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In an interim analysis of a small phase I study reported in The New England Journal of Medicine, Chiesa et al found that base-edited CAR7 T cells were active in pediatric patients with relapsed T-cell acute lymphoblastic leukemia (ALL). As stated by the investigators: “Cytidine deamination that is...
On July 20, 2023, quizartinib was approved for use with standard cytarabine and anthracycline induction and cytarabine consolidation and as maintenance monotherapy following consolidation chemotherapy in adults with newly diagnosed acute myeloid leukemia that is FLT3 internal tandem duplication...
Patients with acute myeloid leukemia (AML) who received vitamin C and D supplements during intensive chemotherapy had lower rates of complications such as infections, bleeding, and inflammation compared with patients who did not receive the supplements, according to a recent study published by...
Nicholas J. Short, MD, of The University of Texas MD Anderson Cancer Center, discusses findings from a phase II study subgroup analysis that explored the question of whether ponatinib and blinatumomab, both active in Philadelphia chromosome–positive acute lymphoblastic leukemia, could offer an effective chemotherapy-free treatment for patients with newly diagnosed disease as well as reduce the need for allogeneic stem cell transplantation (Abstract S118).
In a phase I/II study (TRANSCEND CLL 004) reported in The Lancet, Tanya Siddiqi, MD, and colleagues found evidence of activity with the CD19-directed chimeric antigen receptor (CAR) T-cell therapy lisocabtagene maraleucel in patients with relapsed or refractory chronic lymphocytic leukemia...
Researchers may have identified how the TET2 gene may fuel rapid cancer growth in patients with acute myeloid leukemia (AML), according to a recent study published by Li et al in Cell Stem Cell. Background AML is distinguished by the rapid division and metastasis of immature leukemia stem cells....
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...
Alexey Danilov, MD, PhD, Co-Director, Toni Stephenson Lymphoma Center and Professor, Division of Lymphoma, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope, Duarte, California, commented on the phase III ALPINE trial comparing ibrutinib and zanubrutinib in patients...
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...
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...
In a Chinese study (CCLG-AML 2015) reported in the Journal of Clinical Oncology, Li et al found that homoharringtonine (HHT)-based induction therapy was associated with promising outcomes in pediatric acute myeloid leukemia (AML). As stated by the investigators, “HHT is commonly used for the...
Nigel Russell, MD, of Guy’s and St. Thomas’ NHS Foundation Trust, discusses the latest results from the AML19 trial, which showed the chemotherapy regimen FLAG-Ida (fludarabine, high-dose cytarabine, idarubicin, and granulocyte-colony stimulating factor), when combined with gemtuzumab ozogamicin, reduced levels of measurable residual disease and improved overall survival in patients with NPM1-mutated acute myeloid leukemia after induction therapy.
In a retrospective study reported in the Journal of Clinical Oncology, Elizabeth A. Raetz, MD, and colleagues found that outcomes in children and young adults with T-cell acute lymphoblastic leukemia (ALL) who do not achieve remission at the end of induction therapy have improved in contemporary...
The second-generation FLT3 inhibitor quizartinib has recently emerged as a treatment option for patients with acute myeloid leukemia (AML) in both FLT3-ITD–wild-type and FLT3-ITD–mutated cases. At the European Hematology Association (EHA) 2023 Hybrid Congress, several studies demonstrated the...
A new therapeutic option is under study for use in a difficult-to-treat subset of patients with acute myeloid leukemia (AML), according to a presentation during the European Hematology Association (EHA) 2023 Hybrid Congress.1 Exploratory results of the phase III MORPHO trial showed a benefit to the ...
In a recent study (Dutch Childhood Oncology Group [DCOG] ALL11) reported in the Journal of Clinical Oncology, Pieters et al found that modifications in therapy appeared to improve outcomes and reduce drug exposure in pediatric patients with acute lymphoblastic leukemia (ALL) compared with treatment ...
The 6-year follow-up of a landmark study has revealed significant treatment-free remissions and safety findings in elderly patients with chronic lymphocytic leukemia (CLL) and coexisting medical conditions.1 Long-term results of the CLL14 trial, presented during the European Hematology Association...
On July 20, the U.S. Food and Drug Administration (FDA) approved quizartinib (Vanflyta) with standard cytarabine and anthracycline induction and cytarabine consolidation, and as maintenance monotherapy following consolidation chemotherapy, for the treatment of adults with newly diagnosed acute...
In a phase Ib trial (2215-CL-0103) reported in the Journal of Clinical Oncology, Keith W. Pratz, MD, and colleagues found that incorporation of the FLT3 inhibitor gilteritinib into intensive induction and consolidation chemotherapy and its use as single-agent maintenance therapy were associated...
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 L. Jeffrey Medeiros explore the World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...
The 5-year survival rate of pediatric patients with acute lymphoblastic leukemia (ALL) has continued to increase to 94%, according to a new study published by Pieters et al in the Journal of Clinical Oncology. Background ALL is the most common form of pediatric cancer in the Netherlands—with about...
Jennifer R. Brown, MD, PhD, of Dana-Farber Cancer Institute, discusses phase I/II findings from the Bruin study of resistance to pirtobrutinib in patients with covalent BTK inhibitor–pretreated chronic lymphocytic leukemia (CLL). The aim of the study was to explore the genomic evolution of resistance to this agent.
In the phase I/II BRUIN trial reported in The New England Journal of Medicine, Anthony R. Mato, MD, and colleagues found that the noncovalent (reversible) Bruton’s tyrosine kinase (BTK) inhibitor pirtobrutinib exhibited strong activity in patients with relapsed or refractory chronic lymphocytic...
An elevated body mass index (BMI) could potentially be associated with inferior treatment outcomes in adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL), according to a new study published by Shimony et al in Blood Advances. The findings may demonstrate the impact of...
The implementation of a collaborative program between North American and Mexican medical institutions to achieve sustainable, high-quality care at a public hospital in the United States–Mexico border region for children with acute lymphoblastic leukemia (ALL) has resulted in significant improvement ...
In a Chinese phase III trial reported in the Journal of Clinical Oncology, Ling et al found that conditioning with busulfan/fludarabine resulted in reduced transplantation-related mortality vs busulfan/cyclophosphamide in patients with acute myeloid leukemia (AML) undergoing human leukocyte antigen ...
In an analysis reported in the Journal of Clinical Oncology, Ariffin et al found noninferior event-free survival with an anthracycline-free vs anthracycline-containing regimen among children with favorable-risk B-cell precursor acute lymphocytic leukemia (ALL) enrolled in two Malaysia-Singapore ALL ...
On June 21, the U.S. Food and Drug Administration (FDA) approved the supplemental biologics license application for blinatumomab (Blincyto) for the treatment of adult and pediatric patients with CD19-positive B-cell precursor acute lymphoblastic leukemia (ALL) in first or second complete remission...
In an analysis of the phase III GLOW trial reported in the Journal of Clinical Oncology, Talha Munir, MBBS, and colleagues found that fixed-duration ibrutinib/venetoclax produced higher rates of undetectable measurable residual disease (MRD) vs chlorambucil/obinutuzumab in previously untreated...
As reported in the Journal of Clinical Oncology by Hogan et al, the phase III Children’s Oncology Group AALL1331 trial has shown that the addition of blinatumomab to standard chemotherapy improved survival outcomes among younger patients with low-risk B-cell acute lymphoblastic leukemia (ALL) in...
In an analysis reported in JAMA Network Open, Phillips et al found that adult survivors of childhood cancer were at an increased risk of new-onset memory impairment vs their siblings. Modifiable factors associated with increased risk of impairment among survivors were identified. Study Details The...
For some precancerous cells, traveling from the bone marrow to the skin can trigger genetic transformations that can result in leukemia, according to a novel study published by Griffin et al in Nature. The new findings may have shed light on what researchers have termed the “genetic travelogue” of...
In a single-institution phase II study reported in the Journal of Clinical Oncology, Rashidi et al found that fecal microbiota transplantation (FMT) did not reduce the risk of infection in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) or patients with acute myeloid...
Jennifer A. Woyach, MD, of The Ohio State University Comprehensive Cancer Center, discusses results of a phase III study showing that progression-free survival with ibrutinib plus obinutuzumab plus venetoclax is not superior to ibrutinib plus obinutuzumab for treatment-naive older patients with chronic lymphocytic leukemia (CLL) in the setting of the COVID-19 pandemic. Long-term follow-up will determine whether there are advantages to obinutuzumab plus venetoclax, with special attention to measurable residual disease and therapy discontinuation (Abstract 7500).
Sarah K. Tasian, MD, of Children’s Hospital of Philadelphia, summarizes three studies presented at ASCO: genomic determinants of outcome in acute lymphoblastic leukemia (ALL), a phase III trial of inotuzumab ozogamicin for high-risk B-cell ALL, and preliminary results from the first-in-child phase II trial of bosutinib in pediatric patients with newly diagnosed chronic myeloid leukemia (Abstracts 10015, 10016, and 10017).
Paula Aristizabal, MD, MAS, of the University of California, San Diego, and Rady Children’s Hospital, talks about using a health systems strengthening approach to improve leukemia care and survival in a public Mexican hospital in the region of the border between the United States and Mexico. The demonstrated increase in overall survival across a decade after implementation of the program seems to validate the use of such models, not only to improve clinical outcomes, but also to build sustainable hospital capacity, financially and organizationally (Abstract 1502).
Claire Roddie, PhD, MBChB, of University College London, discusses results of the FELIX study, which showed that the second-generation chimeric antigen receptor (CAR) T-cell therapy obecabtagene autoleucel is safe for adults with relapsed or refractory B-cell acute lymphoblastic leukemia, even those with a high burden of disease. This agent yielded high rates of complete response and ongoing CAR T-cell persistence in most patients whose disease responded (Abstract 7000).
Eunice S. Wang, MD, of Roswell Park Comprehensive Cancer Center, and Gregory Roloff, MD, of the University of Chicago, discuss data that are the first to demonstrate post–FDA approval efficacy and toxicity rates of brexucabtagene autoleucel in adults with relapsed or refractory B-cell acute lymphoblastic leukemia. Although the data may confirm high response rates associated with this agent, they also highlight the need for interventions to reduce associated toxicities (Abstract 7001).
LaQuisa C. Hill, MD, of Baylor College of Medicine, Houston Methodist Hospital, discusses study findings showing that CD5 chimeric antigen receptor (CAR) T cells may induce clinical responses in heavily treated patients with relapsed or refractory T-cell acute lymphoblastic leukemia. Manufacturing CD5 CAR T cells with tyrosine kinase inhibitors seemed to improve their potency and antitumor activity (Abstract 7002).
Today is the era of the multidisciplinary oncology care approach, cancer staging facilitates precision in documenting disease extent, all of which improved the quality of patient care. However, in the United States, the Rai staging system is still the most commonly used clinical staging system for...
The implementation of a collaborative program between North American and Mexican medical institutions to achieve sustainable, high-quality care at a public hospital in the United States–Mexico border region for children with acute lymphoblastic leukemia (ALL) and improve outcomes has resulted in...
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 L. Jeffrey Medeiros explore the World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...
Results of the Intercontinental-Berlin-Frankfurt-Münster 2009 trial in childhood acute lymphoblastic leukemia (ALL) were reported in the Journal of Clinical Oncology by Campbell et al. Findings included no benefit of augmented early intensification in intermediate-risk or high-risk patients and no...
In the phase III GAIA–CLL13 trial reported in The New England Journal of Medicine, Barbara Eichhorst, MD, and colleagues found better outcomes with venetoclax plus obinutuzumab and venetoclax, obinutuzumab, and ibrutinib compared with chemoimmunotherapy as first-line treatment in fit patients with ...
As reported in The Lancet Oncology by Peter Hillmen, MBChB, PhD, and colleagues, an interim analysis of the UK phase III FLAIR trial has shown significantly improved progression-free survival with ibrutinib and rituximab vs fludarabine, cyclophosphamide, and rituximab (FCR) in previously untreated...
In an analysis reported in the Journal of Clinical Oncology, O’Connor et al found that pediatric and young adult patients with T-cell acute lymphoblastic leukemia (T-ALL) who did not respond to induction therapy had poorer outcomes vs those with induction response. The investigators also attempted...
In a phase II trial reported in The New England Journal of Medicine, van der Sluis et al found that the addition of blinatumomab—a bispecific T-cell engager molecule targeting CD19—to standard chemotherapy appeared to result in marked improvements in outcome among infants with KMT2A-rearranged...
As reported in The Lancet by Erba et al, the phase III QuANTUM-First trial has shown prolonged overall survival with the addition of the FLT3 inhibitor quizartinib to chemotherapy in patients with newly diagnosed FLT3-internal-tandem-duplication (ITD)-positive acute myeloid leukemia (AML). Study...
Bone marrow transplantation in leukemia is one of the great success stories in the history of oncology, as is that of the late Nobel Laureate E. Donnall Thomas, MD, the pioneering clinical researcher whose name is synonymous with life-saving marrow transplantation. Dr. Thomas, who was born in the...
Pediatric patients with acute lymphoblastic leukemia (ALL) living in extreme poverty and undergoing maintenance therapy may have almost a twofold greater risk of relapse compared with pediatric patients who weren’t living in extreme poverty, according to a new study published by Wadhwa et al in...