Current Hematologic Malignancy Reports最新文献_第9页

Management of CNS Disease in Pediatric Acute Lymphoblastic Leukemia. 小儿急性淋巴细胞白血病中中枢神经系统疾病的治疗。

IF 2.9 3区医学

Current Hematologic Malignancy Reports Pub Date : 2022-02-01 Epub Date: 2022-01-13 DOI: 10.1007/s11899-021-00640-6

Jennifer L McNeer, Kjeld Schmiegelow

{"title":"Management of CNS Disease in Pediatric Acute Lymphoblastic Leukemia.","authors":"Jennifer L McNeer, Kjeld Schmiegelow","doi":"10.1007/s11899-021-00640-6","DOIUrl":"https://doi.org/10.1007/s11899-021-00640-6","url":null,"abstract":"Purpose of review: The treatment of acute lymphoblastic leukemia (ALL) is one of the success stories of pediatric oncology, but challenges and questions remain, including the optimal approach to the treatment of central nervous system (CNS) leukemia. It is unclear why some children with ALL develop CNS leukemia and others do not, and there remains debate regarding optimal regimens for prophylaxis, upfront treatment, and the treatment of CNS relapses. These topics are especially important since both cranial radiation therapy (CRT) and intensive intrathecal therapy carry risks of both short- and long-term adverse effects. In this review, we aim to identify areas of ongoing debate on this topic, review the biology of CNS leukemia, and summarize clinical trial data that address some of these questions.Recent findings: Both retrospective and meta-analyses have demonstrated that few patients with ALL benefit from CRT as a component of CNS-directed treatment for de novo disease, allowing cooperative groups to greatly limit the number of patients undergoing CRT as part of their initial ALL regimens. More recent efforts are focusing on how best to assay for low levels of CNS disease at the time of diagnosis, as well as the biological drivers that may result in CNS leukemia in certain patients. Progress remains to be made in the identification and treatment of CNS leukemia in pediatric ALL. Advancements have occurred to limit the number of children undergoing CRT, but much has yet to be learned to better understand the biology of and risk factors for CNS leukemia, and novel approaches are required to approach CNS relapse of ALL.","PeriodicalId":10852,"journal":{"name":"Current Hematologic Malignancy Reports","volume":"17 1","pages":"1-14"},"PeriodicalIF":2.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39678956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Management of Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma in the Era of Targeted Therapies. 靶向治疗时代复发/难治性慢性淋巴细胞白血病/小淋巴细胞淋巴瘤的治疗

IF 2.9 3区医学

Current Hematologic Malignancy Reports Pub Date : 2022-02-01 Epub Date: 2022-01-13 DOI: 10.1007/s11899-021-00652-2

Michael Rainone, Tanya Siddiqi

{"title":"Management of Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma in the Era of Targeted Therapies.","authors":"Michael Rainone, Tanya Siddiqi","doi":"10.1007/s11899-021-00652-2","DOIUrl":"https://doi.org/10.1007/s11899-021-00652-2","url":null,"abstract":"Purpose of review: The treatment landscape for relapsed chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) has changed substantially over the past decade and continues to evolve. Despite the emergence of targeted therapies that are well tolerated and prolong survival, the disease remains incurable and relapse is common particularly in individuals with high-risk features. Herein, we review the key literature about the current options for relapsed disease and explore the emerging role of cellular therapies.Recent findings: Clinical trials have established the role of Bruton tyrosine kinase inhibitors, selective BCL-2 inhibition, and anti-CD20 monoclonal antibodies as treatment options for CLL/SLL. The role of chimeric antigen receptor T cells has shown promise in individuals with CLL/SLL in early phase clinical trials. Novel therapeutic approaches with targeted therapies have redefined the management of CLL/SLL in both the front-line and relapsed/refractory settings. Optimal management in terms of sequencing or combining therapies, especially in individuals with high-risk features, remains a challenge. The emerging role of cellular therapies has the potential to build upon and further improve the current treatment paradigm.","PeriodicalId":10852,"journal":{"name":"Current Hematologic Malignancy Reports","volume":"17 1","pages":"39-45"},"PeriodicalIF":2.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39819903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Use of Telemedicine in Care of Hematologic Malignancy Patients: Challenges and Opportunities. 远程医疗在血液恶性肿瘤患者护理中的应用:挑战与机遇。

IF 2.9 3区医学

Current Hematologic Malignancy Reports Pub Date : 2022-02-01 Epub Date: 2022-01-11 DOI: 10.1007/s11899-021-00642-4

Jennifer Lloyd, Catherine J Lee

{"title":"Use of Telemedicine in Care of Hematologic Malignancy Patients: Challenges and Opportunities.","authors":"Jennifer Lloyd, Catherine J Lee","doi":"10.1007/s11899-021-00642-4","DOIUrl":"https://doi.org/10.1007/s11899-021-00642-4","url":null,"abstract":"Purpose of review: For nearly 20 years, oncology specialty practices have been working to integrate telemedicine technologies into standard patient care models. However, hematology practices have been slower to adopt telemedicine due to traditional care models that rely on interdisciplinary regional care centers and their ability to provide comprehensive and centralized services. Patients have traditionally been able to access high-quality medical care, diagnostics, supportive care, and clinical trials from these regional care centers, but they are required to attend frequent in-person visits to access these services. Rural and underserved patients experience more barriers than their urban counterparts to access the same level of care.Recent findings: The COVID-19 pandemic has elevated telemedicine into the forefront of care, highlighting both promise and limitations to incorporating telemedicine into specialty hematology care. Hematologists should consider the benefits of incorporating telemedicine technologies into standard-of-care practices to promote patient-centered care and provide equal access to all patient populations.","PeriodicalId":10852,"journal":{"name":"Current Hematologic Malignancy Reports","volume":"17 1","pages":"25-30"},"PeriodicalIF":2.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8749341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39671822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Multidisciplinary Approach to Older Adults with Hematologic Malignancies-a Paradigm Shift. 多学科方法治疗老年血液恶性肿瘤-一个范式转变。

IF 2.9 3区医学

Current Hematologic Malignancy Reports Pub Date : 2022-02-01 Epub Date: 2022-01-13 DOI: 10.1007/s11899-021-00646-0

Sarah A Wall, Erin Stevens, Jennifer Vaughn, Naresh Bumma, Ashley E Rosko, Uma Borate

引用次数: 2

Future Directions in Chronic Phase CML Treatment. 慢性期CML治疗的未来方向。

IF 2.9 3区医学

Current Hematologic Malignancy Reports Pub Date : 2021-12-01 DOI: 10.1007/s11899-021-00658-w

Nathalie Javidi-Sharifi, Gabriela Hobbs

{"title":"Future Directions in Chronic Phase CML Treatment.","authors":"Nathalie Javidi-Sharifi, Gabriela Hobbs","doi":"10.1007/s11899-021-00658-w","DOIUrl":"https://doi.org/10.1007/s11899-021-00658-w","url":null,"abstract":"Purpose of review: This review will focus on recent and emerging treatment paradigms in chronic phase CML. The discussion of each novel treatment or drug combination will include a brief overview of scientific rational and pre-clinical data, followed by recently published or ongoing clinical trial efforts. The review will be divided into three focus areas in CML treatment: new frontline approaches and approaches to deepen remission, second treatment-free remission studies, and the treatment of refractory disease.Recent findings: The section on new frontline approaches will highlight several strategies of combination therapy. These can be grouped into immunomodulatory approaches with interferons and immune checkpoint inhibitors, targeting of leukemia stem cells with compounds such as venetoclax and pioglitazone, and BCR-ABL1-intrinsic combination therapy with asciminib. The chance at a second treatment-free remission is an important emerging clinical trial concept, and again combination approaches are under investigation. Lastly, in advanced disease, the development of novel tyrosine kinase inhibitors remains a major focus. This review will provide an overview and perspective of treatment strategies on the horizon for chronic phase CML. Despite the already excellent clinical outcomes for most patients, challenges remain with regard to deepening initial responses, prolonging treatment-free remission, and providing efficacious and tolerable options for patients with refractory disease and resistance mutations.","PeriodicalId":10852,"journal":{"name":"Current Hematologic Malignancy Reports","volume":"16 6","pages":"500-508"},"PeriodicalIF":2.9,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9482097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Acute Lymphoblastic Leukemia and Acute Lymphoblastic Lymphoma: Same Disease Spectrum but Two Distinct Diagnoses. 急性淋巴母细胞白血病和急性淋巴母细胞淋巴瘤:相同的疾病谱系但两种不同的诊断。

IF 2.9 3区医学

Current Hematologic Malignancy Reports Pub Date : 2021-10-01 Epub Date: 2021-08-21 DOI: 10.1007/s11899-021-00648-y

Kathryn A F Kline, Michael E Kallen, Vu H Duong, Jennie Y Law

{"title":"Acute Lymphoblastic Leukemia and Acute Lymphoblastic Lymphoma: Same Disease Spectrum but Two Distinct Diagnoses.","authors":"Kathryn A F Kline, Michael E Kallen, Vu H Duong, Jennie Y Law","doi":"10.1007/s11899-021-00648-y","DOIUrl":"https://doi.org/10.1007/s11899-021-00648-y","url":null,"abstract":"Purpose of review: Rare malignancies developing from lymphocyte precursor cells, lymphoblastic leukemia (LBL), and acute lymphoblastic lymphoma (ALL) have historically been viewed as different manifestations of the same disease process. This review examines data on their epidemiology, genetics, clinical presentation, and response to treatment while highlighting areas of similarity and divergence between these two clinical entities.Recent findings: Pediatric-type ALL chemotherapy regimens, compared to both lymphoma-type chemotherapy and adult-type ALL regimens, have led to improved outcomes for children, adolescents, and young adults with ALL. BCR-ABL-targeting tyrosine kinase inhibitors (TKIs) have improved outcomes in Philadelphia chromosome-positive (Ph +) ALL and in rare cases of Ph + LBL. Newer therapies including blinatumomab, inotuzumab, CAR-T therapy, and nelarabine have improved outcomes in selected cases of ALL and have an emerging role in the management of LBL. Better understanding of ALL and LBL biology allows for the development of therapies that target immunophenotypic or genetic features found in subsets of both diseases. Novel therapies are leading to improved outcomes in Ph + and relapsed and refractory disease.","PeriodicalId":10852,"journal":{"name":"Current Hematologic Malignancy Reports","volume":"16 5","pages":"384-393"},"PeriodicalIF":2.9,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s11899-021-00648-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39331064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Elevating Twitter-Based Journal Club Discussions by Leveraging a Voice-Based Platform: #HemepathJC Meets Clubhouse. 利用语音平台提升基于twitter的期刊俱乐部讨论:#HemepathJC与Clubhouse会面。

IF 2.9 3区医学

Current Hematologic Malignancy Reports Pub Date : 2021-10-01 Epub Date: 2021-09-29 DOI: 10.1007/s11899-021-00644-2

Aadil Ahmed, Kamran M Mirza, Sanam Loghavi

引用次数: 3

Avapritinib in the Treatment of Systemic Mastocytosis: an Update. 阿伐替尼治疗系统性肥大细胞增多症的最新进展。

IF 2.9 3区医学

Current Hematologic Malignancy Reports Pub Date : 2021-10-01 Epub Date: 2021-09-27 DOI: 10.1007/s11899-021-00650-4

Samantha Below, Laura C Michaelis

{"title":"Avapritinib in the Treatment of Systemic Mastocytosis: an Update.","authors":"Samantha Below, Laura C Michaelis","doi":"10.1007/s11899-021-00650-4","DOIUrl":"https://doi.org/10.1007/s11899-021-00650-4","url":null,"abstract":"Purpose of review: Patients with systemic mastocytosis, a dangerous and rare myeloid neoplasm, have long had few therapies available to them and, historically, rarely achieved from significant disease control. However, research and translational developments over the last decade have led to promising new options for disease management. In this review, we briefly outline the history of treatment for systemic mastocytosis and subsequently focus on the clinical development and potential applications of avapritinib (previously known as BLU-285), a potent and selective oral inhibitor of the tyrosine kinase most commonly mutated in this condition.Recent findings: Phase I data and recent phase II data have demonstrated both safety and efficacy of this agent used as monotherapy, even in patients who have progressed on other targeted therapy. Studies to date have focused on patients with the most aggressive disease, but new trials in indolent mastocytosis are accruing currently. Over the next several years, one may anticipate finalized, peer-reviewed, and formally published data for this agent in both advanced systemic and indolent mastocytosis. Evidence from these early studies will also likely highlight where more research is needed.","PeriodicalId":10852,"journal":{"name":"Current Hematologic Malignancy Reports","volume":"16 5","pages":"464-472"},"PeriodicalIF":2.9,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39464222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Challenges in Chronic Myeloid Leukemia Management in South America. 南美慢性髓性白血病管理的挑战。

IF 2.9 3区医学

Current Hematologic Malignancy Reports Pub Date : 2021-10-01 Epub Date: 2021-10-15 DOI: 10.1007/s11899-021-00654-0

Katia B Pagnano, Ana Ines Varela, Carolina Pavlovsky, Israel Bendit, Vaneuza A M Funke, Virginia Abello Polo

引用次数: 0

Management Issues and Controversies in Low-Risk Patients with Essential Thrombocythemia and Polycythemia Vera. 原发性血小板增多症和真性红细胞增多症低危患者的管理问题和争议。

IF 2.9 3区医学

Current Hematologic Malignancy Reports Pub Date : 2021-10-01 Epub Date: 2021-09-03 DOI: 10.1007/s11899-021-00649-x

Joan How, Gabriela Hobbs

{"title":"Management Issues and Controversies in Low-Risk Patients with Essential Thrombocythemia and Polycythemia Vera.","authors":"Joan How, Gabriela Hobbs","doi":"10.1007/s11899-021-00649-x","DOIUrl":"https://doi.org/10.1007/s11899-021-00649-x","url":null,"abstract":"Purpose of review: Essential thrombocythemia (ET) and polycythemia vera (PV) are the most common myeloproliferative neoplasms (MPNs). Treatment of ET and PV is based on the risk for subsequent thrombosis. High-risk patients, defined as older than 60, JAK2 V617F-positive patients, or patients with a history of prior thrombosis, merit cytoreduction to control blood counts, whereas a watchful waiting paradigm is utilized in low-risk patients. However, low-risk patients have a host of other specific management issues that arise during their disease course. This review will discuss the most common management issues specific to the care of low-risk patients, including anti-platelet therapy dosing, pregnancy, and indications for early cytoreduction.Recent findings: Although low-dose aspirin is well established in PV, its indications and dosing regimens are less clear in ET. Recent evidence has supported twice daily low-dose aspirin in ET and observation alone in very low-risk ET patients. Pregnancy is not contraindicated in MPNs, and we recommend aspirin throughout pregnancy with consideration for prophylactic postpartum anticoagulation. High phlebotomy needs, symptom burden, and extreme thrombocytosis are common reasons for initiation of cytoreduction in low-risk patients, although we typically do not start cytoreduction for an isolated high platelet count alone. Recent data has also demonstrated a potential disease-modifying effect of interferons in MPNs, with some experts now advocating the early use of interferon in low-risk patients, although more mature data is needed before practice guidelines change. We evaluate the literature to inform clinical decision-making regarding these controversies, including most recent data that has challenged the \"watchful waiting\" paradigm. Our discussion provides guidance on common clinical scenarios seen in low-risk ET and PV patients, who face a myriad of complex management decisions in their care.","PeriodicalId":10852,"journal":{"name":"Current Hematologic Malignancy Reports","volume":"16 5","pages":"473-482"},"PeriodicalIF":2.9,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39383536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3