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Guillermo Garcia-Manero, M.D.,
Associate Professor, Department of Leukemia |
The annual meeting of the American Society of Hematology (ASH), which was held in December 2007, showcased the complex and fascinating research taking place in the field of hematology, from the laboratory to the clinic.
For instance, a lot of promising work on myelodysplastic syndrome (MDS) is taking place at our institution and around the world. A prospective, randomized phase III study presented at ASH demonstrated that 5-azacitidine, a hypomethylating agent, significantly improved survival in patients with higher-risk MDS. In this study, the probability of survival at 2 years was approximately double in patients treated with 5-azacitidine versus other interventions, including cytarabine-based chemotherapy. Overall survival increased by nearly 10 months. These results establish 5-azacitidine as the current standard frontline therapy in higher-risk MDS.
Two important studies were presented that identified new molecular alterations in 5q– syndrome (a subset of MDS characterized by deletion of part of the long arm of human chromosome 5). Both papers discussed the use of short hairpin RNA (shRNA) technology and identified two genes (RPS14 and HSPA9B) as potential key molecular mediators of this syndrome. The relationship between these two genes and 5q– syndrome in MDS now needs to be clarified.
Multiple discoveries were reported in leukemia and lymphoma, including new therapeutic agents and molecular markers. Researchers from M. D. Anderson reported on two drugs showing promise as frontline therapy in chronic myelogenous leukemia (CML), dasatinib and nilotinib, which are currently used as second-line agents in imatinib-resistant CML. Also from M. D. Anderson, exciting initial data were presented on the use of two JAK2 inhibitors in myeloproliferative disorders, as well as the results of a study of combination epigenetic therapy in acute myelogenous leukemia and high-risk MDS.
In multiple myeloma, several studies established the role of the proteasome inhibitor bortezomib and the immunomodulatory drug lenalidomide. Finally, data were presented indicating the safety of cord blood transplantation and establishing the role of mini-transplantation in multiple myeloma. (More information on ASH-presented research is on page 6. – Ed.)
It’s an exciting time for the field of malignant hematology, given the new drugs coming into clinical use and our growing understanding of these diseases. Important findings are being quickly translated into clinical practice—and that translates into better outcomes.
For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.
Other articles in OncoLog, February 2008 issue:
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