When should patients be vaccinated after a bone marrow transplantation? What agent might be considered as a new chemotherapy option in younger patients with AML in first remission? Test your knowledge in our latest quiz.
When should patients be vaccinated after a bone marrow transplantation? What system should be used for the final diagnosis and classification of acute leukemia? Test your knowledge in our latest quiz.
B. 6 months
Authors of a recent “How I Treat” article in Blood recommend use of a six-question algorithm, with any unfavorable response triggering “a vaccine deferral (except for flu shots) until at least 1 year post-transplant. Our approach takes into consideration that vaccine efficacy depends on at least partial reconstitution of adaptive immunity.”
D. World Health Organization
The guideline specifically recommends the current World Health Organization classification of neoplasms of the hematopoietic and lymphoid tissues, which was published in 2001, updated in 2008, and revised in 2016.
A. Decreased 3-year overall survival
The presence of CNAs also decreased event-free survival, according to the study. “If replicated in other data sets, CNA presence could be considered for inclusion in AML risk stratification,” the authors concluded.
C. Inferior event-free survival
In the study, CNS2 was defined as < 5 WBCs/Î¼L and blasts with/without ≥ 10 RBCs/Î¼L or ≥ 5 WBCs/Î¼L plus blasts, with WBCs ≥ 5 times the number of RBCs. “In multivariable analysis that included age, race/ethnicity, initial WBC, and day-29 minimal residual disease < 0.1%, CSF blast, regardless of cell count, was an independent adverse predictor of outcome for patients with standard- or high-risk disease according to National Cancer Institute criteria,” the authors noted. “These data suggest that additional augmentation of CNS-directed therapy is warranted for CNS2 disease,” they concluded.
The 2-year relapse-free survival was higher in the CLARA arm (53.3% vs 31%), according to the results of the study. “These results suggest that CLARA might be considered as a new chemotherapy option in younger patients with AML in first remission,” the authors concluded.