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PER Pulse Recap
PER Pulse Recap
17th Annual International Congress on Hematologic Malignancies®
Chronic Lymphocytic Leukemia and Lymphoma The 17th Annual International Congress on Hematologic Malignancies®, which was held February 15-17, 2013, was convened to share the latest information on the management of patients with leukemias, lymphomas, and myeloma. This second of three PER Pulse Recaps from the International Congress on Hematologic Malig-nancies® is centered on the management of elderly patients with chronic lympho-cytic leukemia (CLL) and the treatment of relapsed or refractory lymphoma.
Medical Writer: Jennifer Klem, PhD
• Dr. Alessandra Ferrajoli discussed the treatment of elderly patients with CLL. Although CLL is often described as an indolent disease, SEER data show that elderly patients with CLL have a shortened survival time relative to age-matched controls, illustrating the need for active therapy in these patients. Elderly pa- tients can be functionally divided into distinct treatment groups based on their frailty. Those who have no significant comorbidities and excellent renal function can be treated with standard chemoimmunotherapy (fludarabine + cyclophos-phamide + rituximab), regardless of age. Those patients who are less healthy but are still fit enough for active therapy can receive reduced-intensity regimens; good response rates can be achieved with this type of therapy, but the depth of response is typically suboptimal, with few complete responses. Several such regimens have been used successfully in these patients, including rituximab plus chlorambucil, rituximab plus granulocyte-macrophage colony-stimulating factor (GM-CSF), and single-agent lenalidomide, but there is currently no standard of care for these patients.
• Dr. Anas Younes presented data on the treatment of patients with relapsed dif- fuse large B-cell lymphoma (DLBCL), beginning with the acknowledgment that rituximab plus CHOP (R-CHOP) produces a clear survival advantage over CHOP alone, but the addition of rituximab does not cure everyone. In the first random-ized trial of patients with relapsed disease following rituximab-based therapy, patients were randomized to either R-DHAP (rituximab + dexamethasone + cytarabine + cisplatin; popular in Europe) or R-ICE (rituximab + ifosfamide + carboplatin + etoposide; popular in the US), after which all responding patients received autologous stem cell transplant (ASCT). Progression-free survival and overall survival results were similar between the R-DHAP and R-ICE arms, sug-gesting that R-ICE followed by ASCT remains the standard in the US. However, patients who were refractory to or relapsed within 1 year of initial rituximab therapy responded poorly to salvage rituximab therapy and transplantation, high-lighting the need for better therapies in this patient population. Clinical trials are This activity is supported by educational investigating novel combination regimens for patients not eligible for transplant, and they are also using biomarker-driven trials to test new targeted agents in this Pharmaceuticals Corporation, Onyx Pharmaceuticals, and Seattle Genetics, Inc.
This activity is not approved for AMA PRA Category 1 Credit ™.
PER Pulse Recap: Chronic Lymphocytic Leukemia and Lymphoma 1
PER Pulse Recap
Other important CLL and lymphoma topics discussed included:
• Prognostic Factors: How to Use in Clinical Practice • How I Manage Early-Stage DLBCL • Targeted Therapy for CLL: Focusing on the B Cell Receptor • New Directions in Follicular Lymphoma • Stem Cell Transplantation in Indolent Lymphoma • IMiDs and Combinations: How to Integrate Standard Therapy 2 PER Pulse Recap: Chronic Lymphocytic Leukemia and Lymphoma

Source: http://www.gotoper.com/_media/_pdf/HEM13_PulseRecap_2.pdf