ASH News Daily 2016 - Issue 2 - A-12

ASH News Daily

Page A-12

Sunday, December 4, 2016

AC U T E M Y E L O I D L E U K E M I A

WHO's on First?
By Naveen Pemmaraju, MD

ho's on First," the classic
Abbott and Costello comedy routine, could have
been about the confusing, challenging and downright exasperating,
diagnostic criteria for some of the
rarer categories of acute leukemia,
as much as it is about baseball. For
the busy practitioner, it can be frustrating trying to nail down a tough
diagnosis. But don't worry; the 2016
ASH Annual Meeting Education
Program is here to help. The latest
updates on the World Health Organization (WHO) classifications
for acute myeloid leukemia (AML)
were presented in the session titled
"AML According to WHO: Newer
Approaches to Therapy."
Dr. Jessica Altman chaired this informative session and kicked it off
by speaking about advances in this
highly curable (but still among the
deadliest when starting therapy)
form of acute leukemia: acute promyelocytic leukemia (APL). Her
talk is particularly relevant to com-

munity physicians and those who
practice at academic centers due to
the universal need for quick recognition of patients presenting with
APL so a cure is not missed for a
complication.
In contrast, the remainder of the
session focused on two clinically
challenging entities with historically unfavorable outcomes. Dr. David Rizzieri presented a lecture on
an increasingly recognized entity in
the leukemia field: blastic plasmacytoid dendritic cell neoplasm (BPDCN). In addition to Dr. Rizzieri's
talk, this year's meeting features
six abstracts focused specifically on
BPDCN - a staggering amount for
this rare disease. By way of background, this highly aggressive malignancy's name has changed many
times throughout the past three
decades. It wasn't until 2008 when
the name BPDCN emerged, and
the disease was placed under the
umbrella of AML. In the most recent reclassification (Arber DA et al.
Blood. 2016;127:2391-2405), BPDCN
stepped out on its own among my-

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American Society of Hematology

Drs. Jessica Altman (from left), Michael Heuser, and David Rizzieri present the
education session "AML According to WHO: Newer Approaches to Therapy"
Saturday morning.

eloid neoplasms based on the recognition of its unique biology and clinical course. Due to its rare nature,
BPDCN is known for poor outcomes
with no standard-of-care therapy. I
had the chance to catch up with Dr.
Andrew A. Lane, who discussed
the growing enthusiasm in the field
of BDPCN. "This is a very exciting
meeting for research in BPDCN," he
stated. "For an orphan disease that
had unclear biology and no targeted
therapies only a few years ago, there
is now a thriving effort to develop
new approaches."
Some of the approaches, Dr. Lane
mentioned, are already in clinical
evaluation. The BPDCN presenta-

tions at this meeting include a phase
II trial of SL-401 that shows remarkable response rates, a pilot study
demonstrating clinical activity of
BCL-2 inhibition, preclinical data using BET inhibitors and CAR T-cells,
and genomic analysis revealing novel disease mechanisms and potential
targets. "I'm confident we have made
significant steps forward for patients
with BPDCN," he concluded.
A growing concern in the clinic
has been the increasing incidence
of therapy-related and secondary
myeloid neoplasms. Dr. Michael
Heuser presented the third talk of
»» WHO Page A-16

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Table of Contents for the Digital Edition of ASH News Daily 2016 - Issue 2