Authored by Brian Koffman,(MDCM )retired, MSEd
All those with chronic lymphocytic leukemia (CLL), regardless of their stage or treatment status, are immunocompromised, but what does that really mean? Saying one is immunocompromised is really a hand-waving term for an incredibly complex and varied condition. True, CLL is a cancer of the immune system – specifically of the B lymphocytes that are part of the liquid or humoral line of defense with antibody production – but all aspects of our body’s deeply layered response to threats can be compromised by CLL / SLL and its treatment. The depth, breadth, and impact of that can range from trivial to catastrophic.
A better definition of immune status and how to first quantify and later reduce risk is a growing concern for chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL / SLL) patients. CLL / SLL patients are living longer, but increasingly dying of infections and second cancers, often a direct result of their impaired immunity, even when their cancer is in remission. That is why CLL Society funds research on immune reconstitution, continuing to make it a priority. The research is also why we may be on the cusp of a new era of understanding. Just as when we discovered the biology of the CLL cancer itself, more than a decade ago, it unleashed a revolution in care. With new targeted therapies, we may be on the cusp of a new era of understanding of the immune system in CLL, one that could lead to better survivorship for our community.
CLL Society has played a leadership role globally in defining where we are in our present understanding of infection prevention and management. Working with CLL Advocates Network (CLLAN) and CLL Immune Compromised (CLLIC) Task Force, an international group of CLL experts, patients, and advocates, together we produced this patient-facing practical guideline: Navigating Immune Challenges in CLL: Infection Prevention and Management.
More will be coming focused on the scientific and medical research priorities. For now, this guideline is a valuable resource we highly recommend.
Stay strong. We are all in this together.
Brian Koffman MDCM (retired) MS Ed
