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The World’s Leading Authority for Chronic Lymphocytic Leukemia Patients

April 2023 CLL Bloodline

In science and medicine, information is constantly changing and may become out-of-date as new data emerge. All articles and interviews are informational only, should never be considered medical advice, and should never be acted on without review with your health care team.

Over the course of a year of monthly meetings, The CLL Society Bloodlinewill 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:

  1. A lymphoma, as it arises from lymphocytes.
  2. A leukemia, as it is a cancer of the blood cells.
  3. Neither, as it is a hybrid disease that is classified by itself.
  4. 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 Jan. 27, 2023, the FDA granted accelerated approval to pirtobrutinib (Jaypirca) for relapsed/refractory mantle cell lymphoma (MCL). This means it can be used “off label” for CLL / SLL but insurance may not cover it.

We are thrilled to invite you to participate in CLL Society’s second annual Celebrating Long Lives 5K event! Join us on Saturday, May 13th for a virtual 5K walk or run to support fellow individuals of the CLL / SLL community and raise funds for the mission of CLL Society. Support group members are encouraged to set up a fundraising team and participate in the event together. More details on the website.

Join us on April 12th for the CLL Society webinar The Importance of Front-Loading Your Knowledge During the Early Journey of CLL / SLL with Dr. Joanna Rhodes and Stephen Feldman.

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 Treatpages on the website.

WORD/ACRONYM OF THE MONTH:  Immunosuppressed

All CLL patients are immunosuppressed to a lesser or greater extent depending on disease stage and treatment history. Immunosuppressed or deficient is a catchall term for different weakened immune defenses. 85% of CLL patients make lower than normal amounts of antibodies or immunoglobulins. 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.

The CLL Society is invested in your long life.  Please invest in the long life of the CLL Society.