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CC BY 4.0 · Indian J Med Paediatr Oncol 2023; 44(05): 452-459
DOI: 10.1055/s-0043-1768567
Perspective

What Does an Adult Hemato-Oncology Physician Expect from a Hematopathologist?

Fen Tity Saj
1   Department of Medical Oncology, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
,
Prasanth Ganesan 
1   Department of Medical Oncology, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Abstract

Recent advances in the field of hemato-oncology have significantly improved outcomes for patients. However, these changes have also increased the complexity of investigations required at the time of diagnosis and during the follow-up of these patients. Close interaction and exchange of information between the pathologist and the clinician is important for sucessful management of patients. This article briefly discusses the advances in the field and the impact of these changes on the management of patients. A clinician's perspective of what is required from a hematopathologist while managing patients in the current era is presented. An attempt is made to classify the requirements as to what is expected in ideal as well as in resource-limited settings.

Keywords

hematological malignancies - cancer - pathology - expectations - advances


Publication History

Article published online:
04 November 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Canellos GP, Rosenberg SA, Friedberg JW, Lister TA, Devita VT. Treatment of Hodgkin lymphoma: a 50-year perspective. J Clin Oncol 2014; 32 (03) 163-168
    CrossrefPubMedGoogle Scholar
  • 2 Kantarjian H. Acute myeloid leukemia: major progress over four decades and glimpses into the future. Am J Hematol 2016; 91 (01) 131-145
    CrossrefPubMedGoogle Scholar
  • 3 Samra B, Jabbour E, Ravandi F, Kantarjian H, Short NJ. Evolving therapy of adult acute lymphoblastic leukemia: state-of-the-art treatment and future directions. J Hematol Oncol 2020; 13 (01) 70
    CrossrefPubMedGoogle Scholar
  • 4 Rajkumar SV. Multiple myeloma: 2020 update on diagnosis, risk-stratification and management. Am J Hematol 2020; 95 (05) 548-567
    CrossrefPubMedGoogle Scholar
  • 5 O'Brien SG, Guilhot F, Larson RA. et al; IRIS Investigators. Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med 2003; 348 (11) 994-1004
    CrossrefPubMedGoogle Scholar
  • 6 Huang SJ, Gerrie AS, Young S. et al. Comparison of real-world treatment patterns in chronic lymphocytic leukemia management before and after availability of ibrutinib in the province of British Columbia, Canada. Leuk Res 2020; 91: 106335
    CrossrefPubMedGoogle Scholar
  • 7 Coiffier B, Lepage E, Briere J. et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 2002; 346 (04) 235-242
    CrossrefPubMedGoogle Scholar
  • 8 Mathews V, George B, Chendamarai E. et al. Single-agent arsenic trioxide in the treatment of newly diagnosed acute promyelocytic leukemia: long-term follow-up data. J Clin Oncol 2010; 28 (24) 3866-3871
    CrossrefPubMedGoogle Scholar
  • 9 Brüggemann M, Kotrova M. Minimal residual disease in adult ALL: technical aspects and implications for correct clinical interpretation. Blood Adv 2017; 1 (25) 2456-2466
    CrossrefPubMedGoogle Scholar
  • 10 Gökbuget N, Dombret H, Giebel S. et al. Minimal residual disease level predicts outcome in adults with Ph-negative B-precursor acute lymphoblastic leukemia. Hematology 2019; 24 (01) 337-348
    CrossrefPubMedGoogle Scholar
  • 11 National Cancer Grid. National Cancer Grid Guidelines 2019: Adult Hematolymphoid Malignancies Management Guidelines. Accessed April 11, 2023 at: https://tmc.gov.in/ncg/docs/pdf/NCG_Guidelines_%202019/NCG%20Guidelines%20for%20Adult%20Hematolymphoid-2019.pdf
    Google Scholar
  • 12 Ganesan P, Kayal S, How I. Treat adult acute lymphoblastic leukemia in India. Indian J Med Paediatr Oncol 2021; 42 (06) 584-594
    Article in Thieme ConnectGoogle Scholar
  • 13 Yadav V, Ganesan P, Veeramani R, Kumar V D. Philadelphia-like acute lymphoblastic leukemia: a systematic review. Clin Lymphoma Myeloma Leuk 2021; 21 (01) e57-e65
    CrossrefPubMedGoogle Scholar
  • 14 Svaton M, Skotnicova A, Reznickova L. et al. NGS better discriminates true MRD positivity for the risk stratification of childhood ALL treated on an MRD-based protocol. Blood 2023; 141 (05) 529-533
    CrossrefPubMedGoogle Scholar
  • 15 Döhner H, Wei AH, Appelbaum FR. et al. Diagnosis and management of AML in adults: 2022 recommendations from an international expert panel on behalf of the ELN. Blood 2022; 140 (12) 1345-1377
    CrossrefPubMedGoogle Scholar
  • 16 Pollyea DA, Bixby D, Perl A. et al. NCCN Guidelines Insights: Acute Myeloid Leukemia, Version 2.2021. J Natl Compr Canc Netw 2021; 19 (01) 16-27
    CrossrefPubMedGoogle Scholar
  • 17 El Achi H, Kanagal-Shamanna R. Biomarkers in acute myeloid leukemia: leveraging next generation sequencing data for optimal therapeutic strategies. Front Oncol 2021; 11: 748250
    CrossrefPubMedGoogle Scholar
  • 18 Slovak ML, Kopecky KJ, Cassileth PA. et al. Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/Eastern Cooperative Oncology Group Study. Blood 2000; 96 (13) 4075-4083
    CrossrefPubMedGoogle Scholar
  • 19 Hourigan CS. Achieving MRD negativity in AML: how important is this and how do we get there?. Hematology (Am Soc Hematol Educ Program) 2022; 2022 (01) 9-14
    CrossrefPubMedGoogle Scholar
  • 20 Bower H, Björkholm M, Dickman PW, Höglund M, Lambert PC, Andersson TM. Life expectancy of patients with chronic myeloid leukemia approaches the life expectancy of the general population. J Clin Oncol 2016; 34 (24) 2851-2857
    CrossrefPubMedGoogle Scholar
  • 21 Jabbour E, Kantarjian H. Chronic myeloid leukemia: 2022 update on diagnosis, therapy, and monitoring. Am J Hematol 2022; 97 (09) 1236-1256
    CrossrefPubMedGoogle Scholar
  • 22 Clark RE, Apperley JF, Copland M, Cicconi S. Additional chromosomal abnormalities at chronic myeloid leukemia diagnosis predict an increased risk of progression. Blood Adv 2021; 5 (04) 1102-1109
    CrossrefPubMedGoogle Scholar
  • 23 Guilhot F. Cytogenetics in CML: more important than you think. Blood 2016; 127 (22) 2661-2662
    CrossrefPubMedGoogle Scholar
  • 24 Ni J, Hong J, Zhang Z. et al. Marrow fibrosis is an independent predictor of hematological toxicity of tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia. Leuk Lymphoma 2020; 61 (05) 1195-1200
    CrossrefPubMedGoogle Scholar
  • 25 Cross NCP, White HE, Evans PAS. et al. Consensus on BCR-ABL1 reporting in chronic myeloid leukaemia in the UK. Br J Haematol 2018; 182 (06) 777-788
    CrossrefPubMedGoogle Scholar
  • 26 Shanmuganathan N, Pagani IS, Ross DM. et al. Early BCR-ABL1 kinetics are predictive of subsequent achievement of treatment-free remission in chronic myeloid leukemia. Blood 2021; 137 (09) 1196-1207
    CrossrefPubMedGoogle Scholar
  • 27 Soverini S, Abruzzese E, Bocchia M. et al. Next-generation sequencing for BCR-ABL1 kinase domain mutation testing in patients with chronic myeloid leukemia: a position paper. J Hematol Oncol 2019; 12 (01) 131
    CrossrefPubMedGoogle Scholar
  • 28 Soverini S, Bernardi S, Galimberti S. Molecular testing in CML between old and new methods: are we at a turning point?. J Clin Med 2020; 9 (12) 3865
    CrossrefPubMedGoogle Scholar
  • 29 Burger JA. Treatment of chronic lymphocytic leukemia. N Engl J Med 2020; 383 (05) 460-473
    CrossrefPubMedGoogle Scholar
  • 30 Jain N, Keating M, Thompson P. et al. Ibrutinib plus venetoclax for first-line treatment of chronic lymphocytic leukemia: a nonrandomized phase 2 trial. JAMA Oncol 2021; 7 (08) 1213-1219
    CrossrefPubMedGoogle Scholar
  • 31 Catherwood MA, Wren D, Chiecchio L. et al. TP53 mutations identified using NGS comprise the overwhelming majority of TP53 disruptions in CLL: results from a multicentre study. Front Oncol 2022; 12: 909615
    CrossrefPubMedGoogle Scholar
  • 32 Crombie J, Davids MS. IGHV mutational status testing in chronic lymphocytic leukemia. Am J Hematol 2017; 92 (12) 1393-1397
    CrossrefPubMedGoogle Scholar
  • 33 Alaggio R, Amador C, Anagnostopoulos I. et al. The 5th edition of the World Health Organization Classification of haematolymphoid tumours: lymphoid neoplasms. Leukemia 2022; 36 (07) 1720-1748
    CrossrefPubMedGoogle Scholar
  • 34 Friedberg JW. How I treat double-hit lymphoma. Blood 2017; 130 (05) 590-596
    CrossrefPubMedGoogle Scholar
  • 35 Susanibar-Adaniya S, Barta SK. 2021 update on diffuse large B cell lymphoma: a review of current data and potential applications on risk stratification and management. Am J Hematol 2021; 96 (05) 617-629
    CrossrefPubMedGoogle Scholar
  • 36 Swerdlow SH, Campo E, Pileri SA. et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016; 127 (20) 2375-2390
    CrossrefPubMedGoogle Scholar
  • 37 Di Napoli A, Remotti D, Agostinelli C. et al. A practical algorithmic approach to mature aggressive B cell lymphoma diagnosis in the double/triple hit era: selecting cases, matching clinical benefit : a position paper from the Italian Group of Haematopathology (G.I.E.). Virchows Arch 2019; 475 (04) 513-518
    CrossrefPubMedGoogle Scholar
  • 38 Alkan S, Cosar E, Ergin M, Hsi E. Detection of T-cell receptor-γ gene rearrangement in lymphoproliferative disorders by temperature gradient gel electrophoresis. Arch Pathol Lab Med 2001; 125 (02) 202-207
    CrossrefPubMedGoogle Scholar
  • 39 Palumbo A, Rajkumar SV, San Miguel JF. et al. International Myeloma Working Group consensus statement for the management, treatment, and supportive care of patients with myeloma not eligible for standard autologous stem-cell transplantation. J Clin Oncol 2014; 32 (06) 587-600
    CrossrefPubMedGoogle Scholar
  • 40 Ding H, Xu J, Lin Z. et al. Minimal residual disease in multiple myeloma: current status. Biomark Res 2021; 9 (01) 75
    CrossrefPubMedGoogle Scholar
  • 41 Granell M, Calvo X, Garcia-Guiñón A. et al; GEMMAC (Grup per l'estudi del mieloma i l'amiloïdosi de Catalunya). Prognostic impact of circulating plasma cells in patients with multiple myeloma: implications for plasma cell leukemia definition. Haematologica 2017; 102 (06) 1099-1104
    CrossrefPubMedGoogle Scholar
  • 42 Barbui T, Thiele J, Gisslinger H. et al. The 2016 WHO classification and diagnostic criteria for myeloproliferative neoplasms: document summary and in-depth discussion. Blood Cancer J 2018; 8 (02) 15
    CrossrefPubMedGoogle Scholar
  • 43 Grinfeld J, Nangalia J, Baxter EJ. et al. Classification and personalized prognosis in myeloproliferative neoplasms. N Engl J Med 2018; 379 (15) 1416-1430
    CrossrefPubMedGoogle Scholar
  • 44 Della Starza I, Chiaretti S, De Propris MS. et al. Minimal residual disease in acute lymphoblastic leukemia: technical and clinical advances. Front Oncol 2019; 9 (726): 726
    CrossrefPubMedGoogle Scholar
  • 45 Fürstenau M, De Silva N, Eichhorst B, Hallek M. Minimal residual disease assessment in CLL: ready for use in clinical routine?. HemaSphere 2019; 3 (05) e287
    CrossrefPubMedGoogle Scholar
  • 46 DiNardo CD, Jonas BA, Pullarkat V. et al. Azacitidine and venetoclax in previously untreated acute myeloid leukemia. N Engl J Med 2020; 383 (07) 617-629
    CrossrefPubMedGoogle Scholar
  • 47 Facon T, Kumar S, Plesner T. et al; MAIA Trial Investigators. Daratumumab plus lenalidomide and dexamethasone for untreated myeloma. N Engl J Med 2019; 380 (22) 2104-2115
    CrossrefPubMedGoogle Scholar
  • 48 Kantarjian H, Stein A, Gökbuget N. et al. Blinatumomab versus chemotherapy for advanced acute lymphoblastic leukemia. N Engl J Med 2017; 376 (09) 836-847
    CrossrefPubMedGoogle Scholar
  • 49 Khoury JD, Solary E, Abla O. et al. The 5th edition of the World Health Organization classification of haematolymphoid tumours: myeloid and histiocytic/dendritic neoplasms. Leukemia 2022; 36 (07) 1703-1719
    CrossrefPubMedGoogle Scholar
  • 50 Ganesan P. Interim-response-adapted therapy in advanced Hodgkin's lymphoma: current status. Indian J Med Paediatr Oncol 2019; 40 (04) 566-569
    Article in Thieme ConnectGoogle Scholar
  • 51 Jain N, Lamb AV, O'Brien S. et al. Early T-cell precursor acute lymphoblastic leukemia/lymphoma (ETP-ALL/LBL) in adolescents and adults: a high-risk subtype. Blood 2016; 127 (15) 1863-1869
    CrossrefPubMedGoogle Scholar
  • 52 Ravandi F. How I treat Philadelphia chromosome-positive acute lymphoblastic leukemia. Blood 2019; 133 (02) 130-136
    CrossrefPubMedGoogle Scholar
  • 53 Alexander TB, Orgel E. Mixed phenotype acute leukemia: current approaches to diagnosis and treatment. Curr Oncol Rep 2021; 23 (02) 22
    CrossrefPubMedGoogle Scholar
  • 54 Heuser M, Freeman SD, Ossenkoppele GJ. et al. 2021 update on MRD in acute myeloid leukemia: a consensus document from the European LeukemiaNet MRD Working Party. Blood 2021; 138 (26) 2753-2767
    CrossrefPubMedGoogle Scholar