Beyond maximum grade: modernising the assessment and reporting of adverse events in haematological malignancies

Gita Thanarajasingam, Lori M. Minasian, Frederic Baron, Franco Cavalli, R. Angelo De Claro, Amylou C. Dueck, Tarec C. El-Galaly, Neil Everest, Jan Geissler, Christian Gisselbrecht, John Gribben, Mary Horowitz, S. Percy Ivy, Caron A. Jacobson, Armand Keating, Paul G. Kluetz, Aviva Krauss, Yok Lam Kwong, Richard F. Little, Francois Xavier MahonMatthew J. Matasar, María Victoria Mateos, Kristen McCullough, Robert S. Miller, Mohamad Mohty, Philippe Moreau, Lindsay M. Morton, Sumimasa Nagai, Simon Rule, Jeff Sloan, Pieter Sonneveld, Carrie A. Thompson, Kyriaki Tzogani, Flora E. van Leeuwen, Galina Velikova, Diego Villa, John R. Wingard, Sophie Wintrich, John F. Seymour, Thomas M. Habermann

Research output: Contribution to journalReview articlepeer-review

46 Scopus citations


Tremendous progress in treatment and outcomes has been achieved across the whole range of haematological malignancies in the past two decades. Although cure rates for aggressive malignancies have increased, nowhere has progress been more impactful than in the management of typically incurable forms of haematological cancer. Population-based data have shown that 5-year survival for patients with chronic myelogenous and chronic lymphocytic leukaemia, indolent B-cell lymphomas, and multiple myeloma has improved markedly. This improvement is a result of substantial changes in disease management strategies in these malignancies. Several haematological malignancies are now chronic diseases that are treated with continuously administered therapies that have unique side-effects over time. In this Commission, an international panel of clinicians, clinical investigators, methodologists, regulators, and patient advocates representing a broad range of academic and clinical cancer expertise examine adverse events in haematological malignancies. The issues pertaining to assessment of adverse events examined here are relevant to a range of malignancies and have been, to date, underexplored in the context of haematology. The aim of this Commission is to improve toxicity assessment in clinical trials in haematological malignancies by critically examining the current process of adverse event assessment, highlighting the need to incorporate patient-reported outcomes, addressing issues unique to stem-cell transplantation and survivorship, appraising challenges in regulatory approval, and evaluating toxicity in real-world patients. We have identified a range of priority issues in these areas and defined potential solutions to challenges associated with adverse event assessment in the current treatment landscape of haematological malignancies.

Original languageEnglish (US)
Pages (from-to)e563-e598
JournalThe Lancet Haematology
Issue number11
StatePublished - Nov 2018

ASJC Scopus subject areas

  • Hematology


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