CONGRESS NEWS

Driver mutations and their evolution in CLL

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Whole-exome sequencing studies have already uncovered some cancer drivers in chronic lymphocytic leukaemia (CLL) and have provided insights in disease pathogenesis, evolution and prognostication. At the 2015 annual EHA meeting in Vienna, Prof. Dr. Eugen Tausch (Universität Ulm) presented data of whole-exome sequencing of samples of 278 patients in the CLL8 trial.

(BELG J HEMATOL 2015;6(3):96–7)

Venetoclax-rituximab induces deep responses in relapsed CLL

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BCL-2 represents a major apoptosis escape mechanism in chronic lymphocytic leukaemia (CLL), allowing the leukaemic cells to evade normal processes that lead to programmed cell death. Venetoclax is a selective inhibitor of BCL-2 and as such has the potential to restore apoptotic mechanisms. In a phase Ib study, presented at EHA 2015, the chemotherapy-free combination of venetoclax and rituximab was evaluated in 49 patients with relapsed CLL.

(BELG J HEMATOL 2015;6(3):98)

Advances in Acute Myeloid Leukaemia: Increased insights in chemoresistance and first randomised evidence for kinase inhibition

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Although most patients with acute myeloid leukaemia (AML) initially respond to anti-leukaemic chemotherapy, the majority of patients subsequently relapses and dies of relapsed or refractory disease. Recent studies have suggested that therapeutic relapse is the result of persistent, chemo-resistant AML cells that survive initial therapy, who serve as a reservoir for genetic/epigenetic evolution and subsequent clinical relapse. Although many AML patients have evidence of residual leukemia at clinical remission, the mechanisms leading to chemo-resistance and to the survival of AML cells in response to chemotherapy have not been delineated. During EHA 2015, a study was presented showing that mutant DNMT3A promotes chemoresistance in AML, suggesting the possibility of unique vulnerabilities in DNMT3A-mutant cells that can be exploited therapeutically. In a second presentation, tyrosine kinase inhibition was for the first time identified as a therapeutic option in this leukaemia subtype.

(BELG J HEMATOL 2015;6(3):99–100)

Highlights in Non-Hodgkin’s Lymphoma

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At the 2015 annual EHA meeting in Vienna, one session was dedicated to the ‘treatment and outcome in non-Hodgkin lymphoma’. Topics included, among others, the long-term outcome in early stage extra-nodal marginal zone lymphoma, a subgroup analysis of the MCL-002 (SPRINT) study, the PINK/PINK-E prognostic model for extra nodal NK/T-cell lymphoma.

(BELG J HEMATOL 2015;6(3):101–3)

Prevention of febrile neutropenia with prophylactic G-CSF improves outcome

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The use of recombinant granulocyte-colony stimulating factors (G-CSF’s) has significantly reduced the risk of febrile neutropenia associated with myelosuppressive chemotherapy. Recommendations published by the European Organisation for Research and Treatment of Cancer (EORTC) provide guidance on the use of G-CSF’s in European clinical practice. During the EHA 2015 Congress, a satellite symposium entitled: ‘Contemporary therapeutic strategies in B-cell lymphomas’ was organized by PriME Oncology and supported by Teva Pharma. One of the main topics discussed during this symposium was the implication of the latest EORTC recommendations in clinical practice. In his lecture, Dr. Matti Aapro, leading author of the EORTC guidelines, elaborated on these recommendations and on reducing the incidence of febrile neutropenia by improving the usage of G-CSF’s. A summary is given below.

(BELG J HEMATOL 2015;6(3):105–7)

Immunotherapy: a new era in the management of lymphoma and multiple myeloma?

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Harnessing the body’s own immune system to fight cancer has long been a dream. After decades of disappointments, the tide has recently changed due to the success of recent proof-of-concept clinical trials. Most notably have been the advances made with CTLA4 and PD-1 inhibition in patients with advanced melanoma. These findings formed the spark for a flood of clinical trials evaluating a plethora of immunotherapeutic agents in all imaginable tumor types. During the 2015 annual meeting of the European Hematology Association, Bristol-Myers Squibb organized a satellite symposium assessing the potential of immunotherapy in the treatment of lymphoma and multiple myeloma.

(BELG J HEMATOL 2015;6(3): 108–10)

Nivolumab is safe and effective in patients with relapsed/refractory lymphoid malignancies and classical Hodgkin lymphoma

(BELG J HEMATOL 2015;6(3):111–2)