Hematology

While the wholesale acquisition cost of the hemophilia A drug is approximately $482,000 for the first year of treatment and $448,000 for subsequent years, a draft report found that the drug would reduce the budget by approximately $1.85 billion per patient annually for patients aged 12 and older. In patents aged 12 and younger, emicizumab at wholesale acquisition cost pricing would reduce the budget by approximately $720,000 per patient annually.

Every year, central lines are associated with causing blood infections in an estimated 400,000 patients with cancer. However, new research has found that changes in the microbiome may be responsible for some or many of the infections usually attributed to central lines.

The FDA has approved a supplemental New Drug Application to add new overall survival (OS) data for carfilzomib (Kyprolis). The label will now show that carfilzomib and dexamethasone reduced the risk of death by 21% and increased OS by 7.6 months compared with bortezomib and dexamethasone in patients with relapsed or refractory multiple myeloma (MM).

Despite years of stability, patients with monoclonal gammopathy of undetermined significance (MGUS) are at risk of progressing to multiple myeloma or another blood cancer, according to a long-term follow-up study published in New England Journal of Medicine. MGUS usually causes no problems, but it is a precursor to cancer.

A study finds that protein markers may be a better predictor of drug response than genetic mutation are in patients with acute myeloid leukemia (AML). As a result, some patients who could benefit from treatment may not be eligible under current approval specifications.

The challenges that adolescents and young adults face before and after treatment are all unique to an individual patient, according to Julie Wolfson, MD, of the University of Alabama at Birmingham School of Medicine.

Recently, the FDA granted a breakthrough therapy designation to eltrombopag (Promacta, Novartis) for combination use with standard immunosuppressive therapy as a first-line treatment for patients with severe aplastic anemia (SAA).

A subset of patients with chronic lymphocytic leukemia (CLL) with highly expressed CD49d have poorer outcomes while on Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib, which antagonizes B-cell receptor (BCR) signals. However, a team of researchers may have found a way to treat these patients.

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.

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.