American Society of Hematology, Dec. 10-13, 2011

The 53rd American Society of Hematology Annual Meeting and Exposition

The annual meeting of the American Society of Hematology was held from Dec. 10 to 13 in San Diego, and attracted more than 20,000 participants from around the world, including hematology specialists as well as clinical practitioners and other health care professionals. The conference featured presentations focusing on the diagnosis, treatment, and prevention of disorders affecting blood; bone marrow; and the immunologic, hemostatic, and vascular systems.

In a phase III study, Sylvie Castaigne, M.D., of the Hopital de Versailles in France, and colleagues found that the addition of fractionated doses of gemtuzumab ozogamicin (GO) to standard chemotherapy in patients with acute myeloid leukemia (AML) improved event-free and overall survival.

"We evaluated whether adding GO to current standard of care was more effective than the current standard of care alone over three years. The primary end point was event-free survival. The secondary end points included response rate, disease-free survival, overall survival, and safety," Castaigne said. "We found an improvement in event-free survival and overall survival in AML patients who received GO as compared to those who did not receive the combination. The overall survival in those who received standard of care was 19 months, and [it was] 34 months in the GO group."

In terms of adverse events, the investigators found an elevated risk for prolonged thrombocytopenia and liver toxicity, identifying three patients with cases of liver disease in the GO group.

"The question that arises is whether this combination approach could become standard of care and first-line therapy," Castaigne added. "Our results and those of another group will perhaps lead to a new development of GO."

One author disclosed a financial relationship with Pfizer/Wyeth, the manufacturer of GO, which is used off-label in Europe as a compassionate treatment for relapsed AML.

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In another study, Cecilia Becattini, M.D., of the University of Perugia in Italy, and colleagues evaluated the efficacy and safety of aspirin for the prevention of venous thromboembolism (VTE) recurrence after a conventional course of oral anticoagulation therapy; they found a 40 percent reduction in the risk of recurrence of VTE.

"VTE recurrence occurred in approximately 6 percent per year of those who received aspirin and 11 percent per year of those who received placebo -- all after a course of anticoagulation therapy. In addition, the incidence of adverse events was almost identical between the two groups," Becattini said. "Based on these results, aspirin may be an alternative to the extended treatment of the primary prevention of VTE after a six- to 18-month course of anticoagulant therapy."

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Ralph M. Meyer, M.D., of Queen's University in Kingston, Canada, and colleagues found that overall survival was improved in patients with Hodgkin's lymphoma (HL) who received chemotherapy alone as compared to those who received radiation. The investigators evaluated whether death from adverse events associated with treatment exceeded death from HL at 12 years. The study accrued patients from 1994 through 2002 and followed patients through to 2011.

"The overall survival rate at 12 years was 94 percent in those who received chemotherapy as compared to 87 percent in those who received radiation. Twelve patients in the chemotherapy group died, with six due to HL and six due to other causes," Meyer said. "In addition, 24 patients in the radiation group died, with four due to HL and 20 due to other causes. The improved survival seen with chemotherapy alone was despite observing that radiation treatment was associated with better control of HL -- at 12 years, the freedom from disease progression (no recurrence of HL after initial therapy) was 92 percent with radiation treatment and 87 percent with chemotherapy alone."

It is important to note that the investigators used extended field radiation, which is now considered excessive and is not currently the standard of care. However, according to Meyer, the results with chemotherapy alone show a similar ability to control HL as compared with modern radiation therapy when combined with chemotherapy, and current radiation treatment may still carry long-term risks.

"Based on these findings, we believe that more physicians will opt for using chemotherapy alone because it is a reasonable option for patients with HL," Meyer said.

Three authors disclosed financial relationships with several pharmaceutical companies.

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ASH: Catheter-Directed Thrombolysis Cuts DVT Risks

TUESDAY, Dec. 13 (HealthDay News) -- For patients with deep vein thrombosis (DVT), additional catheter-directed thrombolysis (CDT) reduces the frequency of post-thrombotic syndrome (PTS) and improves iliofemoral patency, according to a study published online Dec. 13 in The Lancet to coincide with presentation at the annual meeting of the American Society of Hematology, held from Dec. 10 to 13 in San Diego.

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ASH: Most Cancer-Related Clots Occur in Outpatients

TUESDAY, Dec. 13 (HealthDay News) -- More than two thirds of the venous thromboembolism (VTE) complications in cancer patients occur in those undergoing outpatient cancer treatment, according to a study being presented at the annual meeting of the American Society of Hematology, held from Dec. 10 to 13 in San Diego.

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ASH: Somatic Mutations ID'd in Chronic Lymphocytic Leukemia

MONDAY, Dec. 12 (HealthDay News) -- Somatic mutations at significant frequencies have been identified in nine genes in patients with chronic lymphocytic leukemia, according to a study published online Dec. 12 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Society of Hematology, held from Dec. 10 to 13 in San Diego.

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ASH: Chemo Alone Improves Long-Term Hodgkin's Survival

MONDAY, Dec. 12 (HealthDay News) -- In patients with stage IA or IIA Hodgkin's lymphoma, treatment with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) alone improves long-term overall survival compared with treatment that includes subtotal nodal radiation therapy, according to a study published online Dec. 11 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Society of Hematology, held from Dec. 10 to 13 in San Diego.

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ASH: Hydroxyurea Safe, Effective in Pediatric Sickle Cell

MONDAY, Dec. 12 (HealthDay News) -- Hydroxyurea can be safely and effectively continued in young children with sickle cell anemia (SCA), and is not associated with a significant increase in genotoxicity, according to two studies being presented at the annual meeting of the American Society of Hematology, held from Dec. 10 to 13 in San Diego.

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ASH: Gene Therapy Shows Promise for Hemophilia B

MONDAY, Dec. 12 (HealthDay News) -- Peripheral vein infusion of a single dose of serotype-8 pseudotyped self-complementary adeno-associated virus (AAV) vector, which expresses the codon-optimized coagulation factor IX (FIX) transgene (scAAV2/8-LP1-hFIXco), can prevent spontaneous hemorrhage in patients with severe hemophilia B (HB), according to a study published online Dec. 10 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American Society of Hematology, held from Dec. 10 to 13 in San Diego.

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ASH: Aspirin Safe and Effective for Preventing VTE Recurrence

MONDAY, Dec. 12 (HealthDay News) -- For patients with a first unprovoked venous thromboembolism (VTE), taking low-dose aspirin for at least two years after standard anticoagulant therapy is safe and effective for preventing recurrence, according to a study presented at the annual meeting of the American Society of Hematology, held from Dec. 10 to 13 in San Diego.

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