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
Novel agents emerge for hemophilia, Shapiro AD, et al. J Thromb Haemost. 2018 Sep 28
Bleeding risk with acute myocardial infarction, Dodson JA et al. JACC Cardiovasc Interv. 2018 Nov 26;11:2287-96
Identifying thrombosis risk in ITP patients, Balitsky AK et al. Blood. 2018 Nov 8. doi: 10.1182/blood-2018-08-868406
Preop blood management lessons, Cahill CM et al. AABB 2018, Abstract PBM4-ST4-22
Treating osteoporosis caused by transfusion-dependent thalassemia , Terpos E et al. Blood Adv. 2018;2:2837-47
Must Reads in CLL
The role of PTPN22 R620W in CLL, Leukemia & Lymphoma 2018
Ibrutinib dosing changes and the impact on survival, Williams AM et al. Clin Lymphoma Myeloma Leuk. 2018 Oct 12. doi: 10.1016/j.clml.2018.10.005
Long-term ibrutinib data in older patients, Barr PM et al. Haematologica. 2018;103(9):1502-10
First-line ibrutinib has long-term survival benefit, Barr PM et al. Haematologica. 2018;103(9):1502-10.
Obinutuzumab plus venetoclax compares well with established CLL therapies, Cramer P et al. Lancet Oncol. 2018 Aug 13. doi: 10.1016/S1470-2045(18)30414-5.