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:
- Saturday, September 26th is our Celebrating Long Lives 5K Walk & Run, and we hope you all can join us to help raise awareness. If you need assistance participating or have questions, please reach out to [email protected], and CLL Society can support your efforts.
- September is Blood Cancer Awareness Month, starting with World CLL Day on the 1st.Follow us on social media as we highlight programs and resources to support those with CLL and their loved ones.
- Join us on September 28th for the webinar A Guide to CLL / SLL Treatment Selection and Sequencing with Dr. Jennifer Woyach and patient advocate Terry Evans.
- If you missed the webinar Understanding the Numbers: A Patient’s Guide to CLL / SLL Testing and Imaging, you can find the on-demand replay, slide deck, and transcript on our website.
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 very 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), chlorambucil and more rarely pentostatin. 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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