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Cancer can be physically and emotionally demanding. For some people, this can also put them at risk of substance use. May is the Mental Health Awareness month and in this article we break down how substance use can affect cancer outcomes and explore how stigma can get in the way of care. You’ll also learn how treatment approaches can better support patients managing both cancer and substance use.

Substance Use Is Often Overlooked in Cancer Care

As cancer treatments improve, more patients are living longer. However, mental health and substance use care often remain under-prioritized in oncology. There is a link between substance use and cancer that cannot be overlooked as it goes both directions. Meaning that substance use can increase the risk of certain cancers, and a cancer diagnosis can also trigger or worsen substance use as patients manage pain or emotional distress.

In one study from JAMA Oncology involving over 6,000 adult cancer survivors, 3.83% had an active substance use disorder (SUD), with alcohol use disorder being the most common at 2.78%. This matters because patients with a SUD may receive less effective pain management and face more challenges following their cancer treatment plans. These difficulties can reduce quality of life and lower the chance of recovery.

Why Cancer and Substance Use Often Overlap

A cancer diagnosis often brings physical pain, stress, anxiety, and depression. To cope, some patients turn to alcohol, smoking, or other substances. Pain is commonly treated with opioids, which can be effective but also carry a risk of developing opioid use disorder (OUD).

To read more about opioid use and pain in cancer, visit this article of HealthTree Research findings by clicking the button below.

Managing Pain and Opioid Use for Myeloma Patients

Tobacco and alcohol are the most widely used substances that raise cancer risk.

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Tobacco causes about 30% of all cancer deaths, including 80% of lung cancer deaths. It is also linked to cancers of the mouth, throat, larynx, esophagus, stomach, colon, rectum, pancreas, liver, kidney, bladder, cervix, and even blood cancers. Tobacco not only increases the risk of cancer, but can also produce metabolic and circulation issues in the body that make receiving cancer treatment more challenging.
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Alcohol is responsible for about 3.5% of cancer deaths. The risk is proportional to the intake; higher amounts over long periods pose a higher risk. For women, heavy use means more than 4 drinks per day or 8 per week. For men, it’s more than 5 drinks per day or 15 per week. Alcohol is processed by the liver and can interfere with the metabolism of other cancer treatments, increase the risk of worse side effects, and, in some cases, inactivate the medication.
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These facts are important because quitting tobacco and reducing alcohol use, even after a cancer diagnosis, can still lower future cancer risks and improve health.

Other Substances That Can Complicate Cancer Treatment and Health

Aside from tobacco and alcohol, the following substances are also frequently seen among patients and can interfere with treatment:

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Cannabis or marijuana is a natural opioid that can be synthesized into CBD. It can be prescribed by a doctor and administered under controlled conditions. Medical-grade marijuana has strict sanitary regulations and can be beneficial for many people. There is a risk of fungal infection of the lungs associated with marijuana produced in unofficial or unsanitary settings. You can read more about safe uses of cannabis and its risks from the American Thoracic Society here.
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Anabolic steroids are the most commonly used drugs among athletes to improve physical performance and aesthetic appearance. These drugs interact with hormone cycles and can also have a negative impact on other organs such as the liver, the cardiovascular, central nervous, musculoskeletal, endocrine, and reproductive systems. It is important to note that anabolic steroids are different from the commonly used steroids in cancer treatments.
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Injection drugs, including heroin. These drugs are administered directly into the veins, and their use has risks besides addiction. They can cause vascular strokes, blood and tissue infections, and blood-transmitted diseases like hepatitis and HIV.
Prolonged use can affect the main veins, limiting the option for intravenous cancer medications or increasing the need for longer hospital stays to monitor its applications.
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Synthetic drugs, such as methamphetamine (“meth” or “crystal”) is associated with liver cancer and affects psychiatric and physical performance. It is a toxic chemical substance for multiple organs, including the heart, brain and other liver.
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Cocaine is a powder absorbed by the mucous membranes. While cocaine’s impact on cellular processes is not fully understood, researchers speculated that the drug might stimulate white blood cell activity and growth. This could potentially speed up the formation of genetic errors that could lead to cancer. Read more about the link of cocaine and cancer here.
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Each of these substances has harmful effects on the body in more than one way. For example, meth, heroine and cocaine are often mixed with other toxic chemicals and powders such as benzene, a known carcinogen. All of these substances, once they’ve entered the body, are processed for elimination, interfering with the proper functioning of organs and metabolism. When receiving cancer treatment, they can also interfere with the absorption and beneficial effects of the therapy.

Challenges in Coordinating Cancer and SUD Treatment

Treating cancer and SUD at the same time is complex. Some medications used to treat SUD, like buprenorphine or methadone, can interfere with cancer pain treatments or may be stopped when patients begin cancer care. Conversely, untreated SUD can make it harder to manage symptoms or keep up with appointments.

Patients taking naltrexone for alcohol use disorder may not be able to use certain cancer pain treatments that act on the same parts of the brain.

How Does Stigma Affect People With Substance Use Disorders?

Patients with past or current substance use may fear judgment or treatment changes if they disclose their use. This stigma can prevent honest conversations with their medical team. Feeling stigmatized can reduce the willingness of individuals with SUD to seek treatment.

Stigma remains a major barrier. Some healthcare providers are not trained to manage SUDs in cancer patients, leading to missed opportunities for care. Stigmatizing language and views can negatively influence health care provider perceptions of people with SUD, which can impact the care they provide.

Reducing Stigma and Improving Support

One approach that has shown great results is harm reduction. This means supporting patients in reducing risky behaviors without judgment. For example, rather than requiring someone to fully quit a substance, providers can offer ways to reduce harm while continuing cancer treatment. These can include safer use tips, mental health support, or starting SUD treatment when the patient is ready.

When harm reduction strategies are used with all patients, stigma can be reduced, and more people feel safe sharing their needs.

The way we name things impacts stigma around substance use disorders

There is a story behind every person, some wording perceived as popular, common or “harmless” can stigmatize people living with substance use disorders and prevent them for receiving the care they need. Reducing the stigma can start with simple things such as how we name things.

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n

\n Preferred terms that do not stigmatize \n	\n Common terms that might stigmatize \n	\n Why change the language we use? \n
\n Person or patient *with* a: \n \n \n Substance use disorder \n \n \n Opioid use disorder \n \n \n Alcohol use disorder \n \n \n	\n Someone who is a/an: \n \n \n Junkie \n \n \n Addict \n \n \n Alcoholic \n \n \n	\n \n \n Person-first language \n \n \n Demonstrates a person “has” a problem, rather than “is” the problem \n \n \n Avoids negative associations or personal blame \n \n \n
\n \n \n Use (illicit substance) \n \n \n Misuse (prescription medications) \n \n \n	\n \n \n Substance abuse \n \n \n	\n \n \n “Abuse” is associated with negative judgments and punishment \n \n \n
\n \n \n Substance-free \n \n \n Expected/unexpected findings \n \n \n	\n \n \n Clean or dirty \n \n \n Positive/negative \n \n \n	\n \n \n Preferred terms are clinically accurate, non-stigmatizing \n \n \n
\n \n \n Recovery \n \n \n Remission \n \n \n Substance-free \n \n \n	\n \n \n Clean \n \n \n Sober \n \n \n	\n \n \n Preferred terms are clinically accurate and non-stigmatizing, similar to other medical conditions \n \n \n
\n \n \n Addiction \n \n \n	\n \n \n Habit \n \n \n Behavior \n \n \n	\n \n \n Substance use disorders are medical conditions \n \n \n “Habit” or “behavior” is inaccurate and implies control \n \n \n

Chart from Addiction in Patients With Cancer: Challenges and Opportunities

Sourced from National Institute on Drug Abuse (2020)

Moving Toward More Inclusive, Effective Cancer Care

Patients with cancer who also use substances deserve care that addresses all aspects of their health. Integrating addiction services into cancer centers and training oncology providers in harm reduction and substance use management are important next steps.

Better education, open communication, and a compassionate approach can improve outcomes and make sure no patient feels left behind. Substance use is not a failure; it’s a health issue that deserves understanding and treatment, especially during cancer care.

Stay tuned for more articles at the HealthTree News Site, where we publish a wide variety of topics, from conference updates to treatment innovations. Click the button below to keep reading more articles.

For more information and help for people with substance use disorders, you can visit the following assistance resources:

SAMHSA - Substance Abuse and Mental Health Services https://www.samhsa.gov/

Medication Assistance Therapy Care Clinic https://www.matcareclinics.com/

American Addiction Centers https://drugabuse.com/addiction/health-issues/cancer/

CDC Mental Health Resources https://www.cdc.gov/mental-health/caring/index.html#:~:text=Key%20points,to%20the%20nearest%20crisis%20center.

American Society of Addiction Medicine https://www.asam.org/

Start Your Recovery Organization https://startyourrecovery.org/experiences/co-occurring-disorders

Sources:

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As part of Mental Health Awareness Month, we’ll cover the causes, symptoms, and ways to manage brain-related side effects (difficulty thinking, headaches, etc.) that can happen from blood cancer treatment.

How Blood Cancer Treatments and Other Risk Factors May Impact Brain Function

Several factors can contribute to changes in brain function as a result of blood cancer treatment.

The treatments themselves, like chemotherapy, targeted therapy, radiation, and immunotherapy, can affect brain health by:

Crossing the barrier that protects your brain and directly impacting brain cells.
Triggering inflammation through immune system activation, which clouds brain function.
Remaining oxidative stress after treatment—caused by too many free radicals and not enough antioxidants—can damage healthy cells and trigger inflammation, affecting areas like the brain.

Factors That Increase Your Risk

Having certain health conditions before starting blood cancer treatment can raise the risk of brain-related side effects afterward. These include past cognitive issues (memory loss or trouble concentrating), anemia, mood disorders, chronic stress, hormone imbalances, high blood pressure, poor sleep, nutrient deficiencies, diabetes, systemic inflammation, or recurring infections, among others.

Even without treatment, cancer cells can increase inflammation in the body, which may dampen brain function.

What Do Symptoms Look Like?

The brain-related symptoms you may experience from certain blood cancer treatments may include:

Mild to moderate symptoms: trouble thinking clearly, confusion, fatigue, headaches
More serious issues (rare): difficulty speaking, tremors, seizures

These symptoms are sometimes called chemo brain, brain fog, cognitive impairment, neurological issues, or ICANS (immune effector cell-associated neurotoxicity syndrome). They can be short-term or last longer, but in either case, it is important to communicate with your care team if you are experiencing any of these symptoms for the first time or if they are worsening.

Tips for Recovery

If your brain-related symptoms aren’t improving over time, it’s important to get help. Here are some supportive strategies:

Consult with your blood cancer specialist: Talk to your doctor about ways to manage treatment side effects. For example, if you're experiencing headaches from a cancer therapy, ask what can help. They might recommend adding a headache-relief medication, adjusting the dose, or switching to a different treatment.
Nutrition support: Work with a registered dietitian to reduce inflammation and address nutrient gaps that directly impact brain health.
Visit a functional neurologist: See a functional neurologist who can pinpoint which areas of your brain need support and create a personalized therapy plan using targeted eye, hand, or balance exercises to help strengthen them. They may also suggest adding certain medications. This differs from a neurologist, who focuses mostly on medication to treat symptoms.
Mental health support: A licensed therapist can help you manage stress, anxiety, or trauma, and teach coping skills—like mindfulness and breathing techniques—that may reduce inflammation and improve your quality of life.
Lifestyle habits: Getting enough sleep, staying hydrated, exercising moderately, and eating nutrient-dense foods can support brain health.

Coping support: As you work to regain full cognitive function, tips like using a planner, taking frequent breaks, and doing brain-stimulating activities like puzzles or reading can help you support yourself during recovery.

Key Takeaways

Brain-related side effects from blood cancer treatments can occur and range from mild brain fog to more serious neurological issues.

While these changes can be influenced by the treatments themselves and pre-existing health conditions, there are several supportive strategies—from nutrition and functional neurological therapy to mental health care and lifestyle habits—that may help manage symptoms and promote recovery.

Even if side effects are expected, working closely with your care team is key to finding the right solutions for your cognitive health and overall well-being.

Discover Patient-Reported Side Effect Solutions

Want to share side effects you've experienced during treatment and what helped you manage them? Or curious about what’s worked for other patients? Use HealthTree’s patient-reported side effect solutions tool to learn and contribute below!

Access Side Effect Solutions

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Sources:

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On April 30, 2025, the United States Senate Appropriations Committee gathered for a hearing to discuss the future of federal funding for biomedical research in the United States. This session engaged a variety of voices from committee members, physicians, patients, caregivers, and advocates.

The Committee's main responsibility is to distribute federal funds that ensure that agencies like the FDA and the NIH have the necessary resources to drive scientific discoveries.

During the hearing, several experts and advocates testified, sharing their views on the benefits of federal funding and the urgent need for continued investment in life-saving research.

Federal Funds Advance Discovery, Save Lives, and Offer Hope

For many years, the U.S. has prioritized biomedical research, trained the next generation of scientists, and accelerated the pace of disease-curing discoveries. In the last 30 years, cancer death rates have dropped by 34%. These improvements are a direct result of federally funded programs devoted to cancer prevention, early detection, and advancing treatment options.

Maintaining strong federal support allows researchers to keep making progress, develop new treatments faster, and expand access to clinical trials for patients across the country.

There was strong support from both political parties in attendance for maintaining—and not cutting—federal funding for biomedical research. Legislators on both sides agree that continued federal support is essential for helping agencies like the NIH and FDA build on past achievements and address pressing health challenges.

Committee Chair Susan Collins (R-ME) pointed out that the FDA has approved over 600 cancer treatments because of years of government-supported research. Agencies will need continued funding to build on this progress.

Senator Tammy Baldwin (D-WI) spoke about the long-term impact of cutting biomedical research funding, highlighting that cuts will likely lead to fewer medical student acceptances and research positions, slowing progress in finding new treatments.

Emily Stenson, a pediatric cancer advocate, shared her daughter Charlie’s experience with cancer and emphasized that federal funding for clinical trial research has given her family the hope that she believes every family facing a cancer diagnosis deserves. “Hope gets you through the hardest days. Sometimes hope is all you have. We need to be able to provide that to all families”.

Investing in Innovation and Public Health

Continued investment in health agencies promises not only medical advancements but also helps grow the economy and improve public health outcomes. The Committee’s discussion shows a strong commitment to advancing biomedical research and ensuring that the United States remains a leader in scientific innovation.

How You Can Help Advance Research Through Your Experience

In addition to federal funding, progress in cancer research also depends heavily on understanding the real-world experiences of people living with blood cancer. Your voice can directly shape the future of blood cancer treatment.

By using tools like HealthTree Cure Hub®, you can complete short yet impactful surveys about your diagnosis, treatments, and side effects. This information helps speed up research and leads to more personalized and effective care.

Click the buttons below to access these simple surveys and to learn the results of past patient-accelerated research.

Make an Impact with Brief Blood Cancer Surveys

News Updates on Real-World Research

Sources:

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When you or a loved one is diagnosed with acute myeloid leukemia (AML), understanding how the cancer affects the body becomes crucial. A recent study of 565 AML patients has revealed important insights about a condition called cachexia that can significantly impact treatment outcomes.

What is Cancer Cachexia?

Cancer cachexia is much more than ordinary weight loss. It's a complex condition that affects how your body maintains muscle and fat, how you feel about eating, and even how your body uses the energy from food. Your body's response to cancer triggers these changes in three main ways:

Cancer cells release signals that cause muscle and fat loss, even if you're eating well
Your appetite often decreases, leading to reduced food intake
Your body's metabolism changes, making it harder to use glucose (sugar) for energy

How Cachexia Can Affect AML Treatment Outcomes?

What the Research Tells Us

A comprehensive study followed AML patients with a median age of 67 years through their treatment journey. The researchers used something called the Weight Loss Grading Scale (WLGS) to track how cachexia affected patients over time. Here's what they discovered:

During treatment:

About one-third of patients (31%) showed significant weight loss at 3 months
This number decreased to 19% by the 12-month mark

These findings become particularly meaningful when we look at survival rates. Patients with more severe weight loss (grade 3 or higher) had a median survival time of 16.4 months, while those with less weight loss typically survived for about 25.7 months. Interestingly, the study found that while weight loss affected survival, it didn't significantly impact how quickly the disease might return (relapse time).

Cachexia Can Affect Results Regardless of Treatment Type

The study included patients receiving various types of treatment, including:

Chemotherapy only (58%)
Combinations of chemotherapy with targeted agents (36%)
Other (6%)

This diverse treatment background helps us understand how cachexia affects patients regardless of their specific treatment plan.

What This Means for You

If you're dealing with AML, these findings suggest that paying attention to weight changes, especially in the first three months of treatment, could be crucial. Here's what you can do:

Monitor your weight regularly
Keep your healthcare team informed about any changes
Work with a nutritionist who understands cancer care
Discuss your risk factors with your doctor, especially if you have intermediate or high-risk AML

Looking Ahead

While these findings might seem concerning, they're helping doctors better understand how to care for AML patients. Future studies are exploring whether adding specific treatments for cachexia might help improve outcomes, especially for patients with higher-risk disease.

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Join Our Community

At HealthTree, we want to make sure you have all the information you need to make decisions about your care and better navigate your disease. Through our free educational webinars and support resources, you can:

Learn from leading AML experts
Connect with other patients who understand your journey
Stay updated on the latest research
Access practical tips for managing your condition

Whether you're newly diagnosed or well into your treatment journey, understanding cachexia is an important part of managing AML. By staying informed and working closely with your healthcare team, you can better advocate for your health and potentially improve your treatment outcomes.

Want to learn more or share your experience? Join our next webinar or connect with our supportive community.

Explore Upcoming AML Webinars

Source:

The Impact of Weight Loss Grading Scale, a Measure of Cancer Cachexia, on Clinical Outcomes in Patients with Acute Myeloid Leukemia

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It's no secret that the last two months have been very tumultuous. Layoffs in very important parts of government, as well as potential cuts in very useful and popular programs, are causing havoc in our stock market and living rooms across the country and, in fact, the world. In this article, we'll explore how these changes might affect your healthcare and what steps you can take to protect yourself.

I have decided to review how some of these issues can affect you, how you can be aware of changes that might affect you, and what you can possibly do to mitigate negative impacts on your healthcare. Additionally, I will provide you with sources where you can find timely and relevant information that can help you navigate the best you can.

Understanding Medicare and Medicaid Changes

The Current Situation

Some of the issues we have seen before, others we haven't, so it is yet to be seen how the latter will shake out. The House passes a budget resolution instructing the House Energy and Commerce Committee to reduce the federal deficit by at least $800 billion over the next 10 years. In the resolution, Medicaid is not mentioned directly; however, because Medicaid is E&C's jurisdiction, the cuts are expected to come from Medicaid. The Congressional Budget Office early confirms this.

What These Cuts Mean

Major cuts to Medicaid are the only way to meet the House's budget resolution requirements. There are many ways to cut Medicaid. And as states administer Medicaid, they would be left raising revenue or cutting spending. Cutting Medicaid would mean dropping coverage for some people, eliminating coverage of high-cost optional benefits such as prescription drugs, or cutting payment rates to health plans and providers.

State-by-State Impact

Different policies would have different implications for states, with policies such as a per capita cap having widespread effects across all states and policies such as cuts to the federal share of funding for the Affordable Care Act (ACA) expansion. As subsidies are automatically set to expire at the end of 2026, some changes may not be implemented before then.

Additional Policy Changes

The cost-cutting will disproportionately affect red and blue states that have expanded Medicaid. Additional Medicaid policies that may be implemented include: limiting supplemental payments to hospitals, which accounted for one-fifth of all spending on hospital care in 2023. These cuts could disproportionately affect the healthcare industry, with the consequences being larger in states with greater reliance on such payments. Again, those with expanded Medicaid, additional proposed changes to Medicaid include work requirements. Some states have already started trying to implement this. Some of the concerns patients may have are making too much money to qualify for Medicaid and too much for the Affordable Care Act.

Impact on Social Security and Healthcare Access

Social Security Processing Delays

Social Security is also in the crosshairs, though the President has said he won't touch it. There is precedent to say he might. However, reductions in the workforce at the Social Security Administration will put an additional strain on application processing. In December, the average wait time for a Social Security disability application processing was 255 days, with a 1.2 million application backlog. With a reduction in the workforce, that processing timeline is sure to be extended.

Assisting people with enrollment in Medicare Parts A and B, along with Part D prescription benefits, Social Security Disability Income, Supplemental Security Income (SSI), and Social Security Retirement income will also be impacted.

Tips for Disability Applications

If you are going to apply for Social Security Disability Benefits, consider working with an attorney. This will help to make sure your paperwork is in good order when you first apply, and reduce errors and wait times. Make sure you start as early as possible to reduce a lapse in income and coverage.

Rural Healthcare Concerns

For those who live in rural areas, the closing of many medical facilities has created difficulty in accessing care. The cost of travel to get medical treatment may become more expensive. Telehealth has been a saving grace for many people. Unfortunately, the extension of telehealth faces uncertainty in Congress.

Treatment Access and Clinical Trial Updates

Supply Chain Concerns

The cost of prescription drugs can increase with a supply shortage, particularly for medicines coming from China, India, the EU, Canada, and Mexico. In fact, the majority of active pharmaceutical ingredients come from other countries, 70% from China and India. If there are shortages, it could exacerbate the already existing shortage. Go to the FDA database to see which therapies are in short supply.

Impact on Clinical Trials

Medicine shortages can affect clinical trials by causing them to pause or shut down because they may not have enough of the treatment needed for the study. If you are in a clinical trial, the care team will update you about any shortages or delays.

Research and Trial Availability

The National Institutes of Health has recently lost researchers and funding. These can reduce the number of clinical trials that are started and completed. If you are concerned about your clinical trial, contact the study team or the trial sponsor for updates.

Taking Action

A lot is going on right now, and we may be processing this for quite a while. This is definitely not a time to ignore what is going on, as one or more of these issues may affect you directly.

What can you do? Be aware of what's happening. Start budgeting for additional costs if you can. Advocate! Send letters to your state representatives. Call them! They want to hear from their constituents; after all, they want to stay in office. And if they aren't serving those who elected them, staying in office becomes a major challenge.

Stay Connected and Informed

Join me for regular updates and guidance through our Financial Connect channel, our bi-monthly Q&As, and webinars. Together, we can navigate these challenges and ensure you have the support you need.

Join the Financial Support Group

Sources:

HealthTree Webinar: Navigating Financial Uncertainty: Proactive Tips for Blood Cancer Patients and Families. March 4, 2025
American Hospital Association. Feb 2025 Fact Sheet: Telehealth Waivers and ACA
KFF: The Math is Conclusive: Major Medicaid Cuts are the Only Way to Meet House Budget Resolution Requirements. Alice Burns, March 7, 2025
KFF: Workforce Reduction at Social Security Could Affect Medicare and Medicaid Coverage. Juliette Cubanski, March 3, 2025

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Does a type of sugar called fructose impact cancer cells? Glucose, the main form of sugar in the blood, is known to be used by all cells, including cancer cells. Fructose is naturally found in certain fruits and vegetables but has also been increasingly added to food products over the last 50 years, notably as high-fructose corn syrup—an artificial mixture of fructose and glucose.

Researchers have been exploring whether fructose impacts specific types of solid-tumor cancer cells in mice. The findings of these studies offer new insights into how different sugars could affect cancer growth.

Oncology Registered Dietitian Shares Thoughts on Sugar and Cancer

Before examining these findings, it’s beneficial to understand some fundamental concepts about sugar and cancer, shared by Joan Elizondo, a registered dietitian specializing in oncology nutrition at the Huntsman Cancer Institute. During a webinar hosted by HealthTree, Elizondo explained:

\n
\"Foods containing any type of sugar or carbohydrate are broken down into glucose by the body. This glucose then pairs with insulin to enter our cells and provide them with energy. Excess energy gets stored for later use. While all cells utilize glucose, it does not necessarily mean that sugar causes cancer to spread or grow. Additionally, even without sugar or carbohydrate intake, the body can produce glucose from other sources like protein and fat. Thus, you cannot starve cancer cells of glucose without also starving your healthy cells.\"
\n

Elizondo also highlighted the link between added sugars and obesity, a known risk factor for cancer. By reducing intake of added sugars, one can decrease excess calorie consumption and maintain a healthier weight.

Reviewing Fructose’s Impact on Solid-Tumor Cancer Cells

Building on this knowledge, researchers specifically looked at how fructose affected melanoma, breast cancer, and cervical cancer cells in mice. They discovered that cancer cells cannot directly use fructose.

Instead, after fructose is metabolized in the liver, they use one of the byproducts—lysophosphatidylcholines (LPCs), a type of fat molecule— to build their outer membranes and grow. It is not yet known if this is how all cancer cells use fructose or only the ones in the study.

A significant aspect of the study involved blocking the protein KHK, which is responsible for breaking down fructose. This inhibition lowered the levels of the fat molecules or LPCs, thereby hindering the growth of cancer cells.

Contrary to what might be expected, feeding mice fructose supplements did not lead to weight gain or insulin resistance, which are commonly associated with increased cancer risk.

It's crucial to note that these findings are based on animal models, and the exact implications for humans are still to be determined. Further studies are planned to explore whether inhibiting KHK could slow cancer growth in humans without requiring dietary changes.

The researchers emphasized that this does not mean people should eliminate fructose from their diets but rather encourage moderation of fructose-containing foods in their natural forms, like fruits and vegetables.

An additional study that echoes the use of fructose in moderation studied people who ate it in excess. Excessive consumption of fructose, particularly in processed forms like high-fructose corn syrup, not only differs in how it’s metabolized from whole fruits and vegetables but can also increase inflammation, a known promoter of cancer growth. A notable finding was that this effect was observed more frequently in Black populations.

Understanding your risk status can help you take preventive measures. If you are concerned about ways to manage inflammation, please consult your doctor.

!AD!

Summary

Researchers have discovered that while certain solid tumor cancer cells cannot directly utilize fructose, they can use LPCs—fat molecules produced when fructose is metabolized in the liver—to construct their outer membranes.

Although these findings are based on animal studies and are preliminary, they advocate for moderation in fructose consumption, encouraging individuals to favor natural sources over processed forms like high-fructose corn syrup, which are metabolized differently.

This study not only highlights the unique ways fructose affects cancer cell metabolism but also suggests new avenues to restrict cancer cell growth, such as with KHK inhibitors.

Are you interested in helping researchers understand the correlation between diet and blood cancer? Click the button below to participate in our survey. Your answers are anonymous to researchers.

Take the Survey

Sources:

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Hospital readmissions can measure the quality of care provided to patients. Unplanned readmissions can affect patient outcomes, and they also cost the U.S. healthcare system an estimated $15-20 billion annually. Cancer patients, including those undergoing AML treatment, experience high readmission rates, ranging from 30% to 60%. The readmission burden is more significant for patients with lower socioeconomic status, showing the need to address income-based disparities in care.

We had the privilege of interviewing the lead investigator and presenter of this important study, Dr. Ayobami Olafimihan, who discussed how social and economic status and healthcare disparities might result in hospital readmissions and lower quality of care.

Analyzing a Decade of AML Readmissions in the U.S.

This retrospective analysis used the Nationwide Readmissions Database (NRD) for 2010, 2012, 2014, 2016, and 2018. The study included 181,432 hospitalizations of adult AML patients, stratified by median household income (MHOI):

Low Income (LIQ)
Middle Income
Upper Middle Income
High Income (HIQ)

Patients were followed for 30 days after discharge to identify all-cause readmissions and also identified those specifically for neutropenic fever. Other factors were also analyzed over time, including age and sex.

Rising readmission rates: Overall, 30-day all-cause readmission rates stood at 29.7% across the study period, with a significant upward trend from 2010 to 2018.
Age and income disparities: The mean age at the time of readmission was 59.9 years, with older patients more likely to belong to higher income groups.
Neutropenic fever readmissions: The overall 30-day neutropenic fever-specific readmission rate was 5.1%, and high-income patients had higher odds of being admitted to the hospital for neutropenic fever compared to low-income patients.
Mortality during readmissions declined from 10.0% in 2010 to 7.8% in 2018, reflecting improvements in inpatient care.

How Income Impacts AML Care

This study underscores the disproportionate burden of unplanned readmissions on low-income AML patients and highlights the critical need for interventions tailored to this population. Key recommendations include:

Transition of Care Programs: to address gaps in care after hospital discharge.
Targeted Social Support: to cover the specific needs of low-income patients, including financial assistance, transportation, and access to outpatient care.
Enhanced follow-up care to reduce the risk of complications like neutropenic fever.

Looking Forward

To improve the care throughout a patient's journey it's important to also consider socioeconomic disparities. By addressing them, patient outcomes can be improved, reduce healthcare costs, and bridge gaps in care for vulnerable populations. It is the job of healthcare professionals to recognize disparities and provide equal care that improves patient outcomes. For patients, self-advocacy is crucial, and understanding disparities can make a big impact when discussing the best treatment options and strategies. This study offers a roadmap for prioritizing socioeconomic factors in AML care strategies and calls for further research to implement effective, equitable solutions.

Keeping up to date with AML news and research is one step further into self-advocacy and advancements in patient-centered care. That’s why at HealthTree, we provide comprehensive updates for patients and caregivers.

Keep Reading More News

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The Importance of Patient Perspectives in Clinical Trial Research

Research shows that Patient-Reported Outcomes (PROs) are often not well-reported in cancer clinical trials. PROs are data directly from patients about the effects of treatment, including physical symptoms, emotional responses, and overall well-being. A review of studies on solid tumors found that PROs and Health-Related Quality of Life are frequently underreported. Even when reported, these measures often fail to address long-term impacts. Given the serious nature of blood cancer and its potential to affect daily living and quality of life, it is especially important to consider PROs when studying the effectiveness of a treatment

Measuring Data in Clinical Trial Research

In clinical trials, researchers establish endpoints—measurable data that show how effective a treatment is. There are three main types of endpoints: primary, secondary, and exploratory.

Primary endpoints are outcomes that help to determine how safe and effective the treatment is. These endpoints typically address the main research hypothesis. Secondary endpoints provide additional information about a treatment's effects, often evaluating side effects or quality of life. Exploratory endpoints may reveal patterns or trends and help develop new hypotheses for future research.

Endpoints provide crucial information that guides treatment decisions and shapes the future of blood cancer research. A typical endpoint in blood cancer trials is survival, or whether the treatment helps a patient live longer.

Although PROs are Measured in Most Trials, They Are Not Always Reported

A recent study reviewed publications from eight leading oncology journals to examine how often patient-reported treatment impacts are collected during clinical trials and shared in journal articles. The study looked at 90 blood cancer clinical trials to determine whether PROs were used as an endpoint and whether that data was included in primary trial publications.

Out of the 90 clinical trials, 66 included PROs as an endpoint. In these trials, PROs were a primary endpoint in one trial, a secondary endpoint in 50 trials, and an exploratory endpoint in 15 trials.

However, although PRO data was collected in the majority of studies, fewer than half of these studies reported the data in the primary publication. Furthermore, the PRO data that was published showed either improvement or no change in symptoms, with no reports of worsening symptoms. This raises the concern that worsening symptoms may be underreported in clinical trial publications.

HealthTree is Dedicated to Ensuring Patient Perspectives Are Shared

PRO data provides important insights for both researchers and patients. While PROs are often included as an endpoint in blood cancer clinical trials, they are frequently not reported in the final publications. Further, when PRO data is reported, it typically shows improvement or no change, indicating bias in the way the data is presented. When PRO data is not shared, essential details about the patient experience are lost. Including PRO data in studies and publications is vital for helping providers and patients make more informed decisions about care.

HealthTree is committed to elevating patient perspectives. To achieve this, we publish our research at medical conferences and online to ensure that information about patient experiences is widely available to researchers, medical providers, patients, and caregivers.

To participate in research with HealthTree by taking simple surveys to collect patient-reported outcomes, like in the above article, follow the link below.

HealthTree Research

Source:

Patient-Reported Outcomes in Phase 3 Clinical Trials for Blood Cancers: A Systematic Review

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Last week at the HealthTree AML Webinar, AML specialist Dr. Evan Chen, attending physician in the adult AML program at the Dana Farber Cancer Institute and Instructor in Medicine at Harvard Medical School gave a comprehensive view for patients to the steps after being diagnosed with AML which involve understanding the disease, deciding which treatment path to take, and managing symptoms.

The presentation covered how AML develops, the most common symptoms and affected cells. Dr. Chen guided us through the way AML is diagnosed, highlighting how patients can self-advocate and participate in their treatment decisions at every step of their journey after diagnosis. Dr. Chen's presentation also reminded us that many people can accompany you, such as family, friends, social workers, support and community groups, and a medical team.

You can join the HealthTree community and become a part of our Regional Cure Teams!

Join My Cure Team

The Treatment Roadmap After Diagnosis

The roadmap starts after the bone marrow biopsy that confirms AML diagnosis. First, your doctor discusses your treatment options with you. These options depend on your priorities, AML characteristics, and therapeutic goals.

The first step is different for each patient, but it can go two ways, depending on the decision made for step 2:

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n

Step 1

Step 2

Intensive treatment for 2-3 months

Allogeneic Bone Marrow Transplant

Less intensive treatment that is given

until the treatment stops working.

No Transplant

Step 2 is crucial as it impacts the whole treatment plan after diagnosis.

Looking at the Big Picture for Choosing the Best Option

Dr. Chen explained the duration of each treatment step, from initial treatment to transplant and, if chosen, post-transplant treatment, all in an effort to ensure that the treatment chosen ensures a longer period of remission. The purpose of intensive treatment before a transplant is to prepare the body and induce a remission. Dr. Chen also addressed the fact that patients can actively participate in their treatment decisions and be informed of what they will undergo before starting to align their priorities, such as quality of life, with the treatments.

What is Intensive Treatment for AML?

Usually, intensive treatment is given before a transplant, but in some cases, when a transplant is not an option, it can be given as well. Sometimes this type of treatment requires a brief hospital stay to monitor for side effects.

Intensive treatment has two parts:

Induction: The goal is induce a remission this is when a hospital stay is more likely to happen, the time varies between 4-6 weeks.
Consolidation: Used for reinforce the remission and prevent relapse while waiting for a transplant.

Keep Reading AML Treatments

Transplant Insights

For AML, only allogeneic stem transplantation is possible. Make sure to have all your questions cleared before deciding what is best for you.

In this event, Dr. Chen responded to the most common questions around transplantation, such as:

When am I ready for a transplant? He described the main conditions to be considered ready for transplantation.
How do I find a transplant donor? He explained the importance of having a BMT team to accelerate finding a donor.

Watch the full recording to learn more about Dr. Chen’s presentation.

Watch the Recording

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Understanding frailty is crucial for patients as it is typically associated with negative outcomes. However, it is helpful for both patients and their healthcare team to consider whether or not they meet frailty criteria, as they can create strategies to improve the quality of life and reduce risks in frail patients. Research on frail patients can also be difficult, especially in some interventions where the exclusion criteria might cover some characteristics of frail patients. However, there is a need to continue exploring ways to improve the outcomes in this group.

In this article, you’ll learn the most important updates on personalizing treatment for those patients with AML considered frail. These were presented by blood cancer experts at the 66th ASH conference.

What is Frailty?

Frailty is a term that refers to certain symptoms that make a person more susceptible to experiencing adverse effects and incidents such as falls. The criteria is clinical and a medical professional can assess it with the clinical history and physical examination. To be considered frail, one must meet the following criteria:

Increased vulnerability resulting from aging-associated decline in multiple body systems and an affected ability to cope with everyday or acute challenges.
Low grip strength, low energy, slowed walking speed, low physical activity, and/or unintentional weight loss.

Frailty and Long-Term Survival Among Older Adults with Blood Cancer

The Older Adult Hematologic Malignancy (OHM) Program at Dana-Farber Cancer Institute conducted a study on 1271 older adults (median age 78) with blood cancer to evaluate three frailty assessment tools and how they relate to survival outcomes. All tools could reveal that there is a relationship between the dose of medication and frailty severity and survival. These findings highlight that assessing frailty in older adults before they receive cancer treatment can improve their care and outcomes.

Based on the assessment tools, 52% of the 1271 participants reported weak grip strength, 31% had an unintentional weight loss of ≥10 pounds in the past year, and 10% experienced exhaustion.

All frailty assessment tools were able to identify patients whose frailty levels were associated with higher mortality.

Impact of Frailty Assessment on Hospital Stays in AML Patients

This population-based study of 5450 patients with AML analyzed how frailty impacts health resource utilization. The findings highlight that assessing frailty is essential for predicting healthcare resource utilization. Frailty was a stronger determinant than chemotherapy intensity or secondary AML, making it a crucial factor for tailoring AML treatment strategies. When addressed, it could potentially reduce healthcare resource utilization while improving patient outcomes.

Patient Distribution by Fitness Status: 32.1% of patients didn’t meet frailty criteria, and 33.5% were evaluated as frail. Frailty was more prevalent in patients over 60 years old (42.2%).
Median overall survival: 12.5 months (non-frail had 17.6 months, while frail patients had 8.5 months).
Healthcare Resource Utilization (HRU): Frail patients required longer hospital stays, 81% longer intensive care unit (ICU) stays, and 12% more frequent admissions.
Age Associations: Ages over 65 are correlated with higher intensive care unit admissions, longer hospital stays, and more hospital admissions.

The Impact of Frailty on Outcomes and Quality of Life in Allo-HCT

This multicenter study, conducted across 13 Spanish institutions, evaluated the feasibility and impact of using the HCT Frailty Scale in 403 adult patients. The study shows that frailty can change over time. Hence, it’s important to keep reassessing it to adjust treatment strategies and other supportive measures because there are different factors that can impact frailty such as treatment, symptoms, and time. Findings emphasize the importance of frailty assessment and tailored interventions to optimize allo-HCT outcomes.

Key Study Findings

Frailty assessment integration: The HCT Frailty Scale assessment takes only 8-10 minutes, and when efficiently integrated into clinical practice, it can effectively identify frailty without additional resources. It is a vital tool that is easy to integrate and it provides crucial information to the care team.
Pre-habilitation benefits: Patients who underwent pre-habilitation had a significantly lower likelihood of frailty at admission for stem cell transplant.
Stem cell transplant impact on frailty: The study showed that after 1 year of receiving a stem cell transplant, frailty was reduced by 6.4%.
Frailty correlated with lower 1-year overall survival (OS) rates.
Risk factors: Some indicators, such as active disease, abnormal cognitive screening, and acute graft versus host disease, are considered to predict frailty.

Conclusions

The abstracts mentioned above shed light on the importance of frailty assessment in providing patients with better treatments, preventing longer hospitalizations, and improving overall survival.

If you are a newly diagnosed blood cancer patient and want to know more about patient-centered care and comprehensive updates, we have more in-depth articles available here.

Sources:

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The excitement around menin inhibitors, a new class of targeted therapy for leukemia, is building. And for good reason: these new oral medications are showing promising results for patients with specific genetic changes in their leukemia cells.

\n
\"Menin inhibitors are a very exciting new type of therapy,\" explains Dr. Amer Zeidan, Professor of Medicine and Chief of Hematologic Malignancies at Yale University. \"They are pills that target specific alterations that occur in around 40% of patients with acute leukemia.\"
\n

A Treatment Twenty Years in the Making

The story of menin inhibitors began almost two decades ago, initially driven by pediatric oncologists seeking better treatments for infants with a particularly challenging type of acute lymphoblastic leukemia (ALL). Through years of careful research, scientists discovered that blocking the interaction between two proteins - menin and KMT2A - could force leukemia cells to mature into normal cells. This fundamental discovery has now led to a new class of treatments that could help both children and adults with certain types of leukemia.

What Are Menin Inhibitors and Who Could Benefit?

Menin inhibitors are targeted therapies - meaning they're designed to attack specific features of leukemia cells while largely sparing healthy cells. Your doctor might consider a menin inhibitor if your leukemia has specific genetic features:

NPM1 mutations: These are more common in younger patients and in those whose leukemia cells look normal under the microscope (what doctors call \"normal karyotype\"). About 30% of AML patients have this mutation.
KMT2A rearrangements: These occur in 5-10% of patients with acute leukemia. Your doctor might particularly suspect this if you've had previous chemotherapy for another cancer, especially breast cancer or lymphoma. These changes often occur in young children with ALL and in a type of AML where the leukemia cells look like monocytes (a type of white blood cell).

\n
\"Between these two alterations, around 40% of patients will have one of those changes. This targeted therapy follows the path of other targeted therapies we have used in AML, such as IDH inhibitors and FLT3 inhibitors,\" notes Dr. Zeidan.
\n

The Current Landscape: Multiple Menin Inhibitors in Development

Early clinical trials with different menin inhibitors are showing some consistent patterns:

About 60% of patients show some response to treatment
Around 25% or more achieve a complete remission
For those who respond, the benefits typically last about 6.5 months
Many patients who respond can proceed to stem cell transplant, which might provide longer-term control of their leukemia
The primary difference between menin inhibitors may be largely related to their safety profile

Several menin inhibitors are being studied:

Revumenib:

The first FDA-approved menin inhibitor (We'll have a detailed article about revumenib coming soon!)

Ziftomenib:

Combined with standard chemotherapy (7+3) in newly diagnosed AML patients
Impressive early results:\n
- Overall, 91% of patients responded to this treatment.
- The majority of patients (>80% in all subgroups) showed a complete remission of leukemia cells, including both NPM1-mutated patients and those with KMT2A rearrangements
- 76% of patients achieved MRD negativity (no detectable disease using sensitive testing)
\n

Based on the encouraging early results, there are now multiple trials underway investigating ziftomenib for both newly diagnosed and relapsed patients with acute leukemia. Additionally, an expanded access program has been established for patients with acute leukemia who have exhausted all other treatment options.

Bleximenib:

The latest results are from a study with 146 patients with relapsed/refractory acute leukemia, mostly AML\n
- Nearly 50% overall response rate, 38% of patients achieved complete remission, and 14% of patients were able to proceed to transplant so far, although the study is still ongoing
\n
When administered in combination with intensive chemotherapy to treat patients with newly diagnosed AML:\n
- Almost all patients quickly showed some level of response, and 86% achieved a complete remission
\n

Bleximenib is also moving forward in clinical development and is currently being studied in multiple clinical trials. The investigators shared that they are very excited to see these response rates, but that they are still on the learning curve with these agents and hypervigilant to make sure they are administered safely to patients who can benefit the most.

Enzomenib:

Enzomenib was designed to improve its specificity to hit its target, potentially reducing the side effects
It has shown activity both when administered alone and when combined with other medications
Response rates:\n
- 65.2% in KMT2A-rearranged leukemia
- 58.8% in NPM1-mutated leukemia
\n
Some patients (34% with KMT2A and 12% with NPM1) were able to proceed to allogeneic transplant
Notably, researchers did not have to alter the dose of enzomenib when prescribing an antifungal medication (also called an azole), which are frequently used to prevent infections in patients with leukemia.

Enzomenib is being studied in an international phase 1/2 study, which is still recruiting participants as of April 2025

What to Know About Menin Inhibitors Side Effects

While each menin inhibitor has its own safety profile, your healthcare team will help you monitor for and manage potential side effects. Here's what you need to know:

Differentiation Syndrome (DS):

Occurs in 10-15% of patients, and it is due to the rapid death of a large number of leukemia cells
Signs include: fever, breathing difficulties, fluid retention or swelling, rashes, low blood pressure, or even kidney failure

When treated early, it is manageable with temporary treatment interruption and steroids, so it is key that patients report any symptoms as soon as possible so the care team can treat them early.

Blood Count Changes:

Changes are common, especially when menin inhibitors are given in combination with chemotherapy
Patients take regular blood tests to monitor the cell counts
Significant changes in cell counts may lead to adjustments in the medication doses.

General Side Effects:

Nausea and vomiting (particularly with some agents)
Generally manageable with supportive care
Patients need to take their temperature twice daily

Managing Expectations

While the early results with menin inhibitors are encouraging, leading experts emphasize the importance of careful research. Experts are eagerly waiting for results from larger and randomized trials, which compare new treatments directly with current standards. These are essential to understand truly:

How long do responses last
Whether patients live longer with this treatment
Long-term side effects
Who benefits most from these treatments

\n
As Dr. Laura Michaelis from the Medical College of Wisconsin notes, \"All the data we have so far comes from non-comparative studies [there is no control arm]. We need to wait for randomized trials to really know the impact of these new treatments.\"
\n

Find Open Clinical Trials with Menin Inhibitors

\n
\"When you have a good drug that is active, you try to combine it in earlier lines of treatment with other standard of care treatments,\" explains Dr. Zeidan.
\n

This is exactly what's happening with menin inhibitors:

Studies combining them with standard chemotherapy
Trials with venetoclax and azacitidine combinations
Thoroughly being studied for newly diagnosed patients, relapsed/refractory, and also as maintenance after transplant

With HealthTree's Clinical Trial Finder, you can review all the clinical trials with menin inhibitors that are currently looking for patients with leukemia. If you connect your medical records, our Patient Navigators will also be able to assist you in understanding your eligibility to participate in these studies. Create a free Cure Hub account below and start exploring all your options:

Find Open Studies with Menin Inhibitors

Watch our full interview below with Dr. Zeidan, who discusses the latest menin inhibitor research.

What This Means for Patients

If you have AML or ALL, your doctor might test your leukemia cells for NPM1 mutations or KMT2A rearrangements. This testing helps determine if a menin inhibitor might be right for you now or in the future.

Remember: This is an exciting time in leukemia treatment, with new options becoming available for specific genetic changes. Talk to your healthcare team about whether genetic testing and menin inhibitors might be right for your situation.

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Continue learning about menin inhibitors from the experts. Click here to listen to Dr. Joshua Zeidner's experience with these revolutionary new treatments.

Continue Reading Leukemia News

Sources:

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For older patients over the age of 75 or those who can’t receive intensive chemotherapy, the combination of venetoclax with a hypomethylating agent (Ven/HMA) offers a highly effective alternative. However, the long-term curative potential of this regimen remains uncertain.

Dr. Andrew Zale, resident at The Johns Hopkins Hospital, shared the findings of a retrospective study at the 66th annual ASH conference. This study focused on NPM1-mutated AML patients without FLT3-ITD mutations, and theorized that their AML can be cured with intensive chemotherapy alone.

A retrospective analysis compared overall survival (OS) between patients with favorable-risk NPM1-mutated AML treated with either intensive chemotherapy or venetoclax combined with a hypomethylating agent. The study analyzed 55 patients, aged 60 to 75, from the Johns Hopkins institutional database and used advanced statistical methods to evaluate survival outcomes and contributing factors.

Key Study Findings

Patients treated with intensive chemotherapy were younger and more likely to have undergone treatment before the FDA approved venetoclax
A higher proportion of patients, 69%, underwent transplantation at first remission
Response and Survival Outcomes: Response rates were similar between the two groups. Median overall survival was 6.2 years for the intensive chemotherapy group compared to 4.9 years for the Ven/HMA group.
Factors Influencing Survival:\n
- Higher baseline white blood cell counts were associated with worse survival outcomes
- Transplantation in first remission significantly improved survival
\n

Among Ven/HMA-treated patients who underwent transplantation (37%), survival outcomes were excellent. None experienced a relapse, and only one patient passed due to non-relapse causes.

Takeaway Message

For patients aged 60 to 75 with favorable-risk NPM1-mutated AML, both intensive chemotherapy and venetoclax/hypomethylating agents can offer comparable responses, which can lead to eligibility for stem cell transplant and ultimately, comparable survival outcomes. Choosing between these therapies depends on the patient’s characteristics and individual preferences.

This analysis emphasizes the importance of tailoring treatment decisions to the unique circumstances of each patient. It also highlights the need for alternative therapy options that further improve outcomes, as well as next-generation sequencing for measurable residual disease testing. These findings provide valuable guidance for patients and caregivers navigating treatment options and underscore the evolving landscape of AML management.

Learn More With HealthTree!

If you are interested in keeping up to date with more AML news you can bookmark the HealthTree News site, and explore other interesting and comprehensive articles, made just for you!

Keep Reading More News

","language":"EN","metaDescription":"Learn about survival outcomes for older NPM1-mutated AML patients treated with chemotherapy or venetoclax and hypomethylating agents.","metaTitle":"Treatment Insights for NPM1-Mutated AML Patients","publishedAt":{"_type":"Date","value":"Wed Apr 02 2025 06:00:00 GMT+0000 (Coordinated Universal Time)"},"seoKeywords":"NPM1-mutated AML, AML survival outcomes, venetoclax treatment, hypomethylating agents, Johns Hopkins study, AML treatment options, AML intensive chemotherapy, AML patient care, favorable-risk AML, AML research findings","slug":"ash-24-intensive-chemo-vs-hma-for-aml","status":"ACTIVE","title":"What Works Better for AML: Intensive Chemotherapy or Venetoclax/HMAs?","updatedAt":{"_type":"Date","value":"Fri Mar 28 2025 23:27:59 GMT+0000 (Coordinated Universal Time)"}},"included":{},"ref":{"_type":"DocumentReference","path":"apps/community/articles/S551cSujhuSJI4tN4AGx"},"snapshot":{"exists":true,"id":"S551cSujhuSJI4tN4AGx","ref":{"_type":"DocumentReference","path":"apps/community/articles/S551cSujhuSJI4tN4AGx"}}},{"data":{"author":{"_type":"DocumentReference","path":"apps/community/authors/GxAhXAnh3drV4xY5Vf3A-1620"},"category":{"_type":"DocumentReference","path":"apps/community/categories/MB3xw38fuKkx0LdszsrL"},"createdAt":{"_type":"Date","value":"Fri Feb 14 2025 18:03:59 GMT+0000 (Coordinated Universal Time)"},"disease":{"_type":"DocumentReference","path":"diseases/WCJo8IouncjDW6exT1YS"},"diseases":[{"_type":"DocumentReference","path":"diseases/WCJo8IouncjDW6exT1YS"}],"headerImageUrl":"https://healthtree.org/images-resize?imageUrl=https%253A%252F%252Ffirebasestorage.googleapis.com%252Fv0%252Fb%252Fhealthtree-production.appspot.com%252Fo%252Fgallery%25252Fpublic%25252Ftime_d47e24e3-18ba-4b3f-b84a-bd66fc41f83f.jpg%253Falt%253Dmedia","htmlContent":"

A recent study examined how the time between an acute myeloid leukemia (AML) diagnosis and the start of treatment affects patient outcomes. The research focused on 488 adults in the United States who began treatment with a combination of hypomethylating agents (HMAs) and venetoclax, a common therapy for AML.

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Key Findings

Longer Time to Treatment (TDT): The study found that patients who had a longer period between diagnosis and the start of treatment, experienced better overall survival rates. This suggests that taking additional time for thorough disease assessment and treatment planning may be beneficial.
Comprehensive evaluation: Delaying treatment allowed healthcare providers to conduct a complete appraisal of the disease's biology, leading to more personalized and effective treatment strategies.
Patient wellbeing: The findings indicate that improving a patient's general health and performance status before beginning therapy could enhance treatment outcomes.

Implications for AML Patients and Caregivers

These results, shared at the ASH 2024 Conference, suggest that immediately starting treatment after an AML diagnosis may not always be necessary. Allowing time for comprehensive evaluations and personalized treatment planning can lead to better survival outcomes.

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“A lot of times, [when] patients first get diagnosed, they may have an infection, they may need transfusions… to see a physical therapist… a nutritionist…we want to focus on optimizing patient’s care outside of the fact that they have newly diagnosed AML,” shares Samuel Yates, MD, MS, the primary investigator on the study.
\n

Patients and caregivers should feel empowered to discuss the timing of treatment initiation with their healthcare team to ensure the best possible approach is taken.

Watching the following interview can provide further insights into the study's findings and their implications for AML treatment:

For further learning on this topic, check out the following webinar on AML Treatment with Dr. James Dugan.

View the Webinar

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Source:

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Impact of Time from Diagnosis to Treatment on Outcomes of Adults with AML Treated with HMA and Venetoclax: A US-Based, Multi-Center, Real-World, Retrospective Analysis from the Consortium on Myeloid Malignancies and Neoplastic Diseases (COMMAND)
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Understanding CAR-T Options for Multiple Myeloma

Ciltacabtagene autoleucel (Carvykti or cilta-cel, marketed by Johnson & Johnson/Legend Biotech) and idecabtagene vicleucel (Abecma or ide-cel, marketed by Bristol Myers Squib) are currently the only two approved CAR T-cell products for myeloma. In addition to their current indication, there are multiple ongoing clinical trials to have these CAR-T therapies moved into earlier use, for example, following diagnosis.

Let us turn our attention to our fellow patients now. At some point in our treatment journey, we may be faced with the question of whether CAR-T treatment may be an option to extend our lives. But, how to choose? First and foremost, we must turn to our myeloma specialist for guidance. He/she will have first-hand knowledge of what is best for a given patient, knowing the patient’s individual health history.

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Comparing Clinical Outcomes: A Retrospective Analysis

Because we can’t compare two different clinical trials that were not designed for that goal, and we don’t have any clinical trials comparing both products, the sources we can use are retrospective analysis. These are a type of study where researchers look back at existing data and analyze different outcomes. For example, they can use the medical records and patient histories from one or more cancer centers to identify patterns, the incidence of a rare side effect, or to compare different treatment strategies. While these studies can provide valuable insights, they rely on previously collected data, which can limit their accuracy and the ability to establish cause-and-effect relationships when compared to prospective studies.

The Journal of Clinical Oncology has recently published a retrospective study comparing the outcomes of a large cohort of patients (386 for Abecma and 255 for Carvykti). The lead author of the study was also the lead of a presentation on the same subject at the most recent annual forum of the American Society of Hematology. The research team published the following results.

Please note that the information below is using Abecma as a “referent” – in other words, Carvykti results are presented using Abecma as a base that is set to 1.00 (which makes the comparison easier).

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n

\n Outcomes \n	\n Ide-cel (Abecma) \n	\n Cilta-cel (Carvykti) \n
\n Safety \n	\n % Patients \n	\n Referent = 1.00 \n	\n % Patients \n	\n Compared to the referent \n
\n Any CRS \n	\n 84% \n	\n 1.00 \n	\n 75% \n	\n 0.69 \n
\n Severe CRS ≥3 \n	\n 2% \n	\n 1.00 \n	\n 5% \n	\n 6.80 \n
\n Any ICANS \n	\n 22% \n	\n 1.00 \n	\n 14% \n	\n 0.82 \n
\n Severe CRS ≥3 \n	\n 4% \n	\n 1.00 \n	\n 4% \n	\n 1.54 \n
\n Delayed Neurotoxicity \n	\n 0.6% \n	\n 1.00 \n	\n 10% \n	\n 20.07 \n
\n Infections \n	\n 35% \n	\n 1.00 \n	\n 47% \n	\n 2.03 \n
\n Secondary Malignancies \n	\n 5% \n	\n 1.00 \n	\n 9% \n	\n 1.77 \n
\n Second Primary \n Malignancy: MDS, AML, Lymphoma \n	\n 2% \n	\n 1.00 \n	\n 2% \n	\n 0.94 \n
\n Severe Cytopenia day = 30 \n	\n 58% \n	\n 1.00 \n	\n 50% \n	\n 0.97 \n
\n Severe Cytopenia day = 90 \n	\n 31% \n	\n 1.00 \n	\n 25% \n	\n 0.92 \n
\n Response \n	\n % Patients \n	\n Referent = 1.00 \n	\n % Patients \n	\n Compared to the referent \n
\n Best ORR (≥ PR) \n	\n 79% \n	\n 1.00 \n	\n 89% \n	\n 1.6 \n
\n Best CR or better \n	\n 47% \n	\n 1.00 \n	\n 70% \n	\n 2.42 \n

Acronyms: AML, acute myeloid leukemia; CR, complete response; CRS, cytokine release syndrome; ICANS, Immune Effector Cell-Associated Neurotoxicity Syndrome; MDS, myelodysplastic syndrome; ORR, overall response rate

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Key Differences Between Carvykti and Abecma

The authors summarize their conclusions for this comparison:

A higher number of patients showed a response to Carvykti, including a higher complete response rate when compared to Abecma. This advantage was also seen in different patient subgroups, such as those with extramedullary disease, high-risk cytogenetics, prior exposure to BCMA-therapy, or older age. Higher response rates also translated into longer survival outcomes.
Patients treated with Carvykti also experienced higher rates of certain side effects and toxicities, including severe CRS, delayed neurotoxicities, and infections. Researchers also reported a trend towards higher incidence of secondary malignancies.
There were no differences in other toxicity rates and non-relapse mortality.

Making an Informed Treatment Decision

As mentioned earlier, please talk to your myeloma specialist! It's important to stay updated on new therapies, especially CAR T-cell treatments. While promising, ongoing studies are still revealing how to use these therapies effectively and who may benefit the most.

If you have any questions or concerns about the latest data, don’t hesitate to discuss them with your medical team. Each situation is unique, and considering factors like previous treatments and other health conditions is vital in choosing the best strategy for you.

Stay informed, as it can help you engage in meaningful conversations about your treatment options. Click below to keep reading the latest treatment advances in myeloma:

NEWS

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What is Cancer Cachexia?

Cancer cells release signals that cause muscle and fat loss, even if you're eating well
Your appetite often decreases, leading to reduced food intake
Your body's metabolism changes, making it harder to use glucose (sugar) for energy

How Cachexia Can Affect AML Treatment Outcomes?

What the Research Tells Us

During treatment:

About one-third of patients (31%) showed significant weight loss at 3 months
This number decreased to 19% by the 12-month mark

Cachexia Can Affect Results Regardless of Treatment Type

The study included patients receiving various types of treatment, including:

Chemotherapy only (58%)
Combinations of chemotherapy with targeted agents (36%)
Other (6%)

This diverse treatment background helps us understand how cachexia affects patients regardless of their specific treatment plan.

What This Means for You

If you're dealing with AML, these findings suggest that paying attention to weight changes, especially in the first three months of treatment, could be crucial. Here's what you can do:

Monitor your weight regularly
Keep your healthcare team informed about any changes
Work with a nutritionist who understands cancer care
Discuss your risk factors with your doctor, especially if you have intermediate or high-risk AML

Looking Ahead

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Join Our Community

Learn from leading AML experts
Connect with other patients who understand your journey
Stay updated on the latest research
Access practical tips for managing your condition

Want to learn more or share your experience? Join our next webinar or connect with our supportive community.

Explore Upcoming AML Webinars

Source:

The Impact of Weight Loss Grading Scale, a Measure of Cancer Cachexia, on Clinical Outcomes in Patients with Acute Myeloid Leukemia

Thinking about joining a clinical trial? Join our final episode for the season where we answer common patient concerns, bust myths, and explain how trials work, who they’re for, and why they’re critical to advancing treatment.

Thank you for listening! Reach out to Mary at mary@healthtree.org to share your thoughts about today's episode.

To keep learning about today's topic, check out these additional resources mentioned in today's episode!

Join Cure Hub Now!

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If you want to talk to other listeners about this episode, join HealthTree Connect below and start the conversation!

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What better way to kick off 2025 than with a discussion about the transformative power of nutrition in AML care? Our expert speakers, Francesca Castro, and Peter Adintori, brought their wealth of knowledge to the table, offering actionable strategies for managing the nutrition side effects of AML treatment while laying the foundation for a healthier year ahead. If you’ve ever wondered how tailored nutrition can fuel recovery and improve energy levels, this is a conversation you won’t want to miss.

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• [41:00] What dietary considerations are essential before, during, and after a transplant?

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