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
Gene sequencing bone marrow in myelodysplastic syndrome, Duncavage EJ et al. N Engl J Med 2018;379:1028-41.
Levofloxacin prophylaxis in ALL, AML , Alexander S, et al. JAMA. 2018;320(10):995-1004
Genetic markers signal poor prognosis in MCL, Obr A et al. Clin Lymphoma Myeloma Leuk. 2018 Aug 23. doi: 10.1016/j.clml.2018.07.282
Disparities in ALL treatment toxicity, Taylor OA et al. Clin Cancer Res. 2018 Sep 11. doi: 10.1158/1078-0432.CCR-18-0939
Leukemia risk after maternal contraception use, Hargreave M et al. Lancet Oncol. 2018 Sep 6. doi: 10.1016/S1470-2045(18)30479-0
Must Reads in CLL
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.
Caution urged over real-world bleeding risk with ibrutinib, Kunk PR et al. Clin Lymphoma Myeloma Leuk. 2018 Jul 15. doi: 10.1016/j.clml.2018.07.287
New guidelines from the UK on chronic lymphocytic leukemia, Schuh AH et al. Br J Haematol. 2018 Jul 15. doi: 10.1111/bjh.15460
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.