Berlin was the setting this year for the 14th Congress of the European Hematology Association. Grey, damp, and windswept as it was, the place still thumped its magic—cranes soared into the sky as, unbelievably, more and more stunning examples of prize-winning architecture go up all over this ever-changing city.
Approximately 7,100 participants attended this year, and although it would be an exaggeration to say the meeting was bursting with breaking news, it was overall very positive with cheering news for treatment in many areas.
Collectively, blood cancers cause more deaths in the world than all other cancers, except for lung cancer, but perhaps the message from this Congress was that these types of cancers are now beginning to move out of the killer category and into the long-term chronic disease category.
As was made manifestly clear in various presentations, there are now so many new treatments for most blood cancers that survival has been extended considerably in many of them. Following are summaries of some of this year's interesting reports.
German Hodgkin Study Group HD14 Trial Results in New Standard of Treatment of Early Unfavorable HD
The German Hodgkin Study Group (GHSG) reported very positive news in Hodgkin's lymphoma from the GHSG HD14 trial, which set out to improve the prognosis of patients with early unfavorable disease. The researchers compared the old standard treatment (four courses of ABVD, followed by localized radiotherapy), with an intensive regimen of two courses of BEACOPPescalated, followed by two courses of ABVD and the same localized radiotherapy.
The study was terminated early, because of the significantly better outcome for patients treated with BEACOPP and ABVD. The progression-free survival rate was significantly better than for patients on standard treatment, and there was more progressive disease, relapse, and higher mortality in those receiving four cycles of ABVD.
The Group has thus established a new standard treatment for the management of early unfavorable Hodgkin's.
Professor Gianantonio Rosti, MD, from the University of Bologna in Italy, presented early results from the GIMEMA trial on the use of nilotinib in chronic myelogenous leukemia (CML). Although further confirmation is needed, early results are that the drug could be a viable alternative to imatinib in early-phase CML, as the data suggest patients have a greater and more rapid response to nilotinib than to imatinib. Furthermore, the tolerability is better than imatinib's, due to the drug's improved selectivity.
Myeloma: Good Results with Lenalidomide + Dexamethasone
And from the University of Salamanca in Spain, an analysis of data showed that a combination of lenalidomide with dexa-methasone significantly increased survival in patients with relapsed/refractory multiple myeloma.
Looking at pooled data from the MM-009/MM-010 international Phase III trials, the Spanish scientists considered survival estimates for patients achieving a partial response or better, comparing patients on continuous treatment with patients who discontinued treatment early due to adverse events, consent withdrawal, or other reasons. Median follow-up time for surviving patients was 48 months.
The estimated median survival time for patients continuing treatment after achieving at least a partial response was 50.9 months compared with about 35 months for those who discontinued treatment early. When differences in the groups' patient characteristics were also taken into account, the group that continued treatment had significantly better survival outcomes than did the group that discontinued therapy.
Myeloproliferative Genetic Signature
From the UK, Professor Nick Cross, from Salisbury General Hospital, revealed that his group had discovered a common genetic signature that predisposes to myeloproliferative neoplasms. Although he explained that the predisposition was so subtle that it could not be used as a predictor of disease development, it could be an important step, he said, towards understanding how these cancers develop.
In an analysis of the Australian AZA-001 survival trial of patients with higher-risk myelodysplastic syndromes (MDS), overall survival relative to transfusion status was considered. The researchers, at the Peter MacCallum Cancer Centre in East Melbourne, looked at a total of 179 patients with higher-risk MDS and WHO-defined AML who were randomized to azacitidine and evaluated for red blood cell (RBC) or platelet transfusion independence, which was defined as a transfusion-free period of at least 56 consecutive days.
In the azacitidine group, 50 of 111 RBC transfusion-dependent patients achieved RBC-transfusion independence, and 16 of 38 patients with platelet transfusion dependence achieved platelet-transfusion independence.
Additionally, patients who were transfusion independent at some point during treatment regardless of their baseline transfusion status had a longer duration of azacitidine therapy and longer overall survival.
“We were able to confirm that patients who became or remained transfusion-independent as a result of Vidaza therapy had longer treatment duration and a prolonged overall survival compared to transfusion-dependent patients,” said Dr. John Seymour from East Melbourne.
Congress & Association: Fast Facts
The EHA Congress, held every June, has sessions on clinical and laboratory hematology and covers all the major hematologic subspecialties, including hemato-oncology, red cell disorders, hemostasis, thrombosis, pediatric hematology and transfusion medicine.
The European Hematology Association itself now has approximately 3,200 active members from 95 countries, and among its many projects, each year also cosponsors a joint session at the American Society of Hematology Annual Meeting in December.