Health Professional Version

Health Professional Version

Find answers to some of the most commonly asked questions about multiple myeloma from nurses and patients.

John Gribben of Barts Cancer Institute, London, UK, chairs an insightful discussion with Barbara Eichhorst of the University of Cologne, Cologne, Germany, Susan O�Brien of the University of California, Irvine, CA, and Matthew Davids of Dana-Farber Cancer Institute, Boston, MA, on the latest CLL updates from the recent Virtual ASCO and EHA 2020 Meetings. The speakers discuss frontline therapy for CLL, BTK inhibitors, novel combination therapies and the importance of measurable residual disease (MRD) assessment. Treatment sequencing and novel therapies, in particular CAR T-cell approaches were also discussed.

Bruno Paiva, PhD, of the University of Navarra, Pamplona, Spain, Noemi Puig, MD, PhD, of the University Hospital Salamanca, Salamanca, Spain, and Benjamin Derman, MD, of the University of Chicago, Chicago, IL, discuss key research, presented at this year�s Congress of the European Hematology Association (EHA 2021), investigating the role of MRD in the management of multiple myeloma.

Nitin Jain, MD, of the University of Texas MD Anderson Cancer Center, Houston, TX, and Anthony Mato, MD, and Meghan Thompson, MD, both from Memorial Sloan Kettering Cancer Center, New York, NY, discuss some of the latest updates in CLL treatment presented at this year�s virtual American Society of Hematology (ASH) meeting.

Featuring an interview with Dr Steven Coutre on the following topics: Front-line treatment of CLL (0:00) Recent data with ibrutinib-based regimens as first-line therapy for CLL (5:31) Results of the Phase III ELEVATE-TN study evaluating the efficacy and safety of acalabrutinib with obinutuzumab compared to acalabrutinib alone or obinutuzumab with chlorambucil for treatment-naive CLL (14:22) Case: A man in his late 70s experiences atrial fibrillation after receiving ibrutinib as first-line treatment for CLL (19:08) Case: A woman in her early 60s develops arthralgias after treatment with ibrutinib for CLL (25:08) Case: A man in his early 70s receiving ibrutinib for CLL experiences easy bruising on his forearms (27:28) Results from the CLL14 trial evaluating the addition of venetoclax versus chlorambucil to obinutuzumab for patients with previously untreated CLL and coexisting medical conditions (32:06) Monitoring and management of tumor lysis syndrome (TLS) in patients receiving venetoclax (37:07) Impact of minimal residual disease (MRD) assessment on outcomes for patients with CLL (41:26) Spectrum of adverse events with Bruton tyrosine kinase (BTK) inhibitors for CLL (46:22) CME information and select publications.

Of all the hematologic malignancies, multiple myeloma has one of the greatest disparities in incidence and prevalence, with incidence in African American patients more than twice that in white patients. These podcasts will teach clinicians culturally sensitive approaches for management of multiple myeloma in African Americans, how to address barriers due to racial disparities, and strategies to implement newly gained knowledge for the best outcomes of African American patients with multiple myeloma.

Adults with relapsed or refractory B-precursor acute lymphoblastic leukaemia have an unfavourable prognosis�This study aimed to confirm the activity and safety profile of blinatumomab for ALL.

This Review presents an overview of the various techniques for MRD detection in patients with MM. In addition, this article discusses challenges and opportunities for the routine use of MRD testing, possible future directions for clinical trials and implications for drug approval processes.

Authors identified genetic mutations in CD19 and loss of heterozygosity at the time of CD19� relapse to chimeric antigen receptor (CAR) therapy.

Assessment of MRD is rapidly transforming the therapeutic and prognostic landscape of a wide range of hematological malignancies. Its prognostic value in ALL has been established and MRD measured at the end of induction is increasingly used to guide further therapy. Although MRD detectable immediately before allogeneic HCT is known to be associated with poor outcomes, it is unclear if or to what extent this differs with different types of conditioning.

This comprehensive review focuses on the recent advances and future directions in novel therapeutic strategies in adult ALL.

In relapsed and/or refractory multiple myeloma, daratumumab reduced the risk of progression or death by > 60% in POLLUX (daratumumab/lenalidomide/dexamethasone [D-Rd]) and CASTOR (daratumumab/bortezomib/dexamethasone [D-Vd]). Minimal residual disease (MRD) is a sensitive measure of disease control. Sustained MRD negativity and outcomes were evaluated in these studies.

Brief review article that concludes, "With the approval of several new drugs with different mechanisms of action and the incorporation of MRD as an end-point in clinical trials, the management landscape of MM is changing rapidly. Given the significant impact of MRD negativity on the outcomes, it could be a new regulatory surrogate end-point for survival in clinical trials and a main driver of research and clinical practice in MM in the future.

This review summarizes current data on MRD in the clinical management of MM, highlights open issues and discusses the challenges and the endless opportunities arising for both patients and clinicians. Furthermore, it focuses on the current status of MRD in clinical trials, its dynamics in addressing debatable aspects in the clinical handling and its potential role as the prevailing factor for future MRD-driven tailored therapies.

In adults with relapsed/refractory ALL receiving first salvage therapy, achievement of MRD negativity is an important therapeutic outcome. Patients who achieve MRD negativity with first salvage treatment and undergo SCT have the best long-term survival.

In patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM), daratumumab reduced the risk of disease progression or death by 44% in MAIA (daratumumab/lenalidomide/dexamethasone [D-Rd]) and 58% in ALCYONE (daratumumab/bortezomib/melphalan/prednisone [D-VMP]). Minimal residual disease (MRD) is a sensitive measure of disease and response to therapy. MRD-negativity status and durability were assessed in MAIA and ALCYONE.

Initial imatinib-based therapy of Ph+ adult ALL is associated with lower early mortality and higher CR rate. In adults with Ph+ ALL, allogeneic SCT in first CR prolongs relapse-free survival and OS.

Ten of 36 patients (28%) achieved an OS ?30 months in a blinatumomab study in relapsed/refractory acute lymphoblastic leukemia. Long-term survival may be associated with T-cell expansion, B-cell depletion, and a minimal residual disease response.