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DAT-Negative Autoimmune Hemolytic Anemia
Hematologists often rely on the results of a positive direct antiglobulin test to confirm a diagnosis of autoimmune hemolytic anemia, but immune hemolytic anemia can occur when no immunoglobulin is detectable by routine methods. Negative DATs in these patients may be due to a small quantity of IgG on their red blood cells (RBCs) (below detectable levels), or when low-affinity anti-IgG is present, or when the autoantibodies are IgA or IgM in nature. A panel of tests developed to detect immunoglobulins on these patients ’ RBCs may be performed in a few specialized laboratories. These tests can be helpful in instances where...
Source: Hematology/Oncology Clinics of North America - March 10, 2022 Category: Cancer & Oncology Authors: Karen Rodberg Source Type: research

The Epidemiology of Central Nervous System Tumors
This article reviews the current epidemiology of central nervous system tumors. Population-level basic epidemiology, nationally and internationally, and current understanding of germline genetic risk are discussed, with a focus on known and well-studied risk factors related to the etiology of central nervous system tumors. (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 18, 2021 Category: Cancer & Oncology Authors: Stephen S. Francis, Quinn T. Ostrom, David J. Cote, Timothy R. Smith, Elizabeth Claus, Jill S. Barnholtz-Sloan Source Type: research

Is There a Role for Immunotherapy in Central Nervous System Cancers?
Glioblastoma has emerged as an immunotherapy-refractory tumor based on negative phase III studies of anti –programmed cell death-1 therapy among newly diagnosed as well as recurrent patients. In addition, although much work on vaccine and cellular approaches is ongoing, therapeutic benefit with these approaches has been underwhelming. Much scientific insight into the multitiered layers of immunosuppre ssion exploited by glioblastoma tumors is emerging that sheds light on the explanation for the disappointing results to date and highlights possible therapeutic avenues that may offer a better likelihood of therapeutic bene...
Source: Hematology/Oncology Clinics of North America - November 18, 2021 Category: Cancer & Oncology Authors: Catherine Flores, Gavin Dunn, Peter Fecci, Michael Lim, Duane Mitchell, David A. Reardon Source Type: research

Biology and Treatment of Meningiomas
Meningiomas are largely indolent tumors with a benign clinical course, but a minority exhibit aggressive behavior characterized by rapid growth, neurologic deficits, and increased mortality. Identifying high-risk patients requiring intervention is challenging, but recent insights into meningioma biology provide a useful guide for decision making. Standard of care for recurrent or biologically aggressive tumors consists of surgery and radiation therapy. Systemic therapies targeting vascular endothelial growth factor signaling and somatostatin analogues are potential options for those with refractory disease but display only...
Source: Hematology/Oncology Clinics of North America - November 18, 2021 Category: Cancer & Oncology Authors: J. Ricardo McFaline-Figueroa, Thomas J. Kaley, Ian F. Dunn, Wenya Linda Bi Source Type: research

Primary Central Nervous System Lymphomas
Primary central nervous system lymphoma is a rare and aggressive extranodal non-Hodgkin lymphoma restricted to the brain, spinal cord, cerebrospinal fluid, and eyes. Optimization of treatment including high-dose methotrexate-based chemotherapy followed by consolidation therapy in the form of autologous stem cell transplant or whole-brain radiation leads to improved survival. However, several patients do not respond to upfront therapy and the relapse risk is high. Additionally, there is a risk of delayed neurotoxicity, particularly in older patients. Recent molecular insights underlying the pathophysiology of PCNSL have led...
Source: Hematology/Oncology Clinics of North America - November 18, 2021 Category: Cancer & Oncology Authors: Ugonma Chukwueke, Christian Grommes, Lakshmi Nayak Source Type: research

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In this issue of Hematology/Oncology Clinics of North America, we summarize key scientific and treatment updates related to primary and metastatic tumors of the central nervous system (CNS). Tumors of the CNS remain one of the greatest challenges in current medical oncology. Despite nihilistic attitudes that have historically dampened enthusiasm for the treatment of these tumors, the underlying science and clinical care of patients with these tumors continue to markedly evolve. An expanding repertoire of treatment interventions that integrate medical and neuro-oncologists is fueling a growing excitement for achieving bette...
Source: Hematology/Oncology Clinics of North America - November 18, 2021 Category: Cancer & Oncology Authors: David A. Reardon Tags: Preface Source Type: research

Disparities and Inequities Among Patients with Central Nervous System Tumor
Since the 2002 Institute of Medicine report, which many cite as a landmark in first defining and calling attention to the concept of health disparities in medicine, much work has been dedicated to characterizing health disparities in medical care with the aim of eliminating them. Importantly, this report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” laid bare the differences in quality of health care that are based on race, ethnicity, and socioeconomic status. Here, the authors elaborate on these issues and discuss the role of the neuro-oncologic workforce in pot entially mitigating th...
Source: Hematology/Oncology Clinics of North America - November 18, 2021 Category: Cancer & Oncology Authors: Ugonma N. Chukwueke, Shawn Hervey-Jumper, Alyx Porter Source Type: research

Central Nervous System Malignancies
HEMATOLOGY/ONCOLOGY CLINICS OF NORTH AMERICA (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 18, 2021 Category: Cancer & Oncology Authors: David A. Reardon Source Type: research

Copyright
ELSEVIER (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 18, 2021 Category: Cancer & Oncology Source Type: research

Contributors
GEORGE P. CANELLOS, MD (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 18, 2021 Category: Cancer & Oncology Source Type: research

Contents
David A. Reardon (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 18, 2021 Category: Cancer & Oncology Source Type: research

Forthcoming Issues
New Developments in the Understanding and Treatment of Autoimmune Hemolytic Anemia (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 18, 2021 Category: Cancer & Oncology Source Type: research

Central Nervous System Tumor Classification
In 2016, the World Health Organization Classification of CNS Tumors introduced molecular abnormalities that refined tumor diagnoses. Around this time, the introduction of large scale genetic mutational analyses quickly advanced our knowledge of recurrent abnormalities in disease. In 2017, the C-IMPACT group was established to render expert consensus opinions regarding the application of molecular findings into central nervous system tumor diagnoses. C-IMPACT have presented their recommendations in 7 peer-reviewed publications; this article details those recommendations that are expected to be incorporated into the upcoming...
Source: Hematology/Oncology Clinics of North America - November 4, 2021 Category: Cancer & Oncology Authors: Roger E. McLendon, Anthony T. Yachnis, Christopher Ryan Miller, Ho- Keung Ng Source Type: research

Isocitrate Dehydrogenase Wild-type Glial Tumors, Including Glioblastoma
Isocitrate dehydrogenase (IDH) 1 and 2 mutations represent essential components for the diagnosis of diffuse astrocytic tumors and oligodendroglioma. IDH wild-type glial tumors include a wide spectrum of tumors with differences in prognosis and recommended therapeutic approaches. Tumors characterized as molecular glioblastoma in the World Health Organization 2021 classification should be treated according to the glioblastoma therapeutic principles and included in glioblastoma trials. Improving on existing treatments options including targeted and immunotherapy approaches is imperative for most patients with IDH wild-type g...
Source: Hematology/Oncology Clinics of North America - October 29, 2021 Category: Cancer & Oncology Authors: Evanthia Galanis, Patrick Y. Wen, John F. de Groot, Michael Weller Source Type: research

Leptomeningeal Disease
Leptomeningeal disease (LMD), also known as leptomeningeal metastases or carcinomatosis, is a devastating complication. No reliable epidemiologic data are available, but it is usually agreed that LMD occurs in approximately 10% of patients with cancer.1 LMD has a very poor prognosis with a median overall survival (OS) of weeks without treatment and a modestly improved OS of 3 to 6.3  months despite multiple therapies.2–11 LMD can affect any part of the central nervous system (CNS) axis and can manifest with a wide variety of clinical signs and symptoms. (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - October 29, 2021 Category: Cancer & Oncology Authors: Yolanda Pi ña, Dorothee Gramatzki, Peter Forsyth, Eudocia Q. Lee, Emilie Le Rhun Source Type: research