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Leukemia

Fixed-Duration Venetoclax Plus Ibrutinib Achieves Deep and Durable MRD Remissions in CLL

Two different trials presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition found that fixed-duration treatment with ibrutinib and venetoclax achieved deep and sustained undetectable measurable residual disease (MRD) status when used as first-line therapy for...

Leukemia

Improved Outcomes With Time-Limited Venetoclax Combinations vs Chemoimmunotherapy in Fit Patients with CLL

Administering time-limited regimens that were combinations of venetoclax plus obinutuzumab or venetoclax plus obinutuzumab and ibrutinib was superior to chemoimmunotherapy in achieving undetectable measurable residual disease in the peripheral blood at month 15 in fit patients with chronic...

Leukemia

Report Documents Third Known Case of HIV Remission Involving Stem Cell Transplant

A woman with human immunodeficiency virus (HIV) who received a cord blood stem cell transplant to treat acute myeloid leukemia has had no detectable levels of HIV for 14 months, despite cessation of antiretroviral therapy, according to research presented at the Conference on Retroviruses and...

Leukemia
Cardio-oncology

After Two Cancer Diagnoses, I’m Grateful for Another Day

The start of January 2014 was filled with excitement. I was undergoing fertility treatments to have a second child and was living my professional dream. I was a network news anchor and medical news reporter for a national broadcast network. Although I was exhausted from my grueling early morning...

Leukemia

Expert Point of View: Joshua Brody, MD

Joshua Brody, MD, Director of the CLL/Lymphoma Immunotherapy Program, Icahn School of Medicine at Mount Sinai, New York, who was not involved in these trials, commented: “CLL is an extremely prevalent disease affecting nearly 200,000 patients in the United States. Most patient do not require...

Leukemia

Fixed-Duration Venetoclax Plus Ibrutinib Achieves Deep and Durable MRD Remissions in CLL

Two different trials presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition found that fixed-duration treatment with ibrutinib and venetoclax achieved deep and sustained undetectable measurable residual disease (MRD) status when used as first-line therapy for...

Leukemia

Expert Point of View: Hanno R. Hock, MD, PhD

In an interview with The ASCO Post, Hanno R. Hock, MD, PhD, Assistant Professor of Medicine at Harvard Medical School and Massachusetts General Hospital, highlighted the study’s “very nice response rate” and “encouraging data” while also noting that a pediatric-based treatment regimen in fit adults ...

Leukemia

Study Finds Pediatric-Based Treatment Regimen Feasible and Effective in Older Adults With ALL

A pediatric-based protocol has delivered promising preliminary results in adults with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL), according to data presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Findings from the large,...

Leukemia
Genomics/Genetics

Use of Polygenic Cytarabine Response Score to Identify Candidates With Pediatric AML for Chemotherapy Augmentation

In a study reported in the Journal of Clinical Oncology, Elsayed et al developed a risk score based on single nucleotide polymorphisms (SNPs) associated with cytarabine pharmacodynamics or clinical outcomes that identified pediatric patients with acute myeloid leukemia (AML) who could benefit from...

Leukemia
Genomics/Genetics

New Study Examines Role of Genetic Ancestry in Pediatric Leukemia

Scientists at St. Jude Children’s Research Hospital are studying the impact of genetic ancestry on childhood acute lymphoblastic leukemia (ALL). The scientists assembled an international cohort to determine how genetic ancestry affects leukemia biology and outcomes for modern therapy; they found...

leukemia

Matthew S. Davids, MD, on Younger Patients With CLL: Ibrutinib Plus Fludarabine, Cyclophosphamide, and Rituximab as Initial Therapy

Matthew S. Davids, MD, of Dana-Farber Cancer Institute, discusses phase II results from a multicenter study that showed the efficacy of ibrutinib plus fludarabine, cyclophosphamide, and rituximab in younger, fit patients with chronic lymphocytic leukemia who desire the possibility of a functional cure with time-limited therapy (Abstract 640).

Leukemia
Lymphoma
Immunotherapy

Rituximab Plus Chemotherapy for Pediatric Mature B-Cell Non-Hodgkin Lymphoma and Mature B-Cell Acute Leukemia

On December 2, 2021, rituximab was approved for use in combination with chemotherapy for pediatric patients (≥ 6 months to 18 years) with previously untreated, advanced-stage, CD20-positive diffuse large B-cell lymphoma, Burkitt lymphoma, Burkitt-like lymphoma, or mature B-cell acute leukemia.1...

Leukemia

Inotuzumab Ozogamicin for Pediatric Patients With Relapsed or Refractory B-Cell ALL

In a phase II trial (Children’s Oncology Group AALL1621) reported in the Journal of Clinical Oncology, O’Brien et al found that inotuzumab ozogamicin produced a high response rate in children and adolescents with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL). Study Details In the ...

Leukemia

Study Finds Improved 2-Year Survival Rate for Adult Patients With Relapsed Philadelphia Chromosome–Positive ALL After Allogeneic Hematopoietic Cell Transplantation Over 20 Years

A retrospective, registry-based multicenter study by Bazarbachi et al published in Clinical Cancer Research evaluated clinical outcomes in patients with relapsed Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL) after allogeneic hematopoietic cell transplantation over a...

Leukemia

AGILE Study: Addition of Ivosidenib to Azacitidine Triples Median Overall Survival in Difficult-to-Treat AML Population

In patients with newly diagnosed acute myeloid leukemia (AML) with an IDH1 mutation who were ineligible for intensive chemotherapy, the addition of the IDH1 inhibitor ivosidenib to azacitidine significantly improved survival vs azacitidine alone, according to data presented at the 2021 American...

Leukemia

Incidence of Chronic Graft-vs-Host Disease: Effect of Depleting Naive T Cells From Peripheral Blood Stem Cell Allografts in Patients With Leukemia

Although allogeneic hematopoietic cell transplantation can result in a cure for patients with advanced hematologic malignancies, studies show chronic graft-vs-host disease occurs in 30% to 60% of patients receiving unmanipulated grafts, often requires prolonged immunosuppression, and may cause...

leukemia
genomics/genetics

Musa Yilmaz, MD, on FLT3-ITD–Mutated AML: Findings on Quizartinib With Decitabine and Venetoclax

Musa Yilmaz, MD, of The University of Texas MD Anderson Cancer Center, discusses study results suggesting that quizartinib with decitabine and venetoclax is active in patients with FLT3-ITD–mutated acute myeloid leukemia and that RAS/MAPK mutations continue to drive primary and secondary resistance (Abstract 370).

Leukemia
Immunotherapy

Pretreatment Disease Burden and Outcomes With Commercial Tisagenlecleucel in Pediatric/Young Adult B-Cell ALL

In an analysis from the Pediatric Real-World Chimeric Antigen Receptor Consortium reported in the Journal of Clinical Oncology, Schultz et al found that pretreatment high disease burden was associated with poorer outcomes in pediatric and young adult patients who received commercial...

Leukemia

Association of Response Rate and Event-Free Survival With Overall Survival in Newly Diagnosed AML: FDA Analysis

In a trial-level analysis of randomized studies submitted to the U.S. Food and Drug Administration (FDA) reported in the Journal of Clinical Oncology, Norsworthy et al found that complete remission rate was moderately correlated, and event-free survival was strongly correlated, with overall...

leukemia

Sangeetha Venugopal, MD, on Secondary AML: Impact of Front-Line Treatment Approach

Sangeetha Venugopal, MD, of The University of Texas MD Anderson Cancer Center, discusses a retrospective analysis of 562 patients with treated secondary acute myeloid leukemia and prior exposure to hypomethylating agents (HMAs). The results showed that an HMA plus venetoclax yielded significantly higher overall response rates and improved overall survival compared with intensive chemotherapy or low-intensity chemotherapy, particularly in patients 60 years or older who had a karyotype without adverse risk (Abstract 794).

leukemia

Andrew Matthews, MD, on AML: CPX-351 vs Venetoclax/Azacitidine for Initial Therapy

Andrew Matthews, MD, of the Abramson Cancer Center, University of Pennsylvania, discusses findings from a retrospective study at an academic institution, which showed there was no statistically significant difference in overall survival between induction with CPX-351 and venetoclax/azacitidine for adults with acute myeloid leukemia. Prospective studies to confirm similar effectiveness with careful attention to side effects, quality of life, and impact on transplant outcomes may help clinicians decide between these therapies (Abstract 795).  

Leukemia

Association of MRD Response and Prognosis in Patients With AML Treated With Venetoclax and Azacitidine

�In an analysis from the phase III VIALE-A study reported in the Journal of Clinical Oncology, Keith W. Pratz, MD, and colleagues found that among treatment-naive patients with acute myeloid leukemia (AML) who experienced complete remission after receiving treatment with venetoclax/azacitidine,...

Leukemia

Expert Point of View: Krish Patel, MD

Krish Patel, MD, Director of the Lymphoma Program at the Swedish Cancer Institute in Seattle and Interim Director of the Hematological Malignancies and Cellular Therapy Program, commented on the implications of Dr. Soumerai’s presentation. “We know that, in general, reaching [undetectable...

Leukemia

Measurable Residual Disease Kinetics: A Potential New Tool in CLL

Achieving undetectable measurable residual disease (MRD) is an important milestone in the treatment of patients with chronic lymphocytic leukemia (CLL) as well as those with other hematologic malignancies undergoing treatment. Now a small phase II study, presented at the 2021 American Society of...

leukemia
myelodysplastic syndromes

Alba Rodriguez-Meira, DPhil, on TP53-Mutated Leukemic Transformation in Myeloproliferative Neoplasms

Alba Rodriguez-Meira, DPhil, of the University of Oxford, discusses a comprehensive analysis of the genetic, cellular, and molecular landscape of TP53-mediated transformation, providing insights into the evolution of chronic hematologic malignancies toward an aggressive acute leukemia. Because TP53 is the most commonly mutated gene in human cancer, these findings may well be of broad relevance (Abstract 3).

Leukemia

Association of CD123 Expression With High-Risk Disease Characteristics and Outcomes in Pediatric AML

In an analysis from the Children’s Oncology Group AAML1031 trial reported in the Journal of Clinical Oncology, Lamble et al found that increased CD123 expression was associated with high-risk genetic alterations and poorer treatment outcomes in pediatric patients with newly diagnosed acute myeloid...

leukemia
genomics/genetics

Eunice S. Wang, MD, on FLT3-Mutated AML: Gilteritinib and Azacitidine for Intensive Induction Chemotherapy–Ineligible Patients

Eunice S. Wang, MD, of Roswell Park Comprehensive Cancer Center, discusses phase III results showing that gilteritinib and azacitidine led to significantly higher composite complete response rates in patients with newly diagnosed FLT3-mutant acute myeloid leukemia who are ineligible for intensive induction chemotherapy. Overall survival was similar to that of azacitidine alone (Abstract 700).  

leukemia

Carsten Utoft Niemann, MD, PhD, on CLL: Time-Limited Venetoclax and Ibrutinib for Patients With Relapsed or Refractory Disease

Carsten Utoft Niemann, MD, PhD, of Copenhagen University Hospital, discusses a primary analysis of the phase II Vision HO141 trial, which showed the feasibility of stopping and restarting ibrutinib and venetoclax in patients with relapsed or refractory chronic lymphocytic leukemia who have undetectable measurable residual disease. A favorable benefit-risk profile was demonstrated, with no new safety signals (Abstract 69).

leukemia

Masayuki Umeda, MD, on Pediatric AML: Identifying a Key Subtype-Defining Lesion

Masayuki Umeda, MD, of St. Jude Children's Research Hospital, discusses his research which showed that UBTF-TD (upstream binding transcription factor-tandem duplications) define a unique subtype of acute myeloid leukemia that previously lacked a clear oncogenic driver. UBTF-TD is associated with FLT3-ITD and WT1 mutations, adolescent age, and poor outcomes. These alterations are critical for future risk-stratification for this patient cohort.

Leukemia

Ibrutinib Plus Fludarabine, Cyclophosphamide, and Rituximab for Younger Patients With CLL

A study presented by Matthew S. Davids, MD, of Dana-Farber Cancer Institute, and colleagues at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 640) suggests that a 2.5-year regimen involving ibrutinib and chemoimmunotherapy may provide deep and lasting...

leukemia
genomics/genetics

Talha Badar, MD, on TP53-Mutated AML and the Impact of Allogeneic Stem Cell Transplantation on Survival

Talha Badar, MD, of the Mayo Clinic, discusses the near-universal poor outcomes for patients with TP53-mutated acute myeloid leukemia and the findings that show allogeneic stem cell transplantation appears to improve the long-term survival in a subset of these patients. Effective therapies may successfully bridge patients to transplant and prolong survival for those who are transplant-ineligible (Abstract 797).

Leukemia
Myelodysplastic Syndromes

Study Identifies Factors for Severe COVID-19 Illness Among Patients With Acute Leukemia or MDS

In separate analyses of 257 patients with acute leukemia or myelodysplastic syndrome (MDS) who developed COVID-19 and are part of the American Society of Hematology (ASH) RC COVID-19 Registry for Hematology, both neutropenia and having active MDS or leukemia (vs being in remission) were found to...

Leukemia
Palliative Care

Study Reveals Gaps in Code Status Discussions Among Patients With High-Risk AML

Oncologists and health-care professionals who treat patients with high-risk acute myeloid leukemia (AML) are missing important opportunities to have end-of-life discussions at earlier stages in the disease course, when patients are best able to discuss their options and preferences. These findings...

Leukemia
Genomics/Genetics

Ivosidenib/Azacitidine vs Azacitidine Alone in Patients With Newly Diagnosed IDH1-Mutated AML

In the phase III AGILE trial, the combination of ivosidenib and azacitidine was found to be superior in treating newly diagnosed patients with IDH1-mutated acute myeloid leukemia (AML) compared to azacitidine alone in terms of event-free survival, the study’s primary endpoint. The combination also...

Myelodysplastic Syndromes
Leukemia
COVID-19

Antibody Response to Second Dose of mRNA COVID-19 Vaccine in Patients With AML and MDS

In one of the largest studies to date of the antibody response to vaccination against COVID-19 in people who had been treated for acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), patients responded well to two doses of the Moderna mRNA vaccine and saw a pronounced increase in levels ...

leukemia

Paolo Ghia, MD, PhD, on CLL: New Data on Treatment With Ibrutinib Plus Venetoclax

Paolo Ghia, MD, PhD, of the Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, discusses disease-free survival results from the measurable residual disease cohort of the phase II CAPTIVATE trial. This multicenter trial focuses on first-line ibrutinib plus venetoclax in patients with chronic lymphocytic leukemia (Abstract 68).

Leukemia

Study Reveals Underrepresentation of AYA Hispanic Patients in a Large ALL Clinical Trial

A study of U.S. adolescent and young adult patients with acute lymphoblastic leukemia (ALL) found that Hispanic patients were significantly underrepresented in a large clinical trial compared with the general patient population. The study, presented by Muffly et al at the 2021 American Society of...

Leukemia

Outcomes Among Pediatric and Young Adult Patients With ALL Differ By Race, Ethnicity, and Socioeconomic Status

A study of nearly 25,000 patients with acute lymphoblastic leukemia (ALL) aged up to 30 years old revealed significant gaps in survival rates between White, Hispanic, and Black patients, as well as worse outcomes among those of lower socioeconomic status. Biologic or genetic factors accounted for...

Leukemia

Brexucabtagene Autoleucel for Relapsed or Refractory B-Cell Precursor ALL

On October 1, 2021, the CD19-directed chimeric antigen receptor (CAR) T-cell therapy brexucabtagene autoleucel was approved for adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).1 The product is available only through a restricted program under a Risk Evaluation ...

Leukemia

Asciminib for Philadelphia Chromosome–Positive Chronic Myeloid Leukemia

On October 29, 2021, the oral kinase inhibitor asciminib was granted accelerated approval for adults with Philadelphia chromosome–positive chronic myeloid leukemia (CML) in chronic phase previously treated with at least two tyrosine kinase inhibitors and regular approval for adults with...

Leukemia
Immunotherapy

Next-Generation Sequencing of Bone Marrow DNA to Predict Relapse Following CAR T-Cell Therapy in Patients With ALL

Next-generation sequencing of bone marrow samples from pediatric and young adult patients with acute lymphoblastic leukemia (ALL) treated with tisagenlecleucel was more accurate in predicting relapse than flow cytometry and monitoring of B-cell aplasia, according to the results from a study by...

Leukemia
Lymphoma
Immunotherapy

FDA Approves Rituximab Plus Chemotherapy for Several Pediatric Hematologic Malignancies

On December 2, the U.S. Food and Drug Administration (FDA) approved rituximab (Rituxan) in combination with chemotherapy for pediatric patients (≥ 6 months to < 18 years old) with previously untreated, advanced-stage, CD20-positive diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma,...

Leukemia

COG AAML1331 Trial: Arsenic Trioxide and All-Trans Retinoic Acid in Pediatric Patients With APL

As reported in JAMA Oncology by Kutny et al, the Children’s Oncology Group (COG) AAML1331 trial has shown that treatment with arsenic trioxide and all-trans retinoic acid (ATRA) with no maintenance therapy produced high event-free and overall survival rates in pediatric patients with acute...

Leukemia
Immunotherapy

Impact of Prior Blinatumomab Exposure on CD19-Targeted CAR T-Cell Therapy Outcomes in Pediatric Patients With B-Cell ALL

In a study reported in the Journal of Clinical Oncology, Myers et al found that lack of response to prior blinatumomab treatment was associated with poorer outcomes with CD19-targeted chimeric antigen receptor (CAR) T-cell therapy (CD19-CAR) in children and young adults with relapsed or refractory...

Leukemia

Novel Therapies Under Study in Acute Myeloid Leukemia

Newly identified genetic abnormalities in acute myeloid leukemia (AML), as well as therapies that can target some of those abnormalities, are now available as the landscape for treatment continues to evolve. During the 2021 National Comprehensive Cancer Network (NCCN) Annual Congress: Hematologic...

Leukemia

Novel Therapies Under Study in Acute Myeloid Leukemia

Newly identified genetic abnormalities in AML have led to novel therapies that can target some of them, as the landscape for treatment continues to evolve. During the 2021 National Comprehensive Cancer Network (NCCN) Annual Congress: Hematologic Malignancies, Alice S. Mims MD, presented updates in...

Leukemia

Study Examines Availability of All-Trans Retinoic Acid in U.S. Hospitals

New research published by Geer et al in JNCCN—Journal of the National Comprehensive Cancer Network has found that fewer than one-third of hospitals in the United States had immediate availability of all-trans retinoic acid (ATRA), a crucial blood cancer medication. ATRA is initiated early in the...

Leukemia

Novel Drug Combination May Help Children With Acute Promyelocytic Leukemia Avoid Conventional Chemotherapy

A clinical trial recently published by Kutny et al in JAMA Oncology found that the combination of all-trans retinoic acid and arsenic trioxide was highly effective in children with standard- and high-risk acute promyelocytic leukemia (APL). Nearly all patients in the trial survived for 2 years...

Leukemia

Measurable Residual Disease Dynamics and Extended Follow-up in CLL14 Trial of Venetoclax/Obinutuzumab in Previously Untreated Chronic Lymphocytic Leukemia

In an analysis of the pivotal CLL14 trial reported in the Journal of Clinical Oncology, Al-Sawaf et al found that venetoclax plus obinutuzumab was associated with higher rates of undetectable measurable residual disease (MRD) and prolonged MRD doubling time vs chlorambucil plus obinutuzumab at 3...

leukemia
lymphoma

Jennifer A. Woyach, MD, on CLL/SLL: Using Minimal Residual Disease Assessment in Clinical Practice

Jennifer A. Woyach, MD, of The Ohio State University Comprehensive Cancer Center, talks about whether modifications of treatment based on minimal residual disease is beneficial to patients with chronic lymphocytic leukemia and small lymphocytic lymphoma.

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