Best Practice and Research. Clinical Haematology This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Do cytogenetics affect the post-remission strategy for older patients with AML in CR1?
Publication date: Available online 7 October 2017 Source:Best Practice & Research Clinical Haematology Author(s): James Foran Data have shown that intensified cytarabine in consolidation for treatment of acute myeloid leukemia (AML) does not equally benefit patients older than 60 years, and older patients experience significantly more neurotoxicity than younger patients. In addition, older patients are more likely to have abnormal or unfavorable cytogenetics, which also tend to confer limited efficacy with intensified cytarabine. This poses a treatment dilemma as to the best post remission therapy to treat older...
Source: Best Practice and Research Clinical Haematology - October 8, 2017 Category: Hematology Source Type: research

Familial myelodysplastic syndrome/acute myeloid leukemia
Publication date: Available online 4 October 2017 Source:Best Practice & Research Clinical Haematology Author(s): Jane E. Churpek A growing number of inherited genetic loci that contribute to myelodysplastic syndrome/acute myeloid leukemia (MDS/AML) development in both children as well as adults are rapidly being identified. In recognition of the clinical impact of this emerging field, the World Health Organization, National Comprehensive Cancer Network, and European LeukemiaNet have all added consideration of inherited predisposition to MDS/AML classification and management. Study of these disorders is providin...
Source: Best Practice and Research Clinical Haematology - October 5, 2017 Category: Hematology Source Type: research

How can one optimize induction therapy in AML?
Publication date: Available online 4 October 2017 Source:Best Practice & Research Clinical Haematology Author(s): Selina M. Luger Induction therapy for acute myeloid leukemia has not changed much since 1973, when the 7 + 3 regimen of cytarabine and daunorubicin was born. Since then, various strategies have been evaluated to improve patient response, including dose intensification, the incorporation of additional agents into the regimen, the development of novel agents, and modified approaches for older patients. Recently, two novel agents, CPX-351 and gemtuzumab ozogamicin, have been approved by the US Food an...
Source: Best Practice and Research Clinical Haematology - October 5, 2017 Category: Hematology Source Type: research

Autologous hematopoietic cell transplantation for adult acute myeloid leukemia: An obsolete or resurfacing concept?
Publication date: Available online 22 September 2017 Source:Best Practice & Research Clinical Haematology Author(s): Hillard M. Lazarus, Najla El Jurdi Improving long-term outcomes of adult acute myeloid leukemia (AML) patients remains a challenge. Major scientific and clinical advances have led to a better understanding of the disease biology, and the majority of patients achieve a complete remission (CR) after induction therapy. Relapse risk, however, remains considerable and is the leading cause of death in this patient population. Significant efforts to improve outcomes emphasize use of post-remission thera...
Source: Best Practice and Research Clinical Haematology - September 23, 2017 Category: Hematology Source Type: research

Relapsed acute lymphoblastic leukemia: Is it crucial to achieve molecular remission prior to transplant?
Publication date: Available online 22 September 2017 Source:Best Practice & Research Clinical Haematology Author(s): Mary Eapen In patients with acute lymphoblastic leukemia (ALL) the risk of recurrent leukemia influences the choice of treatment between chemotherapy and allogeneic hematopoietic cell transplantation. The evaluation of minimal residual disease (MRD) is now considered to be the greatest progress in risk stratification in regard to leukemia recurrence. Achieving molecular remission at the end of induction therapy after diagnosis or after relapse has influenced treatment choice. Failure to achieve mo...
Source: Best Practice and Research Clinical Haematology - September 23, 2017 Category: Hematology Source Type: research

Intracellular protein degradation: From a vague idea thru the lysosome and the ubiquitin-proteasome system and onto human diseases and drug targeting
Publication date: Available online 22 September 2017 Source:Best Practice & Research Clinical Haematology Author(s): Aaron Ciechanover Between the 1950s and 1980s, scientists were focusing mostly on how the genetic code is transcribed to RNA and translated to proteins, but how proteins are degraded has remained a neglected research area. With the discovery of the lysosome by Christian de Duve it was assumed that cellular proteins are degraded within this organelle. Yet, several independent lines of experimental evidence strongly suggested that intracellular proteolysis is largely non-lysosomal, but the mechanism...
Source: Best Practice and Research Clinical Haematology - September 23, 2017 Category: Hematology Source Type: research

The evolving role of genomic testing in assessing prognosis of patients with myelodysplastic syndromes
Publication date: Available online 22 September 2017 Source:Best Practice & Research Clinical Haematology Author(s): David P. Steensma The introduction into routine hematology-oncology clinical practice of molecular genetic testing assays based on next-generation sequencing platforms is prompting reassessment of the importance of molecular assay results in comparison to existing disease-specific risk stratification tools based on clinical assessment and light microscopy. For patients with myelodysplastic syndromes (MDS), the most commonly used tools for prognostication currently include the International Prognos...
Source: Best Practice and Research Clinical Haematology - September 23, 2017 Category: Hematology Source Type: research

Impact of allogeneic hematopoietic cell transplantation on the outcome of older patients with acute myeloid leukemia
Publication date: Available online 22 September 2017 Source:Best Practice & Research Clinical Haematology Author(s): Frederick R. Appelbaum For younger patients with intermediate- or high-risk acute myeloid leukemia (AML) in first remission, allogeneic hematopoietic cell transplantation (HCT) offers the best chance of cure and therefore is the treatment of choice. The role of allogeneic HCT in the treatment of older patients is less well defined. In this review, four issues concerning the role of HCT in the treatment of older AML patients will be addressed: the frequency of allogeneic HCT in the older AML popula...
Source: Best Practice and Research Clinical Haematology - September 23, 2017 Category: Hematology Source Type: research

Cytokine release syndrome: Who is at risk and how to treat
Publication date: Available online 22 September 2017 Source:Best Practice & Research Clinical Haematology Author(s): Noelle Frey T-cell engaging therapies such as blinatumomab and anti-CD19 chimeric antigen receptor (CAR) T cells have revolutionized our approach to patients with relapsed and refractory acute lymphoblastic leukemia (ALL). However, the immune activation responsible for high remission rates is also responsible for the unique treatment-related toxicity of cytokine release syndrome (CRS). The clinical signs of CRS include fever, hemodynamic instability, and capillary leak, which correlate with T-cell...
Source: Best Practice and Research Clinical Haematology - September 23, 2017 Category: Hematology Source Type: research

AML in 2017: Advances in clinical practice
Publication date: Available online 22 September 2017 Source:Best Practice & Research Clinical Haematology Author(s): Jacob M. Rowe Numerous advances have been made in the biology and treatment of acute myeloid leukemia (AML) in 2017. These include the integration of the assessment of minimal residual disease (MRD) into clinical practice, the approval and near approval of new agents, improvement in therapy for older patients, and the development of a number of promising new agents, including IDH inhibitors, a Hedgehog signaling pathway inhibitor, and a histone deacetylase inhibitor. In addition, the concept of ch...
Source: Best Practice and Research Clinical Haematology - September 23, 2017 Category: Hematology Source Type: research

Which factors influence the development of GVHD in HLA-matched or mismatched transplants?
Publication date: Available online 22 September 2017 Source:Best Practice & Research Clinical Haematology Author(s): Effie W. Petersdorf The sheer diversity of HLA alleles makes the probability of finding matched unrelated donors for patients requiring hematopoietic cell transplantation (HCT) a complex situation. New evidence suggests that mismatching at certain HLA loci may provide a greater benefit in terms of graft-versus-leukemia effect than other mismatches when HLA-matched donors are not available. This review summarizes the current understanding of HLA matching requirements for unrelated donor HCT. (Sourc...
Source: Best Practice and Research Clinical Haematology - September 23, 2017 Category: Hematology Source Type: research

Which new agents will be incorporated into frontline therapy in acute myeloid leukemia?
Publication date: Available online 22 September 2017 Source:Best Practice & Research Clinical Haematology Author(s): Richard M. Stone For 4 decades, new agents had not been approved for use in treating acute myeloid leukemia (AML). The long dry spell was broken in 2017, however, with the approval or recommendation for approval of several agents: midostaurin for addition to chemotherapy in mutant FLT3 patients undergoing intensive chemotherapy, enasidenib in advanced mutant IDH2 patients, CPX-351 in secondary AML patients, and gemtuzumab ozogamicin in conjunction with standard chemotherapy in AML. This review sur...
Source: Best Practice and Research Clinical Haematology - September 23, 2017 Category: Hematology Source Type: research

Philadelphia chromosome negative B-cell acute lymphoblastic leukemia in older adults: Current treatment and novel therapies
Publication date: Available online 3 August 2017 Source:Best Practice & Research Clinical Haematology Author(s): Kristen M. O'Dwyer, Jane L. Liesveld The management of older adult patients with Philadelphia chromosome negative (Ph-) B-acute lymphoblastic leukemia (ALL) remains a challenge. Older adults with Ph- B-ALL have the highest rates of treatment failure and treatment complications, and thus there is no standard treatment approach in this clinical setting. Approximately 16% of patients with newly diagnosed Philadelphia chromosome negative (Ph-) acute lymphoblastic leukemia (ALL) are aged 60 years or older...
Source: Best Practice and Research Clinical Haematology - August 3, 2017 Category: Hematology Source Type: research

The what, when and how of CAR T cell therapy for ALL
Publication date: Available online 3 August 2017 Source:Best Practice & Research Clinical Haematology Author(s): Noelle Frey Chimeric Antigen Receptor (CAR) T cells that have been engineered to target CD19 have shown great promise in patients with relapsed and refractory B cell acute lymphocytic leukemia with remission rates of 70–90%. Some remissions have successfully bridged patients to a curable allogeneic stem cell transplant, some responses have been durable without further treatment, and some patients have achieved durable remissions for relapsed ALL after allogeneic stem cell transplant. Cytokine releas...
Source: Best Practice and Research Clinical Haematology - August 3, 2017 Category: Hematology Source Type: research

How should we treat a patient with relapsed Ph-negative B-ALL and what novel approaches are being investigated?
Publication date: Available online 3 August 2017 Source:Best Practice & Research Clinical Haematology Author(s): Nicola Goekbuget Despite significant improvements in outcome of newly diagnosed B-precursor ALL, the results in relapsed or refractory adult ALL are overall poor. Large retrospective studies revealed significant differences in terms of outcome, with particularly poor response rates in early or refractory relapses, whereas late relapses usually respond very well to repeated standard induction. Particularly new immunotherapy compounds like the CD19 bispecific antibody Blinatumomab and the conjugated CD2...
Source: Best Practice and Research Clinical Haematology - August 3, 2017 Category: Hematology Source Type: research