Over the course of a year of monthly meetings, The CLL Society Bloodline will teach the BASICS needed to understand CLL. It will also provide news, help with the acronyms and new vocabulary words, and offer simple fun quizzes. The cycle restarts and it is updated annually.
MONTHLY QUIZ: CLL is classified as:
- A lymphoma, as it arises from lymphocytes.
- A leukemia, because the cancer cells are found in the blood stream.
- Neither, as it is a hybrid disease that is classified by itself.
- Both, as it arises from lymphocytes and is a blood cancer.
Answer: The correct answer is D or both. All cancers that arise from lymphocytes, a type of our white blood cells, are called lymphomas. As CLL is a cancer of the lymphocytes, specifically the B lymphocytes, it is included in the broad category of Non-Hodgkin’s Lymphomas (NHL). That’s good because we may qualify for NHL clinical trials. It is also a leukemia as the cancerous lymphocytes appears in the blood in most patients. SLL (small lymphocytic lymphoma) is a less common form of the exact same disease where the cancer cells are not found in excess in the blood stream.
NEWS:
- On 3/22, the FDA granted Emergency Use Authorization of Pemivibart (PEMGARDA)), a new mononclonal antibody for passive immune Pre-Exposure Prophylaxis (PrEP) for COVID-19. More information can be found on CLLSociety.org here.
- On 3/14 the FDA approved Breyanzi (lisocabtagene maraleucel; liso-cel), the first chimeric antigen receptor (CAR) T cell therapy for those with CLL / SLL who have had at least 2 prior therapy lines, including a BTK and BCL-2 inhibitor.
- Join the Celebrating Long Lives (CLL) Virtual 5K Walk & Run on Sunday, May 11, 2024 Register here.
THE BASICS: Test Before TreatTM
It is critical to do prognostic and predictive tests before starting each and every treatment. These tests predict the likelihood that our CLL / SLL will respond to different therapies. One critical test is FISH (fluorescent in situ hybridization) that looks for chromosome abnormalities in the cells’ nuclei. For example, finding deletion 17p (del17p) means all chemoimmunotherapy (CIT) won’t work. Another test examines the maturity of our cancer cells by looking at IgVH (aka IgHV) mutation. Some “mutated” patients with other good prognostics may have a very long response to one type of CIT: FCR (fludarabine, cyclophosphamide, and rituximab). TP53 should also be assessed by next generation sequencing (NGS) as its mutation also predicts for poor response to CIT. Check out our Test Before Treat™ pages on the website.
WORD/ACRONYM OF THE MONTH: Immunocompromised or Immunosuppressed
All CLL patients regardless of their treatment status are immunocompromised to some extent that depends on disease stage and treatment history. Immunocompromised is a catchall term for different weakened immune defenses. 85% of CLL patients make lower than normal amounts of antibodies or immunoglobulins such as IGG. Immunoglobulin replacement therapy (IGRT) that can be given either by IV or self-administered subcutaneously at home may help. T cell function or cellular immunity may also be impaired. This makes us higher risk for problems with all infections including COVID-19, and for second cancers. Infection precautions and age and gender appropriate cancer screenings are critical.
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