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Hematologic Oncology

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In the absence of a clear understanding of the underlying biologic heterogeneity, the etiology of the different heavy chain diseases (HCDs) should be taken into consideration when treatment decisions are made. Extrapolation from related conditions, such as aggressive lymphomas (in γ-HCD) and CLL (in μ-HCD), suggests that novel and targeted therapies may be effective in the management of these rare diseases.

A study aimed at defining the natural history of breast implant-associated anaplastic large-cell lymphoma found that outcomes differ between those cases where the disease is confined within the fibrous capsule surrounding the implant and those where a mass is present in the breast.

While the name POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) provides a nice acronym for a collection of seemingly disparate features, the diagnosis does not require that all these elements be present, and many other features are not included.

Ponatinib showed significant antileukemic activity in patients with CML and ALL, according to a phase II study that included a wide range of disease stages and mutation status; patients in the trial had a relatively high rate of adverse thrombotic events, an issue which has led to recent regulatory controversy surrounding the drug.

Following recent trial data showing an increased risk of dangerous blood clots with ponatinib, which led the FDA to request that the manufacturer stop marketing the drug, the FDA’s European counterpart has adjusted its recommendations for ponatinib but has not changed its “positive opinion” that led to the approval.

This article reviews the etiology and incidence of renal adverse events in patients with multiple myeloma, the renal safety profile of single-agent carfilzomib from four phase II studies in patients with relapsed and/or refractory multiple myeloma, and the management of patients with multiple myeloma who receive carfilzomib and are at risk for renal complications.

This article presents an overview of the cardiac and pulmonary safety profile of single-agent carfilzomib therapy in patients with relapsed and/or refractory multiple myeloma from an analysis of four phase II clinical studies, and provides practical recommendations for the management of patients at risk for cardiac events and pulmonary complication.