Recent Advances in CAR-T Cell Therapy for Non-Hodgkin Lymphoma
We describe the recent developments in this field, with emphasis on the complications of therapy and factors contributing to toxicities, efficacy, and resistance. We also describe the ongoing research in this field and the newer CAR-T cell constructs that are being developed to counter the challenges that have been identified in this field.
Although outcomes following first-line therapy for patients with indolent or aggressive non-Hodgkin lymphoma (NHL) are continually improving, relapse is still common. Current treatment options for patients with relapsed or refractory disease have limited efficacy, and various targeted therapies are under investigation to help improve outcomes in this patient population. The phosphatidylinositol 3-kinase (PI3K) pathway was identified as being involved in hematologic malignancies, leading to significant research for potential therapeutic agents.
CONCLUSION: This modified pre-lysis procedure provides a sensitive, robust, time efficient, and relatively cost-effective alternative for MRD testing by MFC at 10-5 , facilitating clinically meaningful deeper response assessment for MM, CLL, and B-NHL. This method adaptation may facilitate more widespread adoption of highly sensitive flow cytometry-based MRD assessment. PMID: 32530574 [PubMed - as supplied by publisher]
This article reviews, in a systematic, organ-based approach, the acute metabolic and mechanical emergencies encountered in the emergency department in patients with hematologic malignancies.
Abstract Hematologic B-cell malignancies, which have varying behavior patterns, disease processes, and treatment responses, include non-Hodgkin lymphoma, leukemias, and myeloma. Although monoclonal antibodies and other agents have led to dramatic advances in the treatment of B-cell malignancies, the development of small molecules have enhanced the ability to treat and manage these malignancies and their adverse events (AEs). Oncology nurses need to be educated on the unique side effects for each class of these agents so that they can administer interventions to prevent and manage AEs in patients. PMID: 321960...
Frontline treatment for patients with indolent non-Hodgkin lymphoma often includes immunochemotherapy. Although the disease of most patients responds to initial treatment, relapse is common. Recent results from the phase 3 Augment trial showed that combining rituximab with the immunomodulatory drug lenalidomide (R2) significantly improved efficacy over rituximab monotherapy in patients with recurrent non-Hodgkin lymphoma. As a result of these data, R2 was approved in the US (Food and Drug Administration) and Japan (Pharmaceuticals and Medical Devices Agency) for previously treated adult patients with follicular and margina...
CONCLUSIONS: Broad-spectrum antibiotics were common in patients with haematological malignancies in Japan; however, antibiotic-resistant bacteria including carbapenem-resistant or multidrug-resistant bacteria were infrequent. Our results provide nationwide, cross-sectional insight into the use of antimicrobial agents, prevalence of bacteria, and antibiotic resistance, demonstrating differences in antimicrobial utilization among different haematological diseases. PMID: 32066448 [PubMed - in process]
Neurolymphomatosis (NL) is a devastating complication of non-Hodgkin Lymphoma (NHL) with significant morbidity. It was first described by Baehring et al in 2003 as the direct infiltration of the cranial and peripheral nervous systems by lymphoma cells (1). It is a rare clinical entity, affecting approximately 0.2% of all NHL patients (2). Most cases are due to B-cell NHL (3). Although typically a hallmark of disease progression, it can also be the presenting symptom of a new diagnosis. When this occurs, it is referred to as “Primary NL” (1).
Positron emission tomography/computed tomography (PET/CT) has important value in staging of many non-Hodgkin lymphoma histologies; however, its role in assessment of marginal zone lymphoma (MZL) is controversial. Evaluation of 571 PET/CT scans of 178 patients with MZL revealed subcutaneous lesions in 11% of patients. We characterized their unique and specific PET/CT findings that enhance clinical diagnosis, accurate staging, and follow-up of MZL.
ConclusionVenetoclax therapy in a real-world cohort offered modest benefits in heavily pretreated patients. Adverse events were observed at a greater incidence than in the clinical trials. A wide heterogeneity of venetoclax dose escalation, multiagent combinations, and timing of initiation were identified and require investigation in subsequent clinical trials.
Shutdowns earlier this year of two facilities that use ethylene oxide (EtO)Â to sterilize medical devices prompted FDA to monitor for supply shortages in the industry because EtO is such a popular sterilization method for medical devices. This week the agency revealed steps it will take to reduce medtech's reliance on EtO sterilization. EtOÂ is a flammable, colorless gas used to sterilize equipment and plastic devices that cannot be sterilized by steam, such as medical equipment. In fact, about half of allÂ sterilized medical devices undergo sterilization using this gas.Â Breathi...