Annual Hematology Conference Outlines New Standard of Care for Chronic Lymphocytic Leukemia
Posted on: December 27, 2018
By Robert Robles, MD
The American Society of Hematology Annual Meeting was held in San Diego at the beginning of December, 2018. An international crowd of 28,000 Hematologists and Oncologists were in attendance. The most important development reported concerned treatment for chronic lymphocytic leukemia, the most common leukemia in North America and Western Europe. A clinical trial completed in the United States compared aggressive chemotherapy with Ibrutinib (Imbruvica), an oral targeted therapy. Imbruvica proved superior to aggressive chemotherapy in a younger, healthier population. This trial, combined with results of previous clinical trials, establishes Ibrutinib as the new standard of care for chronic lymphocytic leukemia in all settings.
A trial from Germany investigated whether a shorter course of chemotherapy would produce outcomes equal to a longer course of the same chemotherapy. Younger patients, ages 18-60 y.o., with “good risk” diffuse large B-cell non Hodgkins Lymphoma (the most common subtype of non Hodgkins Lymphoma) received 4 or 6 treatments of R-CHOP (a standard chemotherapy recipe used worldwide). Survival for both groups was excellent and equal. Not surprisingly, the group which received less chemotherapy had fewer side effects. This trial will need longer follow up before a major change in treatment should be undertaken.
A series of presentations looked at elderly patients with non Hodgkins Lymphoma. The conclusions from these presentations was to not entirely dismiss the idea of chemotherapy for elderly patients with aggressive non Hodgkins Lymphoma. Chemotherapy did improve survival of elderly patients with aggressive non Hodgkins Lymphoma. However, doctors need to consider the support these patients have as well as their overall health, before making a recommendation for or against chemotherapy.
Finally, a timely panel discussion regarding the recent report of a Chinese scientist who allegedly performed gene editing on embryos using CRISPR (a technique which allows for very specific changes to genes). These manipulated embryos were implanted and apparently healthy babies born. The panel included the Director of the National Institutes of Health, Dr. Francis Collins, among others. The conclusions of the discussion was a denunciation of the irresponsibility of this scientist, as the consequences of this procedure will not be known for years.
Robert Robles, MD is board certified in Hematology and Medical Oncology. He practices with Diablo Valley Oncology & Hematology Medical Group, located in Pleasant Hill, Walnut Creek, Brentwood and in San Ramon. Dr. Robles specializes in treating hematologic cancers, lymphomas, and blood and clotting disorders.
January 23, 2019 – The Many Faces of Leukemia, Lymphoma and Myeloma. Join Dr. Robles and Dr. Aditi Choudhry at this free event where they will discuss and share exciting new research, treatments and therapies recently announced at the American Society of Hematology’s annual meeting. 6:30-8:30 PM at the Lafayette Library Community Room, 3491 Mt. Diablo Blvd, Lafayette. To make a reservation, please call 925-677-5041, x272.