Hematology

New drugs to treat multiple myeloma (MM) have provided clinical benefits, but a study published in the Journal of Managed Care & Specialty Pharmacy found not all of them can be considered cost effective.

Carfilzomib was associated with higher rates of all-grade and high-grade cardiovascular adverse events (CVAE), and both later trial phase and higher doses of carfilzomib were associated with higher rates of CVAE, according to a study in JAMA Oncology.

Acute myeloid leukemia (AML) is the most common form of acute leukemia and has a poor 5-year survival rate, especially among older people. Cancer researchers have created a model that can predict mortality after AML treatment, so that it can help guide decision-making for patients and providers.

Management of pediatric oncology patients with febrile neutropenia and hospitalization duration currently vary by institution and by provider. A poster presented at the 59th American Society of Hematology Annual Meeting reviewed pediatric hematology/oncology patients who were admitted with febrile neutropenia to determine discharge and release, as well as subsequent readmission within the next 4 days.

The last 5 years have seen a host of new drugs approved for multiple myeloma, improving survival times for patients, explained Nina Shah, MD, associate professor, University of California, San Francisco, School of Medicine.

Deciding to administer CAR T-cell therapies is an institutional commitment that requires educating all clinicians who will be involved and partnerships with other organizations, said Stephen Schuster, MD, of the Perelman School of Medicine.

Based on long-term observations, granulocyte colony-stimulating factor utilization is a safe and effective treatment to prevent infections and improve quality of life in patients with cyclic neutropenia, according to an analysis in The New England Journal of Medicine.

Physicians caring for patients with severe congenital neutropenia should be ready to detect issues with multiple systems in the body, explained Seth Corey, MD, of the Virginia Commonwealth University and the Massey Cancer Center & Children's Hospital of Richmond, during a session at the 59th American Society of Hematology Annual Meeting and Exposition in Atlanta, Georgia.

The FDA was busy in 2017, with a number of notable approvals, including the first chimeric antigen receptor T-cell treatment. In a session at the 59th American Society of Hematology Annual Meeting and Exposition in Atlanta, Georgia, employees from the FDA presented data on 5 new drug approvals in leukemia and lymphoma in 2017.

Opioids are commonly precribed for the treatment of both acute and chronic pain.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

In a session at the 59th American Society of Hematology Annual Meeting and Exposition in Atlanta, Georgia, Brian Curtis, PhD, of the BloodCenter of Wisconsin Blood Research Institute, highlighted drugs other than chemotherapy that may cause neutropenia in patients.

Discussions at the 59th Annual Meeting and Exposition of the American Society of Hematology (ASH) included progress reports on genetically modified immunotherapy treatments, a new treatment paradigm for advanced Hodgkin lymphoma, possibility of treatment-free remission in chronic myelogenous leukemia, and challenges with hospice utilization for patients with leukemia.

This week, the top managed care news included coverage from the 59th American Society of Hematology Annual Meeting and Exposition; recommendations on the use of diabetes drugs with cardiovascular indications; and a new study found that despite changes in insurance plans to give consumers more clout, unnecessary medical spending remains a problem.

Overuse of medical services has been a costly issue in US healthcare for decades. Now in its fifth year, the Choosing Wisely initiative from ABIM Foundation seeks to increase conversations between physicians and patients to help them make wise decisions about appropriate care and reduce the use of low-value services.

Stephen Schuster, MD, of the Perelman School of Medicine, provides a summary of results seen with CAR T treatments in leukemia, lymphoma, and myeloma.

Adolescents and young adults with acute lymphoblastic leukemia (ALL) tend to have worse outcomes than children with ALL, and new research published at the 59th American Society of Hematology Annual Meeting delved into the reasons why, explained Julie A. Wolfson, MD, of the University of Alabama at Birmingham School of Medicine.

Patients with blood cancers tend to use hospice care services less frequently overall than patients with solid tumors. While there has been an increase in hospice care use in patients with blood cancers, there has been a failure to increase hospice use meaningfully, according to Thomas LeBlanc, MD, of the Duke Cancer Institute.

Providing outpatient hematopoietic stem cell transplant (HSCT) when patients are eligible is a good way to reduce costs, without impacting outcomes, explained Nina Shah, MD, associate professor, University of California, San Francisco, School of Medicine.

Two abstracts at the 59th Annual Meeting of the American Society of Hematology in Atlanta, Georgia found that CTL019 shows promising potential in providing significant benefit and cost effectiveness for pediatric and young adult patients with B-cell acute lymphoblastic leukemia in both the United States and the United Kingdom.

Physician belief in the art of medicine is running up against the challenge of costs being shifted to patients and health systems and the desire of payers to have less variation in care, said Derek Raghavan, MD, PhD, FACP, FRACP, president, Carolinas HealthCare System's Levine Cancer Institute.

Ibrutinib has the potential to improve vaccine response for patients with chronic lymphocytic leukemia, and an ongoing trial will help provide a better understanding, explained Kerry Rogers, MD, assistant professor, internal medicine, Division of Hematology, The Ohio State University Comprehensive Cancer Center.

During a session on the first day of the 59th Annual Meeting and Exposition of the American Society of Hematology in Atlanta, Georgia, physicians shared current knowledge on cardiovascular toxicities of tyrosine kinase inhibitors (TKIs) as well as the potential for treatment-free remission with these agents.

In a large population of patients who died from hematologic malignancies, the majority spent over 120 days at home in the last 6 months of life. Certain demographic features, such as age and gender, indicate which patients are more likely to die at home and suggest an important role for access to caregiver support, according to an abstract presented at the 59th Annual Meeting of the American Society of Hematology in Atlanta, Georgia.

A secondary analysis presented at the 59th Annual Meeting of the American Society of Hematology found that all individual symptoms of myeloproliferative neoplasms correlate with quality of life (QoL), and having either 1 severe symptom or having multiple symptoms of moderate intensity was meaningfully correlated with QoL reduction.