Hematologic Malignancies

Approximately 40% of children with acute lymphoblastic leukemia (ALL) fail to take 6-mercaptopurine (6-MP) as prescribed, and a sizable majority of parents and children with ALL overreport the intake of a critical drug for maintaining remission, according to a study reported by lead investigator Wendy Landier, PhD, RN, NP, Children’s of Alabama, Birmingham, and colleagues at ASH 2015.
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Long-term follow-up of the French 1 Stop Imatinib Study (STIM1) in patients with chronic myeloid leukemia (CML) has demonstrated that imatinib (Gleevec) can be safely discontinued in patients with a deep molecular response (ie, lasting at least 2 years). According to data presented at ASH 2015, molecular relapse was very rare after 6 months of stopping imatinib, and no relapse was reported after 2 years.
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A pediatric regimen achieves superior outcomes compared with adult regimens in adolescents and young adults with acute lymphoblastic leukemia (ALL). Several studies have already shown this outcome, and a multicenter phase 2 study presented at ASH 2015 adds further confirmatory evidence in support of this approach.
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The use of novel agents in multiple myeloma has led experts to question whether autologous stem-cell transplant (ASCT) is warranted upfront, or whether it can be used as effectively after patients relapse.
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The use of therapy with chimeric antigen receptor (CAR)-modified T-cells consistently demonstrated activity in advanced hematologic malignancies, including different types of lymphoma, in multiple trials reported at ASH 2015.
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Immunotherapy is generating great excitement in melanoma and non-small-cell lung cancer (NSCLC). The FDA approvals of checkpoint inhibitors in these tumor types, as well as encouraging preliminary results in other solid tumors, have paved the way for studying these therapies in hematologic cancers.
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Treatment with CD19-targeted immunotherapy blinatumomab (Blincyto) as a single agent showed antileukemic activity in patients with minimal residual disease (MRD) Philadelphia chromosome (Ph)-positive B-cell precursor acute lymphoblastic leukemia (ALL) whose disease progressed after or was intolerant to a second-generation or later tyrosine kinase inhibitor (TKI). The results were presented at ASH 2015.
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Ibrutinib (Imbruvica) significantly reduced the risk for disease progression or death compared with standard treatment with chlorambucil (Leukeran) in older (aged ≥65 years) treatment-naive patients with chronic lymphocytic leukemia (CLL). Ibrutinib achieved a 91% reduction in the risk for disease progression and an 84% reduction in the risk for death compared with chlorambucil.
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Idelalisib (Zydelig) reduced the risk for disease progression and death when added to bendamustine (Treanda) plus rituximab (Rituxan) versus bendamustine plus rituximab alone in patients with relapsed or refractory chronic lymphocytic leukemia (CLL), according to the results of a randomized, double-blind, placebo-controlled, phase 3 late-breaking trial presented at ASH 2015.
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Dose-optimized nilotinib (Tasigna) increased the rates of major molecular response in patients with newly diagnosed chronic myeloid leukemia (CML) in the chronic phase (CP) in the Evaluating Nilotinib Efficacy and Safety in Clinical Trials-Extending Molecular Responses (ENESTxtnd) study. According to the final results of this study presented at ASH 2015, the cumulative major molecular response rates were 70.8% by 12 months and 81.0% by 24 months in patients managed with the dose optimization strategy.
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