In this video, Professor Michael Hallek, M.D., the Director of the Center for Integrated Oncology (CIO) at the University of Cologne, Germany, and the head of the German CLL Study Group (GCLLSG) is interviewed by CLL Society founder and Chief Medical Officer, Dr. Brian Koffman, M.D., a retired family physician and a CLL patient. This video was recorded at the 62nd Annual Meeting of the American Society of Hematology, held virtually in December 2020.
The GCLLSG has conducted numerous extensive collaborative studies. In this latest study, researchers led by Professor Hallek looked at the impact of severe infections on the overall survival (O.S.) of chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) patients who had received chemoimmunotherapy (CIT) at any time in their course of treatment.
Take-Aways
- This study looked at more than 2,000 CLL / SLL patients who had received CIT as one of their courses of treatment. Investigators reviewed patient records from five prior protocols to establish their findings.
- Most patients (66%) received fludarabine, cyclophosphamide, rituximab (FCR), or chlorambucil-containing regimens.
- Genetic abnormalities such as deletion 17p and immunoglobulin heavy chain gene (IGHV) mutation status occurred evenly within these two major groups.
- When comparing all patients in the study, genetic abnormalities and IGHV mutation status appeared to play no role in the rate of severe infections.
- The median time to severe infection from the start of treatment was 1.8 months.
- Researchers found that patients who had severe infections had shortened survival.
- Most of the impact on survival happened very early during treatment, and after the first few months, the overall survival for those with or without infections was very similar.
Conclusions:
As Professor Hallek states, “this data is not going to change practice, but it is adding elements to our therapeutic understanding and the management of CLL / SLL patients.
This study shows the importance of avoiding infection in those patients undergoing chemoimmunotherapy. Possible ways to reduce severe infections include patient education about the early signs of an infection and the need for immediate medical attention, prophylactic (preventative) drug therapies, vaccinations, and immune globulin therapy. However, this abstract did not address those options.
Here is a link to the abstract: Severe Infections in Patients with Chronic Lymphocytic Leukemia Treated with (Immuno-)Chemotherapy: A Pooled Analysis of Gcllsg Trials.
Stay Strong, Stay Safe!
Thomas E. Henry III, MBA, RPh, CPh
Thomas E. Henry III is a Registered Pharmacist and CLL Patient. He is President and Senior Consultant for Burlington Consulting Associates, a company that provides consulting services to health systems nationwide. Tom is a CLL Society Expert Medical Council member and strives to educate other CLL patients through his blog https//www.cllpharmacist.com. He has a forty-two-year career as a licensed pharmacist and has served as Chief Pharmacy Officer at two Top-15 Comprehensive Cancer Centers, Moffitt (Tampa, FL) and Roswell Park Cancer Institute (Buffalo, NY).
