Advances in Blood Cancer Care for Veterans

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Advances in Blood Cancer Care for Veterans

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References
  1. Li W, ed. The 5th Edition of the World Health Organization Classification of
    Hematolymphoid Tumors. In: Leukemia [Internet]. Brisbane (AU): Exon Publications;
    October 16, 2022. https://www.ncbi.nlm.nih.gov/books/NBK586208/
  2. Graf SA, Samples LS, Keating TM, Garcia JM. Clinical research in older adults with
    hematologic malignancies: Opportunities for alignment in the Veterans Affairs. Semin
    Oncol. 2020;47(1):94-101. doi:10.1053/j.seminoncol.2020.02.010.
  3. Tiu A, McKinnell Z, Liu S, et al. Risk of myeloproliferative neoplasms among
    U.S. Veterans from Korean, Vietnam, and Persian Gulf War eras. Am J Hematol.
    2024;99(10):1969-1978. doi:10.1002/ajh.27438
  4. Ma H, Wan JY, Cortessis VK, Gupta P, Cozen W. Survival in Agent Orange
    exposed and unexposed Vietnam-era veterans who were diagnosed with
    lymphoid malignancies. Blood Adv. 2024;8(4):1037-1041. doi:10.1182/
    bloodadvances.2023011999
  5. Friedman DR, Rodgers TD, Kovalick C, Yellapragada S, Szumita L, Weiss ES. Veterans
    with blood cancers: Clinical trial navigation and the challenge of rurality. J Rural
    Health. 2024;40(1):114-120. doi:10.1111/jrh.12773
  6. Parikh DA, Rodgers TD, Passero VA, et al. Teleoncology in the Veterans Health
    Administration: Models of Care and the Veteran Experience. Am Soc Clin Oncol Educ
    Book. 2024;44(3):e100042. doi:10.1200/EDBK_100042
  7. Pulumati A, Pulumati A, Dwarakanath BS, Verma A, Papineni RVL. Technological
    advancements in cancer diagnostics: Improvements and limitations. Cancer Rep
    (Hoboken). 2023;6(2):e1764. doi:10.1002/cnr2.1764
Author and Disclosure Information

Thomas Rodgers, MD

Durham VA Medical Center
Durham, North Carolina


Dr. Rodgers has no relevant financial relationships to disclose.

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Author and Disclosure Information

Thomas Rodgers, MD

Durham VA Medical Center
Durham, North Carolina


Dr. Rodgers has no relevant financial relationships to disclose.

Author and Disclosure Information

Thomas Rodgers, MD

Durham VA Medical Center
Durham, North Carolina


Dr. Rodgers has no relevant financial relationships to disclose.

Click to view more from Cancer Data Trends 2025.

Click to view more from Cancer Data Trends 2025.

References
  1. Li W, ed. The 5th Edition of the World Health Organization Classification of
    Hematolymphoid Tumors. In: Leukemia [Internet]. Brisbane (AU): Exon Publications;
    October 16, 2022. https://www.ncbi.nlm.nih.gov/books/NBK586208/
  2. Graf SA, Samples LS, Keating TM, Garcia JM. Clinical research in older adults with
    hematologic malignancies: Opportunities for alignment in the Veterans Affairs. Semin
    Oncol. 2020;47(1):94-101. doi:10.1053/j.seminoncol.2020.02.010.
  3. Tiu A, McKinnell Z, Liu S, et al. Risk of myeloproliferative neoplasms among
    U.S. Veterans from Korean, Vietnam, and Persian Gulf War eras. Am J Hematol.
    2024;99(10):1969-1978. doi:10.1002/ajh.27438
  4. Ma H, Wan JY, Cortessis VK, Gupta P, Cozen W. Survival in Agent Orange
    exposed and unexposed Vietnam-era veterans who were diagnosed with
    lymphoid malignancies. Blood Adv. 2024;8(4):1037-1041. doi:10.1182/
    bloodadvances.2023011999
  5. Friedman DR, Rodgers TD, Kovalick C, Yellapragada S, Szumita L, Weiss ES. Veterans
    with blood cancers: Clinical trial navigation and the challenge of rurality. J Rural
    Health. 2024;40(1):114-120. doi:10.1111/jrh.12773
  6. Parikh DA, Rodgers TD, Passero VA, et al. Teleoncology in the Veterans Health
    Administration: Models of Care and the Veteran Experience. Am Soc Clin Oncol Educ
    Book. 2024;44(3):e100042. doi:10.1200/EDBK_100042
  7. Pulumati A, Pulumati A, Dwarakanath BS, Verma A, Papineni RVL. Technological
    advancements in cancer diagnostics: Improvements and limitations. Cancer Rep
    (Hoboken). 2023;6(2):e1764. doi:10.1002/cnr2.1764
References
  1. Li W, ed. The 5th Edition of the World Health Organization Classification of
    Hematolymphoid Tumors. In: Leukemia [Internet]. Brisbane (AU): Exon Publications;
    October 16, 2022. https://www.ncbi.nlm.nih.gov/books/NBK586208/
  2. Graf SA, Samples LS, Keating TM, Garcia JM. Clinical research in older adults with
    hematologic malignancies: Opportunities for alignment in the Veterans Affairs. Semin
    Oncol. 2020;47(1):94-101. doi:10.1053/j.seminoncol.2020.02.010.
  3. Tiu A, McKinnell Z, Liu S, et al. Risk of myeloproliferative neoplasms among
    U.S. Veterans from Korean, Vietnam, and Persian Gulf War eras. Am J Hematol.
    2024;99(10):1969-1978. doi:10.1002/ajh.27438
  4. Ma H, Wan JY, Cortessis VK, Gupta P, Cozen W. Survival in Agent Orange
    exposed and unexposed Vietnam-era veterans who were diagnosed with
    lymphoid malignancies. Blood Adv. 2024;8(4):1037-1041. doi:10.1182/
    bloodadvances.2023011999
  5. Friedman DR, Rodgers TD, Kovalick C, Yellapragada S, Szumita L, Weiss ES. Veterans
    with blood cancers: Clinical trial navigation and the challenge of rurality. J Rural
    Health. 2024;40(1):114-120. doi:10.1111/jrh.12773
  6. Parikh DA, Rodgers TD, Passero VA, et al. Teleoncology in the Veterans Health
    Administration: Models of Care and the Veteran Experience. Am Soc Clin Oncol Educ
    Book. 2024;44(3):e100042. doi:10.1200/EDBK_100042
  7. Pulumati A, Pulumati A, Dwarakanath BS, Verma A, Papineni RVL. Technological
    advancements in cancer diagnostics: Improvements and limitations. Cancer Rep
    (Hoboken). 2023;6(2):e1764. doi:10.1002/cnr2.1764
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Advances in Blood Cancer Care for Veterans

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Hematologic malignancies encompass a broad range of distinct cancers, generally categorized as lymphoid (eg, lymphoma), myeloid (eg, leukemia, myelodysplastic syndromes, myeloproliferative neoplasms [MPNs]), and plasma cell neoplasms (eg, multiple myeloma).1 The veteran population is aging; this, in combination with other potential veteran-specific risk factors, is leading to an increased risk of hematologic malignancies.2 Of note, the risk for MPN diagnosis has recently been studied in veterans who served during the Korean, Vietnam, and Persian Gulf War eras.3 In addition, survival trends for different blood cancers, such as lymphoid malignancies, vary among veterans exposed to Agent Orange.4 Conflicting results have been found that point to the importance of future research.

Veterans in rural areas face barriers to treatment and clinical trial enrollment due to long travel distances and lack of trial availability, creating what are termed “clinical trial deserts.”5 Teleoncology has become crucial in bridging this gap by improving access to blood cancer treatments and clinical trials.5,6 Novel decentralized trial designs involving telehealth can further expand participation in remote areas.5 

Over the past year, there have been advances in the treatment of blood cancers as well as the use of large data sets to better understand cancers trends and new technologies to reduce disparities in access to care.6,7 The availability of greater therapeutic options, new care modalities, and improved risk assessments herald an exciting time in the care of patients with hematologic malignancies, with the expectation that this care will continue to advance through 2025.

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Follicular Lymphoma Highlights From ASH 2022

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Follicular Lymphoma Highlights From ASH 2022

Highlights in follicular lymphoma from the 2022 American Society of Hematology (ASH) Annual Meeting are discussed by Dr Thomas Rodgers of the Durham VA Medical Center. 

 

Dr Rodgers begins with a prognostic model designed to evaluate the risk for disease progression in high-risk patients within 24 months of starting first-line treatment with the intention of better individualizing management in this group. 

 

Next, he presents long-term phase 3 data comparing first-line rituximab with a watch-and-wait approach. After 12 years of follow-up, results showed no significant difference in overall survival between watch and wait, rituximab induction, and rituximab induction plus maintenance, suggesting to Dr Rodgers that individualized upfront management can lead to similarly excellent outcomes in patients with low tumor burden. 

 

Turning to relapsed/refractory disease, Dr Rodgers cites a study comparing rituximab plus lenalidomide with rituximab plus placebo. The combination yielded superior results and more durable efficacy than did the control group.  

 

He also discusses studies on the use of novel agent tazemetostat in combination with lenalidomide, and the bispecific monoclonal antibody mosunetuzumab as monotherapy. The US Food and Drug Administration approved mosunetuzumab in December, expanding the armamentarium for patients with follicular lymphoma who have undergone multiple lines of therapy.  

 

--

 

Thomas Rodgers, MD, Assistant Professor, Department of Hematologic Malignancies and Cellular Therapy, Duke University; Staff Physician, Department of Hematology/Oncology, Durham VA Medical Center, Durham, North Carolina 

 

Thomas Rodgers, MD, has disclosed no relevant financial relationships. 

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Follicular Lymphoma Highlights From ASH 2022
Follicular Lymphoma Highlights From ASH 2022

Highlights in follicular lymphoma from the 2022 American Society of Hematology (ASH) Annual Meeting are discussed by Dr Thomas Rodgers of the Durham VA Medical Center. 

 

Dr Rodgers begins with a prognostic model designed to evaluate the risk for disease progression in high-risk patients within 24 months of starting first-line treatment with the intention of better individualizing management in this group. 

 

Next, he presents long-term phase 3 data comparing first-line rituximab with a watch-and-wait approach. After 12 years of follow-up, results showed no significant difference in overall survival between watch and wait, rituximab induction, and rituximab induction plus maintenance, suggesting to Dr Rodgers that individualized upfront management can lead to similarly excellent outcomes in patients with low tumor burden. 

 

Turning to relapsed/refractory disease, Dr Rodgers cites a study comparing rituximab plus lenalidomide with rituximab plus placebo. The combination yielded superior results and more durable efficacy than did the control group.  

 

He also discusses studies on the use of novel agent tazemetostat in combination with lenalidomide, and the bispecific monoclonal antibody mosunetuzumab as monotherapy. The US Food and Drug Administration approved mosunetuzumab in December, expanding the armamentarium for patients with follicular lymphoma who have undergone multiple lines of therapy.  

 

--

 

Thomas Rodgers, MD, Assistant Professor, Department of Hematologic Malignancies and Cellular Therapy, Duke University; Staff Physician, Department of Hematology/Oncology, Durham VA Medical Center, Durham, North Carolina 

 

Thomas Rodgers, MD, has disclosed no relevant financial relationships. 

Highlights in follicular lymphoma from the 2022 American Society of Hematology (ASH) Annual Meeting are discussed by Dr Thomas Rodgers of the Durham VA Medical Center. 

 

Dr Rodgers begins with a prognostic model designed to evaluate the risk for disease progression in high-risk patients within 24 months of starting first-line treatment with the intention of better individualizing management in this group. 

 

Next, he presents long-term phase 3 data comparing first-line rituximab with a watch-and-wait approach. After 12 years of follow-up, results showed no significant difference in overall survival between watch and wait, rituximab induction, and rituximab induction plus maintenance, suggesting to Dr Rodgers that individualized upfront management can lead to similarly excellent outcomes in patients with low tumor burden. 

 

Turning to relapsed/refractory disease, Dr Rodgers cites a study comparing rituximab plus lenalidomide with rituximab plus placebo. The combination yielded superior results and more durable efficacy than did the control group.  

 

He also discusses studies on the use of novel agent tazemetostat in combination with lenalidomide, and the bispecific monoclonal antibody mosunetuzumab as monotherapy. The US Food and Drug Administration approved mosunetuzumab in December, expanding the armamentarium for patients with follicular lymphoma who have undergone multiple lines of therapy.  

 

--

 

Thomas Rodgers, MD, Assistant Professor, Department of Hematologic Malignancies and Cellular Therapy, Duke University; Staff Physician, Department of Hematology/Oncology, Durham VA Medical Center, Durham, North Carolina 

 

Thomas Rodgers, MD, has disclosed no relevant financial relationships. 

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