Blood cancers

News in brief: Immunoglobulin shortage; New CAR T approach for non-Hodgkin’s B-cell lymphoma; Arthritis drug identified as good candidate for high-risk paediatric leukaemias

Immunoglobulin medicine shortage

The TGA has advised that Flebogamma 5% DIF immunoglobulin, normal (human) will be unavailable until 11 September 2021.

The products distributed by Grifols Australia Pty Ltd are listed as a critical shortage on the TGA’s medicine shortage information site.

Flebogamma is used for the treatment of primary immunodeficiency syndromes, myeloma or chronic lymphocytic leukaemia with severe secondary hypogammaglobulinaemia and recurrent infections and for treatment of patients with certain inflammatory disorders such as idiopathic thrombocytopenic purpura (ITP).

New CAR T approach minimises resistance, helps avoid relapse in non-Hodgkin’s B-cell lymphoma

A new approach to CAR T therapy in non-Hodgkin’s B-cell lymphoma has helped minimise treatment resistance, resulting in long-lasting remission in patients whose cancer has come back or not responded to treatment, according to results from a pioneering trial.

The findings, which will be presented at the American Association for Cancer Research Annual Meeting this week, show patients enrolled in the small study achieved a more robust defence and avoided relapse by using the approach, which simultaneously recognises two targets – CD 19 and CD 20 – that are expressed on B-cell lymphoma instead of the conventional single-target approach.

Investigators say the results suggest having more than one antigen to target prevents the loss of the antigen, known as antigen escape, one of the most common mechanisms of treatment resistance.

Four of the five patients enrolled in the study demonstrated a complete metabolic response with minimal toxicity. While the median duration of the response, progression-free survival and overall survival endpoints have not yet been reached, the results are ‘very promising’ say US investigators from the David Geffen School of Medicine at UCLA adding that they are hopeful the dual targeting approach in naïve memory T-cells will “provide patients with relapsed or refractory aggressive B-cell lymphomas, that are otherwise chemotherapy-refractory, a chance at a possible cure or at the very least a lasting long-term remission.”

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Aussie study highlights auranofin as a well-tolerated drug candidate for high-risk paediatric leukaemias

The drug, auranofin, an FDA approved agent for the treatment of rheumatoid arthritis, could have selective anti-cancer activity against leukaemia cells, say a team of researchers in Australia.

Screening over 3700 approved drugs and compounds investigators from NSW and WA identified compounds with selective cytotoxicity against leukaemia cells followed by further preclinical evaluation in patient-derived xenograft models from children with high-risk ALL, versus solid tumour and non-cancerous cells.

Investigators say the anti rheumatic agent induced apoptosis in leukaemia cells by increasing reactive oxygen species (ROS) and heightened the activity of the chemotherapeutic cytarabine against highly aggressive models of infant MLL-rearranged ALL by enhancing DNA damage accumulation.

The enhanced sensitivity of leukaemia cells towards auranofin was associated with lower basal levels of the antioxidant glutathione and higher baseline ROS levels compared to solid tumour cells.

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