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Leukemia

MRD and KMT2A Fusion Partners in Predicting Outcomes of Childhood KMT2A-Rearranged Acute Myeloid Leukemia

In a retrospective study reported in the Journal of Clinical Oncology, van Weelderen et al, of the International Berlin-Frankfurt-Münster Study Group (I-BFM-SG), found that KMT2A fusion partners and measurable residual disease (MRD) at end of induction phase 2 were independent predictors of...

Leukemia
Genomics/Genetics

Combination Therapy May Help Patients With KMT2A-Mutated ALL or AML Overcome BET Inhibitor Resistance

Researchers have developed a novel combination therapy approach to help patients with KMT2A-mutated acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML) overcome resistance to bromodomain and extraterminal domain (BET) inhibitors without adding toxicity, according to a novel study...

Leukemia

Azacitidine in Combination With Trametinib May Be Effective for Pediatric Patients With JMML

Researchers have found that the hypomethylating agent azacitidine plus the MEK inhibitor trametinib may be a promising new combination to treat patients with juvenile myelomonocytic leukemia (JMML), according to a preclinical study published by Pasupuleti et al in Molecular Therapy. Background JMML ...

hematologic malignancies
leukemia

Deborah M. Stephens, DO, on CLL/SLL: NCCN Clinical Practice Guidelines in Oncology® Update

Deborah M. Stephens, DO, of the Huntsman Cancer Institute at the University of Utah, discusses NCCN’s updates to treatment recommendations for patients with chronic lymphocytic leukemia/small lymphocytic lymphoma. Dr. Stephens details the key factors in selecting front-line and subsequent therapies, including IGHV status, del(17p)/TP53 mutation status, age, comorbidities, and resistance mutations.

Leukemia

Menin Inhibitors Under Study in KMT2A-Rearranged or NPM1-Mutant Acute Myeloid Leukemia

Menin inhibitors are making inroads in the treatment of acute myeloid leukemia (AML). These drugs selectively target KMT2A-rearranged or NPM1-mutant AML, and early studies suggest they will be a welcome addition for patients with these aberrations. KMT2A rearrangements occur in about 5% of patients ...

Leukemia
Genomics/Genetics

Study Reveals Potential Cause of Resistance to Revumenib in Patients With Acute Myeloid Leukemia

Use of the novel menin inhibitor revumenib has led to remissions in patients with acute myeloid leukemia (AML), and associated findings have suggested the mechanisms through which cancer cells may become resistant to such treatment, according to two studies published by Issa et al and Perner et al, ...

Leukemia
Hematologic Malignancies

Vitamin A and Risk for Pancreatitis During Chemotherapy for ALL

Consuming a diet rich in vitamin A or its analogs may help prevent pediatric and young adult patients with acute lymphoblastic leukemia (ALL) reduce their risk of developing pancreatitis during chemotherapy, according to a recent study by Tsai et al in Science Translational Medicine. Background For ...

Leukemia

Expert Point of View: Anjali S. Advani, MD

Discussant of the February ASCO Plenary session, Anjali S. Advani, MD, Staff Physician in the Department of Hematologic Oncology and Blood Disorders and Director of the Inpatient Leukemia Program, Taussig Cancer Institute, Cleveland Clinic, noted that the PhALLCON study is the only prospective...

Leukemia

PhALLCON Study: Ponatinib Superior to Imatinib in Combination With Chemotherapy in Newly Diagnosed, Ph-Positive ALL

Ponatinib appears to be a more effective tyrosine kinase inhibitor than imatinib in newly diagnosed, Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL) when combined with reduced-intensity chemotherapy, according to data presented during the ASCO Plenary Series: February 2023...

Leukemia

Blood Test May Identify Patients With AML at Greater Risk of Relapse After Bone Marrow Transplant

Researchers have found that screening for residual disease prior to a bone marrow transplant may help physicians identify which adult patients in remission from acute myeloid leukemia (AML) are at risk of relapsing after the procedure, according to a novel study published by Dillon et al in JAMA....

Myelodysplastic Syndromes
Leukemia

Vitamin B5 May Help Improve Red Blood Cell Production in Patients With Myelodysplastic Syndromes

Researchers have discovered that vitamin B5 in combination with existing drugs may be the key to improving outcomes in patients with myelodysplastic syndromes (MDS) and ineffective red blood cell production, according to a novel study published by Mian et al in Science Translational Medicine....

Leukemia

Can Long Noncoding RNA Expression Help Predict Outcomes in Pediatric Patients With AML?

In a study reported in the Journal of Clinical Oncology, Farrar et al developed a long noncoding RNA (lncRNA) transcription scoring system that distinguished survival outcomes in pediatric patients with acute myeloid leukemia (AML). As stated by the investigators, “Risk classification in pediatric...

Leukemia
Lymphoma

Zanubrutinib for Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

On January 19, 2023, the kinase inhibitor zanubrutinib was approved for treatment of chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).1 Supporting Efficacy Data Approval was based on findings in the SEQUOIA trial (ClinicalTrials.gov identifier NCT03336333) in patients with...

Leukemia

Pediatric Patients With ALL Living Along the Texas-Mexico Border May Experience Lower Rates of Survival

Investigators have found that pediatric patients with acute lymphoblastic leukemia (ALL) who lived along the Texas-Mexico border were more likely to die within 5 years than those living in other areas of the state, according to a new study published by Castellanos et al in Cancer. Background...

Leukemia

Allogeneic HCT vs Consolidation Chemotherapy in Patients Aged 60 Years or Younger With Intermediate-Risk AML

In a German phase III trial reported in JAMA Oncology, Bornhäuser et al found that allogeneic hematopoietic cell transplantation (HCT) was not associated with improved overall survival vs standard consolidation chemotherapy in patients aged ≤ 60 years with cytogenetically defined intermediate-risk...

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

Ponatinib and Blinatumomab Combination Safe and Effective in Patients With Newly Diagnosed, Ph-Positive ALL

The combination of ponatinib and blinatumomab has led to rapid and durable remissions in patients with newly diagnosed Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL), according to data presented at the 2022 American Society of Hematology (ASH) Annual Meeting and...

Leukemia

Addition of Venetoclax to Intensive Chemotherapy Yields Durable Responses in Younger Patients With High-Risk AML

Longer follow-up of a phase II study of venetoclax combined with cladribine, idarubicin, and cytarabine (CLIA) as a front-line induction regimen for younger patients with high-risk acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) shows a pattern of durable efficacy consistent with...

Leukemia
Lymphoma

Expert Point of View: Alexey Danilov, MD, PhD

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...

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

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

Studies Explore Novel Triplet Combinations in AML

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

Ponatinib May Be More Effective Than Imatinib for Newly Diagnosed Patients With Ph-Positive ALL

In newly diagnosed patients with Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL), ponatinib was more effective than imatinib when given with reduced-intensity chemotherapy. These results were presented by Jabbour et al during the February ASCO Plenary Series session...

Leukemia

Influence of the ‘Mark Cuban Effect’ on Cancer Drug Prices in the United States: Focus on CML

The advent of the BCR::ABL1 tyrosine kinase inhibitors for the treatment of Philadelphia chromosome (Ph)-positive chronic myeloid leukemia (CML) was a therapeutic miracle that changed the management paradigm of CML. The first of them, imatinib, was developed in the late 1990s.1,2 Within a few...

Issues in Oncology
Lymphoma
Leukemia
Cardio-oncology

Findings on Cardiovascular Imaging in Patients Receiving Ibrutinib: Association With Cardiotoxicity

In a study reported in JAMA Oncology, Buck et al found that myocardial injury detected on cardiovascular magnetic resonance imaging (CMR) was common in patients treated with ibrutinib and was associated with an increased risk of major adverse cardiac events. Study Details The study included data...

Leukemia

Ponatinib and Blinatumomab Combination Safe and Effective in Patients With Newly Diagnosed, Ph-Positive ALL

The combination of ponatinib and blinatumomab has led to rapid and durable remissions in patients with newly diagnosed Philadelphia chromosome (Ph)-positive acute lymphoblastic leukemia (ALL), according to data presented at the 2022 American Society of Hematology (ASH) Annual Meeting and...

Survivorship
Leukemia
Lymphoma
Sarcoma

Dexrazoxane and Long-Term Heart Function in Survivors of Childhood Cancer Treated With Doxorubicin

In a study reported in the Journal of Clinical Oncology, Eric J. Chow, MD, MPH, and colleagues found that the use of dexrazoxane was associated with long-term protection of heart function in childhood cancer survivors who received doxorubicin for their cancer. According to the study investigators,...

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 AML

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...

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