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
Monetary support affects select prescribing, Mitchell AP et al. JAMA Intern Med. 2018 Apr 9. doi: 0.1001/jamainternmed.2018.0776
Best TKI options in ALL, Jabbour E et al. Clin Lymphoma Myeloma Leuk. 2018 18(4):257-65
2 approaches to diagnosing heparin-induced thrombocytopenia, Pishko A et al. Biennial summit of the Thrombosis & Hemostasis Societies of North America (THSNA) 2018, Abstract 103
Blinatumomab eliminates residual B-cell ALL, Gökbuget N et al. Blood. 2018 Apr 5;131(14):1522-31.
Aryl hydrocarbon receptor antagonist boosts cord blood engraftment, Wagner J et al. 2018 Bone Marrow Transplant Tandem Meetings, Abstract 4.
Must Reads in CLL
Updated CLL guidelines, Hallek M et al. Blood https://doi.org/10.1182/blood-2017-09-806398
Prognostic Testing Patterns, CLL Outcomes Assessed, Clin Lymphoma Myeloma Leuk; ePub 2017 Dec 5; Mato, et al
Liver Dysfunction in Chronic Lymphocytic Leukemia, Am J Hematol; ePub 2017 Oct 19; Hampel, et al
Agent Orange’s Impact on CLL in Vietnam Veterans, Leuk Lymphoma; ePub 2017 Sep 14; Mescher, et al
Survival in Older Patients with CLL/SLL Evaluated, Clin Lymphoma Myeloma Leuk; ePub 2017 Jul 18; Ammann, et al