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JHOP - February 2020 Vol 10, No 1

Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy.1 Current survival rates for pediatric ALL are approaching 90% in the United States.1,2 This has been accomplished by dose intensification, risk stratification, extended treatment duration, and central nervous system prophylaxis.1,2
Granulocyte colony-stimulating factor (G-CSF) is often used after a hematopoietic stem-cell transplant (HSCT) to expedite neutrophil recovery after high-dose chemotherapy. Prolonged neutropenia after HSCT increases the risk for infectious complications and can contribute significantly to morbidity and mortality.1-3
Scleroderma is a condition in which chronic inflammation and immune effects in the tissue lead to fibrotic changes caused by excess collagen and potentially vascular damage in the skin.1,2 These immunologic changes lead to a hardening and thickening of various depths of the skin, which may have profound effects on a patient’s quality of life and requires complex medical management.1,2

Clostridium difficile–related diarrhea is one of the most common types of nosocomial diarrhea in the United States, with an incidence of 15% to 25%.1 Infectious diarrhea resulting from C difficile is a common complication in patients undergoing hematopoietic stem-cell transplant (HSCT), with higher rates in those undergoing allogeneic than autologous HSCT (12%-18% vs 6%-8.5%, respectively).2-4

In the United States, colorectal cancer (CRC) is the third most common cancer type and the second most common cause of cancer mortality.1,2 The lethal nature of CRC is attributable to being largely asymptomatic until advanced stages and the lack of curative treatment options for patients with advanced-stage disease.3 CRC screening in the average-risk population has clear, early detection and mortality benefits.1-3 Recently, not being up to date with screening for CRC was associated with an approximate 3-fold risk for CRC-related mortality.4

This section provides a brief overview of new cancer drugs or new indications approved by the FDA between December 16, 2019, and January 23, 2020.
New data presented at ASH 2019 show that mosunetuzumab holds promise as a durable and safe treatment for patients with treatment-refractory non-Hodgkin lymphoma (NHL), including those whose disease progressed after receiving chimeric antigen receptor (CAR) T-cell therapy. In a phase 1/1b clinical trial, the novel BiTE mosunetuzumab achieved durable responses in patients with refractory NHL, including complete remissions in 22.2% of patients who had previously received CAR T-cell therapy.
A new CD45-targeting antibody radiation-conjugate, iodine-131 (I-131) apamistamab, may be a less toxic alternative to today’s standard practice of chemotherapy-based lymphodepletion regimens before initiation of adoptive cell therapy, according to results presented at ASH 2019.
Zanubrutinib (Brukinsa), a novel Bruton tyrosine kinase (BTK) inhibitor—which was approved by the FDA in November 2019 for the treatment of mantle-cell lymphoma—achieved high overall response rate (ORR) and durable responses in patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), including those with high-risk cytogenetics, according to findings presented at ASH 2019.
Almost 50% of patients with chronic lymphocytic leukemia (CLL) who received treatment with the triplet of acalabrutinib (Calquence), venetoclax (Venclexta), and obinutuzumab (Gazyva) as first-line therapy achieved undetectable minimal residual disease (MRD) in the bone marrow after only 8 monthly cycles of therapy, according to data presented at ASH 2019.
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