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EBV Reactivation and Lymphomagenesis: More Questions than Answers
AbstractPurpose of ReviewEpstein-Barr Virus (EBV) is a ubiquitous herpesvirus that affects almost all humans and establishes lifelong infections by infecting B-lymphocytes leading to their immortalization. EBV has a discrete life cycle with latency and lytic reactivation phases. EBV can reactivate and cause lymphoproliferation in both immunocompetent and immunocompromised individuals. There is sparse literature on monitoring protocols for EBV reactivation and no standardized treatment protocols to treat EBV-driven lymphoproliferation.Recent FindingsWhile there are no FDA-approved therapies to treat EBV, there are several s...
Source: Current Hematologic Malignancy Reports - August 11, 2023 Category: Hematology Source Type: research

Financial Toxicity in Patients with Hematologic Malignancies: a Review and Need for Interventions
DiscussionHowever, few studies to date have focused on implementing successful interventions to assist in mitigating financial difficulties for patients diagnosed with hematologic malignancies and their families. In this review, we examine the current literature with an emphasis on levels of care, including providers, systems, and policies. Specifically, we discuss published interventions including physician education about treatment costs, financial navigation in cancer centers, and novel institutional multidisciplinary review of patients ’ financial concerns. We also discuss the urgent need for societal and governmenta...
Source: Current Hematologic Malignancy Reports - July 25, 2023 Category: Hematology Source Type: research

Developing Targeted Therapies for T Cell Acute Lymphoblastic Leukemia/Lymphoma
AbstractPurpose of ReviewLargely, treatment advances in relapsed and/or refractory acute lymphoblastic leukemia (ALL) have been made in B cell disease leaving T cell ALL reliant upon high-intensity chemotherapy. Recent advances in the understanding of the biology of T-ALL and the improvement in immunotherapies have led to new therapeutic pathways to target and exploit. Here, we review the more promising pathways that are able to be targeted and other therapeutic possibilities for T-ALL.Recent FindingsPreclinical models and early-phase clinical trials have shown promising results in some case in the treatment of T-ALL. Targ...
Source: Current Hematologic Malignancy Reports - July 25, 2023 Category: Hematology Source Type: research

Multiple Myeloma: Current Clinical Landscape and Compounding Costs
AbstractPurpose of ReviewThe treatment landscape of multiple myeloma (MM) has evolved resulting in MM becoming a chronic condition. The costs of MM therapies are substantial and compound as patients remain on long-term maintenance therapies and progress through multiple lines of high-cost therapies. MM predominantly impacts the elderly population insured by Medicare; here, we analyze how these costs impact patients and the Medicare trust fund.Recent FindingsWith the recent passing of the Inflation Reduction Act (IRA), we postulate how costs may be impacted and debate future policy initiatives that may result in sustainabil...
Source: Current Hematologic Malignancy Reports - July 21, 2023 Category: Hematology Source Type: research

Response-Adapted Therapy for Newly Diagnosed Multiple Myeloma
AbstractPurpose of ReviewThe development of potent novel agents has improved outcomes for patients with multiple myeloma (MM). Heterogeneity of response to therapy, an expanding arsenal of treatment options, and cost are however major challenges for physicians making treatment decisions. Response-adapted therapy is hence an attractive strategy for sequencing of therapy in MM. Despite its successful application in other haematologic malignancies, response-adapted therapy is yet to become a standard of care for MM. We provide our perspective on response-adapted therapeutic strategies evaluated thus far and how they may be im...
Source: Current Hematologic Malignancy Reports - July 4, 2023 Category: Hematology Source Type: research

A Journey Through JAK Inhibitors for the Treatment of Myeloproliferative Diseases
AbstractPurpose of ReviewChronic myeloproliferative neoplasms (MPN) represent a group of diseases characterised by constitutive activation of the JAK/STAT pathway in a clonal myeloid precursor. The therapeutic approach aims to treat the symptom burden (headache, itching, debilitation), splenomegaly, slow down the fibrotic proliferation in the bone marrow and reduce the risk of thrombosis/bleeding whilst avoiding leukaemic transformation.Recent FindingsIn recent years, the advent of JAK inhibitors (JAKi) has significantly broadened treatment options for these patients. In myelofibrosis, symptom control and splenomegaly redu...
Source: Current Hematologic Malignancy Reports - July 3, 2023 Category: Hematology Source Type: research

Real-world Management of CML: Outcomes and Treatment Patterns
AbstractPurpose of ReviewChronic myeloid leukemia (CML) is a disease that previously signified a poor prognosis, but treatment options and outcomes have improved over the last several decades. Despite this, challenges remain in optimal management in clinical practice, as the characteristics in trial populations differ from patients who are treated in a real-world setting. This review describes recent updates in real-world treatment patterns and outcomes in patients with CML.Recent FindingsSeveral analyses describing real-world practice patterns show that tyrosine kinase inhibitors (TKIs) are the most commonly prescribed ag...
Source: Current Hematologic Malignancy Reports - July 3, 2023 Category: Hematology Source Type: research

Richter Transformation of Chronic Lymphocytic Leukemia —Are We Making Progress?
Abstract Purpose of ReviewThe treatment paradigm of chronic lymphocytic leukemia (CLL) has dramatically changed with the advent of novel targeted agents over the past decade. Richter transformation (RT), or the development of an aggressive lymphoma from a background of CLL, is a well-recognized complication of CLL and carries significantly poor clinical outcomes. Here, we provide an update on current diagnostics, prognostication, and contemporary treatment of RT.Recent FindingsSeveral genetic, biologic, and laboratory markers have been proposed as candidate risk factors for the development of RT. Although a diagnosis...
Source: Current Hematologic Malignancy Reports - June 9, 2023 Category: Hematology Source Type: research