Haematology

Pushing the boundaries of science to redefine care in haematology

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Despite great strides in the treatment and understanding of blood cancers in recent years, there remain critical unmet needs for this diverse and complex family of diseases. These significant gaps in treating and caring for patients with blood cancer are why AstraZeneca is committed to help transform the haematologic cancer care experience.


We strive to be a scientific leader in haematology by helping to care for the 3.6 million people living with blood cancers* worldwide as of 2020.1


Blood cancers are a diverse and complex family of diseases. There are blood cancers and related disorders of the blood, bone marrow or lymph nodes, including leukaemias, lymphomas and myelomas.2 Among haematologic malignancies, our core areas of focus include acute myeloid leukaemia (AML), myelodysplastic syndrome (MDS), chronic lymphocytic leukaemia (CLL), diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma (MCL) and multiple myeloma (MM).

Applying our deep understanding of blood cancers and leveraging our strength in solid tumour oncology, we are driving the development of novel therapies designed to target underlying drivers of disease across six scientific platforms. Our signature platforms include antibody drug conjugates, immuno-oncology, DNA damage response, tumour drivers and resistance, cell therapy and epigenetics.

By seeking to address blood cancers with high unmet needs, our aim is to deliver new medicines and approaches to healthcare services that have a meaningful impact on patients and caregivers, transforming the haematologic cancer care experience.

Taking courageous, science-driven risks

We are bold and fearless in our approach, innovative in our mindset and committed to taking courageous, science-driven risks. Our science-driven, risk-taking strategy is based on the fundamental principle that we do what is right for patients, and that we pursue scientific excellence.

Our robust development programme includes more than 11 company-sponsored clinical trials across multiple B-cell blood cancers, with investigational agents in pre-clinical through Phase III development.3 We encourage scientific exploration with a smart risk-taking process that allows us to adapt and evolve, accelerating programmes that show promise.

The breadth and depth of our pipeline enables us to explore potential synergies between our own molecules and look at combinations with standard of care where the addition of a novel combination partner may help address an unmet medical need.

Delivering meaningful impact on haematology care, shaped by patient insights

Each person impacted by blood cancer, whether they are a patient, caregiver, family member or friend, is another reason our researchers work every day to advance the science in haematology. We’re proud to be part of and to collaborate with the blood cancer community, integrating patient insights at key decision points of development, to help transform healthcare delivery and create new treatment options for those battling blood cancers.

Though we are at the beginning of our ambitious journey in haematology, but through our strategic partnerships, we are advancing the healthcare ecosystem, delivering greater value for patients, healthcare and society. We are proud of the progress we have made in collaboration with the blood cancer community, yet we recognise that there is far more to be done.


Chronic lymphocytic leukaemia: a common and complex blood cancer

CLL is the most common type of leukaemia in adults, with an estimated 114,000 new cases globally in 2017, and the number of people living with CLL is expected to grow with improved treatment as patients live longer with the disease.4,5,6,7


In CLL, cancerous cells crowd the bone marrow leaving less room for healthy white blood cells, red blood cells and platelets. This can lead to infection, anaemia and bleeding.5 When CLL cells are found mostly in the lymph nodes, they are called small lymphocytic lymphoma (SLL) cells.8 The majority of CLL patients have multiple comorbid health conditions, though disease progression and complications are the primary causes of death.9

There are treatment options to help manage CLL, however, some patients, including those that are older or have other conditions, may experience serious long-term or late effects from existing therapies.10,11 For many patients with CLL, the disease may return even after successful treatment.12 New therapies aim to address these needs for patients with CLL.

CLL is characterised by a variety of molecular abnormalities that are responsible for disease development, progression and transformation.13 The presence of certain biomarkers in CLL is increasingly used to inform the best course of treatment.14 



As our understanding of CLL advances, we are learning more about the disease’s biomarkers and the valuable role their presence plays in determining a patient’s risk category and in guiding treatment decisions.13,15


Mantle cell lymphoma: a rare and highly variable cancer

Lymphoma is a blood cancer of the lymphatic system. It is caused by the rapid production of lymphocytes, a type of white blood cell.16 B cells and T cells are the two types of lymphocytes that can develop into lymphomas.17 The two main types of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma (NHL).16 MCL is a rare NHL typically resulting when B-lymphocytes mutate into malignant cells within a region of the lymph node known as the mantle zone.18,19

MCL is often diagnosed as a late-stage disease after it has spread to the gastrointestinal tract and bone marrow.18 MCL can vary in clinical presentation and aggressiveness. Symptoms may include swelling of the lymph nodes, fever, night sweats, weight loss and fatigue, though some people have zero to few signs of MCL leading to delayed diagnosis and treatment.17,19

There is no cure for MCL; however, there are treatment options to help manage the disease, and recent treatment advances have improved patient outcomes. Unfortunately, for many patients the disease may return after treatment.20 Additional treatment options are needed for people who relapse or do not respond to treatment.

References:

1. World Health Organization. Worldwide Cancer Fact Sheet 2020 (Incidence, Mortality and Prevalence by cancer site). http://gco.iarc.fr/today/data/factsheets/populations/900-world-fact-sheets.pdf. Accessed June 2023.

2. Leukemia and Lymphoma Society. Facts and Statistics Overview. http://www.lls.org/facts-and-statistics/facts-and-statistics-overview. Accessed June 2023.

3. AstraZeneca. Clinical Trials, Q1 2023 Results Update. Published March 2023. Available at: http://6dqa.shorinji-kempo.net/content/dam/az/PDF/2023/q1/Q1-2023-results-clinical-trials-appendix.pdf. Accessed June 2023.

4. American Cancer Society. What is Chronic Lymphocytic Leukemia? Available at http://www.cancer.org/cancer/chronic-lymphocytic-leukemia/about/what-is-cll.html. Accessed June 2023.

5. National Cancer Institute. Chronic Lymphocytic Leukemia Treatment (PDQ®)–Patient Version. Available at http://www.cancer.gov/types/leukemia/patient/cll-treatment-pdq. Accessed June 2023.

6. Global Burden of Disease Cancer Collaboration. Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017. JAMA Oncol. 2019;54(12):1749-1768.

7. Jain N, et al. Prevalence and Economic Burden of Chronic Lymphocytic Leukemia (CLL) in the Era of Oral Targeted Therapies. Blood. 2015;126:871.

8. National Cancer Institute. NCI Dictionaries. CLL/SLL. Available at: http://www.cancer.gov/publications/dictionaries/cancer-terms/def/cll-sll. Accessed June 2023.

9. Strati P, et al. Disease Progression and Complications Are the Main Cause of Death in Patients with Chronic Lymphocytic Leukemia (CLL) Independent of Age and Comorbidities at Diagnosis. Blood. 2015;126(23):5265.

10. Leukemia & Lymphoma Society. Types of Treatment. Available at: http://www.lls.org/treatment/types-of-treatment. Accessed June 2023.

11. Leukemia & Lymphoma Society. Long-Term and Late Effects for Cancer Survivors. Available at: http://www.lls.org/managing-your-cancer/long-term-and-late-effects-for-cancer-survivors. Accessed June 2023.

12. Lymphoma Research Foundation. Understanding Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma. Available at: http://lymphoma.org/wp-content/uploads/2020/11/LRF_FACTSHEET_CLL_SLL-1.pdf. Accessed June 2023.

13. Moia R, et al. Precision Medicine Management of Chronic Lymphocytic Leukemia. Cancers. 10 March 2020;12(3):642. Doi:10.3390/cancers12030642.

14. Amaya-Chanaga CI and Rassenti LZ. Biomarkers in chronic lymphocytic leukemia: Clinical applications and prognostic markers. Best Pract Res Clin Haematol. March 2016;29(1):79-89.

15. Lee J and Want YL. Prognostic and Predictive Molecular Biomarkers in Chronic Lymphocytic Leukemia. J Mol Diagn. 1 September 2020;22(9):1114-1125.

16. Lymphoma Research Foundation. About Lymphoma. http://lymphoma.org/aboutlymphoma/. Accessed June 2023.

17. Lymphoma Research Foundation. Non-Hodgkin Lymphoma (NHL). http://lymphoma.org/aboutlymphoma/nhl/. Accessed June 2023.

18. Lymphoma Research Foundation. Mantle Cell Lymphoma. http://lymphoma.org/aboutlymphoma/nhl/mcl/. Accessed June 2023.

19. National Organization for Rare Disorders. Mantle Cell Lymphoma. http://rarediseases.org/rare-diseases/mantle-cell-lymphoma/. Accessed June 2023.

20. Leukemia & Lymphoma Society. Mantle Cell Lymphoma Facts. http://www.lls.org/sites/default/files/file_assets/mantlecelllymphoma.pdf. Accessed June 2023.