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EHA25: AML, myeloma, & more with EHA President John Gribben

Thursday, June 25, 2020

What were the late-breaking and practice-changing presentations at EHA25 Virtual? John Gribben, MD, DSc, president of the European Hematology Association, highlighted some of them in this podcast.

Dr. Gribben and host David H. Henry, MD, discussed presentations on acute myeloid leukemia (AML), multiple myeloma, polycythemia vera (PV), and COVID-19. Videos of these and other presentations will be available on the EHA25 website until Oct. 15.

Randomized, double-blind, placebo-controlled study of venetoclax with azacitidine vs. azacitidine in treatment-naïve patients with acute myeloid leukemia ineligible for intensive therapy—VIALE-A:

  • Adding venetoclax to azacitidine improved survival, response, and transfusion independence in older patients with treatment-naïve AML.
  • Older AML patients have seen “very little progress” in outcomes for decades, but advances such as these are “really moving the field,” Dr. Gribben said.
  • Abstract LB2601: https://rb.gy/fou9jp
  • Presentation: https://rb.gy/mmwn6s

Phase 2 randomized trial comparing ropeginterferon versus phlebotomy in low-risk patients with polycythemia vera. Results of the pre-planned interim analysis:

  • Ropeginterferon was safe and more effective than phlebotomy for keeping hematocrit on target in patients with low-risk PV.
  • These findings suggest ropeginterferon is a viable option for PV patients, but “old-fashioned phlebotomy can also be quite efficient,” Dr. Gribben said.
  • Physicians will have to weigh the risks and benefits, including cost-effectiveness, of each treatment, he added.
  • Abstract LB2602: https://rb.gy/uicnmo
  • Presentation: https://rb.gy/sj60ia


Isatuximab plus carfilzomib and dexamethasone vs carfilzomib and dexamethasone in relapsed/refractory multiple myeloma (IKEMA): Interim analysis of a phase 3, randomized, open-label study:

  • Adding isatuximab to carfilzomib-dexamethasone improved progression-free survival and time to next treatment. Overall survival data are not mature.
  • The study was stopped early because the primary endpoint was met, as isatuximab “clearly demonstrated superiority,” Dr. Gribben noted.
  • It isn’t clear how isatuximab stacks up against daratumumab, but these results suggest “people now have another CD38 antibody to consider as part of their armamentarium,” Dr. Gribben said.
  • Abstract LB2603: https://rb.gy/gmxcgk
  • Presentation: https://rb.gy/v209ol


Endotheliopathy in COVID-19 associated coagulopathy

  • This study showed “very clear evidence” of endothelial damage contributing to coagulopathy among severely ill patients with COVID-19, Dr. Gribben said.
  • Endothelial cell and platelet markers were elevated in COVID patients who required intensive care, and soluble thrombomodulin was linked to survival.
  • These findings prompted the decision to give all COVID patients aspirin.
  • Abstract LB2605: https://rb.gy/sdc9dv
  • Presentation: https://rb.gy/nxvpxj

Iron metabolism in health and disease (Plenary I)

  • This presentation suggested inflammation-induced hypoferremia can predict disease severity in COVID-19 patients.
  • The presenter posited that iron accumulation in macrophages may increase inflammation and contribute to organ damage in COVID patients.
  • “You can imagine a whole cascade of events that this virus triggers off,” Dr. Gribben said.

Disclosures:

Dr. Gribben reported relationships with Janssen, Celgene, Bristol Myers Squibb, AstraZeneca, AbbVie, Roche, Genentech, and Acerta Pharma.

Dr. Henry reported having no disclosures relevant to this episode.

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Podcast Participants

David Henry, MD
David Henry, MD, FACP, is a clinical professor of medicine at the University of Pennsylvania and vice chairman of the department of medicine at Pennsylvania Hospital in Philadelphia. He received his bachelor’s degree from Princeton University and his MD from the University of Pennsylvania, then completed his internship, residency, and fellowship at the Hospital of the University of Pennsylvania. After 2 years as an attending in the U.S. Air Force, he was drawn to practicing as a hem-onc because of the close patient contact and interaction, and his belief that, win or lose with each patient, one can always make a difference in their care and lives. Follow Dr. Henry on Twitter: @davidhenrymd. Dr. Henry reported being on the advisory board for Amgen, AMAG Pharmaceuticals, and Pharmacosmos. He reported institutional funding from the National Institutes of Health and FibroGen.