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Summary: Older patients with acute myeloid leukaemia (AML) account for nearly half of those with the disease. Because they are perceived to be unfit for, unwilling to receive, or unlikely to benefit from conventional chemotherapy they represent an important unmet need. Tosedostat is a selective oral aminopeptidase inhibitor, which in phase I/II trials showed acceptable toxicity and encouraging efficacy. We report the only randomised study of low‐dose cytosine arabinoside (LDAC) combined with tosedostat (LDAC‐T) versus LDAC in untreated older patients not suitable for intensive treatment. A total of 243 patients were randomised 1:1 as part of the 'Pick‐a‐Winner' LI‐1 trial. There was a statistically non‐significant increase in the complete remission (CR) rate with the addition of tosedostat, LDAC‐T 19% versus LDAC 12% [odds ratio (OR) 0·61, 95% confidence interval (CI) 0·30–1·23; P = 0·17]. For overall response (CR+CR with incomplete recovery of counts), there was little evidence of a benefit to the addition of tosedostat (25% vs. 18%; OR 0·68, 95% CI 0·37–1·27; P = 0·22). However, overall survival (OS) showed no difference (2‐year OS 16% vs. 12%, hazard ratio 0·97, 95% CI 0·73–1·28; P = 0·8). Exploratory analyses failed to identify any subgroup benefitting from tosedostat. Despite promising pre‐clinical, early non‐randomised clinical data with acceptable toxicity and an improvement in response, we did not find evidence that the addition of tosedostat to LDAC produced a survival benefit in this group of patients with AML. International Standard Randomised Controlled Trial Number: ISRCTN40571019 [ABSTRACT FROM AUTHOR]

Keywords: COVID-19; Haematological Conditions; Haematology patients; Lung infiltrates; SARS-Cov-2 EN COVID-19 Haematological Conditions Haematology patients Lung infiltrates SARS-Cov-2 e11 e14 4 12/21/20 20210101 NES 210101 Since COVID-19 first appeared it has been clear that whilst many patients experience relatively minor symptoms, some develop a more serious disease.1-2 Studies have suggested that oncology patients, including those with haematological malignancies, have a greater risk of severe COVID-19 disease with increased morbidity and mortality.3-5 This retrospective study, conducted by clinicians and researchers from nine West Midlands hospitals, included all adult patients with both an underlying haematological disorder and confirmed COVID-19, diagnosed between 1 SP st sp March and 31 SP st sp May 2020. Only 4-4% of patients were asymptomatic and 63% of patients had severe COVID-19 symptoms at presentation. Additionally, haematological disease-based risk status was significant for COVID-19 mortality (mean survival 7 days in the low risk group compared with 11 days among the high risk groups) showing that haematology patients presenting as "low risk" according to the criteria in use at the time of reporting, had worse prognosis. [Extracted from the article]

The article looks at a report from UK PNH Network with paroxysmal nocturnal haemoglobinuria (PNH) is a rare life threatening disease such as lethargy, erectile dysfunction or abdominal pain. It mentions international flow cytometry (FC) recommendations advise PNH testing and lower limit of sensitivity for positive testing ranged from glycosylphosphatidylinositol (GPI)-deficient cells. It also mentions PNH had evolved from aplastic anaemia (AA) from myelodysplastic syndrome (MDS).

A unique case of primary refractory FLT3-itd mutated acute myeloid leukemia in an elderly patient, who achieved completed morphological remission, and FLT3-itd negativity, following 9 cycles of azacitadine in combination with escalating doses of donor lymphocyte infusions following relapse 18 months post reduced intensity HLAA mismatch Campath conditioning allogeneic stem cell transplant. [ABSTRACT FROM AUTHOR]

Blastic plasmacytoid dendritic cell neoplasm is a rare, aggressive tumor characterized by skin and/or marrow infiltration by CD4+ CD56+ cells. Historically, the tumor was variably thought to arise from either monocytes, T cells or NK cells giving rise to terms such as CD4+/CD56+ acute monoblastic leukemia, primary cutaneous CD4+/CD56+ hematodermic tumor and blastic NK-cell lymphoma. Whilst considerable progress has been made in understanding the histogenesis, the best modality of treatment remains to be defined. We are therefore reporting this case which was successfully treated with a T-deplete allogeneic transplant and the patient is currently alive and in remission 4 years post transplant. [ABSTRACT FROM AUTHOR]