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ASCO 2019: Dr. Koffman’s Pick # 9 Assessing the Potential of Immunotherapy in treating chronic lymphocytic leukemia (CLL)

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Dr. Brian Koffman, the Executive Vice President (EVP) and Chief Medical Officer (CMO) of the CLL Society, counts down his top ten CLL related abstract from ASCO or the American Society of Clinical Oncology Annual Meeting held May 31 – June 4, 2019, Chicago, IL.

# 9

Assessing the potential of immunotherapy in treating chronic lymphocytic leukemia (CLL) through meta-analysis.

This is a complicated and technical abstract.


  • T-cell exhaustion is the most prominent finding when looking at the inflammatory marker levels in CLL.
  • Based on the increased (upregulated) levels of PDL-1 and others, B-cells were more immune suppressed.
  • B-cell receptor (BCR) signaling was upregulated, helping explain why BCR blockers such as ibrutinib work so well in CLL.
  • B-cell differentiation or maturation was down regulated, explaining why the B-cells behave so badly.


The authors suggest that more aggressive cases of chronic lymphocytic leukemia are related to these altered immune pathways and that immune therapies may have a significant role in controlling CLL.

The bottom line of this detailed and complicated research is that CLL is more than just too many clonal B-cells. It is a cancer of the immune system that messes with our immune defenses for its own gain and our loss.

Here is a link to my brief 2½ minute overview:

Here is the link to the actual abstract:

Thanks for watching.

Stay strong. We are all in this together.