Articles related to Hematology/Oncology

Publication: JAMA OncologyMethod: Retrospective study of 160 adults with hematologic malignant disease who were vaccinated with 1 of 3 COVID-19 vaccines (February through April 2021).Results: Patients receiving B-cell-depleting immunotherapy may not gain adequate protection from vaccination and may still develop a potentially fatal infection.

Source: Blood AdvancesKey Points: In a cohort of 154 patients with NHL or MM receiving CAR T-cells, clonal hematopoiesis of indeterminate potential (CHIP) was present in 48%. Although associated with worse prognosis in these patients receiving autologous transplantation, no such association was seen in these patients receiving CAR T. Instead, the authors saw increased rates of complete response and cytokine release syndrome severity in the younger than 60 population. However, there was no difference in progression-free or overall survival, regardless of age. Design: Cohort review of 154 patients with NHL or MM receiving CAR T-cells

Key Points: In two study cohorts, less-intensive therapies increased mortality in each of three risk groups defined by age, comorbidities, and cytogenetics. The differences became nonsignificant after accounting for physician perception of cure, emphasizing the need for a randomized trial.Design: Multicenter retrospective cohort (1,292), 6 institutions, 2008-2012; prospective cohort (695), 13 institutions, 2013 – 2017Connected Content: Fitness for Intensive Chemotherapy: A Continuing Conundrum

After diagnosis during a partial mastectomy, this patient’s estimated blood loss was 58 mL, causing anemia and requiring a red blood cell transfusion along with ventriculoperitoneal drain placement. With a substantive bleeding history before the diagnosis, what would you do next with this patient? Work her up for von Willebrand disease? Do a complete blood count test to look at platelet count, a peripheral smear to look at the morphology of the platelets, and a coagulation profile? Offer genetic testing for fibrinogen disorders? What would your next steps be? Read the full case presentation and expert opinion to see how your peers responded.

Publication: Blood Key Points: The authors identified the following four prognostic indicators that could help control CNS relapse in children with ALL. 1) Prephase dexamethasone treatment, 2) delayed intrathecal therapy, 3) use of total intravenous anesthesia during intrathecal therapy, and 4) flow cytometry examination of diagnostic CSF Design: 7,640 consecutive patients treated on Chinese Children’s Cancer Group ALL-2015 protocol

Pediatric B-cell acute lymphoblastic leukemia (B-ALL) is the most common malignancy seen in children and adolescents and young adults (AYAs). This article highlights two recent studies that provide novel evidence of the association between obesity and increased risk of high-risk B-ALL and the effectiveness of a non-pharmacologic intervention for reducing minimal residual disease (MRD) risk.