News in brief: PBS listing recommended for T-cell lymphoma therapy; Australian cases of CLL occurring concurrently with CML

Thursday, 29 Apr 2021

PBS listing recommended for T-cell lymphoma treatment

Brentuximab vedotin (Adcetris) has received a positive recommendation for PBS listing for the treatment of patients with previously untreated CD30 positive peripheral T-cell lymphoma, when used in combination with cyclophosphamide, doxorubicin, and prednisone (CHP). The Pharmaceutical Benefits Advisory Committee (PBAC) accepted that BV+CHP was clinically superior in terms of progression free survival compared to cyclophosphamide, doxorubicin, vincristine and prednisone and that the immature overall survival data also suggested a clinical benefit.

However, at its March meeting the PBAC rejected applications for PBS listings for venetoclax for the treatment of patients with previously untreated acute myeloid leukaemia; gemtuzumab ozogamicin for the treatment of de novo CD33-positive AML patients, and decitabine+cedazuridine in patients with myelodysplastic syndromes (MDS) and chronic myelomonocytic leukaemia (CMML).

TXA prevents post-partum haemorrhage after caesarean delivery

Prophylactic tranexamic acid prevents postpartum haemorrhage following a caesarean delivery, a French trial has shown.

In a double blind RCT involving 4153 women who underwent caesarean delivery, post partum haemorrhage (estimated postpartum blood loss greater than 1000 ml or red-cell transfusion by day two) occurred in 26.7% of women randomised to receive 1g tranexamic acid in addition to uterotonic agents, compared to 31.6% of those in the placebo plus uterotonic group (p=0.003).

There were no between-group differences in secondary haemorrhage-related clinical outcomes, according to the TRAAP2 trial results published in NEJM.

Australian cases of CLL occurring concurrently with CML

Haematologists have reported chronic lymphocytic leukaemia (CLL) occurring concurrently with chronic myeloid leukaemia (CML) in five patients being treated  in Australian hospitals.

Writing in Internal Medicine Journal Dr Julian Cooney and colleagues from Fiona Stanley Hospital, Perth, say prevalence of the dual malignancies is rare, but set to rise due to improved outcomes for each disease with currently available therapies.

All five patients had a diagnosis of CLL before subsequently being diagnosed with CML. Three had received prior fludarabine, all received tyrosine kinase inhibitors (TKI) while none required subsequent therapy for CLL.

With all patients currently have satisfactory blood counts, researchers say the condition can be successfully managed by treating each disorder in the usual way.

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