Hematologic Oncology

In this article, we review the current knowledge on the biological findings, clinical features, and therapeutic approaches for splenic marginal zone lymphoma.

Four publications on cancer treatment during pregnancy were published last week in the journal Lancet, serving as new treatment guidelines for chemotherapy and surgery in pregnant patients with solid tumors and hematologic malignancies.

In the current issue of ONCOLOGY, Gertz and Dispenzieri provide a scholarly review of the early recognition, diagnosis, and treatment of immunoglobulin light-chain (AL) amyloidosis.

Immunoglobulin light chain (AL) amyloidosis develops in 2% of individuals with monoclonal plasma cell dyscrasias. In this issue of ONCOLOGY, Drs. Gertz and Dispenzieri discuss AL amyloidosis, highlighting progress in the field along with outstanding challenges.

Splenic lymphomas are a diverse group of lymphoid malignancies that have clinical behavior ranging from indolent to aggressive and that have both B-cell and T-cell histologies.

The article by Thieblemont and colleagues very nicely summarizes the key pathogenetic and diagnostic features and present treatment of splenic marginal zone lymphoma (SMZL).

The aim of this review is twofold: to summarize descriptions of the clinical presentation provided in published series in order to help clinicians recognize and treat patients, and to discuss diagnostic difficulties faced by hematopathologists when dealing with these lesions and others in the differential diagnosis that must be distinguished from one another.

The results of the 2-year follow-up of the dasatinib DASISION phase III trial show the continued superiority of the drug compared to imatinib. The results provide further support for treatment of first-line chronic phase chronic myeloid leukemia patients that harbor the Philadelphia chromosome.

The phase III randomized RESORT (ECOG Protocol E4402) trial asked whether a maintenance schedule of rituximab every 3 months would lead to a superior disease control outcome compared to retreatment upon progression. The answer, presented this week at ASH, is no.

Updated findings from a multicenter phase Ib/II clinical trial suggest that the novel Bruton’s tyrosine kinase (BTK) inhibitor PCI-32765 may be an important new targeted treatment approach for patients with chronic lymphocytic leukemia.

Researchers presented a late-breaking abstract reporting activity in a metastatic lymphoma mouse model of two monoclonal antibodies combined with CpG, a short synthetic oligonucleotide agonist of TLR9, that mimic bacterial and viral DNA and facilitates a pro-inflammatory immune response.

The first plenary session at this year’s ASH was kicked off by the presentation of a study that showed that when stem cells come from donors unrelated to the patient there is no difference in patient survival between the use of cells sourced from peripheral blood or bone marrow.

The phase III trial comparing the use of gemtuzumab ozogamicin combined with chemotherapy to chemotherapy alone in newly diagnosed acute myeloid leukemia (AML) patients provides evidence that the combination treatment may be promising in this patient population.

Obinutuzumab (GA101) achieved higher response rates than rituximab in the first head-to-head trial of the two biologic agents in patients with relapsed non-Hodgkin lymphoma.

CancerNetwork highlights four sessions--on anaplastic large cell lymphoma, lymphoma in pregnancy, follicular lymphoma, splenic marginal zone lymphoma--you won’t want to miss from this year’s ASH.

The US Food and Drug Administration has approved asparaginase Erwinia chrysanthemi for the treatment of patients with acute lymphoblastic leukemia, who have developed hypersensitivity to E. coli derived asparaginase and pegaspargase chemotherapy.

Two recent reports show that the prognosis of MDS patients after secondary failure of hypomethylating drugs is poor, and switching from one failing hypomethylating drug to another cannot induce clinically significant responses.

A survey of more than 500 long-term survivors of non-Hodgkin’s lymphoma (NHL) has revealed that more than one-third experience persistent or worsening symptoms of post-traumatic stress disorder (PTSD), with nearly 4 of 10 cancer survivors stating they still experience symptoms of PTSD more than a decade after their cancer diagnosis.

Marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT) lymphoma is an indolent B-cell non-Hodgkin lymphoma arising from the lymphoid tissue at extranodal sites.

The rational development of novel targeted therapies is expanding treatment options for patients with relapsed/refractory (R/R) multiple myeloma (MM). The first-in-class proteasome inhibitor (PI) bortezomib (Velcade), the immunomodulatory agents thalidomide (Thalomid) and lenalidomide (Revlimid), and liposomal doxorubicin are currently the major approved therapeutic agents in this setting.[1]

Multiple myeloma (MM) is a malignant, progressive plasma cell tumor characterized by overproduction of monoclonal immunoglobulins, osteolytic bone lesions, renal disease, and immunodeficiency.[1] Before the 1980s, patients with MM experienced a slow, progressive decline in quality of life until death approximately 2 years after diagnosis.

A case report is followed by a review of the diagnosis and treatment of other cutaneous paraneoplastic syndromes that are associated with hematologic malignancies.

A recent case report in the New England Journal of Medicine highlights the promising potentials of adoptive T-cell immunotherapy by redirecting them, through chimeric antigen receptors, as a novel and effective therapeutic modality for cancer.

The U.S. Food and Drug Administration (FDA) announced last week the approval of brentuximab vedotin, a CD30-directed antibody drug-conjugate, for the treatment of refractory Hodgkin lymphoma and systemic anaplastic large-cell lymphoma.

Equine ATG has been used for the treatment of severe aplastic anemia since the 1980s. Rabbit ATG is used in many parts of the world including South America, Japan, and European countries. The results of a randomized study of equine versus rabbit ATG showed that rabbit ATG was inferior to equine ATG.

Researchers at the University of Pennsylvania have reported on the results of a trial in which a patient with chronic lymphocytic leukemia (CLL) experienced a complete remission after immunotherapy with tumor-reactive modified T cells.

Results of a Phase I study of the novel Poly(ADP-ribose) polymerase (PARP) inhibitor veliparib (ABT-888) in solid tumors and lymphoma have just been published in Cancer Research (doi:10.1158/0008-5472.CAN-11-1227).

Researchers at the University of Chicago and colleagues have identified two variants on chromosome 6q21 that are associated with second malignant neoplasms (SMNs) in survivors of pediatric Hodgkin’s lymphoma. The SMNs are linked to radiation therapy used to treat the pediatric cancer.

There has been dramatic progress in the management of acute promyelocytic leukemia during the past three decades. Important insights into the pathogenesis of the disease have come to light and effective treatment has been developed.

Our ability to stratify patients with CLL into high-risk and low-risk categories has advanced dramatically over the past two decades. However, which test or tests are most reliable remains to be seen.