Question 1: What is the most likely diagnosis for this patient? Correct Answer: B. Primary central nervous system lymphoma. Expert Perspective In an immunocompetent host, the differential diagnosis of isolated or multiple brain lesion(s) includes autoimmune etiologies such as neurosarcoidosis,...
Hematology Expert Review is an occasional feature that includes a case report followed by questions,answers, and expert commentary. In this issue of The ASCO Post, Drs. Abutalib and Lukas present part 1 of a case report on primary diffuse large B-cell lymphoma. Part 2 will be published in an...
Question 1: What is next best step in the management of this patient? Correct Answer: C. Ophthalmoscopy/slit lamp examination. Expert Perspective Ophthalmic involvement should be sought by noninvasive procedures such as slit lamp examination and ophthalmoscopy and abnormal findings must be...
The ASCO Post is pleased to present Hematology Expert Review, an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question appear here with expert commentary. In the October 25 issue of The ASCO Post, part 1 of a...
Neutropenic complications remain the main dose-limiting toxicity of cancer chemotherapy treatment and are associated with considerable morbidity, mortality, and costs.1 Although patients who have experienced a prior neutropenic event are at increased risk of subsequent events, several studies have...
ASCO has issued a clinical practice guideline update on use of hematopoietic colony-stimulating factors, as reported in the Journal of Clinical Oncology by Thomas J. Smith, MD, FACP, FASCO, FAAHMP, and colleagues.1 This update to the ASCO 2006 guideline was based on a systematic review of...
Question 1: Based on the rationale for the current “standard of care” for primary diffuse large B-cell lymphoma of the CNS, what is the optimal induction therapy? Correct Answer: C. A high-dose methotrexate–based regimen. Expert Perspective Untreated primary diffuse large B-cell lymphoma of the CNS ...
The ASCO Post is pleased to present Hematology Expert Review, an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question appear on page 84 with expert commentary. In the November 10 issue of The ASCO Post, part 2 of ...
In the phase III HELIOS trial reported in The Lancet Oncology, Chanan-Khan et al found that the addition of the Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib (Imbruvica) to bendamustine (Treanda)/rituximab (Rituxan) increased progression-free survival in patients with chronic lymphocytic ...
Julie Vose, MD, MBA, of the University of Nebraska Medical Center, and John F. Gerecitano, MD, PhD, of Memorial Sloan Kettering Cancer Center, discuss a phase I study of venetoclax monotherapy in patients with relapsed/refractory non-Hodgkin lymphoma, including updated safety and efficacy data (Abstract 254).
Sagar Lonial, MD, of the Emory University School of Medicine, and Alessandra Tedeschi, MD, of the Azienda Ospedaliera Niguarda Cà Granda, discuss this international study of ibrutinib vs chlorambucil in patients 65 years and older with treatment-naive chronic lymphocytic leukemia or small lymphocytic lymphoma (Abstract 495).
Kieron Dunleavy, MD, of the National Cancer Institute, discusses a multi-center trial that set out to validate the effectiveness of DA-EPOCH-R-based therapy and whether a risk-adapted approach using the regimen is beneficial for patients with Burkitt lymphoma (Abstract 342).
Nathan Hale Fowler, MD, of MD Anderson Cancer Center, discusses a multicenter trial in which ibrutinib plus rituximab was administered to treatment-naive patients with follicular lymphoma (Abstract 470).
Craig H. Moskowitz, MD, of Memorial Sloan Kettering Cancer Center, discusses a phase I study of an anti-CD19 monoclonal antibody used in relapsed/refactory B-lineage non-Hodgkin lymphoma (Abstract 182).
Simon Rule, MD, of Derriford Hospital, discusses results from an international, multicenter study in patients with previously treated mantle cell lymphoma (Abstract 469).
Stephen J. Schuster, MD, of the University of Pennsylvania, discusses the findings of a study of chimeric antigen receptor modified T cells directed against CD19 in patients with relapsed or refractory disease (Abstract 183).
Laurie H. Sehn, MD, MPH, of the British Columbia Cancer Agency, discusses a study that showed patients with advanced-stage classical Hodgkin lymphoma, with a negative PET-scan following ABVD chemotherapy, have excellent outcomes without the need for consolidative radiotherapy, regardless of disease bulk at presentation (Abstract 579).
John Leonard, MD, of Weill Cornell Medical College, discusses this phase II study of R-CHOP with or without bortezomib in patients with untreated non-germinal center B-cell-like subtype diffuse large cell lymphoma (Abstract 811).
Andrew J. Davies, MRCP, PhD, of the Cancer Research UK Centre, University of Southampton, discusses a study of targeted treatment for diffuse large B-cell lymphoma based on real-time gene-expression profiling (Abstract 812).
Julie Vose, MD, MBA, of the University of Nebraska Medical Center, and David Straus, MD, of Memorial Sloan Kettering Cancer Center, discuss the initial results of the U.S. Intergroup Trial of response-adapted chemotherapy or chemotherapy/radiation therapy based on PET for nonbulky stage I and II Hodgkin lymphoma (Abstract 578).
Julie Vose, MD, MBA, of the University of Nebraska Medical Center, and Cameron J. Turtle, MBBS, PhD, of the Fred Hutchinson Cancer Research Center, discuss anti-CD19 chimeric antigen receptor-modified T-cell therapy and clinical outcome (Abstract 184).
Jonathon B. Cohen, MD, of the Winship Cancer Institute, discusses a study that used the National Cancer Data Base to study the impact on overall survival of deferring treatment in patients with newly diagnosed mantle cell lymphoma (Abstract 2717).
Olivier Casasnovas, MD, of Hôpital Le Bocage, discusses in French a phase III study comparing an early PET-driven treatment de-escalation to a not PET-monitored strategy in patients with advanced Hodgkin lymphoma (Abstract 577).
Olivier Casasnovas, MD, of Hôpital Le Bocage, discusses a phase III study comparing an early PET-driven treatment de-escalation to a not PET-monitored strategy in patients with advanced Hodgkin lymphoma (Abstract 577). To see the French language version of this video, please click here.
In the phase III HELIOS trial, reported in The Lancet Oncology, Chanan-Khan et al found that adding the Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) to bendamustine (Treanda)/rituximab (Rituxan) increased progression-free survival in patients with chronic lymphocytic leukemia or...
Ninety-three percent of pediatric patients (55 of 59) with relapsed/refractory acute lymphoblastic leukemia (ALL) went into remission after receiving an investigational therapy made from their own immune cells, with continuous remissions of over 1 year in 18 patients and over 2 years in nine...
A study (Abstract 99) to be reported today by Brudno et al at the 57th American Society of Hematology (ASH) Annual Meeting was the first clinical trial to use engineered donor immune cells to prevent progressive cancer after stem cell transplantation. The findings were presented at a...
Ronald Go, MD, of the Mayo Clinic, discusses a study that used the National Cancer Data Base to determine the extent to which the number of non-Hodgkin lymphoma patients treated annually in a facility affects overall survival (Abstract 266).
As reported by Scarisbrick et al in the Journal of Clinical Oncology, a Cutaneous Lymphoma International Consortium study in a large population of patients with advanced-stage mycosis fungoides and Sézary syndrome has identified independent prognostic factors for overall survival that can be ...
For patients with kidney failure, poor kidney function and immunosuppressant medications may increase their risk of developing different types of cancer. The findings, which are published by Yanik et al in the Journal of the American Society of Nephrology, suggest the need for persistent cancer...
A phase I study evaluating the safety, pharmacokinetic profile, pharmacodynamic effects, and antitumor activity of the first-in-class investigational NEDD8-activating enzyme (NAE) inhibitor pevonedistat (TAK-924/MLN4924) in patients with relapsed/refractory lymphoma or multiple myeloma has found...
Mantle cell lymphoma, which is characterized by CD5-positive, CD23-negative follicular mantle B cells with t(11:14)(q13;q32) translocation and cyclin D1 overexpression, is generally incurable and associated with a median survival of between 4 and 5 years. Although front-line treatment for mantle...
A study led by Johns Hopkins researchers has linked the immunosuppressive drug mycophenolate mofetil to an increased risk of central nervous system lymphoma in solid organ transplant patients. But the same study also found that another class of immunosuppressive drugs, calcineurin inhibitors, given ...
In a letter to The New England Journal of Medicine, Hamadani et al describe near-complete and complete responses with the Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) in two heavily pretreated patients with classic Hodgkin lymphoma. Patient 1 The first patient was a 28-year-old...
In a Danish-Swedish population-based study reported in the Journal of Clinical Oncology, El-Galaly et al found that routine imaging for diffuse large B-cell lymphoma in patients in first complete remission does not improve post-treatment survival. Study Details The study included 525 Danish and...
Bone marrow transplantation is a lifesaving therapy for many patients with blood cancers like leukemias and lymphomas. Currently, the gold standard blood-generating stem cells are obtained from a donor, most likely a sibling, with a perfect match to the patient in order to minimize the chance of...
A study published by Forero-Torres et al in Blood reported that brentuximab vedotin (Adcetris) is an effective and safe first course of treatment for older patients with Hodgkin lymphoma who are unfit for chemotherapy. Ineligibility for Chemotherapy Although standard chemotherapy can...
Living in overcrowded conditions appears to protect children and young adults against developing a particular type of Hodgkin lymphoma. This protective effect seems to suggest that infections earlier in life may stimulate the immune system to deal with future infections and cancerous cells more...
A small phase I/IIa study of third-generation CD19 CAR (chimeric-antigen receptor) T-cell therapy combined with chemotherapy pretreatment has resulted in complete responses in 6 of the 11 patients with relapsed or refractory lymphoma and leukemia enrolled in the study. Although CAR T-cell...
In a phase II trial (Cancer and Leukemia Group B 50401/Alliance) reported in the Journal of Clinical Oncology, Leonard et al found that the addition of rituximab (Rituxan) to lenalidomide (Revlimid) produced a higher response rate and longer time to progression than lenalidomide alone in patients...
In a study reported in The Lancet Oncology, Pastore et al found that the addition of mutation status of seven genes to the Follicular Lymphoma International Prognostic Index (FLIPI) and Eastern Cooperative Oncology Group (ECOG) performance status produced a clinicogenetic model (m7-FLIPI) with high ...
In a study reported in the Journal of Clinical Oncology, Vargo et al found that use of consolidative radiotherapy, which continues to decline, is associated with a survival benefit compared with multiagent chemotherapy alone in patients with early-stage diffuse large B-cell lymphoma. Study Details ...
In a study reported in the Journal of Clinical Oncology, Scott et al found that the digital gene expression–based Lymph2Cx assay produced concordant cell of origin assignments in formalin-fixed paraffin-embedded tissue biopsies from patients with diffuse large B-cell lymphoma and showed high...
The U.S. Food and Drug Administration has approved brentuximab vedotin (Adcetris) as post–autologous hematopoietic stem cell transplantation consolidation treatment for patients with classical Hodgkin lymphoma at high risk of relapse or progression, Seattle Genetics has announced. The...
In an equatorial African region known as the “lymphoma belt,” children are ten times more likely than in other parts of the world to develop Burkitt lymphoma. This area is also plagued by high rates of malaria, and scientists have spent the past 50 years trying to understand how the two ...
Risk for melanoma has been found to be increased in non-Hodgkin lymphoma (NHL) survivors. In a study reported in the Journal of Clinical Oncology, Lam et al found that T-cell–activating autoimmune diseases and fludarabine use were associated with an increased melanoma risk among patients with ...
Results of a phase I trial show that an investigational topical drug, resiquimod gel, causes regression of both treated and untreated tumor lesions and may completely remove cancerous cells from both sites in patients with early-stage cutaneous T-cell lymphoma. Currently, there is no cure for...
As reported by Eichenauer and colleagues in the Journal of Clinical Oncology, an analysis of long-term outcomes suggests that involved-field radiotherapy may be the best treatment option in patients with stage IA nodular lymphocyte-predominant Hodgkin lymphoma. Study Details The study involved...
A clinical trial has shown that patients with a specific molecular subtype of diffuse large B-cell lymphoma are more likely to respond to ibrutinib (Imbruvica) than patients with another molecular subtype of the disease. The study was published by Wilson et al in Nature Medicine. In this phase II...
A study published by Bianchi et al in the Journal of the American Medical Association (JAMA) showed that genetic test results revealed by noninvasive prenatal testing for fetal chromosomal abnormalities may detect underlying conditions in the mother, including cancer. The study reports on a case...