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Dr. Pinilla-Ibarz scans the journals, so you don’t have to!

Javier Pinilla-Ibarz MD, PhD
The impact of COVID-19 pandemic has had a major impact on people with blood cancers. CML patients are at an increased risk of poor outcomes after COVID-19 infection even more when associated with other risk factors. The rapid development of COVID-19 vaccines has been successful for the general population but trials excluded patients with blood cancers. So is unclear how these patients will respond to these vaccines. Recently Chowdhury et al Br J Haematol. 2021 Jun 16, had reported the immunological response following a single dose of either BNT162b2 or the AstraZeneca-Oxford ChAdOx1 nCoV-19 (AZD1222) vaccines in patients with CML and other myeloproliferative disorders. From the 12 CML patients studied, half of them were on imatinib and another 6 on second generation TKIs.

 

The seroconversion was highest in patients with CML with 75% and observed in 5/6 (83%) of CML patients receiving imatinib that compare favorably to the total group with 58% of seroconversions. Interestingly patients treated with pegylated interferon also had a a high response with 88% (7/8).

 

Another recent publication by Harrington et al Br J Hem 2021, Jun 3 ahead or print, confirmed and extending the previous data by evaluating humoral and cellular immune responses after a first injection of BNT162b2 vaccine in 16 patients with CML. 87.5% patients have a seroconversion and 93.3% developed a T cell response. These responses are seen in contrast to patients with lymphoid hematological malignancies where the responses have been significantly lower.

 

The main goal of the treatment for chronic phase CML is to stop the progression to more advanced phased of the disease such as blast phase, where treatments are limited and there are no consensus in the treatment approach. In a recent publication by Saxena et al. J Hematol Oncol. 2021 Jun 15 the authors reported the outcomes of patients with BP-CML treated with different regimens that include a combination therapy of tyrosine kinase inhibitor (TKI) with intensive chemotherapy (IC) or hypomethylating agent (HMA) as well as  TKI or IC alone. Response rates were similar between patients treated with IC + TKI and HMA + TKI. When compared to treatment with TKI alone, treatment with IC/HMA + TKI was superior (CRi 57.5% vs 33.9%), as well as higher complete cytogenetic response rate (45% vs 10.7%) and more patients proceeding to ASCT (32.5% vs 10.7%). The results were even better when using a second generation TKI in combination with IC or HMA with a favorable EFS and OS compared to TKI alone.

Author and Disclosure Information

Javier Pinilla-Ibarz MD, PhD, Senior Member, Lymphoma Section Head and Director of Immunotherapy, Malignant Hematology Department, H.Lee Moffitt Cancer Center & Research Institute

Javier Pinilla has disclosed the following relevant financial relationships:

Serve(d) as a speaker or a member of a speakers bureau for: Abbvie; Janssen; Takeda; AstraZeneca
Received research grant from: TG therapeutics; MEI; Sunesis
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Javier Pinilla-Ibarz MD, PhD, Senior Member, Lymphoma Section Head and Director of Immunotherapy, Malignant Hematology Department, H.Lee Moffitt Cancer Center & Research Institute

Javier Pinilla has disclosed the following relevant financial relationships:

Serve(d) as a speaker or a member of a speakers bureau for: Abbvie; Janssen; Takeda; AstraZeneca
Received research grant from: TG therapeutics; MEI; Sunesis
Author and Disclosure Information

Javier Pinilla-Ibarz MD, PhD, Senior Member, Lymphoma Section Head and Director of Immunotherapy, Malignant Hematology Department, H.Lee Moffitt Cancer Center & Research Institute

Javier Pinilla has disclosed the following relevant financial relationships:

Serve(d) as a speaker or a member of a speakers bureau for: Abbvie; Janssen; Takeda; AstraZeneca
Received research grant from: TG therapeutics; MEI; Sunesis
Dr. Pinilla-Ibarz scans the journals, so you don’t have to!
Dr. Pinilla-Ibarz scans the journals, so you don’t have to!

Javier Pinilla-Ibarz MD, PhD
The impact of COVID-19 pandemic has had a major impact on people with blood cancers. CML patients are at an increased risk of poor outcomes after COVID-19 infection even more when associated with other risk factors. The rapid development of COVID-19 vaccines has been successful for the general population but trials excluded patients with blood cancers. So is unclear how these patients will respond to these vaccines. Recently Chowdhury et al Br J Haematol. 2021 Jun 16, had reported the immunological response following a single dose of either BNT162b2 or the AstraZeneca-Oxford ChAdOx1 nCoV-19 (AZD1222) vaccines in patients with CML and other myeloproliferative disorders. From the 12 CML patients studied, half of them were on imatinib and another 6 on second generation TKIs.

 

The seroconversion was highest in patients with CML with 75% and observed in 5/6 (83%) of CML patients receiving imatinib that compare favorably to the total group with 58% of seroconversions. Interestingly patients treated with pegylated interferon also had a a high response with 88% (7/8).

 

Another recent publication by Harrington et al Br J Hem 2021, Jun 3 ahead or print, confirmed and extending the previous data by evaluating humoral and cellular immune responses after a first injection of BNT162b2 vaccine in 16 patients with CML. 87.5% patients have a seroconversion and 93.3% developed a T cell response. These responses are seen in contrast to patients with lymphoid hematological malignancies where the responses have been significantly lower.

 

The main goal of the treatment for chronic phase CML is to stop the progression to more advanced phased of the disease such as blast phase, where treatments are limited and there are no consensus in the treatment approach. In a recent publication by Saxena et al. J Hematol Oncol. 2021 Jun 15 the authors reported the outcomes of patients with BP-CML treated with different regimens that include a combination therapy of tyrosine kinase inhibitor (TKI) with intensive chemotherapy (IC) or hypomethylating agent (HMA) as well as  TKI or IC alone. Response rates were similar between patients treated with IC + TKI and HMA + TKI. When compared to treatment with TKI alone, treatment with IC/HMA + TKI was superior (CRi 57.5% vs 33.9%), as well as higher complete cytogenetic response rate (45% vs 10.7%) and more patients proceeding to ASCT (32.5% vs 10.7%). The results were even better when using a second generation TKI in combination with IC or HMA with a favorable EFS and OS compared to TKI alone.

Javier Pinilla-Ibarz MD, PhD
The impact of COVID-19 pandemic has had a major impact on people with blood cancers. CML patients are at an increased risk of poor outcomes after COVID-19 infection even more when associated with other risk factors. The rapid development of COVID-19 vaccines has been successful for the general population but trials excluded patients with blood cancers. So is unclear how these patients will respond to these vaccines. Recently Chowdhury et al Br J Haematol. 2021 Jun 16, had reported the immunological response following a single dose of either BNT162b2 or the AstraZeneca-Oxford ChAdOx1 nCoV-19 (AZD1222) vaccines in patients with CML and other myeloproliferative disorders. From the 12 CML patients studied, half of them were on imatinib and another 6 on second generation TKIs.

 

The seroconversion was highest in patients with CML with 75% and observed in 5/6 (83%) of CML patients receiving imatinib that compare favorably to the total group with 58% of seroconversions. Interestingly patients treated with pegylated interferon also had a a high response with 88% (7/8).

 

Another recent publication by Harrington et al Br J Hem 2021, Jun 3 ahead or print, confirmed and extending the previous data by evaluating humoral and cellular immune responses after a first injection of BNT162b2 vaccine in 16 patients with CML. 87.5% patients have a seroconversion and 93.3% developed a T cell response. These responses are seen in contrast to patients with lymphoid hematological malignancies where the responses have been significantly lower.

 

The main goal of the treatment for chronic phase CML is to stop the progression to more advanced phased of the disease such as blast phase, where treatments are limited and there are no consensus in the treatment approach. In a recent publication by Saxena et al. J Hematol Oncol. 2021 Jun 15 the authors reported the outcomes of patients with BP-CML treated with different regimens that include a combination therapy of tyrosine kinase inhibitor (TKI) with intensive chemotherapy (IC) or hypomethylating agent (HMA) as well as  TKI or IC alone. Response rates were similar between patients treated with IC + TKI and HMA + TKI. When compared to treatment with TKI alone, treatment with IC/HMA + TKI was superior (CRi 57.5% vs 33.9%), as well as higher complete cytogenetic response rate (45% vs 10.7%) and more patients proceeding to ASCT (32.5% vs 10.7%). The results were even better when using a second generation TKI in combination with IC or HMA with a favorable EFS and OS compared to TKI alone.

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