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Leukemia

Optimizing Treatment Selection for Newly Diagnosed and Secondary AML: Focus on Cytogenetic and Molecular Data

Greater understanding of biological disease factors in acute myeloid leukemia (AML) has led to more effective and personalized treatment options. At the 2023 National Comprehensive Cancer Network (NCCN) Annual Congress: Hematologic Malignancies,1 Rebecca Olin, MD, MSCE, of UCSF Helen Diller Family...

Leukemia

Blinatumomab as an Alternative to First-Line Intensive Chemotherapy in Pediatric B-Cell ALL

In a retrospective study reported in the Journal of Clinical Oncology, Hodder et al found that blinatumomab was effective as a toxicity-sparing alternative to first-line intensive chemotherapy in children and young persons with B-cell acute lymphoblastic leukemia (ALL) who were...

Leukemia

Ibrutinib/Venetoclax vs Chlorambucil/Obinutuzumab in Previously Untreated Chronic Lymphocytic Leukemia: GLOW Trial 4-Year Follow-up

As reported in The Lancet Oncology by Niemann et al, the 4-year follow-up of the phase III GLOW trial has shown a continued progression-free survival benefit with fixed-duration ibrutinib/venetoclax vs chlorambucil/obinutuzumab in the first-line treatment of chronic lymphocytic leukemia in patients ...

Leukemia
Genomics/Genetics

Novel Assay May Help Detect and Treat Patients With AML

A novel assay may be effective at detecting a unique molecular marker in patients with acute myeloid leukemia (AML), according to a recent study published by Young et al in The Journal of Molecular Diagnostics. The new findings may revolutionize the way AML is detected and treated. Background AML...

Leukemia
Lymphoma
Hematologic Malignancies

Nemtabrutinib May Provide Benefit in Patients With Relapsed Hematologic Malignancies

The BTK inhibitor nemtabrutinib may offer a new treatment option for patients with relapsed hematologic malignancies such as chronic lymphocytic leukemia and non-Hodgkin lymphoma, according to a recent study published by Woyach et al in Cancer Discovery. Background Hematologic malignancies are...

Leukemia
Issues in Oncology
Global Cancer Care

Expanded Soy Production in Brazil May Be Linked to Increased Mortality Among Pediatric Patients With ALL

Researchers have reported that soy expansion and the subsequent increase of pesticide use in Brazil’s Cerrado and Amazon biomes may correlate with an increased risk of mortality among pediatric patients with acute lymphoblastic leukemia (ALL). The study was published by Skidmore et al in...

Leukemia
Immunotherapy

Sequential CD19- and CD22-Directed CAR T-Cell Therapy in Pediatric B-Cell ALL

In a Chinese single-center phase II study reported in The Lancet Oncology, Pan et al found that sequential CD19- and CD22-directed chimeric antigen receptor (CAR) T-cell therapy was active in pediatric patients with refractory or relapsed B-cell acute lymphocytic leukemia (ALL). Study Details In...

Leukemia

Getting a Cancer Diagnosis at Age 16 Has Taught Me to Live in the Present

I have been fascinated with death since I was 3 years old. I remember going to my great-grandfather’s funeral and asking my mother where my great-grandfather was. She said he is in heaven. I asked her if I were going to heaven, too, and she said, “Yes, but not for a long time.” Today, I don’t...

Leukemia
Issues in Oncology
Symptom Management

Do Low- and Moderate-Grade Adverse Events Affect Rates of Treatment Discontinuation in CLL?

In an analysis from the phase III ECOG/ACRIN E1912 trial in chronic lymphocytic leukemia (CLL) published in the Journal of Clinical Oncology, O’Connell et al found that grade 1 and 2 adverse events were significant contributors to patient-reported side-effects bother, with grade 2 events being...

Leukemia

Carfilzomib and Lenalidomide–Based Therapy in Primary Plasma Cell Leukemia

In a European phase II trial (EMN12/HOVON-129) reported in The Lancet Oncology, van de Donk et al found that the incorporation of carfilzomib and lenalidomide into induction, consolidation, and maintenance therapies was associated with good outcomes in both younger and older patients with primary...

Leukemia

FDA Approves Bosutinib for Pediatric Patients With Chronic Myelogenous Leukemia

On September 26, the U.S. Food and Drug Administration (FDA) approved bosutinib (Bosulif) for pediatric patients aged 1 year and older with chronic-phase, Philadelphia chromosome–positive chronic myelogenous leukemia (CML) that is newly diagnosed or resistant or intolerant to prior therapy. The FDA ...

Leukemia

Magrolimab Plus Azacitidine in Previously Untreated Patients With AML Ineligible for Intensive Chemotherapy

In a phase Ib study reported in the Journal of Clinical Oncology, Naval G. Daver, MD, and colleagues found that the combination of the anti-CD47 antibody magrolimab and azacitidine was active in previously untreated patients with acute myeloid leukemia (AML) who were ineligible for intensive...

Leukemia

Retrospective Study Reports Tyrosine Kinase Inhibitor Used in CML Associated With Nephrotoxicity

Investigators reported that the tyrosine kinase inhibitor dasatinib, commonly used to treat chronic myeloid leukemia (CML), was associated with nephrotoxicity in 10% of 32 patients with CML being treated with dasatinib in a multicenter, retrospective clinical study conducted to determine the...

Leukemia
Immunotherapy

Relapsed Pediatric T-Cell ALL: Base-Edited CAR7 T Cells

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...

Leukemia

Quizartinib in Newly Diagnosed FLT3-ITD–Positive Acute Myeloid Leukemia

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...

Leukemia
Supportive Care

Vitamin C and D Supplements for Patients With AML Undergoing Intensive Chemotherapy

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...

hematologic malignancies
leukemia

Nicholas J. Short, MD, on Acute Lymphoblastic Leukemia: New Analysis of Ponatinib and Blinatumomab

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).

Leukemia
Lymphoma

CLL/SLL: Efficacy of CD19-Directed CAR T-Cell Therapy in Relapsed or Refractory Disease

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...

Leukemia
Genomics/Genetics

Understanding How TET2 Gene Deficiency May Fuel Development of AML

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....

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
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
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

Homoharringtonine-Based Induction in Pediatric AML

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...

hematologic malignancies
leukemia

Nigel Russell, MD, on Acute Myeloid Leukemia: New Findings on FLAG-Ida and Gemtuzumab Ozogamicin

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.

Leukemia

Outcomes in Children and Young Adults With T-Cell ALL and Induction Failure in Contemporary Treatment Trials

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...

Leukemia

Potential of Quizartinib for Improving Outcomes in Acute Myeloid Leukemia

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...

Leukemia

Gilteritinib Maintenance Therapy After Transplantation in Patients With FLT3-ITD AML Who Have Measurable Residual Disease

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 ...

Leukemia
Genomics/Genetics

Outcomes in Pediatric ALL With Prolonged Therapy for IKZF1 Deletion and Reduced Therapy for Other Risk Groups

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 ...

Leukemia
Geriatric Oncology

CLL14: Long-Term Results of Fixed-Duration Venetoclax Plus Obinutuzumab in Elderly Patients With CLL

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...

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).

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