Hematology

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.

Acute myeloid leukemia treatment episodes such as high-intensity chemotherapy, low-intensity chemotherapy, hematopoietic stem cell transplant, and relapsed-refractory patient episodes pose a significant substantial burden, according to an analysis presented at the 59th Annual Meeting of the American Society of Hematology in Atlanta, Georgia.

Patients with AL amyloidosis from lower socioeconomic status groups, defined in terms of education or employment, conveyed lower health-related quality of life compared to patients with more years of education and/or professional/managerial positions, according to an abstract presented at the 59th Annual Meeting of the American Society of Hematology.

An analysis presented at the 59th Annual Meeting of the American Society of Hematology showed that against a 3-year horizon, ibrutinib succeeds in overall survival (OS) and progression free suvrvival (PFS) over hematopoetic stem-cell transplantation (HSCT) in the treatment of patients with relapsed/refractory chronic lymphocytic leukemia with 17p deletion. Against a lifetime horizon, ibrutinib still proved to be superior in OS and PFS over HSCT, but is no longer cost saving as treatment costs continue.

Landmark study shows clot-busting drugs not recommended for most patients with secondary blood clots in the legs.

A systematic review of the FDA’s Adverse Event Reporting System (FAERS) found elevated reporting for both tofacitinib (Xeljanz) and ruxolitinib (Jakafi) for thromboembolic adverse events (AEs), suggesting the possibility of a class-wide issue with Janus kinase (JAK) inhibitors.

A panel on the importance of clinical and non-clinical stakeholders in a patient’s care trajectory brought together a diverse group of stakeholders at The American Journal of Managed Care®’s Patient-Centered Oncology Care® meeting.

While African Americans are 3 times more likely than Caucasians to be diagnosed with multiple myeloma (MM)—and twice as likely to die of the disease—they are underrepresented in MM disease research.

A study published in JAMA Oncology found that a significant number of patients newly diagnosed with cancer have had a prior cancer. The prevalence differed among age group and incident cancer type.

Chemotherapy and radiation therapy should be the first line of treatment for certain prostate cancers and lymphomas with a major genetic weakness, according to researchers at the University of Virginia School of Medicine.

An early-stage trial in pediatric and young adult patients with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL) has found that modifying the chimeric antigen receptor (CAR) T cells to target the CD22 receptor achieved remission.

Cyclin-dependent kinase 4/6 inhibitors may have proven benefits for treating metastatic breast cancer, but the therapies are associated with hematological toxicities and febrile neutropenia.

Recently reported results from Hydroxyurea Study of Long-Term Effects (HUSTLE) support the use of hydroxyurea in children, and indicate that a preferred dosing strategy should target an HbF endpoint of greater than 20%.