 children with AML, the...

Leukemia

Chronic Myelomonocytic Leukemia: Treatment and Prognosis, Part 2

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In the concluding half of this two-part installment, which began in our November 25 issue, Drs. Syed Ali Abutalib and Mrinal M. Patnaik continue to explore the current...

Leukemia

Ivosidenib/Azacitidine for Newly Diagnosed IDH1-Mutant Acute Myeloid Leukemia in Patients Aged 75 or Older or With Comorbidities

On May 25, 2022, ivosidenib was approved for use in combination with azacitidine for newly diagnosed acute myeloid leukemia with a susceptible IDH1 mutation, as detected by a U.S. Food and Drug Administration–approved test, in patients aged 75 or older or in those who have comorbidities precluding...

leukemia
lymphoma

Jennifer R. Brown, MD, PhD, on CLL/SLL: New Findings on Zanubrutinib vs Ibrutinib for Relapsed or Refractory Disease

Jennifer R. Brown, MD, PhD, of Dana-Farber Cancer Institute, discusses phase III findings of the ALPINE study, which showed that zanubrutinib is more efficacious and better tolerated than ibrutinib as a treatment for patients with relapsed or refractory chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). In this first head-to-head comparison of the two BTK inhibitors, the superior progression-free survival of zanubrutinib was observed across all major subgroups, including high-risk patients (Abstract LBA-6).

leukemia

Mark R. Litzow, MD, on ALL: Consolidation Therapy With Blinatumomab Improves Overall Survival

Mark R. Litzow, MD, of the Mayo Clinic, discusses phase III results from the ECOG-ACRIN E1910 Trial, which show that adding blinatumomab to consolidation chemotherapy resulted in a significantly better overall survival in adult patients aged 30 to 70 years with newly diagnosed B-lineage acute lymphocytic leukemia (ALL) who were measurable residual disease–negative after receiving intensification chemotherapy. The authors believe this may represent a new standard of care for this population (Abstract LBA-1).

Leukemia
Lymphoma
Genomics/Genetics

Scientists Map Genetic Evolution of CLL to Richter Syndrome

Richter syndrome is an aggressive lymphoma that develops in up to 1% of patients with chronic lymphocytic leukemia (CLL) and it serves as an example of histologic transformation. While recent advances have transformed the treatment landscape of CLL, Richter syndrome remains associated with poor...

Leukemia

Zanubrutinib Found Superior to Ibrutinib for CLL and SLL

Zanubrutinib showed superior efficacy to ibrutinib—with fewer side effects—in the first head-to-head comparison between the Bruton’s tyrosine kinase (BTK) inhibitors among patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), according to data presented by Jennifer...

Leukemia

Venetoclax With Intensive Chemotherapy Regimen May Be Effective in Younger Patients With Newly Diagnosed AML, High-Risk Myelodysplastic Syndrome

A novel study evaluating the addition of venetoclax to the intensive chemotherapy regimen of cladribine, idarubicin, and cytarabine as a front-line therapy demonstrated high rates of disease control and remissions in younger patients with newly diagnosed acute myeloid leukemia (AML) and high-risk...

Leukemia

Chemotherapy-Free Regimen of Ponatinib and Blinatumomab May Be Effective for Patients With Newly Diagnosed Philadelphia Chromosome–Positive ALL

A new phase II trial demonstrated that the chemotherapy-free regimen of ponatinib and blinatumomab may have achieved high response rates and reduced the need for an allogeneic stem cell transplant for patients with recently diagnosed Philadelphia chromosome–positive (Ph+) acute lymphoblastic...

Leukemia

Older or High-Risk Patients With Newly Diagnosed AML May Respond to Triplet Therapy

Researchers observed encouraging response rates in older or high-risk patients with newly diagnosed acute myeloid leukemia (AML) when treated with the triplet combination therapy of azacitidine, venetoclax, and magrolimab in a phase I/II trial, according to new findings presented by Daver et al at...

Leukemia
Immunotherapy

Blinatumomab Further Improves Survival Among Patients With B-Lineage ALL and a Good Prognosis

The bispecific T-cell engager molecule blinatumomab was found to improve overall survival for patients with no measurable residual disease (MRD) after initial treatment for B-lineage acute lymphoblastic leukemia (ALL), according to the phase III ECOG-ACRIN E1910 trial presented by Litzow et al at...

Leukemia

Simplified Treatment Regimen Reduces Early Deaths in Patients With APL

The use of a simplified treatment regimen by oncologists—along with management recommendations and 24/7 support provided by a limited and dedicated group of academic disease experts—resulted in a decrease in early deaths from acute promyelocytic leukemia (APL). In the multicenter prospective trial...

Leukemia

Three-Drug Combination Therapy May Be Effective in Patients With High-Risk CLL

A three-drug combination that showed success at sending patients with chronic lymphocytic leukemia (CLL) into deep remissions in a clinical trial may be effective at treating patients with high-risk types of the disease, according to new findings presented by Ryan et al at the 2022 American Society ...

Leukemia

Global Study Uncovers Regional Differences in the Use of Curative Transplants for Patients With AML

The use of stem cell transplantation for acute myeloid leukemia increased by about 55% worldwide from 2009 to 2016, according to new findings presented by Niederweiser et al at the 64th American Society of Hematology (ASH) Annual Meeting and Exposition (Abstract 3638). Although the largest...

leukemia
genomics/genetics

Irene Roberts, MD, on Leukemogenesis in Infants With Trisomy 21

Irene Roberts, MD, of Oxford’s Weatherall Institute of Molecular Medicine, discusses children with Down syndrome, who have a more than 100-fold increased risk of developing acute myeloid leukemia before their fourth birthday compared to children without Down syndrome. Their risk of acute lymphoblastic leukemia is also increased by around 30-fold. Dr. Roberts details current knowledge about the biologic and molecular basis of this relationship between leukemia and Down syndrome, the role of trisomy 21 in leukemogenesis, and the clinical implications of these findings.

leukemia
issues in oncology

Abdul Rahman Al Armashi, MD, on AML: Racial Disparities in Mortality Trends

Abdul Rahman Al Armashi, MD, of Seidman Cancer Center, Case Western University, University Hospitals Cleveland Medical Center, discusses a retrospective analysis, using a CDC database, in one of the largest subgroup-based racial population studies analyzing mortality trends in patients with acute myeloid leukemia (AML). Between 2000 and 2019, AML mortality was the highest in Whites and the lowest in American Indians or Alaska Natives. The highest rate of increase in mortality was seen in Asians or Pacific Islanders. Dr. Al Armashi talks about the many variables that might contribute to these inequalities (Abstract 600).

leukemia

Anand P. Jillella, MD, on Acute Promyelocytic Leukemia: A Simplified Patient Care Strategy to Decrease Early Deaths

Anand P. Jillella, MD, of Georgia Cancer Center at Augusta University, discusses results from the ECOG-ACRIN EA9131 Trial, which showed that using a simplified treatment algorithm and management recommendations made by a group of specialists, resulted in a dramatic improvement in 1-year survival of patients with acute promyelocytic leukemia (Abstract 421).

leukemia

Andrew Matthews, MD, on AML: Real-World Effectiveness of 7 + 3 Intensive Chemotherapy vs Venetoclax and a Hypomethylating Agent

Andrew Matthews, MD, of the Abramson Cancer Center, University of Pennsylvania, discusses findings from a large, multicenter study that showed superior outcomes with 7 + 3 chemotherapy (cytarabine continuously for 7 days, along with short infusions of an anthracycline on each of the first 3 days) vs venetoclax in patients with acute myeloid leukemia (AML). In this real-world data set, the 7 + 3 cohort outperformed historical benchmarks in overall survival and early mortality, perhaps reflecting improved later lines of therapy and patient selection. Prospective studies (such as NCT04801797) must confirm the superiority of intensive chemotherapy (Abstract 426).  

Lymphoma
Leukemia
Immunotherapy

Report Outlines Advance in Retreatment With CAR T-Cell Therapy in Patients With Relapsed or Refractory Non-Hodgkin Lymphoma or CLL

Researchers from the University of Pennsylvania’s Abramson Cancer Center presented preliminary results of an ongoing phase I clinical trial demonstrating successful retreatment with chimeric antigen receptor (CAR) T-cell therapy for patients whose cancers relapsed after previous CAR T-cell therapy. ...

Leukemia
Genomics/Genetics

Targeting Menin May Induce Responses in Patients With Acute Leukemias and KMT2A Rearrangements or NPM1 Mutations

Researchers from The University of Texas MD Anderson Cancer Center showed that inhibiting menin with an oral small-molecule inhibitor of the menin-KMT2A interaction, SNDX-5613—now named revumenib—yielded encouraging responses for patients with advanced acute leukemias and KMT2A rearrangements or...

leukemia

Jorge E. Cortes, MD, on CML: Efficacy and Safety of Vodobatinib

Jorge E. Cortes, MD, of Georgia Cancer Center at Augusta University, discusses new findings on vodobatinib, which was administered to patients with chronic-phase Philadelphia chromosome–positive chronic myeloid leukemia (CML) and appeared to be efficacious and safe in people who had received therapy with two or three prior tyrosine kinase inhibitors (TKIs). Vodobatinib remains a potential option for these highly refractory patients. A phase II study (NCT02629692) of vodobatinib is ongoing in CML patients whose disease has failed to respond to three or more TKIs, including ponatinib (Abstract 84).

leukemia

Elias Jabbour, MD, on CML and ALL: Olverembatinib Overcomes Ponatinib Resistance

Elias Jabbour, MD, of The University of Texas MD Anderson Cancer Center, discusses an analysis confirming that olverembatinib is a potentially viable treatment option for patients with chronic myeloid leukemia (CML) and Philadelphia chromosome–positive acute lymphoblastic leukemia (ALL), including those with CML whose disease did not respond to ponatinib or asciminib, or who had a T315I mutation (Abstract 82).

leukemia
immunotherapy

Eunice S. Wang, MD, on AML: Gemtuzumab Ozogamicin Plus Standard Induction Chemotherapy Improves Outcomes

Eunice S. Wang, MD, of Roswell Park Comprehensive Cancer Center, discusses the outcomes of patients newly diagnosed with acute myeloid leukemia (AML) who were treated with cytarabine plus daunorubicin plus gemtuzumab ozogamicin (GO). These patients experienced higher rates of measurable residual disease–negative complete remission and complete remission with incomplete count recovery, compared to those treated with cytarabine plus idarubicin daunorubicin alone. Although adding GO was not associated with improved overall survival, longer follow-up is warranted to determine an absolute survival advantage of this regimen (Abstract 58).

Leukemia

High-Dose Methotrexate May Make Posttreatment Steroids Unnecessary for Some Pediatric Patients With ALL or LBL

The results of a new study answer some questions and raise new ones about the optimal treatment strategy for children and young adults living with acute lymphoblastic leukemia (ALL) or lymphoblastic leukemia (LBL). The randomized study is the first to test whether the use of a shorter, higher-dose...

Leukemia

Study Explores When to Proceed to Stem Cell Transplantation for Patients With Resistant AML

Patients with acute myeloid leukemia (AML) whose disease relapsed or did not respond to initial chemotherapy had similar outcomes when they proceeded directly to allogeneic stem cell transplantation compared with those who underwent intensive salvage chemotherapy to achieve complete remission...

Leukemia
Immunotherapy

ELIANA Trial 3-Year Update: Tisagenlecleucel in Pediatric and Young Adult Patients With Relapsed or Refractory B-Cell ALL

As reported in the Journal of Clinical Oncology by Laetsch et al, the 3-year update of the phase II ELIANA trial showed durable responses and a manageable safety profile with tisagenlecleucel for the treatment of pediatric and young adult patients with relapsed or refractory B-cell acute...

Leukemia
Genomics/Genetics

FDA Approves Olutasidenib for Relapsed or Refractory AML With a Susceptible IDH1 Mutation

On December 1, the U.S. Food and Drug Administration (FDA) approved olutasidenib (Rezlidhia) capsules for adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible IDH1 mutation as detected by an FDA-approved test. The FDA also approved the Abbott RealTime IDH1...

Leukemia

Zanubrutinib vs Ibrutinib in Relapsed or Refractory CLL

In an interim analysis of the phase III ALPINE trial reported in the Journal of Clinical Oncology, Peter Hillmen, MBChB, PhD, and colleagues found that zanubrutinib produced a significantly higher objective response rate vs ibrutinib in patients with relapsed or refractory chronic lymphocytic...

Leukemia

Chronic Myelomonocytic Leukemia: Treatment and Prognosis, Part 1

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Syed Ali Abutalib and Mrinal M. Patnaik explore the current treatment and prognosis of chronic myelomonocytic leukemia. For each quiz question...

Leukemia
Lymphoma

FDA Approves New Dosing Regimen for Asparaginase Erwinia Chrysanthemi (Recombinant)-rywn

On November 18, the U.S. Food and Drug Administration (FDA) approved a new Monday/Wednesday/Friday dosing regimen for asparaginase erwinia chrysanthemi (recombinant)-rywn (Rylaze). Under the new regimen, patients should receive 25 mg/m2 intramuscularly on Monday and Wednesday mornings and 50 mg/m2...

Leukemia
Immunotherapy

Coadministration of CD19- and CD22-Directed CAR T-Cell Therapy in Pediatric B-Cell ALL

In a Chinese phase II study reported in the Journal of Clinical Oncology, Wang et al found that the coadministration of CD19- and CD22-directed chimeric antigen receptor (CAR) T cells produced promising initial outcomes in pediatric patients with B-cell acute lymphoblastic leukemia (ALL) with...

Leukemia
Immunotherapy

CAR T-Cell Therapy Outcomes Similar Across Different Socioeconomic Levels Among Patients With Pediatric ALL

Although socioeconomic status often influences survival outcomes, pediatric patients with relapsed or refractory acute lymphoblastic leukemia (ALL) who were living in poverty and were treated with CAR T-cell therapy achieved similar overall survival and were equally likely to achieve a complete...

Leukemia
Genomics/Genetics

Rare Germline ATM Variants in Chronic Lymphocytic Leukemia

In a single-institution analysis reported in the Journal of Clinical Oncology, Benjamin L. Lampson, MD, and colleagues found a higher prevalence of rare germline ATM variants in chronic lymphocytic leukemia (CLL) vs other lymphoid and myeloid disorders. They also determined that patients with CLL...

Leukemia
Survivorship

CNS-Directed Therapy and Neurocognitive Outcomes in Survivors of Childhood ALL Receiving No Cranial Irradiation

In a single-institution study reported in the Journal of Clinical Oncology, Jacola et al found that survivors of childhood acute lymphoblastic leukemia (ALL) who received central nervous system (CNS)-directed therapy excluding cranial irradiation had poorer outcomes in numerous neurocognitive...

Leukemia

The Evolving Role of PI3K Inhibitors in Double-Refractory CLL

The treatment paradigm for chronic lymphocytic leukemia (CLL) continues to evolve in the first-line setting and beyond, with the availability of Bruton’s tyrosine kinase (BTK) inhibitors, the BCL2 inhibitor venetoclax, and novel combinations of these agents with anti-CD20 monoclonal antibodies....

Leukemia

With Newer Therapies, AML Diagnosis and Prognosis Evolve

For many years, treatment options for acute myeloid leukemia (AML) were limited mainly to the 7 + 3 regimen. However, more recently, a mini-explosion of AML therapies aimed at newly identified genetic targets makes discussions about treatment of this disease much more complicated. In fact, these...

Leukemia

Newly Diagnosed AML: Induction to Maintenance

When it is dark enough, you can see the stars.” —Ralph Waldo Emerson Low-intensity therapy for older or unfit patients with acute myeloid leukemia (AML) was introduced in the early 2000s in the form of low-dose cytarabine or hypomethylation therapy (azacitidine or decitabine). Recent studies...

Leukemia
Genomics/Genetics

Association of FLT3-ITD Measurable Residual Disease With Outcomes in Newly Diagnosed AML

In a study reported in the Journal of Clinical Oncology, Grob et al found that next-generation sequencing detection of FLT3-internal tandem duplication (FLT3-ITD) measurable residual disease (MRD) in complete remission was associated with markedly increased risk of relapse and poorer overall...

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