Cancer Q&A with HOA: Clinical Trials Awareness
(WSYR-TV) — When it comes to your health, there are three words you never want to hear, and that's 'you have cancer.' But, if that time does ever come, Hematology-Oncology Associates of CNY is here to help.
Dr. Ajeet Gajra joined the show to talk about Clinical Trials Awareness Month during the month of May.
Dr. Gajra explored the following questions:
Can you explain what clinical trials are and why they're so important, especially in cancer care?
What types of clinical trials are currently being offered at Hematology-Oncology Associates of CNY, and who is eligible to participate?
There's often some hesitation or fear around clinical trials—what are some of the most common misconceptions you hear from patients, and how do you address them?
How do clinical trials benefit not just individual participants, but the broader community and future generations of cancer patients?
For viewers who may be interested in learning more or getting involved, what's the best way to start the conversation about participating in a clinical trial?
Learn more about Hematology-Oncology Associates of CNY at hoacny.com. You can also email clinicaltrials@hoacny.com or call (315) 472-7504 ext. 1350.
Head to Cancer.gov/TrialGuide or call 1-800-4-CANCER for information on clinical trials.
Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
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I think the recent New England Journal of Medicine paper by Gagelmann and colleagues spearheaded this molecular remission definition. CIBMTR and Dr Saber are very enthusiastic about this, and I think we can develop reporting forms that consistently capture remission, persistent disease, and relapse as three categories. We acknowledge there will be missing data. Not every center regularly tests molecular driver mutations. We've also discussed the role of chimerism. Fractionated chimerism is important, but most European centers don't assess it. They can do weekly molecular tests; we might test every 3 months at best. So, blood counts and chimerism will still play a role. I've piloted this approach with my patients, and they find it more satisfying. At day 100, I can say, 'You still have fibrosis, splenomegaly, and low platelets — but your JAK2 is negative. We're considering this remission.' That's much more reassuring for them than wondering why we even did the transplant. Jain: I totally agree. Bringing together the American and European efforts — making them globally unified — would be a huge advancement in research. Right now, it's hard to use or compare registry data across systems since it's not apples to apples. You mentioned you're already using this with your patients. There are times when spleen, fibrosis, or counts aren't fully normalized. Can you share your approach for relapse or 'impending relapse' when you see persistent disease features like cytopenias, transfusion needs, splenomegaly, dropping chimerism, or persistent molecular mutations? Salit: We check molecular driver mutations every 3 months — at months 3, 6, 9, and 12. If the 3-month result is negative but the patient still has low CD3 chimerism, needs transfusions, or has fibrosis, we start tapering immune suppression at day 100. We follow chimerism monthly during tapering. If it's not at 100% by 6 months, we may do a bone marrow biopsy to see if anything concerning is present. If the mutation's variable allele frequency is decreasing, that's reassuring. If it's back and chimerism is dropping — say it was 100% at day 100 and 90% at 6 months — we consider donor lymphocyte infusion (DLI), assuming they're off immune suppression and don't have GVHD. If they're still on immune suppression, we taper conservatively and wait a month before giving DLI. We only use therapy like hypomethylating agents and JAK inhibitors if blasts return in the peripheral blood or marrow, or if abnormal cytogenetics reappear. Jain: Those are tough situations — when blasts are visible, or disease features reappear. How often do you consider a second transplant in myelofibrosis? Salit: Not often. Thankfully, we're seeing only 5%-10% relapse rates. At our center, we're still doing relatively mild ablative transplants: Cytoxan/busulfan for those under 60, or decitabine/melphalan for those over 60. If a patient completely loses CD34 or CD33 chimerism, we consider a second transplant. There's concern that giving DLI in that setting could cause aplasia. If the disease burden is too high, we go straight to the second transplant. Jain: That makes sense. Well, this was phenomenal. Thinking about transplant is a nuanced process, and we loved hearing your thoughts. We look forward to reading about the remission definitions post-transplant and implementing them in the clinic. On behalf of our audience, thank you so much for your time. That concludes episode 5 on transplant outcomes in myelofibrosis. We'll see you in the next episode. Listen to additional seasons of this podcast. Primary Myelofibrosis Role of Hematopoietic Stem Cell Transplantation in Patients With Myeloproliferative Disease Decreasing Chronic Graft-Versus-Host Disease Rates in All Populations Diagnosis and Evaluation of Prognosis of Myelofibrosis: A British Society for Haematology Guideline Prognostic Value of Blasts in Peripheral Blood in Myelofibrosis in the Ruxolitinib Era Acute Myeloid Leukemia (AML) CIBMTR Myelofibrosis Medicare Study Proposals for Revised International Working Group-European LeukemiaNet Criteria for Anemia Response in Myelofibrosis Utility of Assessing CD3+ Cell Chimerism Within the First Months After Allogeneic Hematopoietic Stem-Cell Transplantation for Acute Myeloid Leukemia Clearance of Driver Mutations After Transplantation for Myelofibrosis Donor Lymphocyte Infusion and Molecular Monitoring for Relapsed Myelofibrosis After Hematopoietic Cell Transplantation Medscape © 2025 WebMD, LLC Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape. Cite this: Posttransplant Monitoring in Myelofibrosis - Medscape - Jun 10, 2025.