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 chlorambucil and obinituzumab combination:
- Should be considered by all CLL patients regardless of their biomarkers or treatment status.
- Should be reserved for those with bad markers including del 17p or TP53 mutations or unmutated IgHV.
- Should only be used as a first line therapy.
- Should only be used after failing a prior targeted therapy.
- Has 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 repeated demonstrated in multiple large clinical trials to provide better outcomes in all circumstances. Also, CIT increases the risk of secondary 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:
- CLL Society has launched the Young People with CLL Support Group; the first meeting will take place on Saturday, February 28th. For the purposes of this support group, we are defining young people as anyone aged 55 or under.
- Join CLL Society for our next virtual event on March 6, Ask Me Anything: Featuring Dr. Ryan Jacobs and Doreen Zetterlund. These are fun, fast moving educational events for those at any stage of their CLL journey
- If you missed our webinar, ASH 2025 Comes to You! Watch the replay, and review the presentation slides and transcript.
- CLL Society has listed all of our 1-on-1 support programs together for easy access. This support includes treatment-specific questions, general peer support, and connection with a board-certified chaplain.
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 screening 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 B-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!
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