Despite Low Disease Recurrence, Long-Term AML Survivors Require Preventative Care
Many patients with acute myeloid leukemia (AML) achieve complete remission (CR) after induction chemotherapy; however, just 30% of patients maintain CR for three years or longer. Long-term outcomes for those who do maintain CR are largely unknown. Results from a new study have shown that new medical problems frequently occur, and patients require routine surveillance and preventative measures. Catherine Kendall Major, BS, of the MD Anderson Cancer Center in Lakeland, TN, discussed the findings at the ASH Annual Meeting on December 3, 2018.
Geriatric Assessment in Hematology Scale Classifies Frailty Phenotype
Researchers in Spain developed the Geriatric Assessment in Hematology (GAH) scale to classify patients as robust (those with strength or vigorous health) or frail (those with a poorer prognosis). The tool is validated for use in myelodysplastic syndromes, acute myeloid leukemia, multiple myeloma, and chronic lymphocytic leukemia. Researchers assessed its use and validity among patients with lymphoma. Raul Cordoba, MD, PhD, of Fundacion Jimenez Diaz University Hospital in Madrid, Spain, discussed the findings at the ASH Annual Meeting on December 3, 2018.
Mobile Health Technology Provides Symptom Management Information for Pediatric BMT Recipients
Improved monitoring of pediatric patients undergoing blood and marrow transplant (BMT) may result in better precision symptom management strategies. Mobile health and wearable technologies may aid in such efforts by providing data on complex symptom patterns, trajectories, and interactions. Researchers conducted a pilot study and found that integrating mobile health technology into care was feasible, although they had concerns about compliance. Nirmish Shah, MD, of Duke University School of Medicine in Raleigh, NC, discussed the findings at the ASH Annual Meeting on December 3, 2018.
Study Provides Guidance for Transfusion Practices in Patients With Leukemia Who Experience ICH
Intracranial hemorrhage (ICH) is a common complication in patients with acute leukemia and is associated with significant morbidity and mortality. Information on platelet transfusion practice in patients following ICH is limited, so researchers assessed clinical features and outcomes to better guide transfusion practices after ICH. Shannon Nixon, NP, of the Princess Margaret Cancer Centre at the University of Toronto, discussed the findings at the ASH Annual Meeting on December 3, 2018.
Education May Improve Adherence, Quality of Life for Patients With AML
Patients and families can make better healthcare decisions that are consistent with patients’ needs, values, and preferences when they are more informed and educated about the disease, according to study findings that Anne C. Roc, PhD, of PlatformQ Health in Needham, MA, discussed at the ASH Annual Meeting on December 3, 2018.
Long-Term Lymphoma Survivors Describe Unmet Needs in Cancer Care
Although patients with Hodgkin lymphoma can experience long-term survival, they may face difficulty in coping with treatment-related adverse outcomes. Researchers assessed the needs of lymphoma survivors and their caregivers and identified unmet patient-oriented research needs: quality of life after treatment, messaging and communication between the scientific community and patients, and emotional well-being. Jackelyn B. Payne, MPH, BS, BA, of Stony Brook University in New York, discussed the findings at the ASH Annual Meeting on December 2, 2018.
Screening for DDX41 Mutation Can Guide Treatment Decisions for Myeloid Neoplasms
Germline mutations in DDX41 may increase a patient’s lifetime risk of late-onset myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). Identification of this germline mutation leads to more timely and appropriate care for patients with myeloid neoplasms, according to a study. Sarah Bannon, MS, of the University of Texas MD Anderson Cancer Center in Houston, discussed the findings at the ASH Annual Meeting on December 2, 2018.
Majority of Real-World Patients With DLBCL Are Eligible for CAR T-Cell Therapy
Patients with diffuse large B-cell lymphoma (DLBCL) often experience long-term survival after initial anthracycline-containing therapy; however, relapse leads to poor outcomes. Some patients with relapsed or refractory disease may receive additional chemoimmunotherapy followed by hematopoietic cell transplantation (HCT), but as many as 50% of patients cannot undergo HCT because of lack of response to chemoimmunotherapy or comorbidities. Chimeric antigen receptor (CAR) T-cell therapy may be an option for those patients, but real-world data on CAR T-cell therapy for DLBCL are limited.
Risk Assessment Tool Predicts Survival in Older Patients Undergoing HCT
Older patients are at increased risk for complications and death following allogeneic hematopoietic cell transplantation (alloHCT), and traditional transplant-specific prognostic indices such as the hematopoietic cell transplant comorbidity index (HCT-CI) may not adequately predict survival. Researchers found that routine pretransplant assessments by interdisciplinary clinical providers, including advanced practice providers and nursing staff, may uncover additional geriatric deficits. Richard J. Lin, MD, PhD, of Memorial Sloan Kettering Cancer Center in New York, NY, discussed the findings at the ASH Annual Meeting on December 1, 2018.
CBT May Improve Response to Subsequent Treatment in Heavily Pretreated Patients With HL
Patients with relapsed or refractory Hodgkin lymphoma (HL) after checkpoint blockade therapy (CBT) have limited options. However, researchers found that CBT may impact response to subsequent therapies. Nicole A. Carreau, MD, of New York University Langone Health in New York City, discussed the findings at the ASH Annual Meeting on December 1, 2018.
Genetics Plays a Role in Treatment Response for Relapsed or Refractory Multiple Myeloma
No molecular-informed personalized therapies are currently available for patients with relapsed/refractory multiple myeloma (MM); however, cytogenetics and next-generation sequencing (NGS) can identify molecular abnormalities to provide guidance for more targeted therapy. Tarek Assi, MD, of Gustave Roussy Cancer Campus in Villejuif, France, discussed his research team’s findings that tumor genotyping is associated with higher response rates and prolonged duration of therapy at the ASH Annual Meeting on December 1, 2018.
Hematology Training Is Suboptimal for APPs
Advanced practice providers (APPs) may have limited subspecialty training options for hematology, and postgraduate fellowships focused on education in both malignant and nonmalignant hematologic disorders appear to be lacking for APPs. Yi L. Hwa, DNP, of the division of hematology at the Mayo Clinic in Rochester, MN, discussed the findings of a research team’s web-based needs assessment survey that found significant gaps in subspecialty hematology training for APPs at the ASH Annual Meeting on December 1, 2018.
Multiple Myeloma Survivors Still Experience Symptoms and Psychological Concerns
Survival from multiple myeloma (MM) has improved, and more attention is required for symptom burden and psychological impact in the long-term management of this disease. Researchers assessed the incidence of self-reported pain, depression, financial and family burden, and impairment of performance status, as well as determined the correlation of total distress with survival. Joshua R. Richter, MD, at the John Theurer Cancer Center in Hackensack, NJ, discussed the findings at the ASH Annual Meeting.
Physical Activity Level Before and After Cancer Diagnosis Impacts Survival for Lymphoma
Researchers assessed the impact of physical activity levels before and after cancer diagnosis on overall survival (OS) and lymphoma-specific survival (LSS) outcomes in patients with lymphoma. They found that higher levels of physical activity during adult life and within three years of diagnosis improve survival. Priyanka Pophali, MD, at the Mayo Clinic in Rochester, MN, discussed the findings at the ASH Annual Meeting.
Better Symptom Management Is Needed for Patients With CML
Patients with chronic myeloid leukemia (CML) often experience symptoms and treatment-related adverse events (AEs) that are chronic and may require care from an interdisciplinary team. A study sought to assess symptom burden, palliative care needs, and experiences with healthcare team communication in this patient population. Alexandra K. Zaleta, PhD, at the Research and Training Institute, Cancer Support Community in Philadelphia, PA, discussed the findings at the ASH Annual Meeting.
Real-World Findings for Ibrutinib in Patients With CLL: Toxicities, Discontinuations, and More
Ibrutinib is approved by the U.S. Food and Drug Administration (FDA) for the treatment of chronic lymphocytic leukemia (CLL). Researchers sought to study real-world outcomes related to adverse events (AEs), treatment discontinuation, outcomes, and subsequent therapies in those treated with frontline ibrutinib. Anthony R. Mato, MD, at the University of Pennsylvania Abramson Cancer Center in Philadelphia, PA, discussed the findings at the ASH Annual Meeting.
Do Survivorship Care Plans Decrease Cancer Treatment Distress?
Researchers conducted a randomized study to assess the impact of survivorship care plans (SCPs) on cancer survivors who underwent hematopoietic cell transplantation (HCT). They assessed confidence in survivorship information (primary analysis), as well as cancer treatment distress, knowledge of transplant exposures, health behaviors, healthcare use, and health general self-efficacy. Navneet S. Majhail, MD, MS, at the Taussig Cancer Institute at the Cleveland Clinic in Ohio, discussed the findings at the ASH Annual Meeting.
Factors Predict 30-Day Hospital Readmissions for Patients With Hematologic Malignancies
Data are limited on repeated unplanned hospital readmissions among patients with hematologic malignancies, so researchers analyzed baseline characteristics of patients with one or more 30-day unplanned readmissions, as well as factors related to these readmissions. Girish Kunapareddy, MD, at the Taussig Cancer Institute at the Cleveland Clinic in Ohio, discussed the findings at the ASH Annual Meeting.
Individualized Care Plans Decrease Emergency Department Use
Unplanned hospitalizations and emergency department (ED) visits are an ongoing problem for patients with cancer. At the Taussig Cancer Institute, just 6% of all discharged patients accounted for more than 40% of unplanned readmissions (defined as a hospitalization occurring within 30 days of discharge). Those patients are also at high risk for future admissions, intensive care unit (ICU) stay, ED visits, overuse of chemotherapy, and underuse of hospice resources. Researchers developed an individualized care plan (ICP) for patients with the highest preventable use to see if this would impact hospital use and readmissions. Girish Kunapareddy, MD, at the Taussig Cancer Institute at the Cleveland Clinic in Ohio, discussed the findings at the ASH Annual Meeting.
Statins Enhance Venetoclax Response in CLL and MM
Venetoclax—an oral, small-molecule BCL-2 inhibitor—is approved by the U.S. Food and Drug Administration for the treatment of relapsed or refractory chronic lymphocytic leukemia (CLL) in those with del(17p) mutation. Statins, which are used to lower cholesterol, have shown a potential to induce apoptosis in various cancer cell lines, and evidence suggests a synergism when combined with BCL-2 inhibition. Based on this, researchers conducted a post-hoc analysis to see whether statins enhance the activity of venetoclax in patients with CLL or multiple myeloma (MM). Andrew W. Roberts, MS, at AbbVie Inc., in North Chicago, IL, discussed the findings at the ASH Annual Meeting.
Diet Choices and Supplement Use May Affect MPN Symptom Burden
Patients with myeloproliferative neoplasms (MPN) have increased inflammatory cytokines that contribute to symptom burden and nutritional deficiencies. Some studies have indicated that diets and supplements have demonstrated antioxidant and anti-inflammatory pharmacologic properties, such as decreased inflammatory markers and reactive oxygen species. Researchers conducted a study to examine nutritional and supplemental needs in this patient population. Robyn M. Scherber, MD, at Oregon Health and Science University in Portland, discussed the findings at the ASH Annual Meeting.
Patients With CLL Report Worse QoL and Other Factors
Researchers assessed how patients with chronic lymphocytic leukemia (CLL) describe quality of life (QoL) compared to other U.S. populations, as well as the effects on daily living, finances, and professional and family relationships. Joanne S. Buzaglo, PhD, at the Research and Training Institute, Cancer Support Community in Philadelphia, PA, discussed the findings at the ASH Annual Meeting.
Activity Tracker Data Correlates With Patient-Reported Outcomes
Patient-reported outcomes (PROs) are an important part of patient management but may be burdensome for patients to track. Wearable activity monitors provide objective, continuous activity data that may correlate with PROs, and researchers assessed the use of this technology in a study. Carrie A. Thompson, MD, at the Mayo Clinic in Rochester, MN, discussed the findings at the ASH Annual Meeting.
Factors Related to Palliative Care Use in Patients With Hematologic Malignancies
No data exist on current trends and practice patterns for palliative care use among patients with cancer, particularly those with hematologic malignancies. Sikander Ailawadhi, MD, at the Mayo Clinic in Jacksonville, FL, discussed their findings on these trends at the ASH Annual Meeting.
Disease Factors Influence Treatment Decisions More Than Comorbidities in Patients With Follicular Lymphoma
Data from U.S. Lymphocare suggest that older patients with follicular lymphoma (FL) are more commonly treated with watchful waiting or single-agent rituximab and found no difference in outcomes by treatment groups, but comorbidity was not studied. Researchers aimed to describe patient features, comorbidity use of positron-emission tomography (PET) staging, management choices, and the impact of polypharmacy on outcomes of patients with FL aged 70 years or older. Prathima Reddy, MD, at CHI Franciscan Hospital in Federal Way, WA, discussed the findings at the ASH Annual Meeting.
Study Assesses Ibrutinib’s Impact on Major Hemorrhage in Patients With B-Cell Malignancies
Ibrutinib is a first-in-class, once-daily inhibitor of Bruton tyrosine kinase that is approved for various B-cell malignancies. However, the drug is associated with increased rates of low-grade hemorrhage and sometimes serious hemorrhage, which is listed as a warning in the prescribing information. Patients with chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and mantle cell lymphoma (MCL) are at an increased risk for major hemorrhage (MH) compared to the general population.
Autoimmune and Infectious Diseases Are Increased in DLBCL Survivors Compared to Other Cancer Survivors
Many lymphoma treatments are known to affect the immune system, so researchers assessed whether survivors of diffuse large B-cell lymphoma (DLBCL) have an altered risk of developing autoimmune and infectious diseases compared to other cancer survivors. Tanaya Shree, MD, PhD, at Stanford University Medical Center in California, discussed the findings at the ASH Annual Meeting.
Patients With MM Receiving PIs Need Herpes Zoster Prophylaxis
Patients with multiple myeloma (MM) who receive proteasome inhibitors (PIs) are at an increased risk for herpes zoster infection, and National Comprehensive Cancer Network guidelines recommend antiviral prophylaxis for these patients. Researchers examined the use of and adherence to antiviral agents in this patient population. Siyang Leng, MD, at Columbia University Medical Center in Sunnyside, New York, discussed the findings at the ASH Annual Meeting.
Study Compares Adverse Event Profile for CPX-351 and Conventional 7+3 for AML
CPX-351 is a dual-drug liposomal encapsulation of cytarabine and daunorubicin that delivers a synergistic drug ratio. In a randomized, phase III study, researchers evaluated induction therapy with CPX-351 versus conventional cytarabine/daunorubicin (referred to as 7+3 regimen) in adults aged 60–75 years with newly diagnosed, treatment-related acute myeloid leukemia (AML) or AML with myelodysplasia-related changes. Bruno C Medeiros, MD, at Stanford University School of Medicine in California, discussed the findings at the ASH Annual Meeting.