ASH 2008

 
 
 

The 50th Annual Meeting of the American Society of Hematology took place December 6-9, 2008, in San Francisco, California.

 

Thrombocytopenia itself does not define the risk of bleeding

HT Staff Read Article
Published: 12/26/08

A comparison of platelet function and bleeding parameters in immune thrombocytopenic purpura (ITP) patients vs those who have chemotherapy-induced thrombocytopenia (CIT) showed that bleeding is not directly dependent on low platelet levels. Additionally, CIT patients had more significant bleeding and reduced responses to adenosine diphosphate (ADP) and thrombin receptor agonist peptide (TRAP) than ITP patients. These data were presented at a poster session at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Deferasirox removes heart iron from thalassemia patients with myocardial siderosis

Mark Fuerst Read Article
Published: 12/24/08

Iron chelation therapy with deferasirox pulls iron out of the heart of β-thalassemia patients with myocardial siderosis, a new study indicates. Results show deferasirox not only decreases the hepatic and total body iron burden, which improves the myocardial T2*, it also maintains normal cardiac function as assessed by left ventricular ejection fraction (LVEF). Dudley Pennell, MD, of Royal Brompton Hospital in London, presented these results at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Genetic patterns provide insight into chronic ITP

HT Staff Read Article
Published: 12/24/08

To identify pediatric patients who may progress from acute ITP to chronic ITP, a group of researchers studied gene expression patterns in a small cohort of patients. James L. Zehnder, MD, from the Stanford University Medical Center, and colleagues found that vanin1 expression levels and advillin expression levels were significantly higher in patients who developed chronic ITP, as compared to those with acute ITP and control subjects. [Read Article]

Early publication can compromise accuracy of trial results

HT Staff Read Article
Published: 12/24/08

Bone marrow aspirate showing AML
Bone marrow aspirate
showing AML

Publishing clinical trial data too early can lead to inaccurate conclusions, according to an analysis comparing trials of AML patients. Jacob Rowe, MD, from the Technion, Israel Institute of Technology in Haifa, and colleagues from the Eastern Cooperative Oncology Group set out to determine the optimum time for reporting clinical trial data in AML. They decided 3 years after study completion is the appropriate time, as it provides definitive survival data. [Read Article]

Oral factor Xa inhibitor may be a substitute for warfarin in atrial fibrillation

Mark Fuerst Read Article
Published: 12/23/08

The oral factor Xa inhibitor DU-176b, given in 2 different doses to patients with non-valvular atrial fibrillation, offers safety and tolerability comparable to warfarin. Researchers randomized more than 1000 patients to receive either 1 of 4 fixed-dose regimens of DU-176b or warfarin for 12 weeks. The study’s primary endpoints were the incidence of bleeding events (major and clinically relevant non-major) and elevated liver enzymes and/or bilirubin. [Read Article]

Improving imatinib therapy in CML

Mark Fuerst Read Article
Published: 12/23/08

Pegylated interferon
Pegylated interferon

Increasing the dose of imatinib improves response in chronic phase CML, but the best responses occur when pegylated interferon (pegIFN) is added to imatinib therapy. Jorge Cortes, MD, and colleagues found patients respond better to high-dose imatinib than the standard dose, without a significant increase in toxicity. But Francois Guilhot, MD, and colleagues found patients respond best to imatinib plus pegIFN, when compared to standard and high-dose imatinib alone and imatinib plus cytarabine. [Read Article]

Basic science studies not exempt from manufacturer bias

Jen Smith Read Article
Published: 12/22/08

Sara E. Barnato, MD
Sara E. Barnato, MD

Investigations have confirmed that pharmaceutical-sponsored drug studies are more subject to bias than drug studies funded by disinterested groups. New research suggests industry funding can influence the results of basic science studies as well. Researchers evaluated the relationship between manufacturer involvement and results in studies of erythropoietin receptors in solid cancer cell lines. Sara E. Barnato, MD, presented the findings at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Old vs young stem cells and their microenvironments

Bridget Wells Read Article
Published: 12/22/08

Stem cells
Stem cells

New information on the effects of aging and the microenvironment on stem cells has accumulated in the last few years with wide implications, from the pathogenesis of hematologic malignancies to the efficacy of stem cell transplant in elderly patients and from elderly stem cell donors. Margaret A. Goodell, PhD, and Amy J. Wagers, PhD, presented data on age-related changes of stem cells and the effects of the microenvironment at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

IVIg protects platelets from apoptosis

Frieda Pearce, PhD Read Article
Published: 12/22/08

Oliver Speer, PhD
Oliver Speer, PhD

A new study of pediatric patients with acute ITP confirms results observed in murine models that suggest IVIg protects against platelet apoptosis. This study revealed that platelets from children with acute ITP undergo apoptosis similar to that observed in nucleated cells, and treatment with IVIg results in increased platelet counts with a concomitant inhibition of platelet apoptosis. Oliver Speer, PhD, presented these results at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Study shows imatinib response is durable and improves with time

Mark Fuerst Read Article
Published: 12/22/08

imatinib_tablet_240.jpg
Imatinib tablet

The longest duration study of imatinib treatment for patients with Ph+ CML shows 86% of patients are still alive 7 years after beginning therapy. The International Randomized Interferon versus STI571 (IRIS) study revealed that 82% of patients treated with imatinib achieved a complete cytogenetic response, 17% lost that response, and 3% progressed to advanced phases of CML. By year 6, 85% to 90% of patients still taking imatinib had achieved a major molecular response. [Read Article]

Mutations in RUNX1 predict progression of MDS to leukemia

HT Staff Read Article
Published: 12/21/08

RUNX1 mutation may be a high-risk feature for progression from myelodysplastic syndromes (MDS) to secondary acute myeloid leukemia (s-AML), according to data presented at the 50th Annual Meeting of the American Society of Hematology. Frank Dicker, PhD, from the MLL Munich Leukemia Laboratory GmbH in Germany, and colleagues showed that RUNX1 mutations are often present in MDS patients who progress to s-AML. [Read Article]

Novel anticoagulant safe and effective in DVT

Mark Fuerst Read Article
Published: 12/20/08

New research indicates that idrabiotaparinux is just as safe and effective as idraparinux in the treatment of DVT and results in less bleeding. Idrabiotaparinux is a novel, long-acting, reversible anticoagulant that links idraparinux to biotin. Harry Buller, MD, PhD, of the Academic Medical Center in Amsterdam, and colleagues randomized patients with symptomatic, confirmed DVT to receive weekly subcutaneous injections of idrabiotaparinux or idraparinux for 6 months. [Read Article]

Novel anticoagulants could replace heparin and warfarin

Jen Smith Read Article
Published: 12/19/08

Four novel anticoagulants demonstrate the potential to replace heparin and warfarin, new research indicates. J. Evan Sandler, MD, PhD, of Washington University School of Medicine, summarized data on 4 novel anticoagulants that offer benefits over heparin and warfarin in the treatment and prevention of VTE. In addition to efficacy and safety, he said all of the agents offer oral bioavailability, less frequent dosing and monitoring, and reversibility. [Read Article]

Combination chelation therapy may reverse hypothyroidism in beta-thalassemia

Mark Fuerst Read Article
Published: 12/19/08

Blood smear showing thalassemia
Blood smear showing
thalassemia

Intensive combination chelation therapy with desferoxamine (DFO) and deferiprone (DFP) can reverse hypothyroidism in beta-thalassemia major patients, according to a new study. Study investigator Kallistheni Farmaki, MD, of General Hospital of Corinth in Greece, said the treatment may even prevent progression to overt hypothyroidism. Results also suggested that iron-induced damage of the thyroid-pituitary axis might be ameliorated by using a combination of DFO and DFP. [Read Article]

Asparaginase improves salvage therapy for extranodal NK/T-cell lymphoma

Bridget Wells Read Article
Published: 12/19/08

Asparaginase structure
Asparaginase structure

Asparaginase appears to improve salvage therapy for patients with refractory or relapsed extranodal NK/T-cell lymphoma, in comparison to historic results observed with conventional chemotherapy. Arnaud Jaccard, MD, and colleagues treated patients with a regimen of asparaginase, methotrexate, and dexamethasone. A majority of patients responded to treatment, with a high rate of complete response, and the median survival was more than a year. [Read Article]

Conflicting data on Wilms' Tumor 1 mutations in pediatric AML

Bridget Wells Read Article
Published: 12/18/08

Wilms tumor 1
Wilms tumor 1

Two studies on the prognostic significance of Wilms’ Tumor 1 (WT1) mutations in pediatric AML with different conclusions were presented at the 50th Annual Meeting of the American Society of Hematology. Though both studies found worse overall and event-free survival in patients with mutated WT1, one study indicated the mutation is an independent poor prognostic factor and the other did not. [Read Article]

MRD status predictive marker in MCL

Bridget Wells Read Article
Published: 12/18/08

Mantle cell lymphoma cells
Mantle cell lymphoma cells

Minimal residual disease (MRD) status after induction therapy with immunochemotherapy is an independent prognostic factor in MCL patients, according to 2 new studies. Christiane Pott, MD, and colleagues analyzed 259 MCL patients—160 from a trial of younger patients and 99 from a trial of elderly patients. The researchers examined peripheral blood and bone marrow samples for MRD following treatment with immunochemotherapy regimens containing rituximab. [Read Article]

Deferasirox reduces toxic iron levels in MDS

Mark Fuerst Read Article
Published: 12/18/08

Bone marrow aspirate showing MDS
Bone marrow aspirate
showing MDS

Deferasirox can effectively reduce iron burden and is generally well tolerated when used appropriately to treat MDS patients, according to a new study. Norbert Gattermann, MD, of Heinrich-Heine-University in Duesseldorf, and colleagues analyzed the largest cohort of MDS patients evaluated for any chelation therapy to date. The researchers said dose adjustments based on serum ferritin trends and safety markers may be necessary every 3 months to achieve negative iron balance. [Read Article]

Dabigatran safe, effective in elderly surgery patients

Erilyn Riley Read Article
Published: 12/18/08

Researchers confirmed the safety and efficacy of a lower dose of dabigatran etexilate in elderly hip and total knee replacement surgery patients. Dabigatran is a new oral thrombin inhibitor recently approved in Europe for the prevention of VTE in patients undergoing this surgery. Ola E. Dahl, MD, and colleagues analyzed patients older than 75 years who were enrolled in the RE-MODEL and RE-NOVATE trials, comparing 220 mg and 150 mg once-daily doses of dabigatran to a 40 mg daily dose of enoxaparin. [Read Article]

Lowering platelet dose does not compromise patient safety

Jen Smith Read Article
Published: 12/17/08

Low-dose platelet transfusion is just as effective as higher doses at preventing bleeding in thrombocytopenic patients, according to the recently completed PLADO trial. These data suggest clinicians can safely lower a patient’s prophylactic platelet dose, thereby preventing shortages in platelet supply and reducing the cost of therapy. Sherrill J. Slichter, MD, presented this information at a joint ASH-AABB session at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Combo methotrexate and cytarabine active in primary CNS lymphoma

Bridget Wells Read Article
Published: 12/17/08

In the first randomized trial on primary CNS lymphoma to complete accrual, combination high-dose methotrexate and high-dose cytarabine was significantly more effective than high-dose methotrexate alone in newly diagnosed patients. Andres J. M. Ferreri, MD, of the Istituto Scientifico San Raffaele in Milan, presented the results of the trial at the 50th Annual Meeting of the American Society of Hematology, which took place December 6-9 in San Francisco. [Read Article]

Age doesn’t affect outcome of HSCT in AML or MDS

Jen Smith Read Article
Published: 12/17/08

Sergio Giralt, MD
Sergio Giralt, MD

A CIBMTR study refutes earlier assumptions that age is a contraindication for allogeneic transplant in AML and MDS. Sergio Giralt, MD, of M.D. Anderson Cancer Center in Houston, and colleagues found that age did not affect relapse rate, transplant-related mortality, leukemia-free survival, overall survival, or the incidence of acute or chronic GVHD. Dr Giralt presented these results at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Deferiprone most effective chelation therapy in thalassemia

Mark Fuerst Read Article
Published: 12/17/08

Blood smear showing thalassemia
Blood smear showing
thalassemia

A new study suggests iron chelation therapy with oral deferiprone is more effective than oral deferasirox and subcutaneous deferoxamine in removing myocardial iron from patients with thalassemia major. The study, presented at the 50th Annual Meeting of the American Society of Hematology in San Francisco, indicates that the removal of myocardial iron with deferiprone has the additional positive effect of inducing higher left ventricular ejection fractions than the other 2 chelating drugs. [Read Article]

Notch-1 mutations do not predict better outcome in adult T-ALL patients

HT Staff Read Article
Published: 12/17/08

Unlike in pediatric T-cell acute lymphoblastic leukemia (T-ALL), the presence of Notch-1 and FBXW7 mutations in adult T-ALL patients do not predict for improved survival. Marc R. Mansour, MBChB, MRCP, from the University College London in the United Kingdom, presented these results at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Novel JAK2 inhibitor active in myelofibrosis

Jen Smith Read Article
Published: 12/16/08

Bone marrow biopsy showing myelofibrosis
Bone marrow biopsy
showing myelofibrosis

Though a novel JAK2 inhibitor proved highly potent in myelofibrosis, a majority of patients who received the drug were unwilling to continue therapy. In a recent study, XL019 improved anemia, leukocytosis, splenomegaly, blast counts, and constitutional symptoms. However, 57% of patients discontinued treatment with the drug. Neil P. Shah, MD, PhD, of the University of California in San Francisco, presented these results at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Lenalidomide for relapsed/refractory NHL

Jen Smith Read Article
Published: 12/16/08

Mantle cell lymphoma cells
Mantle cell lymphoma cells

Oral lenalidomide demonstrates measurable activity as single-agent therapy in heavily pretreated relapsed or refractory NHL, according to early results of the NHL-003 study. At the 50th Annual Meeting of the American Society of Hematology, Pier Luigi Zinzani, MD, of the Institute of Hematology and Medical Oncology ‘Seràgnoli’, presented results from NHL-003 observed in patients with MCL. And Myron S. Czuczman, MD, of Roswell Park Cancer Institute, presented results observed in patients with DLBCL. [Read Article]

Second-generation TKIs outperform imatinib

Mark Fuerst Read Article
Published: 12/16/08

Jorge Cortes, MD, presented on behalf of M.D. Anderson
Jorge Cortes, MD, presented
on behalf of M.D. Anderson
©EHA/Wustinger

Two second-generation tyrosine kinase inhibitors approved as fallback therapy for CML appear to outperform historical benchmarks with imatinib when used as front-line treatments. The Gruppo Italiano Malattie Ematologiche dell’Adulto observed favorable results with nilotinib. And researchers at M.D. Anderson Cancer Center compared results they found in trials of nilotinib and dasatinib to results previously observed with imatinib. All 3 trials were presented at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Four new regimens appear promising in MM

Bridget Wells Read Article
Published: 12/16/08

Promising results from trials of 4 new regimens for newly diagnosed multiple myeloma were presented at the 50th Annual Meeting of the American Society of Hematology. The day after Jean-Luc Harousseau, MD, declared, in an education session at the meeting, that “VAD is dead” as induction therapy in multiple myeloma, researchers reported results from new combination induction regimens. All 4 regimens were generally well tolerated and elicited a high number of patient responses. [Read Article]

Birth order impacts outcome of sibling transplant

Erilyn Riley Read Article
Published: 12/15/08

Transplant recipients who receive HLA-identical stem cell transplants from younger siblings appear to have significantly better outcomes than those who receive HLA-identical transplants from older siblings.  Researchers at Hannover Medical School in Germany analyzed 215 patients with ALL, AML, MDS, CML, NHL, and other myeloproliferative syndromes who received fully matched SCTs. Christiane Dobbelstein, MD, reported the results of their study at the 50th Annual Meeting of the American Society of Hematology, which took place December 6-9 in San Francisco. [Read Article]

Prognostic significance of RUNX1 mutations

HT Staff Read Article
Published: 12/15/08

Studies discussed at the 50th Annual Meeting of the American Society of Hematology offered conflicting data regarding the effects of RUNX1 mutations on outcome in patients with acute myeloid leukemia (AML). Research presented by Susanne Schnittger, PhD, from the MLL Munich Leukemia Laboratory GmbH in Germany, and colleagues indicates that RUNX1 mutations are favorable prognostic factors as single genetic aberrations. However, data presented by Verena I. Gaidzik, MD, from the AMLSG and the University of Ulm in Germany, and colleagues suggest they are not. [Read Article]

Nadroparin halves thromboembolic rate in cancer patients receiving chemotherapy

Mark Fuerst Read Article
Published: 12/14/08

A low-molecular-weight heparin can cut in half the incidence of thromboembolic events in patients with cancer, particularly those with lung cancer. Giancarlo Agnelli, MD, from the University of Perugia in Perugia, Italy, and colleagues conducted a multicenter, placebo-controlled study to evaluate the efficacy of nadroparin as thromboprophylaxis in cancer patients receiving chemotherapy. [Read Article]

Reduced relapse doesn't translate to survival benefit in ALL

Erilyn Riley Read Article
Published: 12/13/08

Martin Schrappe, MD
Martin Schrappe, MD

The final results of the large AIEOP-BFM trial in ALL may still not answer definitively the question of which steroid to use in ALL induction therapy. Investigators report that dexamethasone reduces childhood relapse by a third, but the drug does not provide survival benefit in pre-B-ALL. Martin Schrappe, MD, of University Hospital Schleswig-Holstein, Campus Kiel in Germany, presented the data at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

ESAs’ effects on survival clarified

Jen Smith Read Article
Published: 12/12/08

Julia Bohlius, MD
Julia Bohlius, MD

As the research and regulations regarding ESAs continue to develop and change, it’s difficult for clinicians and patients to know where they stand. A group of researchers have tried to provide some answers. They performed a meta-analysis to determine whether or not ESAs affect patient survival and identify factors that might contribute to this effect. Julia Bohlius, MD, of University of Bern in Switzerland, presented the results of the meta-analysis at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

CEBPA mutations are favorable in adult and pediatric AML

Bridget Wells Read Article
Published: 12/12/08

Bas J. Wouters, MD
Bas J. Wouters, MD

Two new studies show that CEBPA mutations have prognostic significance in pediatric and adult AML patients. Bas J. Wouters, MD, and Phoenix Ho, MD, presented the results of their studies at the 50th Annual Meeting of the American Society of Hematology. Dr Wouters’ study showed that adults with double, but not single, CEBPA mutations have improved outcome when compared to patients with wild-type CEBPA AML. And Dr Ho’s study found the same improved outcome in children with any CEBPA mutation. [Read Article]

Early pain intervention critical in SCD

Erilyn Riley Read Article
Published: 12/12/08

Sickle cells
Sickle cells

Pain is the hallmark clinical manifestation of sickle cell disease and can surface in infants as young as 4 to 6 months old. Yet pain hasn’t been given the attention that such a designation in a disease process deserves, according to Lennette J. Benjamin, MD. And failure to address pain early on can have lifelong implications on health. Dr Benjamin discussed pain management in SCD at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

BM adipocytes negatively regulate hematopoiesis

Bridget Wells Read Article
Published: 12/11/08

Olaia Naveiras, MD
Olaia Naveiras, MD

Researchers have found that adipocytes in the bone marrow negatively regulate hematopoiesis. While it was previously known that adipocyte numbers are higher in the bone marrow of older patients and in those with bone marrow failure, the impact of adipocytes on hematopoiesis was unclear. Olaia Naveiras, MD, and colleagues from Children’s Hospital Boston, conducted murine studies to investigate this impact and presented their results at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Events in 2008 include advances in ITP

Jen Smith Read Article
Published: 12/11/08

ASH speaker relates ITP advances to events in 2008
ASH speaker relates ITP
advances to events in 2008

A long-term study of chronic ITP patients supports the recent FDA approval of eltrombopag, demonstrating the drug is effective and well tolerated in this patient population. Gregory Cheng, MD, PhD, of Chinese University of Hong Kong, presented the favorable results observed with eltrombopag at the 50th Annual Meeting of the American Society of Hematology. He also said the impact eltrombopag has made in ITP can be associated with other major, nonhematologic events of 2008. [Read Article]

Epigenetic evaluations useful in AML

Bridget Wells Read Article
Published: 12/11/08

Bone marrow aspirate showing AML
Bone marrow aspirate
showing AML

Epigenetics can be used to stratify AML patients into subtypes for prognosis and treatment selection, according to a speaker at the 50th Annual Meeting of the American Society of Hematology. Ari Melnick, MD, said identifying epigenetic changes may further explain the heterogeneity of AML and help therapeutically target individual patients. Epigenetic markers could even prove more effective than the cytogenetic abnormalities and genetic mutations typically used for patient classification. [Read Article]

Unclear whether NCD limitation on ESAs impacts transfusions

Erilyn Riley Read Article
Published: 12/11/08

Primera Technology, Inc.
©Primera Technology, Inc.

Blood transfusions in the US have risen significantly in cancer patients with chemotherapy-induced anemia (CIA) in the year after the Centers for Medicare and Medicaid Services issued coverage limitations for CIA treated with ESAs, according to an ongoing observational study. However, the regulatory changes did not have the same impact at one institution, according to 2 other reports. All 3 studies were presented at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Study compares stem cell donor sources

Jen Smith Read Article
Published: 12/10/08

Mary Eapen, MBBS
Mary Eapen, MBBS

Cord blood (CB) appears to be a superior alternative to bone marrow (BM) or peripheral blood (PB) for acute leukemia requiring transplant, but only when a fully matched donor is unavailable. Mary Eapen, MBBS, of the Center of International Blood and Marrow Transplant Research, presented data illustrating the benefits of CB as mismatched donor source in transplant for acute leukemia at the 50th Annual Meeting of the American Society of Hematology. [Read Article]

TCD screening prevents stroke in SCD

Jen Smith Read Article
Published: 12/10/08

Transcranial Doppler (TCD) ultrasonography can prevent stroke in pediatric patients with sickle cell disease, but the standard protocol may need some adjustment to optimize this effect. Although TCD screening has fallen into routine use in sickle cell patients at high risk for stroke, the effects of the practice have not yet been quantified. At the 50th Annual Meeting of the American Society of Hematology, Janet K. Kwiatkowski, MD, of Children’s Hospital in Philadelphia, reported on the positive impact of TCD observed at her institution, as well as some areas for improvement. [Read Article]

Novel SYK inhibitor for treatment of lymphoma

Jen Smith Read Article
Published: 12/10/08

Jonathan W. Friedberg, MD
Jonathan W. Friedberg, MD

The novel SYK inhibitor fostamatinib disodium (FosD) shows promise in certain heavily pretreated lymphoma patients, according to a new study. Jonathan W. Friedberg, MD, of James P. Wilmot Cancer Center, and colleagues first determined the optimal dose of FosD and then administered the drug to 68 patients with DLBCL, FL, CLL, SLL, MCL, MALT lymphoma, or lymphoplasmacytic NHL. Dr Friedberg presented the results during the plenary session of the 50th Annual Meeting of the American Society of Hematology. [Read Article]

Combo improves outcome in different CLL populations

Jen Smith Read Article
Published: 12/10/08

Michael Hallek, MD
Michael Hallek, MD

Adding rituximab (R) to therapy with fludarabine (F) and cyclophosphamide (C) significantly improves outcome in patients with CLL, according to 2 studies presented at the 50th Annual Meeting of the American Society of Hematology. Michael Hallek, MD, presented results in previously untreated CLL patients that suggest FCR could become the new standard first-line CLL therapy. And Tadeusz Robak, MD, discussed data showing FCR improves response rates and survival in patients with relapsed or refractory CLL. [Read Article]

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