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MRD in ALL: Optimization and Innovations
AbstractPurpose of ReviewMeasurable residual disease (MRD) is an important monitoring parameter that can help predict survival outcomes in acute lymphoblastic leukemia (ALL). Identifying patients with MRD has the potential to decrease the risk of relapse with the initiation of early salvage therapy and to help guide decision making regarding allogeneic hematopoietic cell transplantation. In this review, we discuss MRD in ALL, focusing on advantages and limitations between MRD testing techniques and how to monitor MRD in specific patient populations.Recent FindingsMRD has traditionally been measured through bone marrow samp...
Source: Current Hematologic Malignancy Reports - May 26, 2022 Category: Hematology Source Type: research

Clonal Hematopoiesis and Myeloid Neoplasms in the Context of Telomere Biology Disorders
AbstractPurpose of ReviewTelomere biology disorders (TBDs) are cancer-predisposing multisystemic diseases that portend a higher risk of transforming into myeloid neoplasms (MNs). Due to the rarity and high variability of clinical presentations, TBD-specific characteristics of MN and the mechanisms behind this predisposition are not well defined. Herein, we review recent studies on TBD patient cohorts describing myeloid transformation events and summarize efforts to develop screening and treatment guidelines for these patients.Recent FindingsPreliminary studies have indicated that TBD patients have a higher prevalence of so...
Source: Current Hematologic Malignancy Reports - May 18, 2022 Category: Hematology Source Type: research

Targeting Apoptosis in ALL
AbstractPurpose of ReviewWhile the treatment of acute lymphoblastic leukemia (ALL) has improved significantly over the last 30  years, the majority of adult patients will have their disease relapse. TheBCL-2 gene was initially discovered from follicular lymphoma research; however, the BH3 family of proteins has is emerging to be crucial in patients with ALL due to their reliance on the balance of these pro-apoptotic and anti-apoptotic proteins in the BH3 family. We discuss apoptosis in ALL, the reliance mechanisms, drug development in this space, and areas for future research.Recent FindingsThe first drugs that were devel...
Source: Current Hematologic Malignancy Reports - May 11, 2022 Category: Hematology Source Type: research

Clonal Hematopoiesis and Myeloid Neoplasms in the Context of Telomere Biology Disorders
AbstractPurpose of ReviewTelomere biology disorders (TBDs) are cancer-predisposing multisystemic diseases that portend a higher risk of transforming into myeloid neoplasms (MNs). Due to the rarity and high variability of clinical presentations, TBD-specific characteristics of MN and the mechanisms behind this predisposition are not well defined. Herein, we review recent studies on TBD patient cohorts describing myeloid transformation events and summarize efforts to develop screening and treatment guidelines for these patients.Recent FindingsPreliminary studies have indicated that TBD patients have a higher prevalence of so...
Source: Current Hematologic Malignancy Reports - May 7, 2022 Category: Hematology Source Type: research

Targeting Apoptosis in ALL
AbstractPurpose of ReviewWhile the treatment of acute lymphoblastic leukemia (ALL) has improved significantly over the last 30  years, the majority of adult patients will have their disease relapse. TheBCL-2 gene was initially discovered from follicular lymphoma research; however, the BH3 family of proteins has is emerging to be crucial in patients with ALL due to their reliance on the balance of these pro-apoptotic and anti-apoptotic proteins in the BH3 family. We discuss apoptosis in ALL, the reliance mechanisms, drug development in this space, and areas for future research.Recent FindingsThe first drugs that were devel...
Source: Current Hematologic Malignancy Reports - April 1, 2022 Category: Hematology Source Type: research

Use of Telemedicine in Care of Hematologic Malignancy Patients: Challenges and Opportunities
AbstractPurpose of ReviewFor nearly 20  years, oncology specialty practices have been working to integrate telemedicine technologies into standard patient care models. However, hematology practices have been slower to adopt telemedicine due to traditional care models that rely on interdisciplinary regional care centers and their ability to provide comprehensive and centralized services. Patients have traditionally been able to access high-quality medical care, diagnostics, supportive care, and clinical trials from these regional care centers, but they are required to attend frequent in-person visits to access these servic...
Source: Current Hematologic Malignancy Reports - February 1, 2022 Category: Hematology Source Type: research

Multidisciplinary Approach to Older Adults with Hematologic Malignancies —a Paradigm Shift
AbstractHematologic malignancies are most likely to present in the seventh and eighth decades of life. Continued population growth will lead to increasing numbers of older adults with hematologic malignancies. Oncology care for older adults is complex and must account for the effect of aging on disease biology and treatment tolerance. Multidisciplinary oncology care has been utilized in solid tumor oncology for decades, initially driven by the need for multi-modality treatment. In this review, we make the case for multidisciplinary oncogeriatric care for older adults with hematologic malignancies in order to best navigate ...
Source: Current Hematologic Malignancy Reports - February 1, 2022 Category: Hematology Source Type: research

Management of CNS Disease in Pediatric Acute Lymphoblastic Leukemia
AbstractPurpose of ReviewThe treatment of acute lymphoblastic leukemia (ALL) is one of the success stories of pediatric oncology, but challenges and questions remain, including the optimal approach to the treatment of central nervous system (CNS) leukemia. It is unclear why some children with ALL develop CNS leukemia and others do not, and there remains debate regarding optimal regimens for prophylaxis, upfront treatment, and the treatment of CNS relapses. These topics are especially important since both cranial radiation therapy (CRT) and intensive intrathecal therapy carry risks of both short- and long-term adverse effec...
Source: Current Hematologic Malignancy Reports - February 1, 2022 Category: Hematology Source Type: research

Management of Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma in the Era of Targeted Therapies
AbstractPurpose of ReviewThe treatment landscape for relapsed chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) has changed substantially over the past decade and continues to evolve. Despite the emergence of targeted therapies that are well tolerated and prolong survival, the disease remains incurable and relapse is common particularly in individuals with high-risk features. Herein, we review the key literature about the current options for relapsed disease and explore the emerging role of cellular therapies.Recent FindingsClinical trials have established the role of Bruton tyrosine kinase inhibitors...
Source: Current Hematologic Malignancy Reports - February 1, 2022 Category: Hematology Source Type: research

Multidisciplinary Approach to Older Adults with Hematologic Malignancies —a Paradigm Shift
AbstractHematologic malignancies are most likely to present in the seventh and eighth decades of life. Continued population growth will lead to increasing numbers of older adults with hematologic malignancies. Oncology care for older adults is complex and must account for the effect of aging on disease biology and treatment tolerance. Multidisciplinary oncology care has been utilized in solid tumor oncology for decades, initially driven by the need for multi-modality treatment. In this review, we make the case for multidisciplinary oncogeriatric care for older adults with hematologic malignancies in order to best navigate ...
Source: Current Hematologic Malignancy Reports - January 13, 2022 Category: Hematology Source Type: research

Management of CNS Disease in Pediatric Acute Lymphoblastic Leukemia
AbstractPurpose of ReviewThe treatment of acute lymphoblastic leukemia (ALL) is one of the success stories of pediatric oncology, but challenges and questions remain, including the optimal approach to the treatment of central nervous system (CNS) leukemia. It is unclear why some children with ALL develop CNS leukemia and others do not, and there remains debate regarding optimal regimens for prophylaxis, upfront treatment, and the treatment of CNS relapses. These topics are especially important since both cranial radiation therapy (CRT) and intensive intrathecal therapy carry risks of both short- and long-term adverse effec...
Source: Current Hematologic Malignancy Reports - January 13, 2022 Category: Hematology Source Type: research

Management of Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma in the Era of Targeted Therapies
AbstractPurpose of ReviewThe treatment landscape for relapsed chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) has changed substantially over the past decade and continues to evolve. Despite the emergence of targeted therapies that are well tolerated and prolong survival, the disease remains incurable and relapse is common particularly in individuals with high-risk features. Herein, we review the key literature about the current options for relapsed disease and explore the emerging role of cellular therapies.Recent FindingsClinical trials have established the role of Bruton tyrosine kinase inhibitors...
Source: Current Hematologic Malignancy Reports - January 13, 2022 Category: Hematology Source Type: research

Use of Telemedicine in Care of Hematologic Malignancy Patients: Challenges and Opportunities
AbstractPurpose of ReviewFor nearly 20  years, oncology specialty practices have been working to integrate telemedicine technologies into standard patient care models. However, hematology practices have been slower to adopt telemedicine due to traditional care models that rely on interdisciplinary regional care centers and their ability to provide comprehensive and centralized services. Patients have traditionally been able to access high-quality medical care, diagnostics, supportive care, and clinical trials from these regional care centers, but they are required to attend frequent in-person visits to access these servic...
Source: Current Hematologic Malignancy Reports - January 11, 2022 Category: Hematology Source Type: research

A Multi-disciplinary Approach to Managing Chronic Myelogenous Leukemia Patients on Oral Anticancer Therapy at a Large Academic Medical Center
AbstractPurpose of ReviewSince the discovery of imatinib, an oral breakpoint cluster region —Abelson murine leukemia tyrosine kinase inhibitor, chronic myelogenous leukemia transformed from a hematologic malignancy primarily treated with intravenous chemotherapy to a disease almost solely managed with oral agents. While certainly there are benefits to taking a medication at home, this ch ange in treatment modality also came with unique challenges, including patient adherence, medication acquisition and cost, and toxicity management.Recent FindingsPharmacists are uniquely equipped to assist with educating patients, safe p...
Source: Current Hematologic Malignancy Reports - December 1, 2021 Category: Hematology Source Type: research