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Featuring an interview with Dr Elias Jabbour, including the following topics: Evolution of research and therapeutic options for acute lymphoblastic leukemia (ALL) (0:00) Clinical and biological characteristics of ALL and implications for prognosis and disease management (6:36) Case: A 48-year-old woman with newly diagnosed Philadelphia chromosome-positive (Ph-positive) ALL attains complete remission with ponatinib/blinatumomab (14:03) Tolerability and improved quality of life with the chemotherapy-free combination of ponatinib and blinatumomab (24:17) Case: A 38-year-old man with newly diagnosed Ph-positive ALL experiences a complete molecular response with induction hyper-CVAD and ponatinib (27:10) CME information and select publications
Featuring a slide presentation and related discussion from Dr Elias Jabbour, including the following topics: Clinical management of Philadelphia chromosome-positive (Ph-positive) acute lymphoblastic leukemia (ALL); factors in the selection of initial induction treatment (0:00) Primary and secondary endpoint outcomes from the Phase III PhALLCON trial comparing ponatinib to imatinib, each with reduced-intensity chemotherapy, as front-line treatment for Ph-positive ALL (5:22) Efficacy and tolerability of ponatinib in combination with blinatumomab for patients with newly diagnosed Ph-positive ALL (17:04) Ongoing research with novel agents and strategies for Ph-positive ALL (24:47) CME information and select publications
Dr Elias Jabbour from the University of Texas MD Anderson Cancer Center in Houston discusses recent advances in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia.
Dr Elias Jabbour from the University of Texas MD Anderson Cancer Center in Houston discusses recent advances in the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia, moderated by Dr Neil Love. Produced by Research To Practice. CME information and select publications here (https://www.researchtopractice.com/OncologyTodayPHPosALL24).
To acknowledge the Philadelphia Chromosome translocation t(9;22) in chronic myeloid leukemia (CML), every September 22 (9/22) is World CML Day. Today's podcast episode looks at this topic through different lenses. First, two members of the Lancet Haematology's committee on adverse events—Jan Geissler, co-founder of the CML Advocates Network, and Gita Thanarajasingam, MD, the committee chair and a hematologist at the Mayo Clinic—discuss how side effects are reported and analyzed and how the committee intends to change that. Geissler also talks about how his experience as a patient with CML led him to become and expert advocate. Additional reading:Geissler J, Huber S. Improving outcomes through patient-generated evidence-the next step in patient advocacy. Lancet Haematol. 2022 Jun;9(6):e399-e400. Thanarajasingam G, et al. Reaching beyond maximum grade: progress and future directions for modernising the assessment and reporting of adverse events in haematological malignancies. Lancet Haematol. 2022 May;9(5):e374-e384Basch E, Deal AM, Dueck AC, Scher HI, Kris MG, Hudis C, Schrag D. Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment. JAMA. 2017 Jul 11;318(2):197-198.
FDA Drug Information Soundcast in Clinical Oncology (D.I.S.C.O.)
Listen to a soundcast of the October 29, 2021, FDA approval of Scemblix (asciminib) for patients with Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase, previously treated with tyrosine kinase inhibitors, and for adult patients in chronic phase with the T315I mutation
While Carlos was studying Biology in the U.S., his father was diagnosed with Philadelphia Chromosome positive Acute Lymphocytic Leukemia (Ph+ALL) in Mexico. The same condition which he’d just learned about in school and had captured his intellectual curiosity was also now very personal. Carlos shares how genetic testing opened up options for his father’s course of treatment but also introduced myriad decisions to be made about his father’s care, the burden of which fell almost entirely upon his mother. He discusses how he thinks a genetic counselor could have helped the family through these many decisions and also shares his perspective on the importance of end of life care. Have thoughts or a related story you’d like to share? Leave us a short voice message here! We may use your message on a future show. Check out other Patient Stories podcast episodes. Read other Patient Stories on the Grey Genetics Patient Stories Page. Do you want to support Patient Stories? You can make a donation online! Want to support Patient Stories in a non-monetary way? Leave us a review on iTunes, or share your favorite episodes on Social Media. Patient Stories on Twitter: @GreyGeneticsPod Patient Stories on Instagram: @patientstoriespodcast Are you looking for genetic counseling? Patient Stories is sponsored by Grey Genetics, an independent telehealth genetic counseling and consulting company. Book an appointment with a genetic counselor specialized in your area of concern. All genetic counseling appointments take place over secure, HIPAA-compliant video-conferencing or by phone. Not quite ready for genetic counseling but still looking for guidance? Check out our new family history review services here.
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In December 2011, Linda noticed that she was more tired than usual and had a rash on her leg. She had excessive bruising in places and was exhausted from playing soccer. She then went to the doctors and learned her rash that she had for 2 weeks was known as Petechial rash. She underwent blood work and other tests and it was determined she had Philadelphia chromosome positive ALL, a rare subtype of ALL. In patients with Philadelphia chromosome positive ALL, the bone marrow produces too many white blood cells, which become cancerous. Her treatment has included a stem cell transplant and radiation. In total her treatment lasted about 2 years. Linda says she has a great relationship with Dr. Hong. She feels very comfortable around him and says he is an amazing doctor that cares for his patients' wellbeing. Linda moved to Wisconsin for a year and saw new doctors and nurses, however it was not the same because she didn't feel comfortable around them – she wanted her doctors that were with her from Day 1: that was and still is Dr. Hong. Linda would like to thank Dr. Hong for being part of the team that saved her life and allowed her to continue living. She says she will forever be grateful and indebted to them no matter what. Linda has 4 siblings, 3 sisters and 1 brother. Her youngest sister Emily, who was only 7 years old at the time, happily donated her stem cells to Linda as she was a match. She enjoys playing volleyball and tennis and hiking in her free time. Linda is currently in college right now attending Massasoit Community College in Brockton studying to become a nurse. She hopes to someday work alongside the team that helped saved her life. She is working as a Clinical Nursing Assistant at Boston Children's Hospital on the HEM/ONC floor.Dr. Hong did his residency training in pediatrics at Boston Children's back in 2008-2011 and then his fellowship training from 2011-2014. He selected pediatrics because he wants kids to be able to be kids and not have the worries of being ill. Being able to help kids get better was been his inspiration for going into medical school. And as a pediatric oncologist, his goals now are to be able to watch his patients grow up to pursue their own passions. Linda came to Boston Children's during the holiday season in 2011. She had a specific type of leukemia which was not treatable 2 to 3 decades ago. This leukemia is called Philadelphia chromosone positive acute lymphoblastic leukemia. Because of hard work of researchers across the world, including at Dana-Farber Cancer Institute, medications have been developed to target this type of cancer to help cause the cancer cells to die in combination with chemotherapy. Since Linda's sister was a perfect match, they were able to give Linda a bone marrow transplant. Dr. Hong says Linda has been a fantastic patient and that “watching her grow up has been very humbling. I'm especially grateful to all the incredible work of the clinicians and researchersbefore me.” He says all their efforts have given her a chance to pursue her passion in becoming a nurse and they have been grateful that she has been performing some of her training at Boston Children's / Dana-Farber.
Prof Ottman speaks with ecancer about the past and future management of Ph ALL. He describes the impact of TKI therapy on prognosis, and how this has gone on to modulate chemotherapy regimens towards less intensive courses, but highlights the difficulty of treating relapsed patients. Prof Ottman also highlights the GRAAPH-2005 trial as confirming indications and patients who respond strongly to allogeneic or autologous stem cell transplant, with age as a major disposing factor. With this in mind, he considers a future in which 3rd generation TKIs, stem cell transplant and immunotherapy might offer a chemo-free treatment regimen for patients.
Dr Slayton talks to ecancertv at ASCO 2015, about the outcomes of Children's Oncology Group trial AALL0622 in patients 1-30 years old. Treating with dasatinib plus intensive chemotherapy versus stem cell transplant (SCT) for Philadelphia chromosome-positive acute lymphoblastic leukaemia. Results showed dasatinib with intensive chemotherapy was well tolerated; subjects with rapid response had excellent outcomes without SCT. Further follow-up and additional trials are necessary to define the relative role of dasatinib and imatinib in promoting long-term survival in paediatric Ph positive ALL.
Prof Harrison talks to ecancertv at EHA 2014 about the Philadelphia chromosome and the role it plays in triggering chronic myeloid leukaemia (CML).
Someday, perhaps 20 or 30 years from now, or maybe even sooner, we will look back at the way we treat most cancers today and be shocked at the barbarism of it all. The surgery, the killer chemicals of chemo, all will be looked at the way we view the leaching of the middle ages. At the forefront of this transition is a discovery made in 1959. A chromosomal mutation dubbed the Philadelphia Chromosome, that caused a deadly form of leukemia. Ultimately a drug would be developed that stopped the cancer at it’s source. Science journalist Jessica Wapner has written The Philadelphia Chromosome: A Mutant Gene and the Quest to Cure Cancer at the Genetic Level. It is both the story of 50 years of the march of science on cancer and also a mystery thriller that lifts the veil on how drugs get developed and make it to the marketplace. My conversation with Jessica Wapner:
Now, for the first time, The Philadelphia Chromosome: A Mutant Gene and the Quest to Cure Cancer at the Genetic Level by Jessica Wapner tells in full the origin story of treating cancer at the genetic level, and unfolds the history behind many of those headlines, to help us understand exactly how targeting cancer at its root came to save so many lives. In her debut book, science journalist Jessica Wapner brings this story vividly to life. The Philadelphia Chromosome opens in 1959 with the discovery in a University of Pennsylvania lab of a chromosomal mutation (christened the Philadelphia chromosome) in which a piece of chromosome 22 breaks off and attaches itself to chromosome 9. Wapner has been a contributor to The New York Times, Scientific American, Slate, and many other outlets, she has been writing about cancer research for the past 13 years.
Runtime 39:00 Physician-scientist Timothy A. Chan discusses cancer genomics at the forefront of cancer research and how developments have allowed researchers to discover what goes wrong in cancer faster than and more thoroughly. read more
Runtime 40:38 Physician-scientist, Ross Levine, discusses how the study of genomic techniques can lead to the development of new treatments. read more
Background: The analysis of complex cytogenetic databases of distinct leukaemia entities may help to detect rare recurring chromosome aberrations, minimal common regions of gains and losses, and also hot spots of genomic rearrangements. The patterns of the karyotype alterations may provide insights into the genetic pathways of disease progression. Results: We developed a simplified computer readable cytogenetic notation (SCCN) by which chromosome findings are normalised at a resolution of 400 bands. Lost or gained chromosomes or chromosome segments are specified in detail, and ranges of chromosome breakpoint assignments are recorded. Software modules were written to summarise the recorded chromosome changes with regard to the respective chromosome involvement. To assess the degree of karyotype alterations the ploidy levels and numbers of numerical and structural changes were recorded separately, and summarised in a complex karyotype aberration score (CKAS). The SCCN and CKAS were used to analyse the extend and the spectrum of additional chromosome aberrations in 94 patients with Philadelphia chromosome positive (Ph-positive) acute lymphoblastic leukemia ( ALL) and secondary chromosome anomalies. Dosage changes of chromosomal material represented 92.1% of all additional events. Recurring regions of chromosome losses were identified. Structural rearrangements affecting ( peri) centromeric chromosome regions were recorded in 24.6% of the cases. Conclusions: SCCN and CKAS provide unifying elements between karyotypes and computer processable data formats. They proved to be useful in the investigation of additional chromosome aberrations in Ph-positive ALL, and may represent a step towards full automation of the analysis of large and complex karyotype databases.