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 acronym and new vocabulary, and offer simple fun quizzes.
MONTHLY QUIZ: The spleen is important in CLL. All the following are true EXCEPT:
- The spleen can serve as a backup to the bone marrow by releasing blood cells into the circulation.
- The spleen is in the left upper quadrant of the abdomen and is tucked away under the ribs where it cannot be palpated (felt) during a physical exam unless it becomes significantly enlarged as can happen when CLL progresses.
- One can live without a well-functioning spleen or even after its total removal.
- 30% of people have a tiny 2nd spleen called a splenule or accessory spleen that grows if the spleen is removed.
- Removal of the spleen is sometimes done prophylactically in CLL to lower the risk of infections and rupture.
The correct answer is #5 The spleen helps the body remove certain common “encapsulated” bacteria that can cause pneumonia, meningitis and other infections and its removal is associated with more serious infections.
NEWS:
- Please provide your feedback in the CLL / SLL Patient and Care Partner Engagement Survey and share your perspective to help CLL Society shape future priorities, programs, resources, and investments around the needs of the community.
- Join us on October 8th for the webinar Understanding Immunity and CLL with Dr. William Wierda and patient advocate Dr. Edward Ratner.
- If you missed the webinar A Guide to CLL / SLL Treatment Selection and Sequencing, you can find the on-demand replay, slide deck, and transcript on our website.
- As cold and flu season approaches, we’re sharing our Vaccinations for Patients with CLL / SLL resource to help patients stay informed about recommended vaccinations.
- A Phase 2 open-label study is recruiting adults with recurring chronic lymphocytic leukemia (CLL) to evaluate retreatment with a fixed-duration treatment. If you are interested in learning more, please click here. Sponsored message from AbbVie.
THE BASICS: Targeted Therapies (TT) are treatments that specifically target cancer cell growth and survival, while mostly sparing other tissues. In CLL, TT include monoclonal antibodies (mAbs) that attack specific proteins found on the CLL cells’ surfaces. This protein may be found on some normal cells but not on most cells. Examples include rituximab and obinutuzumab (Gazyva) that target CD20 found only on CLL and normal B lymphocytes. Another common TT are TKIs or tyrosine kinase inhibitors that inhibit enzymes or kinases such as BTK which is blocked by ibrutinib, acalabrutinib, zanubrutinib and pirtobrutinib, or PI3K blocked by idelalisib and duvelisib. Both BTK and PI3K are part of the B cell receptor (BCR) pathway that the CLL has become “addicted” to and is critical to its survival. Blocking it turns off the messages the cancer receives to “live long and proliferate.” Venetoclax and sonrotoclax (approved for mantle cell lymphoma but not yet CLL / SLL) and the experimental drug lisaftoclax are not TKIs. They turn back on apoptosis or programmed cell death, leading to rapid killing of the CLL cells. CLL cells had turned off apoptosis to improve their survival. Unlike chemotherapies, TT do not damage DNA or target all fast-growing tissues, cancerous or not. The important point is that because TT are “targeted”, they tend to cause less collateral damage, though they too can have significant side effects. They are often newer, more effective and much more expensive than chemotherapy.
WORD/ACRONYM OF THE MONTH: IMMUNOTHERAPY THERAPY: Immunotherapy Therapy uses our immune system to fight cancer and are made from living organisms. They include approved mAbs (monoclonal antibodies) such as rituximab and obinutuzumab and CAR-Ts (genetically modified T cells) such as liso-cel, and experimental bispecific monoclonal antibodies such as epcoritamab. It may also be called biological therapy or targeted therapy.
