Tafasitamab

DLBCL R/R-->

 L MIND study versus real world Tafa ( anti CD 19 Ab)+ Len

- In the real world experience, PFS was less than 2 months and OS 6 months. ORR 30%

-LMIND- PFS 13 months, ORR 55%

-L-MIND phase II study demonstrated durable responses in this population. The regimen consists of tafasitamab 12 mg/kg intravenously in combination with lenalidomide 25 mg orally (days 1–21 of each 28-day cycle) for up to 12 cycles, followed by tafasitamab monotherapy until disease progression or unacceptable toxicity

Now tafa approved in FL -inMIND study for 2nd line FL ( approved June 2025)- PFS 22 months, versus 14 months control arm

AML- Maintenance therapy

 Blood journal March 2025

Case presentation AML:

@age @gender fit/ frail with the following comorbidities:... presented to PCP/ER with 1 month/ week of reduced exercise tolerance/ petechiae/ mucosal bleeding/ fever, weight loss.

WBC- count wth  ...% blasts in the peripheral blood.

Hb-- severe anemia, requiring "x" units transfusion in the ED, plt count of ---

Rapid FISH to rule out APL and corebinding factor rearrangements-- 

peripheral smear showed--

Rapid molecular testing- FLT3, NPM1, IDH1/2

Myeloid NGS-

bmbx -

Other tests: uric acid, blood c/s, fibrinogen, PT/PTT

Treatment started: standard induction or AZA- VEN

Newly diagnosed AML- change in threshold for blasts. 10% or higher qualifies as AML except for CML/ph+ when 10-19% is considered accelerated phase.

There is a hierarchy: recurrent genetic abnormalities, TP 53 mutated, AML with MDS/MPN high risk mutations, AML is MDS associated cytogenetic abnormalities, AML/MDS unspecified.

Newly diagnosed AML ELN 2022

Reference: 

ELN risk classification for patients receiving less-intensive therapies (ELN 2024 Less-Intensive)

Risk category	Genetic abnormality
Favorable	Mutated NPM1 (FLT3-ITDneg, NRASwt, KRASwt, TP53wt) Mutated IDH2 (FLT3-ITDneg, NRASwt, KRASwt, TP53wt) Mutated IDH1∗ (TP53wt) Mutated DDX41†, Other cytogenetic and/or molecular abnormalities‡ (FLT3-ITDneg, NRASwt, KRASwt, TP53wt)
Intermediate	Other cytogenetic and molecular abnormalities‡ (FLT3-ITDpos and/or NRASmut and/or KRASmut; TP53wt)
Adverse	Mutated TP53