Hematology

Patients with relapsed or refractory chronic lymphocytic leukemia are generally divided by those exposed to Bruton's tyrosine kinase inhibitors (BTKi), patients relapsing after venetoclax, and patients relapsing after BTKi and B-cell lymphoma-2 inhibitors.

Robert Z. Orlowski, MD, PhD, director of the Myeloma Section at the University of Texas MD Anderson Cancer Center, reviewed novel agents in the treatment of triple-class refractory myeloma during a session at the 2021 annual meeting of the Society of Hematologic Oncology (SOHO).

The recommendation for managing cytopenias among patients treated with tyrosine kinase inhibitors is to discontinue treatment at the onset of grade 3 or higher.

Risk stratification for survival should not dictate treatment, but stratification for thrombosis risk should play an important role in treatment decisions.

By deactivating a component of the MAPK signaling pathway, researchers were able to reduce the proportion of leukemia cells in blood and bone marrow.

Andrea Silber, MD, said the COVID-19 pandemic has exacerbated disparities that already existed within oncology care, and she said the effects of these disparities on patients are very real and direct.

Crizanlizumab is a humanized IgG2 kappa monoclonal antibody that binds to P-selectin and blocks interactions with its ligands.

A presentation at the Society of Hematologic Oncology 2021 Annual Meeting reviewed the treatment of amyloidosis in multiple myeloma.

Shereen Stutz and Mark Alwardt, of McKesson, said the rise in oral oncolytics during the COVID-19 pandemic allowed pharmacists to be more innovative and to become an even more integrated part of the oncology care team.

Patients now have multiple options, including continuous therapy with BTK inhibitors and fixed-duration therapy with venetoclax-based regimens.

Presenter Maria-Victoria Mateos, MD, PhD, University Hospital of Salamanca-IBSAL, Salamanca, Spain, discussed how optimal sequencing in MM has changed from those outlined in the older EU guidelines.

In the MAGNOLIA trial, the median duration of response was not reached at the median follow-up time of 8.3 months, with 85% of responders still in remission at 12 months.

Cabozantinib (Cabometyx) was approved in 2016 for patients who have advanced renal cell carcinoma and who received prior anti-angiogenic therapy.

With CAR T-cell therapies showing promise for follicular lymphoma and marginal zone lymphoma, clinicians must weigh toxicity and tolerability almost as strongly as efficacy because patients can live years with these diseases

The efficacy of pirtobrutinib does not depend on prior therapy, reason for prior BTK inhibitor discontinuation, or C481 mutation status, according to the presentation.

Because asparaginase is used exclusively in ALL, most adult oncologists do not administer it routinely.

Nearly 20% of patients with multiple myeloma have a form of the disease in which they make high quantities of a component of monoclonal proteins, which damages the kidneys.

Investigators find a precision medicine that can identify those with the rare disorder who may benefit from FDA-approved siltuximab.

The FDA has approved a second drug, zanubritinib, for the treatment of adult patients with Waldenström’s macroglobulinemia.

Lab values for sodium, potassium, chloride, magnesium, BUN, creatinine, glucose, and CO2.

Approved indications for idelalisib include relapsed chronic lymphocytic leukemia, small lymphocytic lymphoma, and follicular B-cell non-Hodgkin lymphoma.

The mutated genes in question, TET2 and DNMT3A, each influence the efficacy of treatment in different ways.

This designation could shorten the FDA review period to 8 months compared to the 12 months under Standard Review.

Alexandra S. Wolff, PharmD, BCOP, comments on her experience with CPX-351 in clinical practice and the potential to combine CPX-351 with targeted agents for AML.

Alexandra S. Wolff, PharmD, BCOP, explores the 5-year follow-up data from the phase 3 trial of CPX-351 in AML.

Expert continues discussion on important considerations for the optimal use if venetoclax in patients with AML, such as CYP3A4 and p-glycoprotein drug interactions.

Alexandra S. Wolff, PharmD, BCOP, highlights considerations for optimal use of venetoclax in patients with AML, such as tumor lysis syndrome prophylaxis.

Expert discusses the role of venetoclax in the treatment of AML and if achievement of MRD negativity can be used to predict long-term outcomes.

Expert continues discussion of IDH1 and IDH2 inhibitors in AML and examines prioritization of IDH1 and IDH2 inhibitors versus venetoclax in newly diagnosed AML.

Tisagenlecleucel is a CD19-directed genetically modified autologous T cell immunotherapy already indicated for B-cell precursor acute lymphoblastic leukemia and diffuse large B-cell lymphoma.