Features For Fellows & Trainees
that it doesn ’ t involve some sacrifice , but we need to find a balance so that our productivity doesn ’ t suffer .
I ’ m not saying that I have perfected that balance , as my husband constantly reminds me ! However , we can get better at realizing when our lives are too imbalanced ; being in perpetual fatigue helps no one .
What are your priorities as chair of the ASH Trainee Council ? As chair , I want to publicize what ASH has to offer for trainees . It was only after I joined the Trainee Council that I discovered the wealth of resources and programs the Society makes available to trainees and fellows – from sample board certification questions to the ASH Image Bank . I wish I had known about these during my first fellowship , but I am grateful that I had them at my fingertips during my second !
“There are so many different ways to make a career within your niche , and I want to give trainees as much exposure to these as possible .”
Even as the chair I ’ m still finding new information ! I email everyone in my program when I find new resources , like TraineE-News . The grants clearinghouse has been an excellent resource for finding funding opportunities ; it should be your first visit when searching for funding . It ’ s all in one place ! The clearinghouse would definitely have saved me some time the first time I applied for a grant .
I also want to continue raising awareness about non-traditional career paths . It often feels like fellows who want to focus on patient care are stigmatized because they aren ’ t as productive in research , which isn ’ t fair to them . We want to train people to be good clinicians , but the first question trainees are asked is usually , “ When are you starting your research project ?” or “ When are you going to publish ?” But , not everyone is going to be a researcher .
There are so many different ways to make a career within your niche , and I want to give trainees as much exposure to these as possible .
NOW APPROVED
The ASH Trainee Council provides an amazing opportunity for young hematologists to get involved in shaping the Society ’ s trainee-focused programs , and the ASH Committee on Training is always looking for new proposals and ideas from Trainee Council members . So , I want to find opportunities to promote alternative career paths . Can we invite someone in private practice to offer their perspective ? Can we get someone who works in industry to share their experiences ? Everyone has different paths and all of those different paths should be nurtured .
The first dual-drug liposomal encapsulation of daunorubicin and cytarabine shown to ...
Deliver superior overall survival vs 7 + 3 a to adults with newly-diagnosed t-AML or AML-MRC 1
VYXEOS improved overall survival compared to 7 + 3 in a Phase 3 trial 1
• Median survival of 9.6 months for VYXEOS vs 5.9 months for 7 + 3 ( P = 0.005 ), HR = 0.69 ( 0.52 , 0.90 )
Study Design 1 The Phase 3 study was a randomized , multicenter , open-label , active-controlled superiority study of VYXEOS versus cytarabine and daunorubicin ( 7 + 3 ) in patients 60 to 75 years of age with newly-diagnosed t-AML or AML-MRC . There were 153 patients randomized to VYXEOS and 156 patients randomized to the 7 + 3 arm . 20 % of patients had t-AML , 54 % had AML with an antecedent hematological disorder , and 25 % had de novo AML with MDS-related cytogenetic abnormalities . Eff icacy was established on the basis of overall survival from the date of randomization to death from any cause .
VYXEOS 44 mg / 100 mg per m 2 ( daunorubicin / cytarabine ) was given intravenously on Days 1 , 3 , and 5 for first induction and on Days 1 and 3 for those needing a second induction . For consolidation , the VYXEOS dose was 29 mg / 65 mg per m 2 ( daunorubicin / cytarabine ) on Days 1 and 3 . In the 7 + 3 arm , first induction was cytarabine 100 mg / m 2 / day on Days 1-7 by continuous infusion + daunorubicin 60 mg / m 2 / day on Days 1-3 . For second induction and consolidation , cytarabine was dosed on Days 1-5 and daunorubicin on Days 1 and 2 .
INDICATION
VYXEOS ( daunorubicin and cytarabine ) liposome for injection 44 mg / 100 mg is indicated for the treatment of adults with newly-diagnosed therapy-related acute myeloid leukemia ( t-AML ) or AML with myelodysplasia-related changes ( AML-MRC ).
IMPORTANT SAFETY INFORMATION
WARNING : DO NOT INTERCHANGE WITH OTHER DAUNORUBICIN AND / OR CYTARABINE-CONTAINING PRODUCTS
VYXEOS has different dosage recommendations than daunorubicin hydrochloride injection , cytarabine injection , daunorubicin citrate liposome injection , and cytarabine liposome injection . Verify drug name and dose prior to preparation and administration to avoid dosing errors .
Contraindications
VYXEOS is contraindicated in patients with a history of serious hypersensitivity reactions to cytarabine , daunorubicin , or any component of the formulation .
Warnings and Precautions
Hemorrhage Serious or fatal hemorrhage events , including fatal CNS hemorrhages , associated with prolonged thrombocytopenia , have occurred with VYXEOS . The overall incidence ( grade 1-5 ) of hemorrhagic events was 74 % in the VYXEOS arm and 56 % in the control arm . The most frequently reported hemorrhagic event was epistaxis ( 36 % in VYXEOS arm and 18 % in control arm ). Grade 3 or greater events occurred in 12 % of VYXEOS-treated patients and in 8 % of patients in the control arm . Fatal treatment-emergent CNS hemorrhage not in the setting of progressive disease occurred in 2 % of patients in the VYXEOS arm and in 0.7 % of patients in the control arm . Monitor blood counts regularly and administer platelet transfusion support as required .
Cardiotoxicity VYXEOS contains daunorubicin , which has a known risk of cardiotoxicity . This risk may be increased in patients with prior anthracycline therapy , preexisting cardiac disease , previous radiotherapy to the mediastinum , or concomitant use of cardiotoxic drugs . Assess cardiac function prior to VYXEOS treatment and repeat prior to consolidation and as clinically required . VYXEOS is not recommended in patients with impaired cardiac function unless the benefit of treatment outweighs the risk .
Total cumulative doses of non-liposomal daunorubicin greater than 550 mg / m 2 have been associated with an increased incidence of drug-induced congestive heart failure . The tolerable limit appears lower ( 400 mg / m 2 ) in patients who received radiation therapy to the mediastinum . Calculate the lifetime cumulative anthracycline exposure prior to each cycle of VYXEOS . VYXEOS is not recommended in patients whose lifetime anthracycline exposure has reached the maximum cumulative limit .
62 ASH Clinical News