Major changes or additions to new guidelines for chronic lymphocytic leukemia include the following:
Molecular genetics: Recognition of the clinical importance of specific genomic alterations/mutations 17p deletion and mutations in TP53 on therapeutic response.
IGHV mutational status: Immunoglobulin variable heavy chain (IGHV) genes offer important prognostic information.
Biomarkers: Soluble CD23, thymidine kinase, and beta-2-microglobulin need to be standardized and used in prospective clinical trials.
MRD: Minimal residual disease should be assessed in clinical trials aimed at maximizing remission depth.
Antiviral prophylaxis: Patients should be tested for HBV serological status before starting on an anti-CD20 agent.
Hallek M et al. Blood https://doi.org/10.1182/blood-2017-09-806398
This Week's Must Reads
Observational study shows hydroxyurea well tolerated in sickle cell disease, Dauvergne B et al. FSCDR 2018, presentation JSCDH-D-18-00052
CAVEAT shows venetoclax plus chemo appropriate for older, fit AML patients , Wei AH et al. EHA Congress, Abstract S1564.
Large cohort study demonstrates DOAC safety vs. warfarin , Vinogradova Y et al. BMJ 2018;362:k2505.
Patients who develop AML may have detectable mutations years earlier, Desai P et al. Nat Med. 2018;24:1015-23.
Oral administration of arsenic + ATRA effective for APML, Zhu HH et al. Lancet Oncol. 2018;19:871-9.
Must Reads in CLL
Escalating venetoclax dose was safe in relapsed CLL, Koenig K et al. EHA Congress (annual meeting of the European Hematology Association), Abstract PF357.
Ibrutinib and venetoclax for relapsed CLL, Niemann C et al. European Society of Hematology Annual Congress 2018. Abstract PF346.
Relapsed CLL responds to rapid venetoclax dose-escalation, Awan F et al. European Hematology Association 2018 Annual Congress. Abstract PF357
Early results presented for dual CAR-T therapy, Liu F et al. EHA Congress, Abstract S149.
CAPTIVATE demonstrates encouraging results in CLL, Wierda WG et al. ASCO 2018, Abstract 7502.