Many patients with acute myeloid leukemia (AML) achieve complete remission (CR) after induction chemotherapy; however, just 30% of patients maintain CR for three years or longer. Long-term outcomes for those who do maintain CR are largely unknown. Results from a new study have shown that new medical problems frequently occur, and patients require routine surveillance and preventative measures. Catherine Kendall Major, BS, of the MD Anderson Cancer Center in Lakeland, TN, discussed the findings at the ASH Annual Meeting on December 3, 2018.

Researchers in Spain developed the Geriatric Assessment in Hematology (GAH) scale to classify patients as robust (those with strength or vigorous health) or frail (those with a poorer prognosis). The tool is validated for use in myelodysplastic syndromes, acute myeloid leukemia, multiple myeloma, and chronic lymphocytic leukemia. Researchers assessed its use and validity among patients with lymphoma. Raul Cordoba, MD, PhD, of Fundacion Jimenez Diaz University Hospital in Madrid, Spain, discussed the findings at the ASH Annual Meeting on December 3, 2018.

Improved monitoring of pediatric patients undergoing blood and marrow transplant (BMT) may result in better precision symptom management strategies. Mobile health and wearable technologies may aid in such efforts by providing data on complex symptom patterns, trajectories, and interactions. Researchers conducted a pilot study and found that integrating mobile health technology into care was feasible, although they had concerns about compliance. Nirmish Shah, MD, of Duke University School of Medicine in Raleigh, NC, discussed the findings at the ASH Annual Meeting on December 3, 2018.

Intracranial hemorrhage (ICH) is a common complication in patients with acute leukemia and is associated with significant morbidity and mortality. Information on platelet transfusion practice in patients following ICH is limited, so researchers assessed clinical features and outcomes to better guide transfusion practices after ICH. Shannon Nixon, NP, of the Princess Margaret Cancer Centre at the University of Toronto, discussed the findings at the ASH Annual Meeting on December 3, 2018.

Patients and families can make better healthcare decisions that are consistent with patients’ needs, values, and preferences when they are more informed and educated about the disease, according to study findings that Anne C. Roc, PhD, of PlatformQ Health in Needham, MA, discussed at the ASH Annual Meeting on December 3, 2018.

Although patients with Hodgkin lymphoma can experience long-term survival, they may face difficulty in coping with treatment-related adverse outcomes. Researchers assessed the needs of lymphoma survivors and their caregivers and identified unmet patient-oriented research needs: quality of life after treatment, messaging and communication between the scientific community and patients, and emotional well-being. Jackelyn B. Payne, MPH, BS, BA, of Stony Brook University in New York, discussed the findings at the ASH Annual Meeting on December 2, 2018.

Germline mutations in DDX41 may increase a patient’s lifetime risk of late-onset myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML). Identification of this germline mutation leads to more timely and appropriate care for patients with myeloid neoplasms, according to a study. Sarah Bannon, MS, of the University of Texas MD Anderson Cancer Center in Houston, discussed the findings at the ASH Annual Meeting on December 2, 2018.

Patients with diffuse large B-cell lymphoma (DLBCL) often experience long-term survival after initial anthracycline-containing therapy; however, relapse leads to poor outcomes. Some patients with relapsed or refractory disease may receive additional chemoimmunotherapy followed by hematopoietic cell transplantation (HCT), but as many as 50% of patients cannot undergo HCT because of lack of response to chemoimmunotherapy or comorbidities. Chimeric antigen receptor (CAR) T-cell therapy may be an option for those patients, but real-world data on CAR T-cell therapy for DLBCL are limited.

Older patients are at increased risk for complications and death following allogeneic hematopoietic cell transplantation (alloHCT), and traditional transplant-specific prognostic indices such as the hematopoietic cell transplant comorbidity index (HCT-CI) may not adequately predict survival. Researchers found that routine pretransplant assessments by interdisciplinary clinical providers, including advanced practice providers and nursing staff, may uncover additional geriatric deficits. Richard J. Lin, MD, PhD, of Memorial Sloan Kettering Cancer Center in New York, NY, discussed the findings at the ASH Annual Meeting on December 1, 2018.

Patients with relapsed or refractory Hodgkin lymphoma (HL) after checkpoint blockade therapy (CBT) have limited options. However, researchers found that CBT may impact response to subsequent therapies. Nicole A. Carreau, MD, of New York University Langone Health in New York City, discussed the findings at the ASH Annual Meeting on December 1, 2018.

No molecular-informed personalized therapies are currently available for patients with relapsed/refractory multiple myeloma (MM); however, cytogenetics and next-generation sequencing (NGS) can identify molecular abnormalities to provide guidance for more targeted therapy. Tarek Assi, MD, of Gustave Roussy Cancer Campus in Villejuif, France, discussed his research team’s findings that tumor genotyping is associated with higher response rates and prolonged duration of therapy at the ASH Annual Meeting on December 1, 2018.

Advanced practice providers (APPs) may have limited subspecialty training options for hematology, and postgraduate fellowships focused on education in both malignant and nonmalignant hematologic disorders appear to be lacking for APPs. Yi L. Hwa, DNP, of the division of hematology at the Mayo Clinic in Rochester, MN, discussed the findings of a research team’s web-based needs assessment survey that found significant gaps in subspecialty hematology training for APPs at the ASH Annual Meeting on December 1, 2018.

Studies suggest that patients with hematologic malignancies receive more aggressive end-of-life (EOL) care than those with solid tumors. 

Survival from multiple myeloma (MM) has improved, and more attention is required for symptom burden and psychological impact in the long-term management of this disease. Researchers assessed the incidence of self-reported pain, depression, financial and family burden, and impairment of performance status, as well as determined the correlation of total distress with survival. Joshua R. Richter, MD, at the John Theurer Cancer Center in Hackensack, NJ, discussed the findings at the ASH Annual Meeting.

Researchers assessed the impact of physical activity levels before and after cancer diagnosis on overall survival (OS) and lymphoma-specific survival (LSS) outcomes in patients with lymphoma. They found that higher levels of physical activity during adult life and within three years of diagnosis improve survival. Priyanka Pophali, MD, at the Mayo Clinic in Rochester, MN, discussed the findings at the ASH Annual Meeting.

Patients with chronic myeloid leukemia (CML) often experience symptoms and treatment-related adverse events (AEs) that are chronic and may require care from an interdisciplinary team. A study sought to assess symptom burden, palliative care needs, and experiences with healthcare team communication in this patient population. Alexandra K. Zaleta, PhD, at the Research and Training Institute, Cancer Support Community in Philadelphia, PA, discussed the findings at the ASH Annual Meeting.

Ibrutinib is approved by the U.S. Food and Drug Administration (FDA) for the treatment of chronic lymphocytic leukemia (CLL). Researchers sought to study real-world outcomes related to adverse events (AEs), treatment discontinuation, outcomes, and subsequent therapies in those treated with frontline ibrutinib. Anthony R. Mato, MD, at the University of Pennsylvania Abramson Cancer Center in Philadelphia, PA, discussed the findings at the ASH Annual Meeting.

Researchers conducted a randomized study to assess the impact of survivorship care plans (SCPs) on cancer survivors who underwent hematopoietic cell transplantation (HCT). They assessed confidence in survivorship information (primary analysis), as well as cancer treatment distress, knowledge of transplant exposures, health behaviors, healthcare use, and health general self-efficacy. Navneet S. Majhail, MD, MS, at the Taussig Cancer Institute at the Cleveland Clinic in Ohio, discussed the findings at the ASH Annual Meeting.

Data are limited on repeated unplanned hospital readmissions among patients with hematologic malignancies, so researchers analyzed baseline characteristics of patients with one or more 30-day unplanned readmissions, as well as factors related to these readmissions. Girish Kunapareddy, MD, at the Taussig Cancer Institute at the Cleveland Clinic in Ohio, discussed the findings at the ASH Annual Meeting.

Unplanned hospitalizations and emergency department (ED) visits are an ongoing problem for patients with cancer. At the Taussig Cancer Institute, just 6% of all discharged patients accounted for more than 40% of unplanned readmissions (defined as a hospitalization occurring within 30 days of discharge). Those patients are also at high risk for future admissions, intensive care unit (ICU) stay, ED visits, overuse of chemotherapy, and underuse of hospice resources. Researchers developed an individualized care plan (ICP) for patients with the highest preventable use to see if this would impact hospital use and readmissions. Girish Kunapareddy, MD, at the Taussig Cancer Institute at the Cleveland Clinic in Ohio, discussed the findings at the ASH Annual Meeting.

Venetoclax—an oral, small-molecule BCL-2 inhibitor—is approved by the U.S. Food and Drug Administration for the treatment of relapsed or refractory chronic lymphocytic leukemia (CLL) in those with del(17p) mutation. Statins, which are used to lower cholesterol, have shown a potential to induce apoptosis in various cancer cell lines, and evidence suggests a synergism when combined with BCL-2 inhibition. Based on this, researchers conducted a post-hoc analysis to see whether statins enhance the activity of venetoclax in patients with CLL or multiple myeloma (MM). Andrew W. Roberts, MS, at AbbVie Inc., in North Chicago, IL, discussed the findings at the ASH Annual Meeting.

Patients with myeloproliferative neoplasms (MPN) have increased inflammatory cytokines that contribute to symptom burden and nutritional deficiencies. Some studies have indicated that diets and supplements have demonstrated antioxidant and anti-inflammatory pharmacologic properties, such as decreased inflammatory markers and reactive oxygen species. Researchers conducted a study to examine nutritional and supplemental needs in this patient population. Robyn M. Scherber, MD, at Oregon Health and Science University in Portland, discussed the findings at the ASH Annual Meeting.

Researchers assessed how patients with chronic lymphocytic leukemia (CLL) describe quality of life (QoL) compared to other U.S. populations, as well as the effects on daily living, finances, and professional and family relationships. Joanne S. Buzaglo, PhD, at the Research and Training Institute, Cancer Support Community in Philadelphia, PA, discussed the findings at the ASH Annual Meeting.

Patient-reported outcomes (PROs) are an important part of patient management but may be burdensome for patients to track. Wearable activity monitors provide objective, continuous activity data that may correlate with PROs, and researchers assessed the use of this technology in a study. Carrie A. Thompson, MD, at the Mayo Clinic in Rochester, MN, discussed the findings at the ASH Annual Meeting.

No data exist on current trends and practice patterns for palliative care use among patients with cancer, particularly those with hematologic malignancies. Sikander Ailawadhi, MD, at the Mayo Clinic in Jacksonville, FL, discussed their findings on these trends at the ASH Annual Meeting.

Data from U.S. Lymphocare suggest that older patients with follicular lymphoma (FL) are more commonly treated with watchful waiting or single-agent rituximab and found no difference in outcomes by treatment groups, but comorbidity was not studied. Researchers aimed to describe patient features, comorbidity use of positron-emission tomography (PET) staging, management choices, and the impact of polypharmacy on outcomes of patients with FL aged 70 years or older. Prathima Reddy, MD, at CHI Franciscan Hospital in Federal Way, WA, discussed the findings at the ASH Annual Meeting.

Ibrutinib is a first-in-class, once-daily inhibitor of Bruton tyrosine kinase that is approved for various B-cell malignancies. However, the drug is associated with increased rates of low-grade hemorrhage and sometimes serious hemorrhage, which is listed as a warning in the  prescribing information. Patients with chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and mantle cell lymphoma (MCL) are at an increased risk for major hemorrhage (MH) compared to the general population.

Many lymphoma treatments are known to affect the immune system, so researchers assessed whether survivors of diffuse large B-cell lymphoma (DLBCL) have an altered risk of developing autoimmune and infectious diseases compared to other cancer survivors. Tanaya Shree, MD, PhD, at Stanford University Medical Center in California, discussed the findings at the ASH Annual Meeting.

Patients with multiple myeloma (MM) who receive proteasome inhibitors (PIs) are at an increased risk for herpes zoster infection, and National Comprehensive Cancer Network guidelines recommend antiviral prophylaxis for these patients. Researchers examined the use of and adherence to antiviral agents in this patient population. Siyang Leng, MD, at Columbia University Medical Center in Sunnyside, New York, discussed the findings at the ASH Annual Meeting.

CPX-351 is a dual-drug liposomal encapsulation of cytarabine and daunorubicin that delivers a synergistic drug ratio. In a randomized, phase III study, researchers evaluated induction therapy with CPX-351 versus conventional cytarabine/daunorubicin (referred to as 7+3 regimen) in adults aged 60–75 years with newly diagnosed, treatment-related acute myeloid leukemia (AML) or AML with myelodysplasia-related changes. Bruno C Medeiros, MD, at Stanford University School of Medicine in California, discussed the findings at the ASH Annual Meeting.

If patients with multiple myeloma are noncompliant with treatment, it can have “devastating consequences on the clinical prognosis,” said Dale Hanna of the Lash Group in Fort Mill, SC. His team presented its evaluation on the impact of a patient-centered program on IV therapy compliance among patients with multiple myeloma on Saturday, December 3, at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA.

Researchers have begun to assess data produced from Internet search engine analysis to better understand the health concerns and awareness of patients and nonmedically savvy individuals. Specifically, Google Trends has increased as a data source because it compiles every Google search worldwide from 2004 to the present, aggregating results into a publicly viewable data site. Adeel M. Khan, MD, MPH, and colleagues at the Cancer Institute at the Cleveland Clinic in Ohio, specifically examined nonmedical and patient Internet users searches related to hematologic malignancies.

Although adolescents and young adults (AYAs) who have survived classical Hodgkin lymphoma (cHL) often have substantial treatment-related morbidity that can lead to premature death, Ana Xavier, MD, and colleagues, in the Department of Pediatrics, Division of Hematology/Oncology at the University of Alabama at Birmingham, questioned whether recent changes in treatment have reduced excess mortality among long-term survivors of AYA-cHL. They presented their research on Monday, December 5, at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA.

Treatment and outcomes for multiple myeloma (MM) have been greatly improved by the introduction of parenteral chemotherapy and novel oral agents such as lenalidomide and thalidomide. However, the cost of those agents typically exceeds $5,000 per month, which continues hinder their accessibility, according to Adam J. Olszewski, MD, in the Division of Hematology-Oncology at Alpert Medical School at Brown University, in Providence, RI. He discussed the ongoing financial difficulties for patients, insurers, and healthcare systems on Monday, December 5, at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA.

Cancer correlates with negative family relationships for pediatric patients with cancer, according to new research presented on Monday, December 5, at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA. The finding is based on data from a newly developed patient-reported outcome tool, recently created as part of the National Institute of Health’s Patient-Reported Outcome Measurement Information System (PROMIS) to evaluate children’s perspectives on family relationships.

A number of non-stem cell therapies, including cellular vaccines and chimeric antigen receptor (CAR) T cells, are offered to cancer centers. “Demand is growing, with several CAR products heading for imminent U.S. Food and Drug Administration approval,” said Sarah Nikiforow, MD, PhD, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School in Boston, MA.

To better understand the real-world impacts of the advances in treatment for multiple myeloma (MM) over the past 15 years, Safiya Abouzaid, PharmD, Celgene Corporation in Summit, NJ, and colleagues sought to describe trends in novel therapy use, total healthcare costs, and survival outcomes among patients newly diagnosed with MM in the United States since 2000. They presented their findings on Sunday, December 4, at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA.

High cost of treatment, in addition to limited reimbursement, can limit ongoing support services for patients in post-treatment settings, despite quality of life (QoL) being considered important to positive health outcomes after treatments. The lack of such support was discussed in terms of hematopoietic stem cell transplant (HSCT) by Connie E. Chen, MD, Stanford Hospital in Palo Alto, CA, on Sunday, December 4, at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA.

A bleeding-risk tool is needed that can determine which patients on anticoagulation therapy (OAT) for venous thromboembolism (VTE) may have an annual rate of major bleeding over 3%. “[Three percent] is the cut-point at which the risk of continued anticoagulant therapy exceeds the benefit,” said Philip S. Wells, MD, Department of Medicine, University of Ottawa and the Ottawa Hospital in Ontario, Canada. Wells presented the research at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA.

Acute myeloid leukemia (AML) is the most common acute leukemia in adults, and treatment outcomes have improved only modestly in recent decades. Ankit Shah, MD, Drexel University College of Medicine, Philadelphia, PA, sought to analyze the differences in trends between teaching versus non-teaching medical institutions for admitted adult patients with active AML in terms of hospital cost, length of stay, in-hospital mortality, and complication rates. Shah presented the research team’s analysis findings at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA.

Researchers classify induction therapy for patients with newly diagnosed acute myeloid leukemia (AML) as intensive or nonintensive. Because of tolerability concerns for patients older than 65 years, nonintensive therapies are increasingly used.

Health care and outcome disparities are of key concern as providers seek to improve the health of all patients regardless of demographics. Megan H. Jagosky, MD, Department of Internal Medicine, Carolinas Medical Center/Carolinas HealthCare System in Charlotte, NC, discussed the outcomes of transplant eligible multiple myeloma (MM) African American patients compared to Caucasian patients at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA.

Older patients and those with poorer overall health are not as likely to receive treatment for multiple myeloma, despite the fact that MM is most commonly a disease of older individuals, with a median age of diagnosis of 66 years.

Although clinicians take great effort to treat patients with hematologic malignancies, they often do not give enough weight to symptoms related to the disease, according to Tatyana Ionova, PhD, Multinational Center for Quality of Life Research in St. Petersburg, Russia, who presented her research on behalf of her colleagues on Saturday, December 3, at the 58th American Society of Hematology Annual Meeting and Exposition in San Diego, CA.

Healthcare providers and patients use shared decision-making (SDM) to consider available clinical evidence and patients’ values or preferences to achieve optimal care and outcomes. However, despite the fact that multiple myeloma (MM) is a particularly complex disease to manage, treatment guidelines do not offer patient-specific treatment recommendations for individual patients.

Clinical research has immense value, leading to the discovery of new treatment pathways and improved patient outcomes. However, such gains may have less positive impact on patients who are ineligible for clinical trials, because the data do not represent how the clinical outcomes affect unincluded populations.