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Leukemia

Minimal Residual Disease in AML: Worth Looking?

As summarized in this issue of The ASCO Post, Ivey and colleagues demonstrated that assessing for NPM1-mutated gene transcripts by reverse-transcriptase quantitative polymerase chain reaction assay is a feasible approach for measuring minimal residual disease after acute myeloid leukemia (AML)...

Leukemia

Minimal Residual Disease Identified by NPM1 Mutation Is a Powerful Marker for Poorer Outcome in Standard-Risk AML

In a study reported in The New England Journal of Medicine, Adam Ivey, MSc, from Guy’s Hospital, London, and colleagues found that a leukemia-specific marker consisting of mutation in the gene encoding nucleophosmin (NPM1) can be used to identify minimal residual disease in peripheral blood in...

Leukemia

Two Types of Asparaginase Compared in Newly Diagnosed Childhood Acute Lymphoblastic Leukemia

Intravenous pegylated (PEG) Escherichia coli (E coli) asparaginase was associated with similar toxicity and efficacy compared with intramuscular native E coli L-asparaginase in children with newly diagnosed acute lymphoblastic leukemia, according to the results of a phase III trial (DFCI 05-001).1 ...

Leukemia

Chronic Lymphocytic Leukemia: The Golden Drug Only for Golden Agers?

As reviewed in this issue of The ASCO Post, Burger and colleagues recently reported findings of the RESONATE-2 trial of ibrutinib (Imbruvica) vs chlorambucil (Leukeran) as initial therapy for elderly patients with chronic lymphocytic leukemia (CLL).1 The study met its primary endpoint of...

Leukemia
Lymphoma

First-Line Ibrutinib Improves Progression-Free and Overall Survival vs Chlorambucil in Older Patients With Chronic Lymphocytic Leukemia

As reported in The New England Journal of Medicine and at the 2015 American Society of Hematology Annual Meeting, Jan A. Burger, MD, PhD, and colleagues found that first-line treatment with the oral Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) improved progression-free and overall...

breast cancer
leukemia
lung cancer

Specific Form of CYP3A7 Gene Associated With Poor Outcomes for Patients With Several Cancer Types

Among patients with breast cancer, lung cancer, or chronic lymphocytic leukemia (CLL), those who had a specific form of the CYP3A7 gene (CYP3A7*1C) had worse outcomes compared with those who did not have CYP3A7*1C. This may be related to how the patients metabolize the therapeutics used to treat...

Hematologic Malignancies
Leukemia

Increasing the Dose of Obinutuzumab Monotherapy Raised the Response Rate

A randomized phase II study in symptomatic, untreated patients with chronic lymphocytic leukemia (CLL) found an increased overall response rate with obinutuzumab (Gazyva) at a 2,000 mg vs 1,000 dose. In addition, the “data demonstrate that obinutuzumab produces a higher response rate in...

Leukemia

Adding Targeted Therapy to Chemoimmunotherapy in Patients With Chronic Lymphocytic Leukemia: Questions as to Optimal Strategy Remain

The HELIOS study is an international phase III trial of bendamustine (Treanda) plus rituximab (Rituxan) in combination with ibrutinib (Imbruvica) vs placebo in patients with previously treated chronic lymphocytic leukemia. As reported by Chanan-Khan in The Lancet Oncology1 and reviewed in this...

leukemia

Children With Leukemia From High-Poverty Areas More Likely to Suffer Early Relapse

Among children with acute lymphoblastic leukemia (ALL), the most common pediatric cancer, those who live in high-poverty areas are substantially more likely to suffer early relapse than other patients, despite having received the same treatment, according to new research from Dana-Farber/Boston...

leukemia

Minimal Residual Disease Identified by NPM1 Mutation May Be Prognostic Marker for Poorer Outcome in Standard-Risk AML

In a study reported in The New England Journal of Medicine, Ivey et al found that a leukemia-specific marker consisting of a mutation in the gene encoding nucleophosmin (NPM1) can be used to identify minimal residual disease in peripheral blood in standard-risk acute myeloid leukemia (AML), with...

Leukemia

Ofatumumab for Extended Treatment of Patients With Recurrent or Progressive Chronic Lymphocytic Leukemia

On January 19, 2016, ofatumumab (Arzerra) was approved for extended treatment of patients in complete or partial response after at least two lines of therapy for recurrent or progressive chronic lymphocytic leukemia (CLL).1,2 Ofatumumab was previously approved for treatment of untreated patients...

leukemia
issues in oncology

Inherited Genetic Variations That Lead to Severe Drug Toxicity in Pediatric Leukemia Discovered

An international research team has determined how inherited gene variations lead to severe drug toxicity that may threaten chances for a cure in children with leukemia. St. Jude Children’s Research Hospital scientists led the study, results of which set the stage to expand the use of a...

leukemia
lymphoma

Younger T Cells May Improve Immunotherapy for Pediatric Cancer

Pediatric oncologists from The Children’s Hospital of Philadelphia (CHOP) have investigated techniques to improve and broaden a novel personalized cell therapy to treat children with cancer. The researchers say that a patient’s outcome may be improved if clinicians select specific...

leukemia
lymphoma
survivorship

Reduction in Late Mortality in Childhood Cancer Survivors in the Childhood Cancer Survivor Study Cohort

In a study reported in The New England Journal of Medicine, Armstrong et al found that late mortality decreased over time among 5-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort. The reduction is consistent with efforts during recent decades to modify treatment with ...

Leukemia

FDA Approves Ofatumumab for Patients With Chronic Lymphocytic Leukemia in Complete or Partial Response

The U.S. Food and Drug Administration (FDA) has approved ofatumumab (Arzerra), a CD20-directed cytolytic monoclonal antibody, for extended treatment of patients who are in complete or partial response after at least two lines of therapy for recurrent or progressive chronic lymphocytic leukemia...

leukemia
issues in oncology

New Assay Detects Persistent Disease in Leukemia Patients Thought to Be in Remission

The outcomes of chronic myeloid leukemia (CML) have dramatically improved as the result of tyrosine kinase inhibitor treatment. Use of a tyrosine kinase inhibitor regimen can lower the blood CML biomarker to levels imperceptible by current detection methods. For patients in “molecular...

leukemia

Bone Loss Associated With Leukemia Therapy Occurs Sooner Than Previously Thought

Investigators at Children’s Hospital Los Angeles (CHLA) have found that significant bone loss occurs during the first month of chemotherapy for acute lymphoblastic leukemia (ALL), which is far earlier than previously assumed. Results of the study were published by Orgel et al in the...

breast cancer
hematologic malignancies
leukemia
sarcoma

Increased Breast Cancer Risk Reported in Childhood Sarcoma and Leukemia Survivors With No History of Chest Radiotherapy

In an analysis of the Childhood Cancer Survivor Study reported in the Journal of Clinical Oncology, Henderson et al found that childhood survivors of sarcoma and leukemia with no history of chest radiotherapy were at an increased risk of breast cancer. Increased Risk The study included data from...

leukemia
lymphoma

Matthew Lunning, DO, on Ublituximab Plus TGR-1202 in Lymphoma

Matthew Lunning, DO, of the University of Nebraska Medical Center, on abstract 801, “Ublituximab, a Novel Glycoengineered Anti-CD20 Monoclonal Antibody, in Combination with TGR-1202, a Next-Generation Once Daily PI3kδ Inhibitor, Demonstrates Activity in Heavily Pretreated and High-Risk Chronic Lymphocytic Leukemia and B-Cell Lymphoma.”

leukemia
lymphoma

Julie M. Vose, MD, MBA, FASCO, on Ublituximab Plus TGR-1202 in Lymphoma

Julie M. Vose, MD, MBA, FASCO, of the University of Nebraska Medical Center, offers her thoughts on abstract 801, “Ublituximab, a Novel Glycoengineered Anti-CD20 Monoclonal Antibody, in Combination With TGR-1202, a Next-Generation Once-Daily PI3kδ Inhibitor, Demonstrates Activity in Heavily Pretreated and High-Risk Chronic Lymphocytic Leukemia and B-Cell Lymphoma,” presented by Matthew A. Lunning, DO.

leukemia

Hagop Kantarjian, MD, on CAR T Cells in Relapsed/Refractory ALL

Hagop Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, offers his thoughts on abstract 380, “T Cells Engineered with a Chimeric Antigen Receptor (CAR)-Targeting CD19 (CTL019) Have Long Term Persistence and Induce Durable Remissions in Children With Relapsed, Refractory ALL,” presented by Stephan A. Grupp, MD, PhD; abstract 381, “Intent-to-Treat Results of a Phase I Trial of CD19 Chimeric Antigen Receptor Engineered T Cells Using a Consistent Treatment Regimen Reveals a 67% Complete Response Rate in Relapsed, Refractory Acute Lymphoblastic Leukemia,” presented by Daniel W. Lee III, MD; and abstract 382, “CD19-Targeted 19-28z CAR Modified Autologous T Cells Induce High Rates of Complete Remission and Durable Responses in Adult Patients With Relapsed, Refractory B-Cell ALL,” presented by Jae H. Park, MD.

leukemia

Hagop Kantarjian, MD, on Inotuzumab Ozogamicin Plus Low-Intensity Chemotherapy in ALL

Hagop Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, offers his thoughts on abstract 794, “Inotuzumab Ozogamicin in Combination With Low-Intensity Chemotherapy (Mini-Hyper-CVD) as Front-Line Therapy for Older Patients (≥ 60 years) With Acute Lymphoblastic Leukemia,” presented by Elias Jabbour, MD.

myelodysplastic syndromes
leukemia

Alan F. List, MD, on Sotatercept in Lower-Risk Myelodysplastic Syndromes

Alan F. List, MD, of Moffitt Cancer Center, offers his thoughts on abstract 3251, “An Open-Label, Phase II, Dose-Finding Study of Sotatercept (ACE-011) in Patients With Low or Intermediate-1–Risk Myelodysplastic Syndromes or Nonproliferative Chronic Myelomonocytic Leukemia and Anemia Requiring Transfusion,” presented by Rami S. Komrokji, MD.

leukemia

Hagop Kantarjian, MD, on Blinatumomab in Precursor B-Cell ALL

Hagop Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, offers his thoughts on abstract 379, “BLAST: A Confirmatory, Single-Arm, Phase II Study of Blinatumomab, a Bispecific T-Cell Engager (BiTE) Antibody Construct, in Patients With Minimal Residual Disease B-Precursor Acute Lymphoblastic Leukemia,” and abstract 3704, “An Evaluation of Molecular Response in a Phase II Open-Label, Multicenter Confirmatory Study in Patients With Relapsed/Refractory B-Precursor Acute Lymphoblastic Leukemia Receiving Treatment With the BiTE Antibody Construct Blinatumomab,” presented by Nicola Gökbuget, MD.

leukemia

Hagop Kantarjian, MD, on Treating Philadelphia Chromosome–Positive ALL

Hagop Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, offers his thoughts on abstract 797, “First Results of the Multicenter Total Therapy Gimema LAL 1509 Protocol for De Novo Adult Philadelphia Chromosome–Positive Acute Lymphoblastic Leukemia Patients,” presented by Sabina Chiaretti, MD, PhD, and abstract 798, “Nilotinib and Chemotherapy for First-Line Treatment in Elderly Patients with De Novo Philadelphia Chromosome/BCR-ABL1–Positive Acute Lymphoblastic Leukemia (ALL): A Trial of the European Working Group for Adult ALL (EWALL-PH-02),” presented by Oliver G. Ottman, MD.

leukemia

Linda J. Burns, MD, on CAR T-Cell Therapy in ALL

2014 ASH President Linda J. Burns, MD, of the University of Minnesota, offers her thoughts on abstract 380, “T Cells Engineered With a Chimeric Antigen Receptor (CAR) Targeting CD19 (CTL019) Have Long-Term Persistence and Induce Durable Remissions in Children with Relapsed, Refractory ALL,” presented by Stephan A. Grupp, MD, PhD. Time: 1:26

leukemia

Linda J. Burns, MD, on the BLAST Study

2014 ASH President Linda J. Burns, MD, of the University of Minnesota, offers her thoughts on abstract 379, “BLAST: A Confirmatory, Single-Arm, Phase II Study of Blinatumomab, a Bispecific T-Cell Engager (BiTE) Antibody Construct, in Patients with Minimal Residual Disease B-Precursor Acute Lymphoblastic Leukemia (ALL),” presented by Nicola Gökbuget, MD. Time: 1:11

leukemia

Richard M. Stone, MD, on the UK NCRI AML17 Trial

Richard M. Stone, MD, of Dana-Farber Cancer Institute, offers his thoughts on abstract 7, “A Randomized Comparison of Daunorubicin 90 mg/m2 vs 60 mg/m2 in AML Induction: Results From the UK NCRI AML17 Trial in 1206 Patients,” presented by Alan K. Burnett, MD. Time: 1:29

leukemia

Richard M. Stone, MD, on the SAL-SORAML Trial

Richard M. Stone, MD, of Dana-Farber Cancer Institute, offers his thoughts on abstract 6,  "Sorafenib vs Placebo in Addition to Standard Therapy in Younger Patients With Newly Diagnosed Acute Myeloid Leukemia: Results from 267 Patients Treated in the Randomized Placebo-Controlled SAL-Soraml Trial," presented by Christoph Röllig, MD.

leukemia
myelodysplastic syndromes

James O. Armitage, MD, FACP, FRCP, and Richard M. Stone, MD, on Clinical Trial Results for AML, MDS, and CMML Treatment

James O. Armitage, MD, FACP, FRCP, of the University of Nebraska Medical Center, and Richard M. Stone, MD of the Dana-Farber Cancer Institute, discuss three clinical trials: different doses of daunorubicin for AML; comparing azacitidine plus lenolidomide to vorinostat vs azacitidine monotherapy in MDS and CMML; and sorafenib vs placebo in addition to standard treatment for AML.

leukemia

James O. Armitage, MD, FACP, FRCP, and Richard M. Stone, MD, on Progress Made Against AML and APL

James. O Armitage, MD, FACP, FRCP, of the University of Nebraska Medical Center, and Richard M. Stone, MD, of the Dana-Farber Cancer Institute, discuss advances in treating acute myeloid leukemia and the acute promyelocytic leukema subtype.

leukemia

James O. Armitage, MD, FACP, FRCP, and Hagop M. Kantarjian, MD, on Advances in the Treatment of ALL

James O. Armitage, MD, FACP, FRCP, of the University of Nebraska Medical Center, and Hagop M. Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, discuss the diagnosis and genetics of ALL, differences in treating younger and older patients, and the latest data on the use of tyrosine kinase inhibitors, monoclonal antibodies, and CAR T cells.

leukemia

William G. Wierda, MD, PhD, on Updates to the Management of CLL

William G. Wierda, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses the latest information on managing CLL and his optimism that a cure is in sight.

leukemia

Jerald P. Radich, MD, on Treatment Milestones in CML: Stay the Course or Change Therapy?

Jerald P. Radich, MD, of the Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance discusses the evolution in treating and monitoring CML and whether monitoring at 3 and 6 months will ultimately prove useful.

leukemia
lymphoma

Asher Alban Chanan-Khan, MD, and James O. Armitage, MD, on Ibrutinib, Bendamustine, and Rituximab in Previously Treated CLL/SLL

James O. Armitage, MD, of the University of Nebraska Medical Center, and Asher Alban Akmal Chanan-Khan, MD, of the Mayo Clinic Cancer Center, discuss an important treatment option that significantly improved overall response rate and reduced risk of progression or death by 80% (Abstract LBA7005).

leukemia
lymphoma

Asher Chanan-Khan, MD, Summarizes Ibrutinib, Bendamustine, and Rituximab in Previously Treated CLL/SLL

Asher Alban Chanan-Khan, MD, of the Mayo Clinic Cancer Center, discusses an important treatment option that significantly improved overall response rate and reduced risk of progression or death by 80% (Abstract LBA7005).

leukemia
lymphoma

Michael Pfreundschuh, MD, on Treating Lymphoid Malignancies in Children and Adults With the Same Protocols

Michael Pfreundschuh, MD, of Universitaetsklinikum des Saarlandes, summarizes a session he chaired on this topic, which covered Burkitt’s lymphoma as well as lymphoblastic leukemia in children and adults.

Myelodysplastic Syndromes
Leukemia
Hematologic Malignancies

Myeloablative Conditioning for Stem Cell Transplantation Remains Standard of Care in Patients With MDS and AML

A randomized trial from the Bone and Marrow Transplant Clinical Trials Network was halted early after concluding that allogeneic stem cell transplantation after a reduced-intensity conditioning regimen resulted in higher relapse rates compared to myeloablative conditioning. The phase III randomized ...

Leukemia

Self-Reports Overestimate Mercaptopurine Intake in Childhood Acute Lymphoblastic Leukemia

Mercaptopurine is critical for maintaining remission in childhood acute lymphoblastic leukemia (ALL). However, a study has shown that overreporting of intake is common, and self-reports of intake are not as reliable as electronic reporting.1 About 86% of parents and children overreported the number ...

Leukemia

Venetoclax May Prove to Be Strong Weapon Against Poor-Prognosis Chronic Lymphocytic Leukemia

Venetoclax, the latest entry into the field of treatment of chronic lymphocytic leukemia (CLL), is a powerful investigational therapy that promises to fill an important niche: treatment of high-risk relapsed/refractory patients with deletions of 17p. Nearly 80% of patients with relapsed/refractory...

Leukemia

Severe Toxicities Seen in Younger Patients Receiving  Front-Line Idelalisib for Chronic Lymphocytic Leukemia

Hematologists and patients with chronic lymphocytic leukemia (CLL) are excited about new drugs that have dramatically improved outcomes. But all drugs have side effects, and it is important to be aware of potential consequences. Hepatotoxicity turns out to be a major concern in younger CLL patients ...

Leukemia
Issues in Oncology

Idelalisib Improves Progression-Free Survival Over Bendamustine Plus Rituximab in Chronic Lymphocytic Leukemia

Idelalisib (Zydelig) combined with bendamustine (Bendeka, Treanda) plus rituximab (Rituxan) was superior to chemotherapy with bendamustine/rituximab plus placebo, reducing the risk of progressive disease and death while improving progression-free survival and overall survival in patients with...

Leukemia

Rituximab Adds Benefit to Chemotherapy in Adult B-Cell Precursor ALL

The addition of rituximab (Rituxan) to the pediatric-inspired chemotherapy protocol for B-cell precursor acute lymphoblastic leukemia (ALL) significantly improved event-free survival in a large European study presented at the 2015 ASH Annual Meeting.1 The GRAALL-R 2005 phase III study is the first...

leukemia

FDA Approves Ofatumumab for Patients With Chronic Lymphocytic Leukemia in Complete or Partial Response

The U.S. Food and Drug Administration today approved ofatumumab (Arzerra) for extended treatment of patients who are in complete or partial response after at least two lines of therapy for recurrent or progressive chronic lymphocytic leukemia (CLL). Ofatumumab was previously approved for the...

leukemia

Increased Response Rate With Higher Dose of Obinutuzumab Monotherapy for Patients With Chronic Lymphocytic Leukemia

A randomized phase II study in symptomatic, untreated patients with chronic lymphocytic leukemia (CLL) found an increased overall response rate with obinutuzumab (Gazyva) at a dose of 2,000 mg vs 1,000. In addition, the “data demonstrate that obinutuzumab produces a higher response rate in...

hematologic malignancies
leukemia

Use of Antilymphocyte Globulin Appears to Reduce Chronic Graft-vs-Host Disease After Allogeneic Stem Cell Transplantation in Acute Leukemia

In a European phase III study reported in The New England Journal of Medicine, Kröger et al found that inclusion of antihuman T-lymphocyte immune globulin (ATG) in the myeloablative conditioning regimen in patients with acute myeloid or lymphoid leukemia resulted in a significant reduction in...

Leukemia

Plenary Report: High-dose Methotrexate Improves Outcome for High-risk Acute Lymphoblastic Leukemia in Younger Patients

High-dose methotrexate achieved superior event-free survival rates compared with standard Capizzi (escalating) methotrexate treatment in children and young adults with high-risk acute lymphoblastic leukemia (ALL), according to a practice-changing study reported during the Plenary Session of the...

Leukemia

Conventional Induction Chemotherapy Beneficial in Only a Subset of Older Adults with AML

Over the past several decades, progress in the treatment of acute myeloid leukemia (AML) in the older population (generally considered to be older than 60 years) has been limited (Fig. 1). In particular, the outcome of patients over age 70 has been poor, with few long-term survivors. Although AML...

Leukemia

Despite Advances, Little Overall Improvement Seen in Treatment of Older Adults with AML

The outcome of treatment of older adults with acute myeloid leukemia (AML) remains unsatisfactory, although certainly not a totally futile exercise. Patients satisfying the entry criteria for cooperative group clinical trials can be expected to have complete remission rates of 50% to 55%, with...

Leukemia

Point of View: Should Patients Over 70 Receive Aggressive Therapy for Acute Myeloid Leukemia?

Despite Advances, Little Overall Improvement Seen in Treatment of Older Adults with AMLBy Charles A. Schiffer, MD The outcome of treatment of older adults with acute myeloid leukemia (AML) remains unsatisfactory, although certainly not a totally futile exercise. Patients satisfying the entry...

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