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Leukemia
Genomics/Genetics

FDA Approves Quizartinib for Newly Diagnosed FLT3-ITD–Positive Acute Myeloid Leukemia

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...

Leukemia

Incorporation of Gilteritinib Into Induction and Consolidation Chemotherapy and as Maintenance Therapy in Newly Diagnosed Patients With AML

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...

Leukemia

WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

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...

Leukemia
Issues in Oncology

Study Examines Impact of Modified Treatment Protocols on Survival in Pediatric Patients With ALL

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...

leukemia
hematologic malignancies

Jennifer R. Brown, MD, PhD, on CLL: Resistance to Pirtobrutinib in Pretreated Disease

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.

Leukemia
Lymphoma

Pirtobrutinib After Covalent BTK Inhibitor Treatment in Relapsed or Refractory CLL/SLL

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...

Leukemia
Issues in Oncology

Overweight and Obese BMI May Be Linked to Adverse Treatment Outcomes in AYA Patients With ALL

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...

Leukemia

Health Systems Strengthening Approach in the United States–Mexico Border Region Improved 5-Year Survival for Children With ALL

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 ...

Leukemia

Comparison of Conditioning Treatments in Patients With AML Undergoing HLA-Haploidentical Hematopoietic Stem Cell Transplant

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 ...

Leukemia

Outcomes With an Anthracycline-Free Treatment Protocol in Favorable-Risk Childhood ALL

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 ...

Leukemia

FDA Grants Full Approval to Blinatumomab for MRD-Positive B-Cell Precursor 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...

Leukemia

Ibrutinib/Venetoclax vs Chlorambucil/Obinutuzumab in Previously Untreated Patients With CLL: Association of MRD With Progression-Free Survival

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...

Leukemia

Addition of Blinatumomab to Standard Chemotherapy in B-Cell ALL in Low-Risk First Relapse

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...

Survivorship
Leukemia
Lymphoma
CNS Cancers

Late-Onset Memory Impairment in Adult Survivors of Childhood Cancer

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...

Leukemia
Genomics/Genetics

Exposure to Ultraviolet Radiation May Propel Transformation of BPDCN Cells to Leukemia in the Skin

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...

Hematologic Malignancies
Leukemia

Fecal Microbiota Transplantation: Its Role for Patients Undergoing Allogeneic HCT and Receiving Induction Therapy for AML

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...

leukemia
covid-19

Jennifer A. Woyach, MD, on New Findings on CLL, COVID-19, and Treatment With Obinutuzumab Plus Venetoclax

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).

leukemia

Sarah K. Tasian, MD, on Hematologic Malignancies in Children: Expert Commentary

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).

global cancer care
leukemia

Paula Aristizabal, MD, MAS, on Surviving Childhood Leukemia Near the Border of the United States and Mexico

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).

leukemia

Claire Roddie, PhD, MBChB, on B-ALL: Safety and Efficacy Data of Obecabtagene Autoleucel

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).

leukemia

Eunice S. Wang, MD, and Gregory Roloff, MD, on B-ALL: Outcomes With Brexucabtagene Autoleucel in Adult Patients

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).

leukemia

LaQuisa C. Hill, MD, on Relapsed or Refractory T-ALL: New Data on CD5 CAR T Cells

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).

Leukemia

Inspired by an Uncle Who Was a Compassionate Family Doctor, This Nonagenarian Continues a Renowned Career in Hematology

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...

Leukemia
Global Cancer Care

Using a Health Systems Strengthening Approach in the United States–Mexico Border Region Improved Survival Rates for Children With ALL

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...

Leukemia
Lymphoma

WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

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...

Leukemia

Augmented Early Intensification and Higher Consolidation Methotrexate Dosing Show No Benefit in Childhood ALL

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...

Leukemia
Immunotherapy

First-Line Venetoclax Combinations vs Chemoimmunotherapy in Fit Patients With CLL

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 ...

Leukemia

Ibrutinib and Rituximab vs Fludarabine, Cyclophosphamide, and Rituximab in Previously Untreated Patients With CLL

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...

Leukemia

Induction Failure in Pediatric and Young Adult Patients With T-Cell ALL

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...

Leukemia
Genomics/Genetics

Addition of Blinatumomab to Chemotherapy in Infant Patients With KMT2A-Rearranged ALL

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...

Leukemia

Addition of Quizartinib to Chemotherapy in Newly Diagnosed FLT3-ITD–Positive Acute Myeloid Leukemia

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...

Leukemia

Homage to a Giant in Hematology: The Fascinating Story of the Quest to Cure Leukemia

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...

Leukemia
Issues in Oncology

Extreme Poverty May Be a Key Driver for Relapse in Pediatric Patients With ALL

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...

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...

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