Research findings being presented during the 64th American Society of Hematology (ASH) Annual Meeting and Exposition challenge standard practices in several areas of blood cancer care and treatment. The studies offer a counterpoint to the tendency to implement ever more intensive therapies and stringent protocols and suggest that sometimes less is more.
“As researchers in hematology, we look at it as our duty to question the standard approaches that we use to treat patients, even those that we thought of as tried-and-true,” said press briefing moderator Mikkael Sekeres, MD, of the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. “These abstracts challenge some of those standards and in fact reveal that in many cases, giving less therapy and being less restrictive is actually better for patients, or at least no worse.”
Each of the studies suggest that certain therapeutics, procedures, or protocols may be omitted from the standard course of blood cancer treatment in some cases to reduce the burden on patients without compromising health outcomes.
The first study suggests that post-treatment courses of steroids may be unnecessary in patients treated with the now-standard use of high-dose methotrexate in children with acute lymphoblastic leukemia and lymphoblastic lymphoma. The second study shows that patients with relapsed or refractory acute myeloid leukemia do not derive extra benefit from undergoing intensive chemotherapy ahead of a stem cell transplant, suggesting many can proceed directly to a transplant. The third study reveals that a restrictive diet of only thoroughly cooked food – long thought to protect patients from bacterial infections – does not reduce infection rates for patients undergoing a stem cell transplant, a finding likely to come as welcome news to patients eager to enjoy a more palatable diet. The fourth study suggests some patients with mantle cell lymphoma may be able to skip stem cell transplantation altogether thanks to the targeted drug ibrutinib.
Taken together, these studies offer opportunities to reduce the intensity, discomfort, and side effects of cancer treatment for many patients.
