Over the course of a year of monthly meetings, the CLL Bloodline will teach the BASICS needed to understand CLL, bring news, help with the acronyms and new vocabulary, and offer simple fun quizzes.
MONTHLY QUIZ: The use of chemo-immunotherapy (CIT), including FCR (fludarabine, cyclophosphamide, and rituximab), BR (bendamustine and rituximab), and the more recently approved chlorambucil and obinituzumabcombination
1. Should be considered by all CLL patients regardless of their biomarkers or treatment status.
2. Should be reserved for those with bad markers including del 17p or TP53 mutations or unmutated IgHV.
3. Should only be used as a first line therapy.
4. Should only be used after failing a prior targeted therapy.
5. Have really no place in CLL management today.
The correct answer is #5. While CIT can be effective in the very limited circumstances of young fit patients with only good prognostic markers, even in those cases, the newer targeted therapies have been repeatly demonstrated in multiple large clinical trials to provide better outcomes in all circumstances. Also, CIT increases the risk of second cancers including MDS (myelodysplastic syndromes) and maybe Richter’s Transformation that are both very difficult to treat blood cancers. CIT should never ever be considered without biomarker testing first, but sadly, too often this is not the case in community practices. Our motto is: TEST BEFORE TREAT™ before each and every new treatment course.
NEWS:
• Join us on February 12th for our Ask Me Anything virtual event featuring Jacqueline Broadway-Durna and Doreen Zetterlund.
• Join us on March 26th for our webinar, CLL 101: Biology, Symptoms, and Diagnosis featuring Josie Montegaardand Stephen Feldman.
• CLL Society’s Expert Access Program™ is available to anyone with a CLL diagnosis residing in the U.S. who needs a 2nd opinion from a CLL expert physician, at no cost through a HIPAA-complaint telehealth appointment. If you have a question, or a pending decision, we are there for you.
• Please finds resources for CLL patients impacted by the California Wildfires here.
THE BASICS: What To Do When First Diagnosed
CLL is usually slow growing, giving you time to plan. Don’t neglect your routine preventive care, especially age and gender appropriate cancer screenings such as PAPs, mammography, PSA, colon cancer screening and especially skin checks, as CLL increases the risk of many secondary cancers, especially skin cancer. Stay up to date with vaccinations and get the annual flu shot and COVID shots but avoid live vaccines such as yellow fever or MMR as they are not known to be safe in CLL. Bone and dental problems are more common so take care of your teeth and protect and assess your bone health. Put together your treatment team (get help at the CLL Society’s online toolkit), join a support group, and frontload your knowledge about your disease.
WORD/ACRONYM OF THE MONTH: Lymphocytes
Lymphocytes are white blood cells. There are 3 basic types: B lymphocytes or cells, T cells, and natural killer (NK) cells. CLL is a cancer of the B cells. Normal B cells mature into plasma cells that make antibodies, T cells are soldiers in our cellular immune system and direct or do the killing themselves, and NK cells are part of our nonspecific innate immune system. Unlike T cells, NK cells don’t need to be primed to kill virally infected or cancer cells. Quite the team!
The CLL Society is invested in your long life. Please invest in the long life of the CLL Society.