Now showing 1 - 3 of 3
  • Publication
    Journal Article
    Assessment and Management of Newly Diagnosed Classical Hodgkin Lymphoma: A Consensus Practice Statement from the Australasian Lymphoma Alliance.
    (2021-09-09)
    Cochrane, T
    ;
    Campbell, B A
    ;
    Gangatharan, S A
    ;
    Latimer, M
    ;
    Khor, R
    ;
    Christie, Drh
    ;
    Gilbertson, M
    ;
    Ratnasingam, S
    ;
    ;
    Lee, H P
    ;
    Trotman, J
    ;
    Hertzberg, M
    ;
    Dickinson, M
    The management of Hodgkin Lymphoma (HL) has undergone significant changes in recent years. Due to the predilection of HL to affect younger patients, balancing cure and treatment related morbidity is a constant source of concern, for physicians and patients alike. PET adapted therapy has been developed for both early and advanced stage HL to try and improve the outcome of treatment, whilst minimising toxicities. The aim of this review is to digest the plethora of studies recently conducted and provide some clear, evidence-based practice statements to simplify the management HL. This article is protected by copyright. All rights reserved.
      1594
  • Publication
    Journal Article
    Targeting Molecular Measurable Residual Disease and Low-Blast Relapse in AML With Venetoclax and Low-Dose Cytarabine: A Prospective Phase II Study (VALDAC).
    (2024-03-01)
    Tiong, Ing Soo
    ;
    Hiwase, Devendra K
    ;
    Abro, Emad
    ;
    Bajel, Ashish
    ;
    ;
    Beligaswatte, Ashanka
    ;
    Reynolds, John
    ;
    Anstee, Natasha
    ;
    Nguyen, Tamia
    ;
    Loo, Sun
    ;
    Chua, Chong Chyn
    ;
    Ashby, Michael
    ;
    Wiltshire, Kaitlyn M
    ;
    Fleming, Shaun
    ;
    Fong, Chun Y
    ;
    Teh, Tse-Chieh
    ;
    Blombery, Piers
    ;
    Dillon, Richard
    ;
    Ivey, Adam
    ;
    Wei, Andrew H
    PURPOSE: A prospective phase II study examined the safety and efficacy of venetoclax combined with low-dose cytarabine (LDAC) in AML at first measurable residual disease (MRD) or oligoblastic relapse. METHODS: Patients with either MRD (≥1 log(10) rise) or oligoblastic relapse (blasts 5%-15%) received venetoclax 600 mg once daily D1-28 plus LDAC once daily D1-10 in 28-day cycles. The primary objective was MRD response in the MRD relapse cohort or complete remission (CR/CRh/CRi) in the oligoblastic relapse cohort. RESULTS: Forty-eight adults with either MRD (n = 26) or oligoblastic (n = 22) relapse were enrolled. Median age was 67 years (range, 18-80) and 94% had received previous intensive chemotherapy. Patients received a median of four cycles of therapy; 17% completed ≥12 cycles. Patients with oligoblastic relapse had more grade ≥3 anemia (32% v 4%; P = .02) and infections (36% v 8%; P = .03), whereas grade 4 neutropenia (32 v 23%) or thrombocytopenia (27 v 15%) were comparable with the MRD relapse cohort. Markers of molecular MRD relapse included mutant NPM1 (77%), CBFB::MYH11 (4%), RUNX1::RUNX1T1 (4%), or KMT2A::MLLT3 (4%). Three patients with a log(10) rise in IDH1/2 (12%) were included. By cycle 2 in the MRD relapse cohort, a log(10) reduction in MRD was observed in 69%; 46% achieved MRD negative remission. In the oligoblastic relapse cohort, 73% achieved CR/CRh/CRi. Overall, 21 (44%) underwent hematopoietic cell transplantation. Median overall survival (OS) was not reached in either cohort. Estimated 2-year OS rate was 67% (95% CI, 50 to 89) in the MRD and 53% (95% CI, 34 to 84) in the oligoblastic relapse cohorts. CONCLUSION: For AML in first remission and either MRD or oligoblastic relapse, venetoclax plus LDAC is well tolerated and highly effective.
      158
  • Publication
    Journal Article
    Reporting bone marrow biopsies for myelodysplastic neoplasms and acute myeloid leukaemia incorporating WHO 5th edition and ICC 2022 classification systems: ALLG/RCPA joint committee consensus recommendations.
    (2024-05-31T14:00:00Z)
    Ng, Ashley P
    ;
    Adams, Rebecca
    ;
    Tiong, Ing Soo
    ;
    Seymour, Louise
    ;
    Talaulikar, Dipti
    ;
    ;
    Enjeti, Anoop
    ;
    Tate, Courtney
    The classification of myeloid neoplasms continues to evolve along with advances in molecular diagnosis, risk stratification and treatment of disease. An approach for disease classification has been grounded in international consensus that has facilitated understanding, identification and management of molecularly heterogeneous entities, as well as enabled consistent patient stratification into clinical trials and clinical registries over time. The new World Health Organization (WHO) and International Consensus Classification (ICC) Clinical Advisory Committee releasing separate classification systems for myeloid neoplasms in 2022 precipitated some concern amongst haematopathology colleagues both locally and internationally. While both classifications emphasise molecular disease classification over the historical use of morphology, flow cytometry and cytogenetic based diagnostic methods, notable differences exist in how morphological, molecular and cytogenetic criteria are applied for defining myelodysplastic neoplasms (MDS) and acute myeloid leukaemias (AML). Here we review the conceptual advances, diagnostic nuances, and molecular platforms required for the diagnosis of MDS and AML using the new WHO and ICC 2022 classifications. We provide consensus recommendations for reporting bone marrow biopsies. Additionally, we address the logistical challenges encountered implementing these changes into routine laboratory practice in alignment with the National Pathology Accreditation Advisory Council reporting requirements for Australia and New Zealand.