Articles related to LEUKEMIA

The authors analyzed a cohort of nearly 5,000 patients with AML for the prevalence and prognostic impact of IDH mutations and found distinct clinical and co-mutational features of the IDH1-R132C mutation. The study identified variable outcomes associated with distinct mutations of IDH and offers additional evidence in support of delineating the IDH2-R172K mutation as a distinct entity based on its co-mutational landscape and significant impact on outcome.

Outcomes from the large PETHEMA registry study shows that secondary AML is common (27% of AML cases) and has a median OS of 5.6 months vs. 10.9 months for primary AML, and has various differing characteristics compared to primary AML. These include older age at diagnosis, more high-risk cytogenetics, less FMS-like tyrosine kinase three internal tandem duplication, fewer NPM1 mutations, and received a lower intensity of chemotherapy.

Extending the ELEVATE-TN to four additional years (beyond the two-year follow-up in the pivotal trial) showed ongoing efficacy with no new safety signals. Additionally, the four year ELEVATE-RR trial comparing acalabrutinib with ibrutinib as monotherapy in high-risk populations showed overall non-inferiority of acalabrutinib and a lower rate of several adverse events, including atrial fibrillation.

Dana Farber’s CLL Center associate director Matthew S. Davids, MD, MMSc highlights some of his key takeaways from the recent ASH meeting: Novel treatment approaches in chronic lymphocytic leukemia (CLL), including large phase 3 studies, some smaller studies combining novel drugs, and long-term follow-ups of prior phase 3 studies; three reports with practice-changing implications; and a surprising finding in the ECOG 1912 study, which demonstrated an overall survival benefit for patients who received ibrutinib with rituximab.

The GLOW study is a phase 3 clinical trial evaluating the efficacy and safety of ibrutinib plus venetoclax (I+V) in elderly or unfit CLL patients. Patients receiving I+V are compared to patients receiving chlorambucil plus obinutuzumab (C+O). Previously this study reported reduced risk of disease progression with I+V vs C+O. This update, presented at ASH 2021, looked at undetectable minimal residual disease (uMRD) – a surrogate for PFS. uMRD was significantly higher in both peripheral blood and bone marrow in the I+V group.

To define the spectrum of alterations common at relapse, the researchers in this study performed integrated profiling of 136 relapsed pediatric AML cases with RNA sequencing (RNA-seq), whole-genome sequencing, and target-capture sequencing. In addition, well-characterized fusion oncoproteins were identified, as were somatic mutations in UBTF (upstream binding transcription factor). See the results from the late-breaking abstract being presented at the ASH Annual Meeting & Exhibition.