A review of current induction strategies and emerging prognostic factors in the management of children and adolescents with acute lymphoblastic leukemia.
Authors: Capria S, Molica M, Mohamed S, Bianchi S, Moleti ML, Trisolini SM, Chiaretti S, Testi AM Abstract Introduction: Acute lymphoblastic leukemia is the most frequent hematologic malignancy in children. Almost 95% of children potentially achieve a complete remission after the induction treatment, but over the last years, new insights in the genomic disease profile and in minimal residual disease detection techniques have led to an improvement in the prognostic stratification, identifying selected patients' subgroups with peculiar therapeutic needs.Areas covered: According to a comprehensive search of peer-revie...
Source: Expert Review of Hematology - May 19, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Sickle cell disease as a vascular disorder.
Authors: Ofori-Acquah SF Abstract Introduction: In sickle cell disease (SCD), hemoglobin S (HbS) red blood cells (RBCs) are characteristically deformed and inflexible. Often breaking down in the circulation, they exhibit increased adhesive properties with the endothelium and activated neutrophils and platelets, increasing the risk of occlusion of the microcirculation. SCD is categorized into two sub-phenotypes: hyperhemolytic, associated with priapism, leg ulcers, pulmonary hypertension, and stroke, and high hemoglobin/viscosity, which may promote vaso-occlusion-associated pain, acute chest syndrome, and osteonecro...
Source: Expert Review of Hematology - May 6, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Evolution of viscoelastic coagulation testing in the perioperative setting.
Authors: Tanaka KA, Henderson RA, Strauss ER Abstract Introduction: The methods of viscoelastic coagulation testing (VCT) have evolved since the original invention of thrombelastography over 60 years ago, and new generations of devices are clinically used to guide hemostatic interventions at bedside. The utility of VCTs has been demonstrated in several clinical trials, but diagnostic performance of VCT may vary between devices, various transfusion algorithms, and patient populations.Areas covered: Working principles and currently available data on the evolving VCTs for coagulation monitoring in acute care settings ...
Source: Expert Review of Hematology - April 22, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Emerging pharmacotherapies for elderly acute myeloid leukemia patients.
Authors: Thomas X, Elhamri M, Heiblig M Abstract Introduction: Acute myeloid leukemia (AML) is a disease mainly seen in the elderly, for which treatment is undergoing rapid changes. Although recent studies have supported the survival benefit of induction chemotherapy in fit patients and that of hypomethylating agents (HMAs) in non-induction candidates, treatment of this patient age population remains a significant challenge for the treating oncologist. Areas covered: In this review, we will examine effectiveness and safety outcomes of upcoming novel treatment strategies in elderly (≥ 60 years old) patients with ...
Source: Expert Review of Hematology - April 22, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Advances in managing rare acquired bleeding disorders.
Authors: Franchini M, Marano G, Cruciani M, Mengoli C, Pati I, Masiello F, Veropalumbo E, Pupella S, Vaglio S, Liumbruno GM Abstract Introduction: Rare acquired bleeding disorders include a wide spectrum of coagulopathies characterized by spontaneous or post-trauma and post-surgery hemorrhages in patients without a previous personal or family history of bleeding.Areas covered: This review, based on a Medline/PubMed search during the last twenty years, will focus mainly on rare acquired bleeding disorders caused by autoantibodies against coagulation factors, including autoantibodies against factor VIII (acquired hem...
Source: Expert Review of Hematology - April 16, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Newly diagnosed multiple myeloma: current treatment strategies, emerging therapeutic approaches and beyond.
Authors: Kocoglu MH, Badros AZ Abstract Introduction: As we have just stepped into a new decade of hopes, the mountain of knowledge learned from multiple myeloma remains unmatched among cancers. In the last decade alone, this rapid-sequence learning curve has led to regulatory approvals of 8 drugs with mechanisms of actions representing 5 different areas of cell biology some of which made to the frontline setting, sparking debates about how to best sequence them in the treatment continuum of induction, consolidation, and maintenance and gained momentum with the realization of the implications of an effective upfron...
Source: Expert Review of Hematology - April 16, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Monoclonal antibodies in newly diagnosed and smoldering multiple myeloma: an updated review of current clinical evidence.
Authors: Musto P, La Rocca F Abstract Introduction: Monoclonal antibodies (MoAbs) are rapidly changing the therapeutic scenario of multiple myeloma. Most of the available data, however, come from studies performed in patients with relapsed or refractory disease.Area covered: Here, the most recent results from clinical trials that have investigated (or are investigating) efficacy and safety of MoAb as front-line treatments in both transplant-eligible and not-eligible patients with newly diagnosed multiple myeloma (NDMM), as well as in smoldering myeloma, are reviewed. PubMed reported articles before March 28, 2020, ...
Source: Expert Review of Hematology - April 16, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Current approaches in the treatment of catheter-related deep venous thrombosis in children.
Authors: Jaffray JA, Goldenberg NA Abstract Introduction: Acutely ill and medically complex pediatric patients typically rely on central venous catheters (CVCs) for vascular acccess. CVCs can have serious complications, including venous thromboembolism (VTE). In children, CVCs are the most common risk factor for VTE.Area covered: Studies focused on prevention and treatment of CVC-related VTE in children have been lacking until recently. Currently there is one U.S. Food and Drug Administration (FDA) approved anticoagulant, dalteparin, and phase 3 trial results for two direct oral anticoagulants (DOACs) in pediatrics...
Source: Expert Review of Hematology - April 16, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Mutational landscape of immune surveillance genes in diffuse large B-cell lymphoma.
Authors: Nesic M, El-Galaly TC, Bøgsted M, Pedersen IS, Dybkær K Abstract Introduction: Immune surveillance is the dynamic process whereby the immune system identifies and kills tumor cells based on their aberrant expression of stress-related surface molecules or presentation of tumor neoantigens. It plays a crucial role in controlling the initiation and progression of hematologic cancers such as leukemia and lymphoma, and it has been reported that diffuse large B-cell lymphoma (DLBCL) fails to express specific cell-surface molecules that are necessary for the recognition and elimination of tumor cells...
Source: Expert Review of Hematology - April 16, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Pralatrexate injection for the treatment of patients with relapsed or refractory peripheral T-cell lymphoma.
Authors: Jennifer C Z, Sara Mohamed J, Salma A, Francine F Abstract Introduction: Peripheral T cell lymphomas (PTCL) are a heterogenous group of lymphoproliferative disorders which are generally not curable with conventional chemotherapy and associated with inferior outcomes. Pralatrexate is a novel folate analog, the first FDA approved drug) for the treatment of relapsed/refractory (R/R) PTCL.Areas covered: This paper provides a comprehensive review of PubMed literature describing the use of pralatrexate in R/R peripheral T-cell lymphoma. Pharmacokinetics and mechanism of action of pralatrexate are discussed as we...
Source: Expert Review of Hematology - April 16, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Autoimmune hemolytic anemia in adults: primary risk factors and diagnostic procedures.
Authors: Barcellini W, Giannotta J, Fattizzo B Abstract Introduction: Autoimmune hemolytic anemia (AIHA) is due to autoantibodies against erythrocytes that may arise either because of primary tolerance breakage or along with several associated conditions, including genetic predispositions, congenital syndromes, environmental triggers, autoimmune diseases, immunodeficiencies, and neoplasms.Areas covered: This review evaluated the risk of AIHA development in associated conditions and summarized disease-intrinsic risk factors for relapse and outcome. Diagnostic procedures were analyzed to properly identify primary and...
Source: Expert Review of Hematology - April 12, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Enhancing CAR T cell efficacy: the next step toward a clinical revolution?
Authors: Namuduri M, Brentjens RJ Abstract Introduction: The field of immunotherapy has witnessed considerable progress over the last two decades. Beginning with the ability to conceptualize CAR T cell therapy as immunotherapeutic approach, to effortlessly genetically modifying T cells, we have now reached the stage of mass production for clinical needs, all within less than quarter of a century.Areas covered: CAR T cell therapy has been tremendously successful in acute leukemia patients, specifically even in relapsed/refractory disease states. However, similar success is yet to be realized in other malignancies. T...
Source: Expert Review of Hematology - April 9, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Leukocytapheresis for patients with acute myeloid leukemia presenting with hyperleukocytosis and leukostasis: a contemporary appraisal of outcomes and benefits.
Authors: Shallis RM, Stahl M, Bewersdorf JP, Hendrickson JE, Zeidan AM Abstract Introduction: Hyperleukocytosis, defined as a total white blood cell count (WBC)>50 or more commonly>100 x 109 cells/L, is a presenting feature of acute myeloid leukemia (AML) in about 6-20% of cases and is associated with a higher risk of tumor lysis syndrome (TLS), disseminated intravascular coagulation (DIC), clinical leukostasis with end organ damage, and mortality.Areas Covered: In this review authors discuss the implications of hyperleukocytosis in AML and the current understanding of cytoreductive strategies with a focus on...
Source: Expert Review of Hematology - April 8, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Risk assessment of venous thromboembolism in hematological cancer patients: a review.
Authors: Chan TS, Hwang YY, Tse E Abstract Introduction: Venous thromboembolism (VTE) is a frequent and serious complication in cancer patients. Nonetheless, patients with hematological cancers receive less attention as compared with their solid tumor counterparts regarding this potentially fatal complication.Areas covered: Risk factors that are associated with the development of VTE in hematological cancers are discussed, based on a PubMed literature search. Since different hematological malignancies carry different risk of VTE, risk assessment in individual types of hematological cancers, including acute leukemia...
Source: Expert Review of Hematology - April 8, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Cost-effectiveness of once weekly carfilzomib 70 mg/m2 plus dexamethasone in patients with relapsed and refractory multiple myeloma in the United States.
Conclusions: When compared with Kd27 BIW, Kd70 QW is the optimal dose that represents a cost-effective utilization of health care budget with incremental CE ratios well below the accepted willingness-to-pay thresholds in the US. PMID: 32249621 [PubMed - as supplied by publisher] (Source: Expert Review of Hematology)
Source: Expert Review of Hematology - April 8, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Therapeutic options for steroid-refractory acute and chronic GVHD: an evolving landscape.
Authors: Shapiro RM, Antin JH Abstract Introduction: The traditional therapeutic modalities to manage SR-acute GVHD have focused on the inhibition of the alloreactive T-cell response, while in the setting of SR-chronic GVHD the focus has been on a combination of T-cell and B-cell targeting strategies. However, new therapeutic modalities have shown promise. The purpose of this review is to summarize the current treatment landscape of SR-acute and chronic GVHD.Areas covered: A systematic search of MEDLINE, EMBASE, and clinicaltrials.gov databases for published articles, abstracts, and clinical trials pertaining to av...
Source: Expert Review of Hematology - April 8, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Advances in the treatment of thrombotic thrombocytopenic purpura: repurposed drugs and novel agents.
Authors: Gómez-De León A, Villela-Martínez LM, Yáñez-Reyes JM, Gómez-Almaguer D Abstract Introduction: Thrombotic thrombocytopenic purpura (TTP) is an infrequent but fatal disease. Plasma exchange and corticosteroids continue to be the mainstay of treatment; however, repurposed drugs and novel agents are emerging as efficient treatment options.Areas covered: In this review, new therapeutic developments in immune-mediated TTP including rituximab, bortezomib, N-acetylcysteine, caplacizumab, and recombinant ADAMTS13, among others, are summarized.Expert opinion: Evidence on the...
Source: Expert Review of Hematology - April 5, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

An update on disease biomarkers for Hodgkin lymphoma.
Authors: Cirillo M, Borchmann S Abstract Introduction: Hodgkin Lymphoma (HL) carries an overall excellent prognosis for young patients treated with multimodal therapy. Predicting an individual patient's prognosis is currently heavily dependent on imaging modalities such as Positron Emission Tomography (PET).Areas covered: Potential biomarkers from serum, tissue, circulating nucleic acids and non-tumour derived cells have all been reported to be of prognostic relevance in HL. We review a range of these biomarkers and discuss the integration of new biomarkers into individualised patient care.Expert opinion: Better pr...
Source: Expert Review of Hematology - March 22, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Patients with hemophilia A and inhibitors: prevention and evolving treatment paradigms.
Authors: Lillicrap D, Fijnvandraat K, Young G, Mancuso ME Abstract Introduction: Novel non-replacement therapies (e.g. emicizumab) have improved the management of patients with hemophilia A with and without inhibitors while introducing new challenges and increasing the complexity of clinical decision-making.Areas covered: Use of emicizumab can substantially delay initial exposure to FVIII thereby altering the natural history of inhibitor development, but it remains unclear whether later exposure to FVIII might modify the incidence of inhibitor development. Moreover, decisions regarding initiation of immune toleranc...
Source: Expert Review of Hematology - March 20, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Ruxolitinib for treatment of steroid-refractory graft-versus-host disease in adults: a systematic review and meta-analysis.
Conclusion: Notwithstanding the need of randomized controlled trials to confirm the effect of RUX on SR-GVHD, response rates among adults with aGVHD and cGVHD seem to be high with use of RUX as a salvage treatment, particularly in cases with gastrointestinal and cutaneous involvement. However, high rates of myelosuppression and infection remain a cause for concern regardless of aGVHD or cGVHD. PMID: 32178541 [PubMed - as supplied by publisher] (Source: Expert Review of Hematology)
Source: Expert Review of Hematology - March 19, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Cui bono? Finding the value of allogeneic stem cell transplantation for lower-risk myelodysplastic syndromes.
Authors: Shallis RM, Podoltsev NA, Gowda L, Zeidan AM, Gore SD Abstract Introduction: The myelodysplastic syndromes (MDS) vary in their risk of disease progression; progression includes increasingly severe bone marrow failure, reclassification as acute myeloid leukemia (AML), and death. Prognostic tools guide recommendations for allogeneic stem cell transplantation (alloSCT), the only curative option. AlloSCT is typically reserved for patients with higher-risk MDS as defined by existing prognostic tools, although additional clinical and biological factors in lower-risk patients may influence this dogma.Areas covere...
Source: Expert Review of Hematology - March 19, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

A critical evaluation of pembrolizumab in addition to lenalidomide and dexamethasone for the treatment of multiple myeloma.
Authors: Oriol A Abstract Introduction: Several modalities of immunotherapy have proved successful in multiple myeloma, including immunomodulatory agents, monoclonal antibodies directed to plasma cell surface antigens and chimeric antigen receptor T cells. The PD-1 pathway is implicated in the progression of multiple myeloma. Several properties of lenalidomide are potentially synergistic with PD-1/PD-L1 blockade.Areas covered: Preclinical data related to anti-PD-1/PD-L1 antibodies and the results of early clinical trials of pembrolizumab single-agent and in combination with lenalidomide and dexamethasone are discus...
Source: Expert Review of Hematology - March 19, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Developments in consolidation and maintenance strategies in post-remission multiple myeloma.
Authors: Morè S, Corvatta L, Maracci L, Costantini B, Olivieri A, Offidani M Abstract Introduction: Multiple Myeloma (MM) is a very heterogeneous clonal plasma cell hematological malignancy for which new therapies and transplantation effectively improve Progression-free survival (PFS) and overall survival (OS). Maintenance seems to have made a significant contribution in achieving these advances, whereas the real role of consolidation is still controversial. Despite lenalidomide having been approved as maintenance therapy after autologous stem cell transplantation (ASCT), the optimal maintenance agent, drug ...
Source: Expert Review of Hematology - March 13, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

An evaluation of the safety and efficacy of turoctocog alfa for hemophilia A.
Authors: Boban A, Hermans C Abstract Introduction: Hemophilia A is an inherited disorder that is characterized by decreased or absent factor (F)VIII and an increased risk of bleeding. Clinical presentation of the severe form of the disease includes spontaneous bleeding into the joints and muscles, while patients with milder forms usually exhibit trauma-associated bleeding. The treatment of hemophilia aims to prevent bleeding. A number of clotting FVIII concentrates are available for managing hemophilia A, which have different safety and efficacy characteristics. Advancements in biotechnology have enabled developmen...
Source: Expert Review of Hematology - March 12, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Monoclonal antibodies in relapsed/refractory myeloma: updated evidence from clinical trials, real life studies and meta-analyses.
Authors: Musto P, La Rocca F Abstract Introduction: In the last few years, monoclonal antibodies have rapidly modified therapeutic strategies for treating patients with multiple myeloma.Areas covered: In this review, the most recent literature data regarding indications for which monoclonal antibodies are currently or potentially approved as salvage therapies in relapsed/refractory myeloma will be discussed. In particular, updated results of antibodies directed against CD38 (daratumumab and isatuximab), SLAMF7 (elotuzumab), BCMA (GSK2857916/belantamab mafodotin), and PD-1/PD-1L axis (nivolumab and pembrolizumab) wi...
Source: Expert Review of Hematology - March 12, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Real-world outcomes and factors impacting treatment choice in relapsed and/or refractory multiple myeloma (RRMM): a comparison of VRd, KRd, and IRd.
Authors: Chari A, Richardson PG, Romanus D, Dimopoulos MA, Sonneveld P, Terpos E, Hajek R, Raju A, Palumbo A, Cain LE, Blazer M, Huang H, Farrelly E, Ailawadhi S Abstract Lack of head-to-head trials highlights a need for comparative real-world evidence of proteasome inhibitors plus Rd.Methods: In this retrospective, US population-representative EHR study of RRMM patients initiating IRd, KRd, or VRd in line of therapy (LOT) ≥2 between 1/2014 and 9/30/2018, 664 patients were treated in LOT ≥2 with: IRd, n = 168; KRd, n = 208; VRd, n = 357. Median age was 71/65/71 years; 67%/70...
Source: Expert Review of Hematology - March 10, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Evaluation of the reported rates of hypersensitivity reactions associated with iron dextran and ferric carboxymaltose based on global data from VigiBase ™ and IQVIA™ MIDAS® over a ten-year period from 2008 to 2017.
Conclusion: The risk of spontaneously reported HSRs was consistently higher with ferric carboxymaltose than with iron dextran over the period 2008-2017. Thus, this study does not support that dextran-free intravenous irons are associated with fewer HSRs than iron dextran. PMID: 32129113 [PubMed - as supplied by publisher] (Source: Expert Review of Hematology)
Source: Expert Review of Hematology - March 6, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Post-chemotherapy cognitive impairment in hematological patients: current understanding of chemobrain in hematology.
Authors: Allegra A, Innao V, Basile G, Pugliese M, Allegra AG, Pulvirenti N, Musolino C Abstract Introduction: Cognitive impairment caused by chemotherapies, a condition known as chemobrain, is a possible side effect that affects alertness, learning, memory, and concentration.Areas covered: Chemobrain has been principally investigated as possible side-effect among cancer patients. However, numerous drugs used to treat hematological malignancies can determine the appearance of chemobrain. In this review we have examined some commonly used drugs for the treatment of hematological malignancies which are known to have ...
Source: Expert Review of Hematology - March 6, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Identifying and treating candidates for checkpoint inhibitor therapies in multiple myeloma and lymphoma.
Authors: Hradska K, Kascak M, Hajek R, Jelinek T Abstract Introduction: One of the hallmarks of cancerogenesis is the ability of tumor cells to evade the immune system. They can achieve it by abusing inhibitory immune checkpoint pathways, which, under normal circumstances, maintain peripheral tolerance during infection. Immune checkpoint inhibitors, especially anti-PD-1/PD-L1 monoclonal antibodies, currently represent a widely discussed treatment option not only in solid oncology, but in hematology-oncology as well.Areas covered: The manuscript is focused on clinical research concerning PD-1/PD-L1 blockade in lymph...
Source: Expert Review of Hematology - March 3, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Clinical spectrum, risk factors, management and outcome of patients with retroperitoneal hematoma: a retrospective analysis of 3-year experience.
Conclusion: Most cases of RPH had an excellent outcome with conservative management alone. PMID: 32089021 [PubMed - as supplied by publisher] (Source: Expert Review of Hematology)
Source: Expert Review of Hematology - February 26, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Challenges to improving patient outcome following massive transfusion in severe trauma.
Authors: Maegele M Abstract Introduction: Uncontrolled haemorrhage with trauma-induced coagulopathy (TIC) still represents the most common cause of preventable death after trauma. Timely diagnosis and treatment including bleeding control and haemostatic resuscitation to correct TIC are important, as death from exsanguination occurs rapidly. Recognizing who requires an early massive transfusion together with the initiation of corresponding massive transfusion protocols (MTPs) is key to outcome.Areas covered: This expert review summarizes the current state of MT including the activation and termination of MTPs, compl...
Source: Expert Review of Hematology - February 22, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Stem cell transplant for the treatment of myelofibrosis.
Authors: Mannelli L, Guglielmelli P, Vannucchi AM Abstract Introduction: Allogeneic hematopoietic stem cell transplantation (HSCT) remains the cornerstone of curative approach to myelofibrosis (MF), although it is burdened by not negligible toxicity andac mortality.Areas covered: In this review, authors discuss the status-of-the art of HSCT in MF, emphasizing the current limits and the areas for improvement. We interrogated public databases for papers published in the last 30 years.Expert opinion: The therapeutic landscape of myelofibrosis has been revolutionized after the approval of JAK inhibitor ruxolitinib, tha...
Source: Expert Review of Hematology - February 22, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Palliative care in hematologic malignancies: a multidisciplinary approach.
This article considers what is known about the palliative care needs of hematologic malignancy patients, shows how the multidisciplinary palliative care team could improve their care, and explores how barriers to this relationship might be overcome. The evidence to support this review comes from review of recent, relevant papers known to the authors as well as PubMed searches of additional relevant articles over the past 3 years.Expert opinion: Further cultivating this relationship requires us to thoughtfully integrate the multidisciplinary palliative care team to respond to each patient's specific disease and needs, ...
Source: Expert Review of Hematology - February 19, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Higher-risk myelodysplastic syndromes with del(5q): does the del(5q) matter?
Authors: Gorshein E, Weber UM, Gore S Abstract Introduction: Myelodysplastic Syndrome (MDS) represents a group of cancers characterized by abnormal blood cell formation and maturation, leading to various degrees of cytopenias and potential transformation to acute myeloid leukemia. Deletion of the long arm of chromosome 5 (del(5q)) is the most common clonal chromosomal anomaly in MDS, yet the population in this disease subtype is quite heterogeneous. This manuscript analyzes literature on high-risk MDS with del(5q) abnormalities.Areas covered: The paper will review outcomes with lenalidomide among high-risk MDS pati...
Source: Expert Review of Hematology - February 19, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Toxicities of novel therapies for hematologic malignancies.
Authors: Simon F, Garcia Borrega J, Bröckelmann PJ Abstract Introduction: Over the last decade targeted therapies have transformed the treatment landscape for hematologic malignancies with>70 new or extended approvals by the FDA since 2010. Since many of these drugs are registered for multiple entities and>1/3 were approved in the last two years, treatment options in hematology are rapidly expanding. Despite the justified excitement around the often previously unseen emerging therapeutic potential, distinct side effect profiles require vigilance and adequate management by patients and caregivers.Areas co...
Source: Expert Review of Hematology - February 12, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

How to manage iron toxicity in post-allogeneic hematopoietic stem cell transplantation?
Authors: Kontoghiorghes GJ PMID: 32037922 [PubMed - as supplied by publisher] (Source: Expert Review of Hematology)
Source: Expert Review of Hematology - February 12, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Refeeding syndrome in hematological cancer patients - current approach.
Authors: Szeja N, Grosicki S Abstract Introduction: According to estimates based on the GLOBOCAN database of the International Agency for Research on Cancer, in 2018 alone, 18 100 000 cancers were globally diagnosed. Importantly, the majority of cancer patients experience unintended weight loss that leads to many adverse clinical consequences, including malnutrition and cancer cachexia. At the same time, each nutritional intervention must be carried out individually, as it can lead to critical complications, resulting in a threat to the health and life of the cachectic patient. An example of this type of risk is re...
Source: Expert Review of Hematology - February 9, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Positive expression of PAX7 indicates poor prognosis of pediatric and adolescent AML patients.
Conclusions: Positive PAX7 expression in pediatric and adolescent AML patients indicates a poor outcome. Hence, the detection of PAX7 expression profiles is helpful for further stratification of intermediate- and low-risk groups. PMID: 31990602 [PubMed - as supplied by publisher] (Source: Expert Review of Hematology)
Source: Expert Review of Hematology - January 30, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

A positive approach: advances in proton therapy for the treatment of mediastinal lymphoma.
Authors: Mailhot Vega RB, Hoppe BS PMID: 31976780 [PubMed - as supplied by publisher] (Source: Expert Review of Hematology)
Source: Expert Review of Hematology - January 26, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Heat shock proteins as a new, promising target of multiple myeloma therapy.
Authors: Grosicki S, Bednarczyk M, Janikowska G Abstract Introduction: The results of therapy of the multiple myeloma (MM) patients remain unsatisfactory despite the constantly observed progress in treatment.Areas covered: It has been shown that mechanisms regulated by heat shock proteins (HSPs) play an important role in pathogenesis of MM and resistance developing to treatment, which constitute a protective shield against external damaging factors in healthy and cancerous cells.Expert opinion: Inhibiting these mechanisms seems to be the natural way of therapy in MM patients. In vitro studies have shown promising e...
Source: Expert Review of Hematology - January 25, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Twin-twin transfusion syndrome in the era of fetoscopic laser surgery: antenatal management, neonatal outcome and beyond.
Authors: Spruijt MS, Lopriore E, Steggerda S, Slaghekke F, van Klink JMM Abstract Introduction: Twin-twin transfusion syndrome (TTTS) is a devastating complication of monochorionic twin pregnancy and remains a major challenge for worldwide fetal medicine specialists. In TTTS, inter-twin transfusion through vascular anastomoses in the shared placenta leads to severe hemodynamic imbalance. This review summarizes the current knowledge of TTTS.Areas covered: The most recent insights concerning the management of TTTS, as well as fetal and neonatal complications are described. Relevant articles were selected based on a P...
Source: Expert Review of Hematology - January 25, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

The clinical and humanistic burden of cutaneous T-cell lymphomas and response to conventional and novel therapies: results of a systematic review.
Conclusion: CTCL negatively affects patients' and caregivers' QoL. A considerable proportion of patients have no response or no sustainable response to current treatments. PMID: 31958235 [PubMed - as supplied by publisher] (Source: Expert Review of Hematology)
Source: Expert Review of Hematology - January 22, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

A comprehensive evaluation of apixaban in the treatment of venous thromboembolism.
This article reviews results from preclinical and healthy volunteer studies that illustrate the noteworthy properties of apixaban such as a proportional dose-response relationship, low daily fluctuation in plasma concentrations, and safety over a 10-fold dosing range. Additionally, the large phase III trials evaluating the safety and efficacy of apixaban compared to low molecular weight heparin (LMWH) overlapped with and followed by vitamin K antagonist (VKA) warfarin for the treatment and secondary prevention of VTE will be discussed. The key studies that have led to apixaban's current licensing and use will be highlighte...
Source: Expert Review of Hematology - January 22, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

What are the considerations for tyrosine kinase inhibitor discontinuation in chronic phase chronic myeloid leukaemia?
Authors: Harrington P, Radia D, de Lavallade H Abstract INTRODUCTION: The outlook for patients with chronic myeloid leukaemia (CML) has changed dramatically with the development of tyrosine kinase inhibitors (TKIs) with the current treatment goal for many patients being to obtain a durable deep molecular remission, discontinue TKI therapy and remain treatment-free.Areas covered: In this article the authors review the data from the major TKI discontinuation studies, explore potential predictors of discontinuation outcome and look at possible mechanisms to explain the variable outcomes following TKI discontinuation i...
Source: Expert Review of Hematology - January 20, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Relapsed/refractory primary mediastinal large B-cell lymphoma: a structured review of epidemiology, treatment guidelines and real-world treatment practices.
Conclusions: Salvage chemotherapy (often with rituximab and radiotherapy), followed by HDT and stem cell transplantation, appears to be the standard real-world treatment for rrPMBCL. However, large prospective and retrospective studies are warranted to improve our knowledge of real-world treatment patterns. PMID: 31951774 [PubMed - as supplied by publisher] (Source: Expert Review of Hematology)
Source: Expert Review of Hematology - January 19, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

The cost of hemophilia treatment: the importance of minimizing it without detriment to its quality.
Authors: Rodriguez-Merchan EC Abstract Introduction: Hemophilia is a very expensive disease. Ameliorations in the management of hemophilia causes increased patient survival, more complex disease management, and augmented treatment costs. A literature search related to the cost of hemophilia was analyzed.Covered areas: Clotting factor concentrates, which are the keystone of management, are costly. In fact, the yearly expenditure in the USA is 250,000 USD per adult patient. Indirect expenses also play a part to the economic load, and include lost productive capacity, uncompensated caretaker tariffs, and hemophilia-re...
Source: Expert Review of Hematology - January 16, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Indirect methods of comparison of the safety of ferric derisomaltose, iron sucrose and ferric carboxymaltose in the treatment of iron deficiency anemia.
Conclusions: The risk of serious or severe HSRs was lower with FDI relative to FCM and IS. Using data from prospective trials including over 8,000 patients coded using a well-defined standard (SMQs) enabled a robust comparison of HSR incidence between the iron formulations. PMID: 31928094 [PubMed - as supplied by publisher] (Source: Expert Review of Hematology)
Source: Expert Review of Hematology - January 15, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Is outcome of older people with AML improving with new therapeutic approaches and stem cell transplantation?
Authors: Ferrara F, Picardi A Abstract Introduction: The clinical outcome of older patients with acute myeloid leukemia is still poor, especially for those who are unfit to treatments aimed at altering the natural course of the disease. Hypomethylating agents (HMA) offer an important therapeutic opportunity to a consistent number of patients, but long-term results are largely unsatisfactory.Area covered: Recently, a number of new agents have been registered for AML, some of which selectively available for older patient population, with promising results in terms of response rate and survival. Furthermore, the upper...
Source: Expert Review of Hematology - January 12, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Why classical cytogenetics still matters in acute myeloid leukemia.
Authors: Lazarevic VL, Johansson B PMID: 31903786 [PubMed - as supplied by publisher] (Source: Expert Review of Hematology)
Source: Expert Review of Hematology - January 7, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research

Management of immune thrombocytopenia in women: current standards and special considerations.
Authors: Rodeghiero F, Marranconi E Abstract Introduction: Immune thrombocytopenia (ITP) is an acquired autoimmune disorder, with an incidence rate of 20-40/million adults/year and an estimated prevalence in women of childbearing age of 24.5/million.Areas covered: Authors discuss management of ITP in pregnancy, treatment-related toxicity, delivery, neonatal thrombocytopenia and breastfeeding, and other women's specific issues. Search of papers published between January 1990 and December 2019 was done on PubMed using combinations of the keywords below. Distinction between ITP and other thrombocytopenias in pregnancy...
Source: Expert Review of Hematology - January 7, 2020 Category: Hematology Tags: Expert Rev Hematol Source Type: research