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In recent years, genetic alterations have played a crucial role in the diagnosis and prognostic stratification of acute myeloid leukemia (AML) and provided targeted spots for molecular targeted therapy. Due to the limitations of traditional chemotherapy, more and more targeted drugs are going to clinic or undergoing clinical trials. This article introduces several molecular targeted agents reported in the 60th American Society of Hematology (ASH) Annual Meeting.
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Patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) after two or more lines of therapy and who are not candidates for stem cell transplantation have limited effective treatment options, resulting in a poor prognosis, thus, treatments with novel mechanisms of action are urgently needed. In the 60th American Society of Hematology (ASH) Annual Meeting, detailed reports focused on the research progresses of single agent, drug combination and chimeric antigen receptor T cell (CAR-T) therapy, providing more treatment options for R/R DLBCL patients.
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High grade B-cell lymphoma (HGBL) has been defined as a separate entity in World Health Organization classification in 2016 and is considered to be clinically aggressive. People make continuous analysis of the subgroups and accurate treatments, such as the comparison between the prognosis of HGBL-not otherwise specified and double-hit lymphoma (DHL), transformed and primary DHL, myc partner/bcl-2/bcl-6 translocation, TP53 expression, serum albumin, chemoimmunotherapy, hematopoietic stem cell transplantation, T cells with chimeric antigen receptors therapy, etc. This report will address the progress of HGBL prognosis and therapy in the 58th American Society of Hematology Annual Meeting.
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In recent years, immunotherapy has become an indispensable part in treatment of cancer, and the immune checkpoint inhibitors are the focus of attention. In the 58th American Society of Hematology (ASH) Annual Meeting, the application of immune checkpoint inhibitors in hematologic malignancies had been widely concerned. The recent progress of immune checkpoint inhibitors in hematologic malignancies in this annual meeting will be briefly introduced.
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In the 58th American Society of Hematology Annual Meeting, some clinical results on B-cell lymphoma were reported. This review will focus on the recent progress of diffuse large B-cell lymphoma and mantle cell lymphoma in this annual meeting.
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Follicular lymphoma (FL) is a kind of indolent non-Hodgkin lymphoma (iNHL), which origins from follicle germinal center. Multiple researches reported the latest development about treatment of FL in the 58th American Society of Hematology (ASH) Annual Meeting. The outcomes of clinical trials in which GAl01 combined with chemotherapy and bendamustine in combination with 90Y-ibritumomab tiuxetan for the advanced stage FL were exciting. Relapsed/refractory FL patients who receive tandem autologous followed by nonmyeloablative allogeneic transplantation could acquire preferable remissions. With the emerging of novel drugs including inhibitor of bcl-2 or PI3K and antibody drug conjugate, more and more improvements of efficacy and remission were made in the treatment of relapsed/refractory FL therapy and remission.
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PET-CT is the only current medical imaging technology to provide both metabolic and morphologic information in anatomical configuration mode,with high sensitivity and non-invasion.As one of the optimal measures in tumor diagnosis and therapy,abnormally-increased FDG uptake of some subtypes therefore makes an increasing application of PET-CT in lymphoma.The progress of PET-CT in lymphoma will be summarized in this paper based on the reports from the 58th American Society of Hematology Annual Meeting.
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Allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a curable method for hematological malignancies.Nearly all transplant candidates have donor with the successful application of haploidentical SCT.This article summarized some reports on donor selection,prophylaxis and treatment of graft-versus-host disease,and graft failure in the 58th American Society of Hematology Annual Meeting to present the progress of allo-HSCT in treating hematological malignancies.
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Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma with highly heterogeneous both clinically and biologically. So the prediction for prognosis of DLBCL and identifying patients with high risk are coming into the focus of the 58th American Society of Hematology (ASH) Annual Meeting. International prognostic index (IPI) risk model is widely known as the powerful prognostic indicator for DLBCL but in rituximab-era is challenged by a variety of new prognosis systems. Biological markers and mutation and expression of genes play an important role in the pathogenesis and progression of lymphoma, and its prognostic value draw much more attention. The prognostic factors of DLBCL, specific types, such as primary breast DLBCL, intravascular large B-cell lymphoma, the presence of a DLBCL component in a follicular lymphoma and relapsed/refractory DLBCL have been paid more attention in this meeting.
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The myelodysplastic syndromes (MDS), which are characterized by the presence of ineffective hematopoiesis and an increased risk of transformation to acute myeloid leukemia (AML), are a group of clonal disorders deriving from damage of the hematopoietic stem/progenitor cells. The 58th American Society of Hematology (ASH) Annual Meeting consists of 5 main subjects, includingchronic myelomonocytic leukemia (CMML) and MDS biology and treatment, higher risk MDS clinical studies, lower risk MDS clinical studies, predisposition and diagnosis of MDS, and prognostic and predictive utility of recurrent somatic mutations in MDS. This article will introduce some highlights of the oral reports in this meeting.
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Mantle cell lymphoma (MCL), being a kind of aggressive non-Hodgkin ' s lymphoma (NHL), accounts for 6 % - 8 % of NHL in adults which is characterized by malignant B cell infiltration of lymph node, gastrointestinal tract and bone marrow. MCL commonly responds to initial therapy but inevitably occurs relapse and drug resistance. The study on MCL in the 58th American Society of Hematology Annual Meeting has covered many aspects such as basic research, clinical treatment and new drug research. The development of novel mouse model and the exploration of signaling pathways provide a basis for the improvement of MCL pathogenesis and new drug research. VcR-CVAD, VCR and some other chemotherapy regimens designed for different patients have showed satisfactory results. New drugs such as inhibitors of CDK, PI3K and bcl-2 in initial clinical trials are also promising. IACS-010759 and other small molecules provide new directions for the treatment of MCL.
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Recent studies have shown that platelets have a variety of important functions, and play an important role in the pathophysiology of liver and renal diseases. The quantitative and functional changes of platelets, could affect the bleeding complications in patients with liver and renal diseases. This article reviews the progress of the effects of thrombocytopenia and platelet dysfunction on patients with liver and renal diseases, and the role of platelets in the pathophysiology of liver and renal diseases in the 58th American Society of Hematology Annual Meeting.
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The incidence of elderly patients with acute myeloid leukemia (AML) is increased year by year, and the median onset age is 67 years old. As old patients often have the viscera dysfunction, it is still lack of unified treatment clinically. This article summarizes the latest research progress of elderly patients with AML in the 58th American Society of Hematology Annual Meeting.
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Tremendous success has emerged in chimeric antigen receptor (CAR)-T cell therapy over the past few years, especially in leukemia and lymphoma. The first CAR-T cell product might be available in America in 2017 due to the emergence of the critical results. This paper focused on the key data presented at the 58th American Society of Hematology Annual Meeting.
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Great advances have been made recently in the therapy of chronic lymphocytic leukemia due mainly to the application of novel agents. In the 58th American Society of Hematology Annual Meeting, the latest outcomes of many clinical studies have been reported. The present article will review the reports and focus on the following studies on chronic lymphocytic leukemia (CLL): the long-term therapeutic outcome of BTKi and the result of combination therapy of BTKi with other agents; the short-term result of bcl-2 inhibitor in CLL; the efficacy of maintenance therapy with lenalidomide in CLL patients; CD19-CAR T-cell therapy achieved good response. Traditional immunochemotherapy with combination of fludarabine, cyclophosphamide and rituximab is still the first-line option for fit patients through long-term follow-up. The allogeneic stem cell transplantation remains a curative strategy for CLL but with stricter indication.
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New progress of treatment of low-risk myelodysplastic syndromes (MDS) reported in the 58th American Socienty of Hematology (ASH) Annual Meetings was reviewed. Anemia is a single common symptom of low-risk MDS, and erythropoietic-stimulating agents (ESA) may be effective. The dose and duration of erythropoietic-stimulating agents (ESA) are critical to determine efficacy. If the treatment of ESA failed, the available options may include lenalidomide (approved for del5q positive cases), hypomethylating agents and a rather large number of experimental agents. The choice for the second-line treatment must consider the biologic, cytogenetic and molecular-identified characteristics of individual patient, as well as frailty and comorbidities. Other cytopenias rarely appear alone. Thrombomimetic agents for thrombocytopenia has been proposed in clinical trials, but there were some safety issues. Although neutropenia is targeted symptomatically with growth factor supportive care, the immunosuppressive therapy is indicated mainly for pancytopenic and hypoplastic low-risk MDS. Finally, hematopoietic stem cell transplantion is the curative option also for low-risk MDS, but it should be carefully evaluated to balancing toxicity and the possibility of survival advantage.
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Telomere and telomerase play important roles in protecting and maintaining the stability and integrity of chromosomes. Telomere and telomerase are closely related with multiple diseases, and their relationship with aging and tumors has become a hot topic in recent years. Relevant reports in the American Society of Hematology Annual Meeting in 2016 will be reviewed together with advances of telomere and telomerase in hematological diseases.
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Peripheral T-cell lymphoma (PTCL) is a kind of highly aggressive lymphoma which contains a collection of subgroups. The patients with PTCL have poor prognosis under current chemotherapy regimens, so the treatment of PTCL remains a big challenge. Brentuximab vedotin combined with CHP regimen, pralatrexate in combination with romidepsin and other regimens have set up more options for patients with PTCL. Novel agents, such as PI3K inhibitors, which entered into clinical trials, bring good news to PTCL patients.
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Marginal zone lymphoma (MZL) accounts for approximately 10 % of non-Hodgkin lymphoma (NHL). It can be divided into three specific entities:extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), nodal marginal zone lymphoma (NMZL) and splenic marginal zone lymphoma (SMZL). MALT lymphoma is the most frequent overall, representing 7.5 % of all NHLs. Reports on research progress of MZL in the 58th American Society of Hematology Annual Meeting covered multiple respects which ranged from basic research to clinical prognosis and treatment. Based on the technology such as flow cytometry, cytogenetics and FISH, further study on pathogenesis of MZL is developing, and new prognostic index system can help to stratify patients more exactly and give a guidance to treatment. What's more, the change of therapy and new drugs will benefit to the clinical efficacy and safety of MZL patients.
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Rituximab in the combination of CHOP regimen has been widely used as the standard treatment of several kinds of B cell non-Hodgkin lymphoma (B-NHL),but there are still about 1/3 of the late B-NHL patients become primary and secondary resistant to the drug.Recently,many translational research progress in malignant lymphoma promoted the development of promising candidate drugs for the treatment of lymphoma.The advances in translational research field were summarized in this manuscript.