In a nutshell
This study reviewed the current assessment and management of patients with chronic lymphocytic leukemia (CLL).
Chronic lymphocytic leukemia (CLL) is a cancer of the bone marrow. This can lead to abnormal immune cells. Treatments often target specific proteins on cancer cells (targeted therapy). These may be used alone or in a combined treatment. Some patients may have more abnormal genes than others. This can lead to poor outcomes and prognosis. It is important to research this area to develop new management plans for patients with CLL.
Methods & findings
All patients with CLL should have their prognosis risk assessed. This includes blood tests which look for abnormal genes, certain proteins, and chemicals in the blood. They also look at white cell counts.
In newly diagnosed patients, all should receive testing for other diseases such as skin cancer. All patients should also receive appropriate vaccinations to reduce infection risk. Patients should start therapy if they have low blood cell counts such as platelets (which help clot the blood), a large spleen, and swollen lymph nodes (immune glands). They should also start treatment if they have disease symptoms including weight loss, fever, night sweats, or tiredness.
Treatment for these patients usually includes chemoimmunotherapies such as FCR (fludarabine, cyclophosphamide, and rituximab) or BR (bendamustine and rituximab).
Patients with CLL unresponsive to treatment should have a bone marrow test and biopsy. They should also have a CT scan of the chest, abdomen, and pelvis. Ibrutinib (Imbruvica) alone, should be used in all patients. If patients remain unresponsive on ibrutinib, a combination treatment with venetoclax (Venclexta) or other therapies may be used. Patients who are older or have other medical conditions could benefit from chlorambucil (Leukeran) and obinutuzumab (Gazyva) treatment.
The bottom line
The study concluded that management for CLL involves combining different tests and treatments to find the most suitable option for each patient.
Talk to your doctor if you have any concerns about treatment for CLL.
Published By :
Blood cancer journal
Oct 03, 2018