Chestnut Hill College hosts Stephen P. Hunger, MD., "Precision Medicine in Pediatric Acute Lymphoblastic Leukemia"

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Board Certified Oncology Pharmacist (BCOP) - Pharmacy exam

Stephan Grupp, MD, PhD, from the Children’s Hospital of Philadelphia, Philadelphia, PA, discusses the results of a global registration trial (NCT02435849) of the efficacy and safety of CTL019 in pediatric patients and young adults with relapsed/refractory acute lymphoblastic leukemia (ALL) at the American Society of Hematology (ASH) Congress 2016 in San Diego, CA. This is the first global trial for a cell therapy in this patient group. Dr Grupp explains that CAR-T-cells, which have been in development for a number of years, are engineered T-cells which can potentially attack cancer, and significant clinical results have been seen in a single-institution trial. In this trial, involving 25 centers in 11 countries, the safety and efficacy of CTL019 was assessed in high-risk relapsed and refractory pediatric and young adult ALL patients. Dr Grupp summarises the results of this study, which showed an initial complete response (CR) rate of 82%, and an overall survival (OS) at 6 months of 89%, with results very similar to the single institution trial. CTL019 was delivered with a high level of safety, and cytokine release syndrome (CRS) was well-managed due to extensive training programs for physicians, with no CRS-associated deaths in the trial. He concludes that from both an efficacy and safety standpoint, the global registration trial worked out well.

0:00 case study
1:08 peripheral blood smear
1:37 genetic causes - more than 50 chromosomes, Philadelphia
2:50 clinical features - fever, pallor, bone pain, generalized lymphadenopathy, mediastinal mass thymus, CNS leukemia
4:17 fab classification L1 L2 L3, B cell, T cell
4:55 treatment - induction vincristine, CNS preventive methotrexate , Intensive methotrexate , maintenance - methotrexate

Hudson has Acute Lymphoblastic Leukemia and receives blood as part of his treatment. He is a fighter and is holding a blood drive to help save the lives of others!

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Chapters

0:00 Introduction
2:38 Causes of Leukaemia
3:19 Symptoms of Leukaemia
3:48 Diagnosis of Leukaemia
4:27 Treatment of Leukaemia


Leukemia, also spelled leukaemia, is a group of blood cancers that usually begin in the bone marrow and result in high numbers of abnormal blood cells. These blood cells are not fully developed and are called blasts or leukemia cells.Symptoms may include bleeding and bruising, feeling tired, fever, and an increased risk of infections.These symptoms occur due to a lack of normal blood cells.Diagnosis is typically made by blood tests or bone marrow biopsy.

The exact cause of leukemia is unknown.A combination of genetic factors and environmental (non-inherited) factors are believed to play a role. Risk factors include smoking, ionizing radiation, some chemicals (such as benzene), prior chemotherapy, and Down syndrome.People with a family history of leukemia are also at higher risk. There are four main types of leukemia—acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML), chronic lymphocytic leukemia (CLL) and chronic myeloid leukemia (CML)—as well as a number of less common types. Leukemias and lymphomas both belong to a broader group of tumors that affect the blood, bone marrow, and lymphoid system, known as tumors of the hematopoietic and lymphoid tissues.