ATLANTA, Dec. 9 /PRNewswire-USNewswire/ -- Data that will have a significant impact on the treatment of patients with certain hard-to-treat lymphomas, myelomas, and myelodysplastic syndromes will be presented at the 49th Annual Meeting of the American Society of Hematology in Atlanta, GA. The data include a late-breaking abstract reporting long-standing remissions for patients with mantle cell lymphoma (a rare type of incurable cancer of the lymph system) who complete a very intensive treatment program. Other data will show improved overall survival or prolonged progression-free survival in Hodgkin lymphoma and follicular non-Hodgkin lymphoma (both cancers of the lymph system), in myelodysplastic syndromes (a group of diseases that affect the bone marrow and blood), and in multiple myeloma (an incurable cancer of the plasma cells). A press conference revealing this new research will take place on Sunday, December 9, from 8:00 a.m. to 9:00 a.m.
"The hematology community is committed to improving patient care and outcomes for malignant diseases of the blood and bone marrow. This is evidenced by the research presented today, which will have important clinical benefits for patients, including prolonged overall survival and possible cures," said Jane Winter, MD, Professor, Division of Hematology/Oncology at Northwestern University, Chicago, IL, and moderator of the hematologic malignancies press conference.
-- Lenalidomide plus low-dose dexamethasone preferred to high-dose combination in multiple myeloma patients [Abstract #74]
S. Vincent Rajkumar, MD, Mayo Clinic, Rochester, MN
In this phase III trial, investigators compared lenalidomide plus high-dose dexamethasone with lenalidomide plus low-dose dexamethasone in 445 newly-diagnosed multiple myeloma patients. Lenalidomide, an agent that can modify and regulate the functioning of the immune system, in combination with dexamethasone, a steroid with strong anti-inflammatory properties, is indicated for the treatment of multiple myeloma patients who have received at least one prior therapy. The goal of this therapy is to kill the malignant cells and eradicate the plasma cells. Although high-dose dexamethasone has been the standard of care for treatment of multiple myeloma, patient survival was superior with the combination of lenalidomide and low-dose dexamethasone because of improved safety and fewer adverse effects (due to a lower dose of steroids), which allowed patients to stay on therapy at effective doses for a longer period of time. Additionally, it may be possible that lenalidomide requires a relatively preserved immune system in order to be effective and the high dose of dexamethasone prevents lenalidomide from working. This study suggests that lenalidomide and low dose dexamethasone should be first-line therapy, as the one-year survival rate in this study is far better than what has been reported in two phase III trials with thalidomide plus dexamethasone, which is an FDA-approved regimen.
-- Chemotherapy standard of care challenged for advanced-stage Hodgkin lymphoma
[Abstract #211]
Volker Diehl, MD, University of Cologne, Cologne, Germany
With a median follow-up of nearly 10 years, Dr. Diehl and colleagues update the results of a phase III trial that included 1,196 advanced-stage Hodgkin lymphoma patients and evaluated escalated doses of BEACOPP, a novel chemotherapy regimen consisting of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone. Patients received one of three chemotherapy regimens: standard of care COPP (cyclophosphamide, vincristine, procarbazine, and prednisone) alternating with ABVD (doxorubicin, bleomycin, vinblastin, and dacarbazine), standard-dose BEACOPP, or escalated-dose BEACOPP. This study found that at 10 years, escalated-dose BEACOPP was associated with significantly improved tumor control and overall survival, and that the overall risk of secondary malignancies was no different from COPP-ABVD. Although the risk of secondary leukemia increased in the escalated-dose-BEACOPP arm, it amounts to .9 percent in a follow-up trial consisting of 1,502 patients with a median of four years follow-up. These results support the use of escalated BEACOPP as first-line therapy in advanced-stage Hodgkin lymphoma.
--Y-ibritumomab tiuxetan prolongs progression-free survival by two years in patients with advanced-stage follicular non-Hodgkin lymphoma [Abstract #643]
Anton Hagenbeek, MD, PhD, University Medical Center Utrecht, Utrecht, Netherlands
This phase III, international, randomized trial evaluated Y-ibritumomab tiuxetan (Zevalin (R)) treatment among patients with advanced-stage follicular non-Hodgkin lymphoma responding to first-line chemotherapy. Y-ibritumomab tiuxetan, a form of radio-immunotherapy employing an anti-lymphoma antibody coupled to a radioactive isotope, is indicated for the treatment of patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin lymphoma. The study, involving 414 patients, found that a single infusion of Y-ibritumomab tiuxetan prolonged the time period with no signs or symptoms of lymphoma by two years in patients with follicular non-Hodgkin lymphoma and has a favorable toxicity profile. In the United States, hundreds of thousands of patients are suffering from non-Hodgkin lymphoma with 60,000 new cases added each year. Follicular non-Hodgkin lymphoma, the second most frequent type of lymph-node cancer, is incurable with currently available treatment modalities.
--Azacitidine superior to conventional care regimens for patients with high-risk myelodysplastic syndromes [Abstract #817]
Pierre Fenaux, MD, Hopital Avicenne, Paris 13 University, Bobigny Cedex, France
This phase III, international, multicenter, randomized, prospective study evaluated 358 patients with high-risk myelodysplastic syndromes (MDS). MDS is particularly difficult to treat, and currently has no curative treatment apart from bone marrow transplantation, which is applicable in only a small number of cases. One group of patients was treated with conventional care regimens (n=179), including chemotherapy in 40 percent of the cases, and the other group was treated with azacitidine (n=179), a hypomethylating agent capable of reactivating genes silenced by the process of methylation, frequent in MDS. The study found that azacitidine prolonged overall survival (24.4 months compared to 15 months with conventional care) and was well tolerated. These findings support the conclusion that azacitidine should now be considered first-line treatment for high-risk MDS patients.
--Intensive immunochemotherapy may cure mantle cell lymphoma
[Late-Breaking Abstract #LB1]
Christian H. Geisler, MD, PhD, Rigshospitalet, Copenhagen, Denmark
This phase II study evaluated 159 patients with mantle cell lymphoma (MCL), a subtype of lymph cancer considered incurable until now. Patients received six cycles of intensive induction immunochemotherapy - a combination of high-dose cytarabine, "maxi-CHOP" chemotherapy (dose-intensified CHOP - day 1: cyclophosphamide 1200 mg/m2, doxorubicin 75 mg/m2, vincristine 2 mg, and days 1-5: prednisone 100 mg) and the anti-B-cell antibody rituximab. Following six cycles of induction therapy, the patients received high-dose chemotherapy with stem cell support. The five-year event-free survival and overall survival were 63 percent and 74 percent, respectively, for all patients enrolled in the trial. Of the 144 responders who completed treatment, 72 percent were without disease at five years. The study found a high rate of long-term event-free survival, suggesting for the first time that mantle cell lymphoma may be cured.
The study authors and press program moderator will be available for interviews after the press program or by telephone. In addition to hematologic malignancies, four additional press briefings will take place at the annual meeting focusing on blood clotting and bleeding disorders, leukemias, sickle cell disease and thalassemia, and transplantation. For the complete annual meeting schedule and additional information, please visit http://www.hematology.org/meetings/2007.
The American Society of Hematology (http://www.hematology.org/) is the world's largest professional society concerned with the causes and treatment of blood disorders. Its mission is to further the understanding, diagnosis, treatment, and prevention of disorders affecting blood, bone marrow, and the immunologic, hemostatic, and vascular systems, by promoting research, clinical care, education, training, and advocacy in hematology.
American Society of Hematology
