Hematologic Oncology

A phase I study showed that azacitidine priming followed by standard chemotherapy could be an effective approach to resistance in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL).

Researchers in London have identified a number of new genetic variants that are linked to myeloma, and one specifically linked to a telomerase RNA component gene called TERC, that helps to control the aging process by acting as a cell’s internal clock.

The real promise of improving patient outcomes in IgD and IgE multiple myeloma lies in multi-drug combinations, next-generation agents, and immunotherapy.

The use of newer methods of disease assessment that focus on minimal residual disease may facilitate the long-term evaluation of IgD and IgE myeloma patients, even if the rare Ig subtype is not identified at diagnosis.

How often do we choose the “second best” treatment as initial therapy for our patients with cancer? The management of chronic myeloid leukemia should be no different.

I am very comfortable in using imatinib as initial therapy in most patients who present in chronic phase, with the possible exception of patients with more advanced disease and higher Sokal scores.

In a new series, beginning this month and running into early 2014, experts on five “unusual dysproteinemias” will share their insights into diagnosis and management.

Although survival of patients with IgD or IgE multiple myeloma is shorter in comparison to those with IgG or IgA multiple myeloma, the outcome for patients with IgD and IgE subtypes is improving with the use of novel agents and autologous transplantation.

The present guidelines review epidemiology, pathology, presentation, workup, staging, prognostic factors, and treatment options for patients with localized nodal indolent lymphoma, with an emphasis on radiation guidelines, including radiation dose, field design, and radiation techniques.

Early treatment with lenalidomide and dexamethasone in patients with high-risk smoldering myeloma significantly delayed progression to symptomatic disease and prolonged survival with a good safety profile.

A study from the Mayo Clinic/University of Iowa assessing the use of surveillance CT scans to detect DLBCL relapses found that the majority of relapses occurred outside of regularly scheduled visits and concluded that it is important to educate patients to be more alert to signs and symptoms of relapse.

Dr. Brian Link discusses challenges in managing very elderly patients with diffuse large B-cell lymphoma and looks ahead to future management of DLBCL in general.

Dr. Brian Link discusses clinical implications of the large Mayo Clinic/ University of Iowa study (ASCO abstract 8504) showing patient symptoms rather than scheduled surveillance imaging drove detection of relapses in patients with diffuse large B-cell lymphoma (DLBCL).

In this interview, we discuss the current state of therapies available in treating CML patients and the role of newer agents.

The phase II portion of the GAUGUIN study found promising activity with the anti-CD20 antibody obinutuzumab in patients with relapsed or refractory indolent NHL.

Older multiple myeloma patients exposed to novel agents prior to autologous peripheral blood stem cell transplantation were at increased risk for engraftment syndrome.

A phase I/II study found that radioimmunotherapy with 177Lu and the anti-CD20 antibody rituximab along with the chelator DOTA is safe and feasible for treatment of relapsed follicular, mantle cell, or other indolent lymphomas.

Palliation is a laudable concept and an important goal in the therapy of all patients with malignant disease. Unfortunately, in the current day and age, the adjective “palliative” is being used in a derogatory manner that suggests palliation of suffering somehow lessens the importance or impact that such a therapy has upon individuals with the disease.

By inhibiting inflammatory cytokines and controlling the signs and symptoms of myelofibrosis, the patient’s body condition improves as the disease is kept under good control. Ultimately, prolonged exposure of a patient with myelofibrosis to ruxolitinib at a clinically effective dose results in prolongation of the his or her life.

A new study validates a simple prognostic score, the EUTOS score, as a useful tool in predicting the therapeutic effects of TKIs for chronic myeloid leukemia.

ARIAD has received marketing authorization from the European Commission for ponatinib (Iclusig) in chronic myeloid leukemia and acute lymphoblastic leukemia.

In this interview we discuss acute myeloid leukemia therapy approaches and new molecular targets based on genetic analyses of the disease with a leukemia expert.

The International Myeloma Working Group recently released new recommendations to aid physicians in the treatment of bone disease related to multiple myeloma.

Monotherapy with the investigational oral Bruton's tyrosine kinase inhibitor ibrutinib was well tolerated and produced durable responses in a phase Ib/II, open-label, multicenter study of 85 patients with relapsed/refractory chronic lymphocytic leukemia or small lymphocytic lymphoma.

Use of the bisphosphonate pamidronate (Aredia) may be “more efficient” than standard regimens as palliative treatment for symptoms of acute symptomatic osteonecrosis in pediatric patients with acute lymphoblastic leukemia.