Novel Therapies in Myelofibrosis: Beyond JAK Inhibitors
AbstractPurpose of ReviewTo discuss the current treatment paradigm, review novel targets, and summarize completed and ongoing clinical trials that may lead to a paradigm shifts in the management of myelofibrosis (MF).Recent FindingsIn addition to the recent approval and ongoing late-stage development of multiple novel JAK inhibitors, recent clinical studies demonstrate therapeutic potential of targeting multiple alternate proteins and pathways including BET, MDM2, telomerase, BCL2, LSD1, PI3K, SMAC, and PTX2 in patients with MF.SummaryMF is a myeloproliferative neoplasm characterized by clonal proliferation of myeloid cell...
Source: Current Hematologic Malignancy Reports - August 19, 2022 Category: Hematology Source Type: research

Precision Medicine in Myeloid Malignancies: Hype or Hope?
Abstract  Purpose of ReviewWe review how understanding the fitness and comorbidity burden of patients, and molecular landscape of underlying acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) at the time of diagnosis is now integral to treatment.Recent FindingsThe upfront identification of patients ’ fitness and molecular profile facilitates selection of targeted and novel agents, enables risk stratification, allows consideration of allogeneic hematopoietic cell transplantation in high-risk patients, and provides treatment selection for older (age ≥ 75) or otherwise unfit patients who may not tolerate...
Source: Current Hematologic Malignancy Reports - August 16, 2022 Category: Hematology Source Type: research

Defining Higher-Risk Chronic Myeloid Leukemia: Risk Scores, Genomic Landscape, and Prognostication
AbstractPurpose of ReviewThe chronic myeloid leukemia (CML) treatment success story is incomplete as some patients still fail therapy, leading to end-stage disease and death. Here we discuss recent research into CML incidence, the role of comorbidities on survival and detecting patients at risk of failing therapy.Recent FindingsThe incidence of CML has fallen markedly in high social-demographic index (SDI) regions of the world but there is disturbing evidence that this is not the case in low and low-middle SDI countries. Now that CML patients more frequently die from their co-morbid conditions than from CML the Adult Comor...
Source: Current Hematologic Malignancy Reports - August 6, 2022 Category: Hematology Source Type: research

Advances in Risk Stratification and Treatment of Polycythemia Vera and Essential Thrombocythemia
AbstractPurpose of ReviewEstimating and modifying thrombotic risk is currently the mainstay of care for patients with polycythemia vera (PV) and essential thrombocythemia (ET). In recent years, however, increased attention has shifted towards quality of life and disease modification. In this review, we discuss recent advances in risk stratification, present updated results for ruxolitinib and interferon randomized clinical trials, discuss new approaches in antiplatelet and anticoagulant treatment, and summarize early phase trials of novel agents and emerging therapeutic concepts for the treatment of PV and ET.Recent Findin...
Source: Current Hematologic Malignancy Reports - August 6, 2022 Category: Hematology Source Type: research

Defining Higher-Risk Chronic Myeloid Leukemia: Risk Scores, Genomic Landscape, and Prognostication
AbstractPurpose of ReviewThe chronic myeloid leukemia (CML) treatment success story is incomplete as some patients still fail therapy, leading to end-stage disease and death. Here we discuss recent research into CML incidence, the role of comorbidities on survival and detecting patients at risk of failing therapy.Recent FindingsThe incidence of CML has fallen markedly in high social-demographic index (SDI) regions of the world but there is disturbing evidence that this is not the case in low and low-middle SDI countries. Now that CML patients more frequently die from their co-morbid conditions than from CML the Adult Comor...
Source: Current Hematologic Malignancy Reports - August 6, 2022 Category: Hematology Source Type: research

Management of Chronic Myeloid Leukemia in Children and Young Adults
AbstractPurpose of ReviewDue to lack of pediatric-specific data, the management of chronic myeloid leukemia (CML) in pediatric, adolescents, and young adults is guided by adult CML evidence-based recommendations. Pediatric CML presents differently than adult CML and is often a more aggressive disease with different biological and host factors, yet there is sparse literature on how to address those differences.Recent FindingsOver the past two decades, tyrosine kinase inhibitors (TKIs) have changed the way CML is treated. There are currently three FDA-approved TKIs (imatinib, dasatinib, and nilotinib) for pediatric patients....
Source: Current Hematologic Malignancy Reports - August 3, 2022 Category: Hematology Source Type: research

Germline CHEK2 and ATM Variants in Myeloid and Other Hematopoietic Malignancies
AbstractPurpose of ReviewAn intact DNA damage response is crucial to preventing cancer development, including in myeloid and lymphoid malignancies. Deficiencies in the homologous recombination (HR) pathway can lead to defective DNA damage responses, and this can occur through inherited germline mutations in HR pathway genes, such asCHEK2 andATM. We now understand that germline mutations can be identified frequently (~  5–10%) in patients with myeloid and lymphoid malignancies, and among the most common of these areCHEK2 andATM. We review the role that deleterious germlineCHEK2 andATM variants play in the development of...
Source: Current Hematologic Malignancy Reports - July 13, 2022 Category: Hematology Source Type: research

Germline Abnormalities in DNA Methylation and Histone Modification and Associated Cancer Risk
AbstractPurpose of ReviewSomatic mutations in DNA methyltransferases and other DNA methylation associated genes have been found in a wide variety of cancers. Germline mutations in these genes have been associated with several rare hereditary disorders. Among the described germline/congenital disorders, neurological dysfunction and/or growth abnormalities appear to be a common phenotype. Here, we outline known germline abnormalities and examine the cancer risks associated with these mutations.Recent FindingsThe increased use and availability of sequencing techniques in the clinical setting has expanded the identification of...
Source: Current Hematologic Malignancy Reports - July 13, 2022 Category: Hematology Source Type: research

Germline and Somatic Defects in DDX41 and its Impact on Myeloid Neoplasms
AbstractPurpose of ReviewWhileDDX41 mutation (m) is one of the most prevalent predisposition genes in adult myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML), most patients do not always present with a family history of MDS/AML. In this review, we will be highlighting epidemiological data onDDX41m, roles ofDDX41 in oncogenesis, mechanisms of clonal evolution with somaticDDX41m, and clinical phenotypes and management of MDS/AML in patients harboringDDX41m.Recent FindingsDDX41 encodes a DEAD-box helicase protein that is considered essential for cell growth and viability. High incidence of myeloid malignancies and o...
Source: Current Hematologic Malignancy Reports - July 4, 2022 Category: Hematology Source Type: research

ANKRD26-Related Thrombocytopenia and Predisposition to Myeloid Neoplasms
AbstractPurpose of reviewThis review describesANKRD26-related thrombocytopenia (RT) from a molecular, clinical, and laboratory perspective, with a focus on the clinical decision-making that takes place in the diagnosis and management of families withANKRD26-RT.Recent findingsANKRD26-related thrombocytopenia (ANKRD26-RT) is a non-syndromic autosomal dominant thrombocytopenia with predisposition to hematologic neoplasm. The clinical presentation is variable with moderate thrombocytopenia with normal platelet size and absent to mild bleeding being the hallmark which makes it difficult to distinguish from other inherited throm...
Source: Current Hematologic Malignancy Reports - June 25, 2022 Category: Hematology Source Type: research

Germline CHEK2 and ATM Variants in Myeloid and Other Hematopoietic Malignancies
AbstractPurpose of ReviewAn intact DNA damage response is crucial to preventing cancer development, including in myeloid and lymphoid malignancies. Deficiencies in the homologous recombination (HR) pathway can lead to defective DNA damage responses, and this can occur through inherited germline mutations in HR pathway genes, such asCHEK2 andATM. We now understand that germline mutations can be identified frequently (~  5–10%) in patients with myeloid and lymphoid malignancies, and among the most common of these areCHEK2 andATM. We review the role that deleterious germlineCHEK2 andATM variants play in the development of...
Source: Current Hematologic Malignancy Reports - June 8, 2022 Category: Hematology Source Type: research

Germline Abnormalities in DNA Methylation and Histone Modification and Associated Cancer Risk
AbstractPurpose of ReviewSomatic mutations in DNA methyltransferases and other DNA methylation associated genes have been found in a wide variety of cancers. Germline mutations in these genes have been associated with several rare hereditary disorders. Among the described germline/congenital disorders, neurological dysfunction and/or growth abnormalities appear to be a common phenotype. Here, we outline known germline abnormalities and examine the cancer risks associated with these mutations.Recent FindingsThe increased use and availability of sequencing techniques in the clinical setting has expanded the identification of...
Source: Current Hematologic Malignancy Reports - June 2, 2022 Category: Hematology Source Type: research