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Leukemia

Newly Diagnosed AML: Induction to Maintenance

When it is dark enough, you can see the stars.” —Ralph Waldo Emerson Low-intensity therapy for older or unfit patients with acute myeloid leukemia (AML) was introduced in the early 2000s in the form of low-dose cytarabine or hypomethylation therapy (azacitidine or decitabine). Recent studies...

Leukemia
Genomics/Genetics

Association of FLT3-ITD Measurable Residual Disease With Outcomes in Newly Diagnosed AML

In a study reported in the Journal of Clinical Oncology, Grob et al found that next-generation sequencing detection of FLT3-internal tandem duplication (FLT3-ITD) measurable residual disease (MRD) in complete remission was associated with markedly increased risk of relapse and poorer overall...

Leukemia
Genomics/Genetics

Chemotherapy Outcomes in Noninfant Childhood ALL With 11q23/KMT2A Rearrangements

In a retrospective study reported in the Journal of Clinical Oncology, Attarbaschi et al described outcomes in patients with noninfant childhood acute lymphoblastic leukemia (ALL) and 11q23/KMT2A rearrangements treated with chemotherapy regimens between 1995 and 2010. Study Details The study...

Leukemia

Richter Transformation Remains Challenging, but Better Treatments Are on the Horizon

Richter transformation, usually a diffuse large B-cell lymphoma developing in a person with CLL, remains a challenging entity, but novel regimens look promising, as described at the 2022 Pan Pacific Lymphoma Conference by Matthew S. Davids, MD, MMSc, Associate Professor of Medicine at Harvard...

Cost of Care
Leukemia

Real-World Cost of Care for Pediatric ALL Among Commercially Insured Patients

In a study reported in JCO Oncology Practice, Lucie M. Turcotte, MD, MPH, and colleagues found that real-world costs for care for commercially insured U.S. pediatric patients with acute lymphoblastic leukemia (ALL) were higher in those diagnosed at age 10 or older and have increased substantially...

leukemia

Christopher E. Jensen, MD, on Older Adults With AML: A Price Paid for High-Intensity Chemotherapy?

Christopher E. Jensen, MD, of the University of North Carolina School of Medicine, talks about older adults with acute myeloid leukemia who receive high-intensity chemotherapy. Although they may live longer, much of their survival gains may be spent engaged in oncology care (Abstract 376).

leukemia
immunotherapy

Barbara Eichhorst, MD, on CLL: Venetoclax and Obinutuzumab With or Without Ibrutinib vs Chemoimmunotherapy

Barbara Eichhorst, MD, of the German CLL Study Group and the University of Cologne, discusses phase III findings from the GAIA/CLL13 trial, which showed that time-limited treatment with venetoclax, obinutzumab, and ibrutinib or venetoclax plus obinutzumab improved progression-free survival compared with standard chemoimmunotherapy in fit, previously untreated patients with chronic lymphocytic leukemia (Abstract LBA2365).

Leukemia
Immunotherapy

Outcomes After Nonresponse and Relapse in Children and Young Adults Receiving Tisagenlecleucel for B-Cell ALL

In a retrospective study reported in the Journal of Clinical Oncology, Schultz et al found poor survival among children and young adults with lack of response to tisagenlecleucel for B-cell acute lymphoblastic leukemia (ALL). Salvage therapy after relapse was capable of inducing responses, but...

Leukemia

Conditioning With Busulfan/Cyclophosphamide vs Total-Body Irradiation/Cyclophosphamide for B-Cell ALL

In a Chinese phase III trial reported in the Journal of Clinical Oncology, Zhang et al found that conditioning with busulfan plus cyclophosphamide (BuCy) was noninferior to total-body irradiation plus cyclophosphamide (TBI-Cy) in 2-year overall survival among adult patients with standard-risk...

Leukemia

Many Families of Children With Leukemia May Experience Food Insecurity That Is Not Alleviated by Federal Assistance Program

Nearly one in four families of pediatric patients with acute lymphoblastic leukemia (ALL) enrolled in a clinical trial experienced food insecurity, and almost half of the families eligible for the Supplemental Nutrition Assistance Program (SNAP) did not receive benefits. In addition, receiving SNAP ...

Leukemia
Lymphoma
Myelodysplastic Syndromes

FDA Approves Pemigatinib for Patients With Myeloid/Lymphoid Neoplasms and FGFR1 Rearrangement

On August 26, the U.S. Food and Drug Administration (FDA) approved pemigatinib (Pemazyre), a selective fibroblast growth factor receptor (FGFR) inhibitor, for the treatment of adults with relapsed or refractory myeloid/lymphoid neoplasms with FGFR1 rearrangement. Myeloid/lymphoid neoplasms with...

Leukemia
Multiple Myeloma

Racial/Ethnic Representation in Pivotal Clinical Trials for Drugs Approved for Leukemias and Multiple Myeloma

In a study reported in the Journal of Clinical Oncology, Casey et al found that most U.S. minority populations were underrepresented in clinical trials leading to U.S. Food and Drug Administration approval of drugs for treating leukemias and multiple myeloma. Study Details The investigators...

Leukemia

Azacitidine for Newly Diagnosed Juvenile Myelomonocytic Leukemia

On May 20, 2022, azacitidine for injection was approved by the U.S. Food and Drug Administration for pediatric patients with newly diagnosed juvenile myelomonocytic leukemia.1 Supporting Efficacy Data Approval was based on findings in the multicenter AZA-JMML-001 trial (ClinicalTrials.gov...

leukemia

Harry P. Erba, MD, PhD, on AML: New Data on Quizartinib Plus Standard Chemotherapy

Harry P. Erba, MD, PhD, of Duke Cancer Institute, discusses potentially practice-changing phase III results from the QuANTUM-First trial, which showed that adding quizartinib to standard chemotherapy and up to 3 years of continuation therapy led to improvement in overall survival for adults aged 18 to 75 with newly diagnosed FLT3-ITD–positive acute myeloid leukemia. The manageable safety profile further supports the use of quizartinib in combination with standard therapy, including allogeneic hematopoietic stem cell transplantation, in this setting (Abstract S100).

Leukemia

Proximity to Fracking Sites May Be Associated With Risk of Pediatric Leukemia

Children in Pennsylvania living near unconventional oil and gas developments at birth were two to three times more likely to be diagnosed with leukemia between the ages of 2 and 7 years than children who did not live near this oil and gas activity, after accounting for other factors that could...

Leukemia
Genomics/Genetics

Molecular Map Reveals Insights Into the Genetic Drivers of CLL

A newly constructed map of the landscape of genetic changes in chronic lymphocytic leukemia (CLL) may provide a better understanding of this complex malignancy, which could lead to more accurate prognoses for patients, improved diagnostics, and novel treatments. These research findings were...

Leukemia
Immunotherapy

Higher Doses of CAR T-Cell Therapy May Improve Survival for Young Patients With B-Cell ALL

Young people with B-cell acute lymphoblastic leukemia (ALL) who received doses of tisagenlecleucel, a chimeric antigen receptor (CAR) T-cell therapy, at the higher end of the approved dosing range had significantly better survival rates at 1 year compared with those who received lower doses within...

Leukemia

Study Finds AYA Leukemia Survivors Have Higher 10-Year Mortality Rates Than the General Population

Although considered a rare occurrence in adolescents and young adults (AYAs), aged 15 to 39 years, the incidence of cancer in this age group has been increasing by approximately 30% since the 1970s. This year, it is estimated that nearly 90,000 new cases of cancer will be diagnosed in this...

Issues in Oncology
Leukemia

Study Evaluates Availability of Imatinib in Online Pharmacies

Patients seeking to purchase chemotherapy drugs online face a confusing array of websites, over half of which potentially operate unsafely or illegally, according to a study published by Sun et al in JNCCN–Journal of the National Comprehensive Cancer Network. A survey of online pharmacies claiming...

Leukemia
Lymphoma

Zandelisib in Continuous or Intermittent Dosing Schedules With or Without Rituximab for Relapsed or Refractory B-Cell Malignancies

In a first-in-patients phase Ib study reported in The Lancet Oncology, John M. Pagel, MD, PhD, and colleagues identified the safety profiles of the PI3Kδ inhibitor zandelisib given in intermittent vs continuous dosing schedules with or without rituximab in patients with relapsed of refractory...

leukemia

Nicholas J. Short, MD, on ALL: Updated Phase II Study Results on Ponatinib and Blinatumomab

Nicholas J. Short, MD, of The University of Texas MD Anderson Cancer Center, discusses updated results from a phase II study that suggests the chemotherapy-free regimen of simultaneous ponatinib and blinatumomab is safe and effective in patients with Philadelphia chromosome–positive acute lymphoblastic leukemia. For patients with newly diagnosed disease, stem cell transplantation does not appear to be needed in first remission (Abstract S114).

Leukemia

Venetoclax Plus Gilteritinib in FLT3-Mutated Relapsed or Refractory Acute Myeloid Leukemia

In a phase Ib study reported in the Journal of Clinical Oncology, Naval Daver, MD, and colleagues found that the doublet of venetoclax plus gilteritinib produced a high modified composite complete response rate in patients with FLT3-mutated relapsed or refractory acute myeloid leukemia. Dose...

Leukemia

Study Reports Time-Limited Venetoclax-Based Regimens of Benefit in Front-Line Treatment of CLL

Time-limited venetoclax-based regimens provide deeper and more durable remissions than chemoimmunotherapy combinations in patients with previously untreated chronic lymphocytic leukemia (CLL), regardless of patients’ fitness, according to late-breaking data presented during the European Hematology...

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
Myelodysplastic Syndromes

Eprenetapopt/Azacitidine Maintenance After Allogeneic HSCT for TP53-Mutant AML and MDS

In a phase II trial reported in the Journal of Clinical Oncology, Mishra et al found that maintenance treatment with the first-in-class small-molecule p53 reactivator eprenetapopt plus azacitidine following allogeneic hematopoietic stem cell transplantation (HSCT) was associated with “encouraging”...

Leukemia
Lymphoma

Zanubrutinib vs Bendamustine/Rituximab in Previously Untreated Patients With CLL or SLL

As reported in The Lancet Oncology by Constantine S. Tam, MBBS, PhD, and colleagues, an interim analysis in the phase III SEQUOIA trial has shown significantly improved progression-free survival with first-line zanubrutinib vs bendamustine/rituximab in patients with chronic lymphocytic leukemia...

Leukemia

Initial Risk Factors and ‘Time to Cure’ in Childhood and Young Adult Acute Lymphoblastic Leukemia

In an analysis of long-term follow-up of the UKALL2003 trial reported in the Journal of Clinical Oncology, Anthony V. Moorman, PhD, and colleagues found that whereas initial risk of relapse in children and young adults with acute lymphoblastic leukemia differed according to risk factors, risk...

Leukemia

Phase III Trial Reports Quizartinib Doubles Overall Survival in FLT3-ITD–Positive AML

A new treatment option has doubled overall survival for a difficult-to-treat subset of patients with acute myeloid leukemia (AML), according to data presented during the Presidential Symposium at the European Hematology Association (EHA) 2022 Congress in Vienna.1 Findings from the phase III...

Leukemia

Study Examines High Early Death Rates, Treatment Resistance, and Short Survival Among Black AYA Patients With AML

New research published by Larkin et al in the journal Blood Advances has found that Black adolescent and young adult (AYA) patients with acute myeloid leukemia (AML) were five times more likely than comparable White patients to die within 30 days of beginning treatment—and were twice as likely to...

Leukemia
Lymphoma

FDA Warns About Possible Increased Risk of Death and Serious Side Effects With Duvelisib

The U.S. Food and Drug Administration (FDA) is warning that results from the phase III DUO clinical trial show a possible increased risk of death with duvelisib compared to ofatumumab among patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). The trial also found...

Leukemia
Survivorship

Long-Term Morbidity in AML Survivors Treated With Blood or Bone Marrow Transplantation

As reported in the Journal of Clinical Oncology by Saro H. Armenian, DO, MPH, and colleagues, findings from the BMT Survivor Study (BMTSS) indicated that survivors of acute myeloid leukemia (AML) treated with blood or marrow transplantation (BMT) are at a markedly increased risk of...

Leukemia

Venetoclax Plus Cladribine and Low-Dose Cytarabine Alternating With Azacitidine and Venetoclax in Newly Diagnosed Older or Unfit Patients With AML

In a single-institution phase II study reported in the Journal of Clinical Oncology, Tapan M. Kadia, MD, and colleagues found that venetoclax and a lower-intensity backbone of cladribine and low-dose cytarabine alternating with azacitidine and venetoclax resulted in a high response rate in older...

Leukemia

MRD-Guided Cessation of Treatment in Patients Receiving Venetoclax/Ibrutinib for Relapsed or Refractory CLL

In a phase II trial (HOVON141/VISION) reported in The Lancet Oncology, Arnon P. Kater, MD, PhD, and colleagues found a high rate of 12-month progression-free survival among patients with relapsed or refractory chronic lymphocytic leukemia (CLL) who stopped venetoclax/ibrutinib after achieving...

leukemia

Eunice S. Wang, MD, on AML: Long-Term Results With Crenolanib Plus Chemotherapy

Eunice S. Wang, MD, of Roswell Park Comprehensive Cancer Center, discusses long-term phase II findings of a trial evaluating crenolanib plus chemotherapy in newly diagnosed adults with FLT3-mutant acute myeloid leukemia. The study showed a composite complete remission rate of 86%. With a median follow-up of 45 months, median overall survival has not been reached. A phase III trial is ongoing (Abstract 7007).

Genomics/Genetics
Myelodysplastic Syndromes
Leukemia

Demethylation and Upregulation of the Oncogene SALL4 After Hypomethylating Therapy

In a study reported in The New England Journal of Medicine, Liu et al found that hypomethylating therapy was associated with upregulation of the oncogene SALL4 in a high proportion of patients with myelodysplastic syndrome. They also identified the gene region that is demethylated and responsible...

Leukemia

Adding Targeted Therapy to Chemoimmunotherapy May Offer Long-Term Benefits for Patients With IGHV-Mutated CLL

In a phase II study, researchers evaluated the efficacy of ibrutinib, fludarabine, cyclophosphamide, and obinutuzumab—a chemoimmunotherapy and targeted therapy combination—in 45 previously untreated patients with IGHV-mutated chronic lymphocytic leukemia (CLL). Nitin Jain, MD, of the Department of...

Leukemia

Magrolimab Plus Azacitidine in TP53-Mutant AML

High-risk patients with TP53-mutated acute myeloid leukemia (AML) have limited treatment options and very poor prognoses. Magrolimab is a monoclonal antibody designed to block CD47, an immune macrophage checkpoint molecule that signals “don’t eat me,” thereby allowing leukemia cell destruction....

Leukemia
Genomics/Genetics

Triplet Combination Therapy Yields High Response Rates in Patients With FLT3-Mutated AML

FLT3-ITD–mutated acute myeloid leukemia (AML) is an aggressive disease usually resistant to available treatment options, resulting in high front-line response rates but short response durations and low survival rates. Quizartinib—a potent selective FLT3 inhibitor—can work synergistically with...

Leukemia
Myelodysplastic Syndromes
Genomics/Genetics

Targeted Therapy Emavusertib Shows Activity in Patients With MDS or AML With Specific Mutations

Mutations in SF3B1 and U2AF1 can drive overexpression of activated IRAK4—which regulates inflammation and promotes cancer cell growth and survival—and are associated with a poor prognosis for patients with high-risk myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Emavusertib is a...

Leukemia
Immunotherapy

Ponatinib Plus Blinatumomab for Patients With Philadelphia Chromosome–Positive ALL

The tyrosine kinase inhibitor ponatinib and monoclonal antibody blinatumomab—which targets CD19 on leukemia cells—are highly effective as monotherapies for patients with Philadelphia chromosome–positive (Ph+) acute lymphoblastic leukemia (ALL). The combination of the two therapies may provide an...

Leukemia

FLT3 Inhibitor Crenolanib in Combination With Chemotherapy for Newly Diagnosed Patients With FLT3-Mutant AML

Eunice Wang, MD, Chief of Leukemia at Roswell Park Comprehensive Cancer Center, and colleagues presented the long-term results of a phase II clinical trial combining crenolanib, a second-generation FLT3 inhibitor, with standard intensive chemotherapy for the treatment of adults with newly diagnosed ...

leukemia

Courtney D. DiNardo, MD, MSCE, and Stéphane de Botton, MD, PhD, on AML: New Data on IDH2-Mutant Alleles, Enasidenib, and Conventional Care

Courtney D. DiNardo, MD, MSCE, of The University of Texas MD Anderson Cancer Center, and Stéphane de Botton, MD, PhD, of Institut Gustave Roussy, discuss phase III findings from the IDHENTIFY trial, which showed that mutational burden and co-mutational profiles differed between patients with relapsed or refractory acute myeloid leukemia that exhibited IDH2-R140 and IDH2-R172 mutations. Enasidenib improved survival outcomes for patients with IDH2-R172 mutations: median overall survival and 1-year survival rates were approximately double those in the conventional care arm (Abstract 7005).

leukemia

Courtney D. DiNardo, MD, MSCE, and Jorge E. Cortes, MD, on CML: New Efficacy and Safety Results for Asciminib

Courtney D. DiNardo, MD, MSCE, of The University of Texas MD Anderson Cancer Center, and Jorge E. Cortes, MD, of Georgia Cancer Center at Augusta University, discuss phase III results from the ASCEMBL trial, which showed that after more than 2 years of follow-up, asciminib continued to yield superior efficacy and better safety and tolerability vs bosutinib in patients with chronic myeloid leukemia (CML) in chronic phase. These results continue to support the use of this kinase inhibitor as a new CML therapy, says Dr. Cortes, with the potential to transform the standard of care (Abstract 7004).

Leukemia

FDA Approves Ivosidenib/Azacitidine for Certain Patients With Newly Diagnosed AML

On May 25, the U.S. Food and Drug Administration (FDA) approved ivosidenib (Tibsovo) in combination with azacitidine for patients with newly diagnosed acute myeloid leukemia (AML) with a susceptible IDH1 mutation as detected by an FDA-approved test in adults aged 75 or older, or who have...

Leukemia

FDA Approves Azacitidine for Newly Diagnosed Juvenile Myelomonocytic Leukemia

On May 20, the U.S. Food and Drug Administration approved azacitidine (Vidaza) for pediatric patients with newly diagnosed juvenile myelomonocytic leukemia (JMML). AZA-JMML-001 Efficacy was evaluated in AZA-JMML-001 (ClinicalTrials.gov identifier NCT02447666), an international, multicenter,...

Leukemia
Multiple Myeloma

Using a Transcriptomic Profile to Identify Plasma Cell Leukemia–Like Disease in Patients With Newly Diagnosed Multiple Myeloma

In a study reported in the Journal of Clinical Oncology, Bruinink et al constructed a transcriptomic classifier for primary plasma cell leukemia (PCL) that identified high-risk PCL-like disease in patients with newly diagnosed multiple myeloma. As stated by the investigators, “Primary PCL is an...

Leukemia
Survivorship

AYA Leukemia Survivors Have Higher Mortality Rates Than the General Population

Although considered a rare occurrence in adolescents and young adults (AYAs), aged 15 to 39 years, the incidence of cancer in this age group has been increasing by approximately 30% since the 1970s. This year, it is estimated that nearly 90,000 new cases of cancer will be diagnosed in this...

Hematologic Malignancies
Multiple Myeloma
Lymphoma
Leukemia

Prevalence of Plasma Cell and Lymphoproliferative Disorders in Relatives of Probands With Light Chain Amyloidosis

In a study reported in the British Journal of Haematology, Staron et al found that the prevalence of plasma cell and lymphoproliferative disorders among blood relatives of probands with light chain (AL) amyloidosis was low overall and varied according to proband AL amyloidosis subtype. Despite...

Immunotherapy
Hematologic Malignancies
Leukemia
Lymphoma

Rehospitalization and Emergency Department Visits After CAR T-Cell Therapy in Commercially Insured Patients With Cancer

In a single-institution study reported in a research letter in JAMA Oncology, Kenzik et al found substantial rates of rehospitalization and emergency department visits after chimeric antigen receptor (CAR) T-cell therapy among commercially insured patients with cancer. Study Details The study...

Hematologic Malignancies
Leukemia
Lymphoma
Multiple Myeloma
Immunotherapy

Hematologic Oncology 2021–2022 Almanac

Ongoing evaluation of novel, targeted, and immunotherapies has led to exciting advances across the array of hematologic malignancies over the past year. The availability of new treatment options, along with emerging data on novel combinations and sequencing approaches, is rapidly changing...

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