MONTHLY QUIZ: B lymphocytes that cause CLL can proliferate in all the following areas of the body except:
- The lymph nodes and the spleen
- The bloodstream
- The bone marrow
ANSWER: The correct answer is # 2. CLL is a cancer of the B lymphocytes. Therefore, it is both a leukemia and lymphoma. The cancer cells accumulate in the blood, making it leukemia with high lymphocyte counts. However, they can both accumulate and proliferate in the nodes, bone marrow, and the spleen. They cannot reproduce in the blood.
NEWS:
- Infectious Disease Society of America recommends pemivibart (Pemgarda) for Pre-Exposure Prophylaxis in the immunocompromised including those with CLL. Any decision should be reviewed with your doctor in light of the current variants and possibly lessened neutralizing capacity.
- September is Blood Cancer Awareness Month, starting with World CLL Day on the 1st. Follow us on social media as we highlight those with CLL. This month, every donation will be matched up to $17,500 by our Board of Directors. Add it to your calendar and help CLL Society increase awareness and advocate for our needs.
- Join CLL Society on September 9th for the webinar, Your Medicare Guide: Tackling Costs and Answering Your Questions, ahead of Medicare enrollment season.
- Join CLL Society on September 17th for the webinar, Beyond Your CLL Diagnosis: Comprehensive Health Management, with nurse practitioner Amy Goodrich.
- CareCast: The CLL Society Podcast is launching this month, and we invite you to listen to our welcome message and stay tuned for more episode clips.
- This year, CLL Society’s Research Program expanded to fund four prestigious researchers and introduced two new awards: the Integrative Medicine Award and the Clinical Scholar Award, in addition to the Young Investigator Award. Each of these awards supports innovative research aimed at enhancing treatment options specifically for individuals living with CLL / SLL. Learn more about the 2024 Awardees.
- This month, our own Dr. Koffman is faculty at the The ImmunoPTImize Network Workshop with the Fred Hutch CC and the CDC in Bethesda, Patient-Centered Oncology Care Conference in Nashville, European Research Initiative on CLL (ERIC) congress and CLL Advocates Network (CLLAN) Horizon, both in Barcelona, making for a very busy month getting the word out about the needs and vulnerabilities of the CLL / SLL community.
BASICS: Types of CLL Treatment – This month, we begin describing broad therapy categories.
Chemo-immunotherapy (CIT) used to be the only treatment for CLL. Today, depending on which CLL expert you consult, there would be no role or at most a limited role for a few frontline patients as it has been repeatedly proven to be inferior to newer targeted therapies. Sadly, it is still being used too often in the community, in up to 15-20% of all patients. CLL Society is trying to change this through educating patients and oncologists.
CIT consists of chemo drugs that damage the cell’s DNA and non-specifically kill anything that grows quickly, such as cancer cells, skin, hair, gut, and normal blood cells. In CLL, common drugs are fludarabine (F), cyclophosphamide (C), bendamustine (B), and chlorambucil. Chemo is more effective when combined with immunotherapy (IT). Usually, a monoclonal antibody (mAb): rituximab (R) or obinutuzumab (Gazyva) that targets a specific marker (CD20) found only on CLL and normal B cells. Common CIT combinations are FCR, BR and chlorambucil plus obinutuzumab. There is NO role for chemotherapy alone to treat CLL, though that too is still used by some hematologists.
WORD/ACRONYM OF THE MONTH: CD
CD or Clusters of Differentiation are proteins on the cell surface used by flow cytometry (cellular fingerprinting) to diagnose CLL or find measurable (minimal) residual disease (MRD). Classically, these surface markers identify CLL cells: CD5, CD19, CD20(dim), CD23, and an absence of FMC-7. CDs are also targets for antibodies and CAR-T. For example, rituximab, obinutuzumab and the experimental epcoritamab target CD20 while the CAR-T liso-cel targets CD19.
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