Topic of interest: Leukemia Treatment and Management.Articles: 1. Development of a dried blood spot sampling method towards therapeutic monitoring of radotinib in the treatment of chronic myeloid leukaemia Citation: Lee, J., Jung, S. Y., Choi, M., Park, J., Park, S., Lim, S., Cho, K. H., Oh, S. Y., Ha, J., Kim, D., & Lee, J. (2020). Development of a dried blood spot sampling method towards therapeutic monitoring of radotinib in the treatment of chronic myeloid leukaemia. Journal of Clinical Pharmacy and Therapeutics, 45(5), 1006–1013. https://doi.org/10.1111/jcpt.13124 2. Treatment of Relapsed Acute Myeloid Leukemia Citation: Thol, F., & Ganser, A. (2020). Treatment of relapsed acute myeloid leukemia. Current Treatment Options in Oncology, 21(8). https://doi.org/10.1007/s11864020-00765-5 3. Quality of life among chronic myeloid leukemia patients in the second‑line treatment with nilotinib and infuential factors Citation: Nguyen, C. T. T., Nguyen, B. T., Nguyen, T. T. T., Petrelli, F., Scuri, S., & Grappasonni, I. (2021). Quality of life among chronic myeloid leukemia patients in the second-line treatment with nilotinib and influential factors. Quality of Life Research. https://doi.org/10.1007/s11136-021-02952-9 4. Management of Chronic Myeloid Leukemia in Advanced Phase Citation: Bonifacio, M. (2019). Management of Chronic Myeloid Leukemia in Advanced Phase. Frontiers. Retrieved October 11, 2022, from https://www.frontiersin.org/articles/10.3389/fonc.2019.01132/full 5. How I treat acute myeloid leukemia in the era of new drugs Citation: DiNardo, C. D., & Wei, A. H. (2020). How I treat acute myeloid leukemia in the era of new drugs. Blood, 135(2), 85-96. https://ashpublications.org/blood/article/135/2/85/428884/How-I-treat-acutemyeloid-leukemia-in-the-era-of Summaries 1. Dried blood spot (DBS) sampling is a minimally invasive method of blood sampling that enables the monitoring of drug concentrations to be more convenient. This study aimed to develop a DBS sampling method for an accurate and precise prediction of radotinib plasma concentrations (Cp) in patients with chronic myeloid leukemia (CML). Dried blood spots and venous blood samples were simultaneously collected from fifty CML patients who had been receiving radotinib for at least a week. Radotinib concentrations were measured using a high-performance liquid chromatographic method with tandem mass spectrometric detection. Unmeasured Cp was predicted directly based on a Deming regression between DBS concentrations (CDBS) and Cp. Unmeasured Cp was also predicted from CDBS corrected by each patient's hematocrit (Hct). Both prediction methods were evaluated for their accuracy and precision using Deming regression and Bland-Altman analysis. The Deming regression equation between CDBS and Cp was obtained as follows: Cp = 1.34∙CDBS + 4.26 (r2 = .97). Cp was directly predictable using Cp, pred1 = 1.34∙CDBS + 4.26. With Hct correction, Cp was alternatively predictable using Cp, pred2 = CDBS/ (1–Hct + Hct2). The slopes of the Deming regression line between predicted and measured Cp were 0.99 and 1.02 for the direct and Hct-corrected methods, respectively. The mean biases (accuracy) were −0.44% and 1.6% with the 95% limits of agreement (precision) of −22.4% to 21.5% and −20.5% to 23.7%, respectively. More than 93% of predicted and measured Cp pairs had their differences within 20% of the mean of each pair in both methods. Radotinib CDBS are highly correlated with radotinib Cp. Radotinib Cp can be accurately and precisely predicted from CDBS using direct or Hct-corrected prediction methods. Both appear to be appropriate for the therapeutic monitoring of radotinib in patients with CML. 2. R/R AML remains a common clinical scenario with poor outcomes. HSCT is necessary for long-term remission and survival. Due to the limited treatment options in relapsed patients, clinical trials are the first choice of therapy. For FLT3- and IDH1-/IDH2-mutated AML patients, targeted therapies have shown results superior to standard therapy. The FDA has approved gilteritinib for FLT3- mutated AML as well as ivosidenib/enasidenib for IDH1-/IDH2-mutated r/r AML patients. Monotherapy with venetoclax, a bcl-2 inhibitor, has moderate efficacy in r/r AML. However, early results in combination with intensive chemotherapy or HMA are very encouraging. Trials combining novel substances with each are necessary. The development of cellular therapies such as CAR-T cells or bispecific T cell engager antibody constructs is very demanding in AML as it is difficult to identify the ideal target structure on AML blasts. 3. This study aims to evaluate the quality of life (QoL) of chronic myeloid leukemia (CML) patients prescribed with nilotinib as a second-line therapy and explores the influential factors. A multicenter retrospective survey was conducted via face-toface interviews based on the EORTC QLQ-C30 questionnaire. A total of 121 adult CML patients resistant to imatinib and used nilotinib for at least 3 months were enrolled. The influential features were assessed by multiple linear regression models. Patients had the mean age of 47.49 (SD = 13.67) years, dominated by middle-aged and male groups. The mean scores of functions ranged from 75 to 83, and those of symptoms were from 5 to 28, with the highest of fatigue (28.28), insomnia (22.87), and pain (21.07). The mean global health status/QoL score was 67.70 (SD = 16.80) with considerable financial difficulties (52.34 (SD = 32.15)). Male patients reported higher functional scores and fewer symptoms compared with female patients. All aspects of QoL became worse with increasing age. Besides age and gender, level of education, duration of nilotinib usage, and comorbidities were also significantly influential factors in many QoL domains. A predicted model for expected mean scores of QoL domains was built based on these factors. The CML patients treated with nilotinib had the above-moderate QoL scores, a light decrease of functional scores, great financial difficulties, and still experienced symptoms. Strategies and more therapeutic considerations to enhance QoL for CML patients targeted toward women, the old, low educational level, and long duration of nilotinib usage, and many comorbidities are needed in the setting. 4. Management of CML in advanced phase remains challenging. However, prognosis for patients diagnosed in AP improved clearly over years, and presently most patients with AP features at diagnosis can be managed as high-risk CP patients. Patients in blast crisis have inferior outcomes due to emergent resistance to TKI. Rational combination of TKI and chemotherapy or, preferably, novel agents including immunotherapy could improve remission rates and duration. Frontline imatinib results challenged the concept of transplantation in CP-CML patients; nowadays the use of more potent TKI might modify the same concept also in patients presenting with advanced disease. However, optimal management of patients in CP represents the best way to avoid disease evolution and to allow a quite normal life duration for all patients. Due to the limited evidence and the still numerous unmet needs, it would be desirable that a dedicated expert panel would provide updated recommendations for the management of CML in advanced phase. 5. The treatment landscape of AML is undergoing unprecedented change, with no fewer than 8 new drug approvals since 2017. Our treatment paradigm has shifted away from a simple binary distinction between “curative, intensive therapy” and “palliative, lower intensity” approaches. Instead, the increased diversity of therapeutic options requires a more nuanced treatment algorithm that incorporates mutation-specific targeted therapies, monoclonal antibodies, and apoptosisinducing small molecules, in addition to improved liposomal delivery of standard therapies. We fully expect and sincerely hope that our review of “new drugs” will be antiquated in the next few years due to the rapid pace of clinical development and abundance of newly approved therapies. We highlight caution, however, in an unrestrained combination of these new drugs outside of the context of clinical trials, as prevention of unanticipated severe drug-induced toxicities is imperative. Carefully conducted clinical studies that report on the safety of new combinations, supported by correlative studies illuminating mechanisms of response and resistance, will be critical to ensure that future progress is safe for patients and supported by a strong body of scientific evidence.