Abstract
The 2017 annual meeting of the American Society of Hematology took place 9–12 December in Atlanta, Georgia. At the meeting, the oral presentations included results from key studies on the first-line treatment of chronic lymphocytic leukemia. A series of phase ii studies focusing on the efficacy and safety of novel treatment strategies were especially notable. One concerned the health-related quality of life results from the gibb study, which had examined the combination of obinutuzumab and bendamustine. A second evaluated the venetoclax–ibrutinib regimen in patients with high-risk disease. The third assessed the combination of ibrutinib, fludarabine, cyclophosphamide, and obinutuzumab in patients with mutated immunoglobulin heavy-chain variable region genes. The fourth examined the combination of ibrutinib, fludarabine, cyclophosphamide, and rituximab in younger patients. And the final study evaluated obinutuzumab–ibrutinib followed by a minimal residual disease strategy in fit patients. Our meeting report describes the foregoing studies and presents interviews with investigators and commentaries by Canadian hematologists about the potential effects on Canadian practice.
Highlights
Chronic lymphocytic leukemia is the most common leukemia in North American adults, with an annual incidence in Canada reported to be approximately 2500 cases[1,2]
The identification of several negative prognostic factors—such as del(17p), TP53 mutations, and unmutated immunoglobulin heavy-chain variable status—might well explain some of the variation[3]. Those factors are clearly associated with lesser response rates to conventional chemoimmunotherapy, how the presence of those factors should influence treatment decisions is unclear
Among 54 abstracts, 12 oral presentations were identified using the search criteria. Of those 12 oral presentations, only studies in phase ii and beyond that focused on efficacy of treatment were included
Summary
Chronic lymphocytic leukemia (cll) is the most common leukemia in North American adults, with an annual incidence in Canada reported to be approximately 2500 cases[1,2]. Most patients with cll are more than 65 years of age (with the median age at diagnosis being between 67 and 72 years) and have an average of 3 other health conditions[2,3]. Despite these patients representing an older population with comorbidities, their survival after diagnosis varies significantly, ranging from a short number of years to decades[2]. The identification of several negative prognostic factors—such as del(17p), TP53 mutations, and unmutated immunoglobulin heavy-chain variable (ighv) status—might well explain some of the variation[3] Those factors are clearly associated with lesser response rates to conventional chemoimmunotherapy (cit), how the presence of those factors should influence treatment decisions is unclear
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