Ask the Doctor Question:
My mother’s CLL has now relapsed after receiving chemo in 2019. Is Imbruvica the only solution to this or there is any other option?
Answer: There are many treatment options now for CLL and in fact, too many to list in one communication. We would suggest the following for your mother:
- First and foremost, please make sure she is being seen by aCLL expert. Chemotherapy is no longer the standard of care for CLL and should be reserved only for a small subset of patients that are younger and healthy and have a mutated IgVH This is because we know that patients with a “mutated” IgVH immunoglobulin do much better with chemotherapy-based regimens than those who are unmutated. Here are a several articles we have posted on the website that you might find helpful on that:
- https://cllsociety.org/2019/09/ash-2018-dr-nitin-jain-on-combining-ibrutinib-with-fludarabine-cyclophosphamide-and-obinutuzumab-for-igvh-mutated-cll-patients/
- https://cllsociety.org/2018/09/what-is-igvh-and-why-is-it-important/
- https://cllsociety.org/2020/01/iwcll-2019-dr-danielle-brander-on-bendamustine-and-rituxan-br-versus-ibrutinib-based-therapies-for-frontline-treatment-of-chronic-lymphocytic-leukemia-cll-in-elderly-patients/
- Please make sure she has had the appropriate biomarker testing before any further treatments are decided upon. You can read more about that here:
- https://cllsociety.org/2021/03/ash-2020-dr-adrian-wiestner-discusses-the-importance-of-test-before-treat-predictive-and-prognostic-testing-in-patients-with-chronic-lymphocytic-leukemia-cll/
- Please read through the treatment section of our website. There are many articles written on the various types of treatment options:
- https://cllsociety.org/beyond-the-basics/treatment/
