Genomic Landscape and Risk Stratification in Chronic Myelomonocytic Leukemia
AbstractPurposeThe advent of next-generation sequencing has allowed for the annotation of a vast array of recurrent somatic mutations across human malignancies, ushering in a new era of precision oncology. Chronic myelomonocytic leukemia is recognized as a myelodysplastic/myeloproliferative neoplasm and displays heterogenous clinical and genetic features. Herein, we review what is currently understood regarding the genomic landscape of this disease and discuss how somatic mutations have impacted current risk stratification methods.Recent FindingsGenomic studies in chronic myelomonocytic leukemia have identified a character...
Source: Current Hematologic Malignancy Reports - March 3, 2021 Category: Hematology Source Type: research

Invited Review: Will Consolidation with ASCT Be a Thing of the Past for MCL and PTCL?
AbstractPurpose of ReviewThe treatment landscape of mantle cell (MCL) and peripheral T-cell lymphomas (PTCL) is rapidly changing; however, despite improvement in patients ’ survival, they still remain a largely incurable diseases. Treatment choice is dependent on patient factors, prior therapy, remission duration, and candidacy for stem cell transplantation (SCT). There are subsets of high-risk patients who do not benefit substantially from autologous SCT (ASCT) an d for whom alternative targeted approaches are being examined. Here, we critically analyze the actual role of ASCT in PTCL and MCL.Recent FindingsResearch in ...
Source: Current Hematologic Malignancy Reports - March 1, 2021 Category: Hematology Source Type: research

Pediatric Neoplasms Presenting with Monocytosis
AbstractPurpose of ReviewJuvenile myelomonocytic leukemia (JMML) is a rare but severe pediatric neoplasm with hematopoietic stem cell transplant as its only established curative option. The development of targeted therapeutics for JMML is being guided by an understanding of the pathobiology of this condition. Here, we review JMML with an emphasis on genetics in order to (i) demonstrate the relationship between JMML genotype and clinical phenotype and (ii) explore potential genetic targets of novel JMML therapies.Recent FindingsDNA hypermethylation studies have demonstrated consistently that methylation is related to diseas...
Source: Current Hematologic Malignancy Reports - February 25, 2021 Category: Hematology Source Type: research

Selecting the Optimal CAR-T for the Treatment of B-Cell Malignancies
AbstractPurpose of ReviewChimeric antigen receptor T-cell (CAR-T) therapy is a form of adoptive cellular therapy that has revolutionized the treatment landscape in hematologic malignancies, especially B-cell lymphomas. In this review, we will discuss some of the landmark data behind these therapies and then lay out our approach to utilizing this new therapy.Recent FindingsCD19-directed CAR-Ts are the most common type currently used in treatment of relapsed B-cell lymphoid neoplasms. There are currently three FDA-approved products: axicabtagene ciluecel and tisagenlecleucel for the treatment of relapsed/refractory large B-c...
Source: Current Hematologic Malignancy Reports - February 25, 2021 Category: Hematology Source Type: research

An Update on the Clinical Evaluation of Antibody-Based Therapeutics in Acute Myeloid Leukemia
This article provides an overview of immunologically relevant antigen targets expressed on the leukemic cells and synopsizes the clinical results evaluating targeted antibody-based therapeutic approach in AML.Recent FindingsAML blasts and leukemic stem cells express several antigens, including CD33, CD47, CD70, CD123, and CLEC12A. The past several years have seen the burgeoning of cell-specific immunotherapy concepts, including checkpoint inhibitors, antibody –toxin conjugates, and bispecific antibodies in the treatment of AML. The first-in-class anti-CD47 antibody magrolimab and anti-CD70 antibody cusatuzumab in combina...
Source: Current Hematologic Malignancy Reports - February 25, 2021 Category: Hematology Source Type: research

Immunotherapies Old and New: Hematopoietic Stem Cell Transplant, Chimeric Antigen Receptor T Cells, and Bispecific Antibodies for the Treatment of Relapsed/Refractory Diffuse Large B Cell Lymphoma
AbstractPurpose of ReviewDiffuse large B cell lymphoma (DLBCL) is curable in a majority of patients; however, a significant portion of patients develop relapsed or refractory disease. High-dose chemotherapy followed by autologous stem cell transplant is the standard approach in appropriately selected patients. Many patients are not candidates for transplant and many who do receive autologous transplant relapse. Therapies which harness T cells including chimeric antigen receptor T cells (CAR-T) and bispecific antibodies are active in this chemotherapy-resistant population. We review the role of autologous and allogeneic ste...
Source: Current Hematologic Malignancy Reports - February 22, 2021 Category: Hematology Source Type: research

Secondary AML Emerging After Therapy with Hypomethylating Agents: Outcomes, Prognostic Factors, and Treatment Options
AbstractPurpose of ReviewSecondary AML (s-AML) encompasses a distinct subgroup of AML with either therapy-related AML or AML arising from preexisting myeloid neoplasms. Despite recent advances in the treatment armamentarium of AML, outcomes remain poor in s-AML. The purpose of this review is to highlight distinct characteristics, prognostic factors, and treatment options for patients with s-AML. Further, we focus on a distinctly poor-risk subgroup of s-AML with previous exposure to hypomethylating agents (HMAs) and describe ongoing clinical trials in this patient population.Recent FindingsCPX-351 (liposomal daunorubicin an...
Source: Current Hematologic Malignancy Reports - February 20, 2021 Category: Hematology Source Type: research

Joining Efforts for PTLD: Lessons Learned from Comparing the Approach and Treatment Strategies Across the Pediatric and Adult Age Spectra
AbstractPurpose of ReviewPost-transplant lymphoproliferative disorders are a rare and heterogeneous group of diseases, where large prospective studies have been difficult to perform and treatment paradigms are often based on retrospective studies. Here, we critically analyze and present the clinical algorithms commonly used for this disease, with a special focus on the challenges and differences of the approaches in the adult and pediatric populations.Recent FindingsClinical trials exploring combinations of immunochemotherapies with a sequential and risk-stratified strategy have demonstrated exciting results, but are hampe...
Source: Current Hematologic Malignancy Reports - February 5, 2021 Category: Hematology Source Type: research

High-Risk Mantle Cell Lymphoma in the Era of Novel Agents
AbstractPurpose of ReviewMantle cell lymphoma (MCL) is a heterogenous disease with a variety of morphologic and genetic features, some of which are associated with high risk disease. Here we critically analyze the current state of the understanding of MCL ’s biology and its implications in therapy, with a focus on chemotherapy-free and targeted therapy regimens.Recent FindingsMantle cell lymphoma (MCL) is a rare subtype of non-Hodgkin ’s lymphoma, defined by a hallmark chromosomal translocation t(11;14) which leads to constitutive expression of cyclin D1. Recent discoveries in the biology of MCL have identified a numbe...
Source: Current Hematologic Malignancy Reports - January 28, 2021 Category: Hematology Source Type: research

A New Target for Hodgkin Lymphoma - Camidanlumab Tesirine
AbstractPurpose of ReviewThere are limited treatment options for relapsed/refractory classical Hodgkin lymphoma (cHL) patients who progress on brentuximab vedotin and programmed death-1 inhibitors. Camidanlumab Tesirine (Cami) is a new agent that has shown activity in multiply relapsed/refractory cHL patients. In this review, we provide a comprehensive overview of Cami.Recent FindingsIn phase 1 study of Cami in relapsed/refractory cHL and non-Hodgkin lymphomas (NHL), Cami was noted to be safe with encouraging clinic activity in multiply relapsed/refractory cHL. Treatment-emergent adverse events (TEAEs) were reported in 95%...
Source: Current Hematologic Malignancy Reports - January 25, 2021 Category: Hematology Source Type: research

High-Dimensional Immune Monitoring for Chimeric Antigen Receptor T Cell Therapies
AbstractPurpose of ReviewHigh-dimensional flow cytometry experiments have become a method of choice for high-throughput integration and characterization of cell populations. Here, we present a summary of state-of-the-art R-based pipelines used for differential analyses of cytometry data, largely based on chimeric antigen receptor (CAR) T cell therapies. These pipelines are based on publicly available R libraries, put together in a systematic and functional fashion, therefore free of cost.Recent FindingsIn recent years, existing tools tailored to analyze complex high-dimensional data such as single-cell RNA sequencing (scRN...
Source: Current Hematologic Malignancy Reports - January 15, 2021 Category: Hematology Source Type: research

Emerging Therapies in Relapsed and Refractory Hodgkin Lymphoma: What Comes Next After Brentuximab Vedotin and PD-1 Inhibition?
AbstractPurpose of ReviewThe standard of care for relapsed/refractory (r/r) Hodgkin lymphoma (HL) patients is autologous stem cell transplantation (ASCT) for patients in a first or second relapse. However, a significant number of patients with r/r HL are either medically ineligible for ASCT or relapse post-ASCT. In recent years, significant advances have been made in the management of r/r HL with the introduction of the anti-CD30 antibody-drug conjugate (ADC) brentuximab vedotin (BV) and the anti-PD1 checkpoint inhibitors (CPI) nivolumab and pembrolizumab. Nonetheless, despite excellent tolerability and high response rates...
Source: Current Hematologic Malignancy Reports - January 6, 2021 Category: Hematology Source Type: research

Tweeting from the Bench: Twitter and the Physician-Scientist Benefits and Challenges
AbstractPurpose of ReviewSocial media platforms such as Twitter are increasingly utilized to interact, collaborate, and exchange information within the academic medicine community. However, as Twitter begins to become formally incorporated into professional meetings, educational activities, and even the consideration of academic promotion, it is critical to better understand both the benefits and challenges posed by this platform.Recent FindingsTwitter use is rising amongst healthcare providers nationally and internationally, including in the field of hematology and oncology. Participation on Twitter at national conference...
Source: Current Hematologic Malignancy Reports - November 11, 2020 Category: Hematology Source Type: research

Social Media for Hematopathologists: Medical Practice Reinvented —#Hemepath
AbstractPurpose of ReviewSocial media engagement by medical professionals with varied background subspecialties has steadily gained popularity in recent years. As a heavily visual discipline, pathology has been able to leverage social media platforms for trainee education, curbside and official consultations, interdisciplinary communication, and interactions among medical professionals and patient education. The pathology community has been at the forefront of using social media as an educational forum, and the hematopathology community has emerged as one of the strongest and most influential presences on these online plat...
Source: Current Hematologic Malignancy Reports - October 30, 2020 Category: Hematology Source Type: research

Navigating Ethical Practices in the Era of High Cost Hematology
AbstractPurpose of ReviewIn this review article, we will highlight ethical issues faced by hematologists due to a growing constellation of expensive diagnostics and therapeutics in hematology. We outline the important issues surrounding this topic including stakeholders, cost considerations, and various ethical challenges surrounding access to care, communication about costs, and individual vs. societal responsibilities. We review available tools to navigate these ethical themes and offer potential solutions.Recent FindingsWe identified several gaps in the literature on the topic of ethical issues in hematology treatment a...
Source: Current Hematologic Malignancy Reports - October 5, 2020 Category: Hematology Source Type: research