European Hematology Association: Bleeding or Clotting in Elderly Patients with Cancer-Associated Venous Thromboembolism: Which is Worse?

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European Hematology Association: Bleeding or Clotting in Elderly Patients with Cancer-Associated Venous Thromboembolism: Which is Worse?

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MADRID, June 24, 2017 /PRNewswire/ —

The risk of blood clots in the veins of the legs or the lungs, known as venous thrombosis (VTE) is higher in cancer patients, and so is the risk of bleeding. Whereas anticoagulant therapy lowers the risk of thrombosis recurrence, it further increases the risk of bleeding. Previous studies suggested that the risks of dying from a thrombosis recurrence or bleeding are similar, but such findings may not apply to cancer patients. We aimed to determine the risk of dying from a thrombosis recurrence or bleeding in patients with cancer and thrombosis. We used administrative databases to conduct a population-based retrospective cohort study in Ontario, Canada, including patients 65 years old and older with cancer and a VTE diagnosed within six months of the cancer diagnosis. We estimated the VTE recurrence and major bleeding (MB; defined as gastrointestinal or intracranial) and the 7-day mortality after VTE recurrence or MB events, as well as the ratios of the mortality for MB compared to VTE recurrence. Between 2004 and 2014 we included 6967 VTE events (mean age 75 years, 52% male) treated primarily with low molecular weight heparin or warfarin, either alone or in combination. At six months of the initial VTE there were 3% MB events and 17% VTE recurrences. The 7-day mortality rate was 0.5% for VTE and 11% for MB with a ratio of 21.8 (95% CI 9-53). There were no differences between anticoagulants. This study suggests that the use of anticoagulants in patients 65 years or older with cancer-related thrombosis results in an at least nine times higher mortality if they develop a major bleeding event, compared to a VTE recurrence. This information should be confirmed in further studies and taken into account when designing studies and interventions in this population.

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Presenter:  Dr Alejandro Lazo-Langner

Affiliation:  Western University, Department of Medicine, London, Canada

Topic:  ASSESSING THE RISK-BENEFIT OF ANTICOAGULANTS IN ELDERLY PATIENTS WITH CANCER-ASSOCIATED VENOUS THROMBOEMBOLISM: A POPULATION BASED STUDY

Abstract S441 will be presented by Alejandro Lazo-Langner on Saturday, June 24, 11:30 – 12:45 in Room N103.

About the EHA Annual Congress
Hematology is a specialty that covers everything to do with blood: its origin in the bone marrow, diseases of blood and their treatments. The latest data on research and developments will be presented. The topics range from stem cell physiology and development, to leukemia, lymphoma, myeloma – diagnosis and treatment; red blood cells, white blood cells- and platelet disorders; thrombosis and bleeding disorders.

SOURCE European Hematology Association

European Hematology Association: Clinical and Biologic Covariates of Outcomes in ZUMA-1: A Pivotal Trial of Axicabtagene Ciloleucel (axi-cel; KTE-C19) in Patients with Refractory Aggressive non-Hodgkin Lymphoma (NHL)

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European Hematology Association: Clinical and Biologic Covariates of Outcomes in ZUMA-1: A Pivotal Trial of Axicabtagene Ciloleucel (axi-cel; KTE-C19) in Patients with Refractory Aggressive non-Hodgkin Lymphoma (NHL)

PR Newswire

MADRID, June 24, 2017 /PRNewswire/ —

Outcomes for patients with refractory, aggressive non-Hodgkin lymphoma (NHL) are poor with current therapies. Axicabtagene ciloleucel (axi-cel) is an anti-CD19 chimeric antigen receptor (CAR) T cell therapy. ZUMA-1 is the first multicenter trial of axi-cel in refractory, aggressive NHL. In this phase 2 trial, 101 patients with diffuse large B cell lymphoma (DLBCL), primary mediastinal B cell lymphoma (PMBCL), or transformed follicular lymphoma (TFL) with refractory or relapsed disease, received axi-cel at a target dose of 2 x 106 cells/kg. ZUMA-1 met the primary study endpoint with an objective response rate (ORR) of 82% (n = 92; P<.0001). In the modified intent-to-treat population of all 101 patients who received axi-cel treatment, the ORR was 82% including a complete response (CR) rate of 54%. These responses were consistent across key covariates including disease subtype, refractory status, stage, and International Prognostic Index score. The CR rate observed in this trial was 7-fold higher compared with historical controls and after a median follow up time of 8.7 months, nearly half of the patients had an ongoing response. Common grade ≥3 treatment-emergent adverse events were neutropenia (66%), leukopenia (44%), anemia (43%), febrile neutropenia (31%), and encephalopathy (21%). Grade ≥3 cytokine release syndrome and neurologic events occurred in 13% and 28% of patients, respectively. These results show that treatment with axi-cel significantly improves ORR with a manageable safety profile in patients with few other treatment options.

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Presenter:  Dr Yi Lin

Affiliation:  Mayo Clinic, Rochester, MN, USA

Topic:  CLINICAL AND BIOLOGIC COVARIATES OF OUTCOMES IN ZUMA-1: A PIVOTAL TRIAL OF AXICABTAGENE CILOLEUCEL (AXI-CEL; KTE-C19) IN PATIENTS WITH REFRACTORY AGGRESSIVE NON-HODGKIN LYMPHOMA (NHL)

Abstract S466 will be presented by Yi Lin on Saturday, June 24, 16:00 – 17:15 in Hall C.

About the EHA Annual Congress
Hematology is a specialty that covers everything to do with blood: its origin in the bone marrow, diseases of blood and their treatments. The latest data on research and developments will be presented. The topics range from stem cell physiology and development, to leukemia, lymphoma, myeloma – diagnosis and treatment; red blood cells -, white blood cells- and platelet disorders; thrombosis and bleeding disorders.

SOURCE European Hematology Association

European Hematology Association: Early Metabolic Response Determination by FDG-PET Allows Substantial Reduction of Chemotherapy and its Toxicity in Patients with Advanced Stage Hodgkin Lymphoma: the GHSG HD18 Study

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European Hematology Association: Early Metabolic Response Determination by FDG-PET Allows Substantial Reduction of Chemotherapy and its Toxicity in Patients with Advanced Stage Hodgkin Lymphoma: the GHSG HD18 Study

PR Newswire

MADRID, June 24, 2017 /PRNewswire/ —

Hodgkin lymphoma is the most common malignancy of young adults. Intensive chemotherapy with eight or six cycles of eBEACOPP is very effective in patients with advanced-stage Hodgkin’s lymphoma (HL), albeit at the expense of severe toxicities. Aiming at better tolerability, we investigated whether metabolic response determined by positron emission tomography after two cycles (PET-2) would allow us to select patients, who could be treated with reduced intensity (four cycles) without loss of efficacy.

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The GHSG HD18 trial was conducted in five European countries (Germany, Switzerland (SAKK), Austria (AGMT), Czech Republic, the Netherlands). Between 05/2008 and 07/2014, 2101 patients aged 18-60 years with newly diagnosed, advanced-stage HL were recruited, of whom 1005 were PET-2 negative.

Reduced therapy with four cycles of eBEACOPP was non-inferior to 6/8 cycles in terms of five-year progression-free survival (92·2% versus 90·8%, difference +1·4%, 95% CI -2·7-5·4). We observed no treatment related mortality in the experimental group, fewer infections, less organ toxicities and a very low incidence of second acute myeloid leukemia. Overall, this resulted in a significantly superior five-year overall survival (97·7% versus 95·4%, log-rank p=0·004) for the patient cohort with reduced treatment.

In conclusion, treatment with four cycles of eBEACOPP in patients with negative PET-2 is extremely effective, very safe, short (12 weeks), and affordable. Results for efficacy and safety compare favorably with any other published treatment strategy.

We therefore recommend PET-2-guided eBEACOPP for patients with advanced-stage HL.

Presenter:  Dr Peter Borchmann

Affiliation:  Uniklinik Koeln, Cologne, Germany

Topic:  TREATMENT REDUCTION IN PATIENTS WITH ADVANCED-STAGE HODGKIN LYMPHOMA AND NEGATIVE INTERIM PET: FINAL RESULTS OF THE INTERNATIONAL, RANDOMIZED PHASE 3 TRIAL HD18 BY THE GERMAN HODGKIN STUDY GROUP

Abstract S150 will be presented by Peter Borchmann on Friday, June 23 15:45 – 17:00 in Hall A.

About the EHA Annual Congress

Hematology is a specialty that covers everything to do with blood: its origin in the bone marrow, diseases of blood and their treatments. The latest data on research and developments will be presented. The topics range from stem cell physiology and development, to leukemia, lymphoma, myeloma – diagnosis and treatment; red blood cells, white blood cells- and platelet disorders; thrombosis and bleeding disorders.

SOURCE European Hematology Association