Inotuzumab ozogamicin as chemotherapy-sparing salvage in a 67-year-old man with primary refractory B-cell acute lymphoblastic leukemia with high-risk genomic features

Publication date: Available online 26 November 2019Source: Leukemia Research ReportsAuthor(s): Xiaochuan Yang, Filiz Sen, Mark B. GeyerAbstractOlder adults with acute lymphoblastic leukemia (ALL) continue to have a poor prognosis, in part due to greater chemotherapy-related toxicities. We herein report a 67-year-old man with Philadelphia chromosome (Ph)-negative B-cell ALL, who exhibited refractoriness to 3 different regimens of induction chemotherapy and experienced multiple complications including intracranial bleeding and respiratory failure, who achieved minimal residual disease (MRD)-negative complete response (CR) after a single cycle of inotuzumab ozogamicin (IO). His ALL was characterized by several high-risk mutations, which may have contributed to chemotherapy-refractory disease. Our case supports incorporating IO into front-line induction regimens for older adults with high-risk B-cell ALL.
Source: Leukemia Research Reports - Category: Hematology Source Type: research

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This study will provide valuable information for the safety and efficacy of apixaban in VTE prevention during induction in paediatric ALL. PMID: 30861550 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: Thromb Haemost Source Type: research
Publication date: December 2018Source: The Lancet Haematology, Volume 5, Issue 12Author(s): Elias Jabbour, Nicholas J Short, Farhad Ravandi, Xuelin Huang, Naval Daver, Courtney D DiNardo, Marina Konopleva, Naveen Pemmaraju, William Wierda, Guillermo Garcia-Manero, Koji Sasaki, Jorge Cortes, Rebecca Garris, Joseph D Khoury, Jeffrey Jorgensen, Nitin Jain, Joie Alvarez, Susan O'Brien, Hagop KantarjianSummaryBackgroundThe combination of chemotherapy and ponatinib in Philadelphia chromosome-positive acute lymphoblastic leukaemia has the potential to be a new standard of care for the disease; however, long-term efficacy and safe...
Source: The Lancet Haematology - Category: Hematology Source Type: research
ConclusionThe monitoring and supplementation of AT in ALL, lymphoblastic lymphoma, and NK/T-cell lymphoma patients was associated with a significant decrease in the occurrence of clinically significant thrombi. Patients in both groups did not experience bleeding events and the overall survival rate was similar between groups. While the average cost of AT repletion was considerable, the cost associated with a thrombus is arguably more substantial when taking into account intensive care admissions, diagnostic exams, and anticoagulation medications. Therefore, the result of this study suggests utilization of monitoring AT act...
Source: Blood - Category: Hematology Authors: Tags: 612. Acute Lymphoblastic Leukemia: Clinical Studies: Poster I Source Type: research
DiscussionThe present study indicates that MRD status after induction and consolidation therapies is a strong prognostic factor. Post-induction MRD-negative patients have been identified to have good-prognosis with chemotherapies, not suitable for up-front allogeneic HSCT.Figure 1.DisclosuresTakamatsu: Taisho Toyama Pharmaceutical: Research Funding; TAIHO Pharmaceutical: Research Funding; Pfizer: Research Funding; Bristol-Myers Squibb: Research Funding; Ono Pharmaceutical: Research Funding; Astellas Pharma: Research Funding; Kyowa Hakko Kirin: Research Funding; Chugai Pharma: Research Funding; Takeda Pharmaceutical: Resear...
Source: Blood - Category: Hematology Authors: Tags: 612. Acute Lymphoblastic Leukemia: Clinical Studies: Poster III Source Type: research
Background Venous thromboembolism (VTE) is a well-known complication in adults receiving asparaginase (ASNase)-based intensification chemotherapy for acute lymphoblastic leukemia (ALL). The optimal preventative strategy is unclear. We previously reported high thrombosis rates during intensification without VTE prophylaxis. Our objective is to determine the effects of weight-adjusted enoxaparin as primary VTE prophylaxis in ambulatory adults receiving ASNase-based intensification chemotherapy for ALL.Methods Patients who achieved complete remission following induction from 2011-2017 went on to receive ASNase-based intensifi...
Source: Blood - Category: Hematology Authors: Tags: 612. Acute Lymphoblastic Leukemia: Clinical Studies: Poster III Source Type: research
​​BY ​​​GURDEEP​ SINGH NAGI, MD; BHAVINI TAILOR, ​MD; & ​AHMED RAZIUDDIN, MDA 40-year-old man with no significant past medical history presented to the emergency department with visual problems. He said he had noticed about four days earlier a dark red circle over any object on which he tried to focus. The condition had been constant and had not improved or worsened over the past few days. He also said it did not matter whether he was focusing on an object that was near or far.The patient had seen an optometrist who recommended he have blood work done, but did not specify what exactly to test...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Conclusion: Under strict standard hygiene and contact isolation for symptomatic patients, genotyping of clinical isolates revealed that in pediatric cancer patients, CDI is not necessarily based on nosocomial transmission. The rate of CDI-related severe complications was low.What is Known:•Pediatric cancer patients face an increased risk of Clostridium difficile-associated disease due to immunosuppression, cancer chemotherapy, mucositis, and dysbiosis following intravenous broad-spectrum antimicrobial treatment.•C. difficile may be transmitted from patient to patient.What is New:•Under strict standard hygien...
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research
We describe the implementation and results of prophylactic anticoagulation guidelines in adults (18 –50 years) treated on a Dana-Farber Cancer Institute ALL pediatric inspired consortium protocol from 2007 to 2013. A high rate of asparaginase related toxicity events, including thrombosis, resulted in a protocol amendment adding guidelines for prophylactic anticoagulation and a modified asparagi nase dose and schedule. After excluding patients with Philadelphia positive ALL, a cohort of 36 patients were treated after the protocol amendment with prophylactic anticoagulation and compared to 49 patients who received...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
Rationale: Pegaspargase has been used in the treatment of acute lymphoblastic leukemia with promising results. However, it has also been associated with several potentially serious complications, including thrombosis. Pegaspargase-induced cerebral venous thrombosis and bone marrow necrosis are very rare. Patient concerns: A 50-year-old female developed headache, weakness of the right lower extremity, fever, and bone pain after chemotherapy including pegaspargase for the treatment of acute lymphoblastic leukemia. Diagnoses: Her imaging studies and bone marrow examinations were compatible with cerebral venous thrombo...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
AbstractPurposeFebrile neutropenia (FN) is an important cause of morbidity and mortality in children with acute lymphoblastic leukemia (ALL). We aimed to look at complications in febrile neutropenia and to derive a risk model for developing complications from the variables predicting complications.MethodsChildren on treatment for ALL, presenting with FN, were prospectively enrolled over a period of 1  year. Their clinical presentation, course during hospital stay, and outcomes were recorded. Complications recorded included septic shock, pneumonia requiring invasive or non-invasive ventilation, renal failure, neutropen...
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
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