John N. Allan, MD, on Research Coming Out of ASH for CLL
John N. Allan, MD, on Research Coming Out of ASH for CLL
This article was originally published on Cancer Network
n an interview with CancerNetwork®, John N. Allan, MD, assistant professor of medicine in the Division of Hematology and Medical Oncology at Weill Cornell Medicine, discussed the latest research coming out of the 62nd American Society of Hematology (ASH) Annual Meeting for patients with chronic lymphocytic leukemia (CLL).
Transcription:
Yeah, so one of the big things I’m most interested about this year’s ASH is as when I was reviewing the abstracts was seeing, how much data is going to be emerging in terms of the combinations and really seeing how deep can these responses go? How durable are these responses after maximal therapy, so to speak, and stopping or fixed durations of therapies and so, so that’ll be really important to keep an eye on. As well as, you know, we’re getting better at understanding resistant mechanisms to these targeted agents, so, looking at how patients relapse, how do they respond to new therapies after they’ve relapsed, especially if they’ve had treatment holidays. So, these are things that will be at this year’s ASH and looking forward to digesting that data.
An Analysis of CLL in Adolescents and Young Adults
An Analysis of CLL in Adolescents and Young Adults
This article was originally published on Docwire News
Most patients diagnosed with chronic lymphocytic leukemia (CLL) are older; the median age at diagnosis is 70 years. Less than 2% of patients are younger than 45 years. Previous research has not evaluated next-generation sequencing (NGS) gene mutation and novel oral therapies in adolescent and young adult (AYA) patients with CLL. A retrospective study evaluated disease characteristics that impact CLL outcomes in AYA patients. The data were presented at the 62nd ASH Annual Meeting & Exposition.
Between January 1, 2000, and December 31, 2019, 227 patients aged 15 to 39 years were diagnosed with CLL/small lymphocytic lymphoma at a single institution. Labs and Rai stage were recorded if available pre-treatment and within 12 months of diagnosis. Fluorescence in situ hybridization (FISH), cytogenetics, CD38, ZAP-70, gene mutations were collected from any time pre-treatment.
The median age at the time of diagnosis was 37 years (range, 17-39 years); from diagnosis, patients were followed for a median of 7.1 years (range, 0-19.3 years).
Among the 167 patients with available pre-treatment FISH data, 65 (39%) had del(13q), 26 (16%) had trisomy 12, 24 (14%) had del(11q), seven (4%) had del(17p), and 45 (27%) had no FISH abnormality. Among the 159 patients with available immunoglobulin heavy chain variable (IGHV) data, 82 (52%) had mutated and 77 (48%) unmutated IGHV. Only 3% of patients had a first-degree relative with CLL. The following rates of gene mutation were identified: TP53, 3% (n=2/59); NOTCH1, 18% (n=8/45); SF3B1, 16% (n=7/45); POT1, 9% (n=4/45); BIRC3, 7% (n=3/45); and MYD88, 11% (n=5/45). Outcomes could not be evaluated by mutation status because of the limited number of patients with available data.
Case Study: COVID-19 and the Coexistence of CLL
Case Study: COVID-19 and the Coexistence of CLL
This article was originally published on Docwire News
Many symptoms of SARS-CoV-2 (COVID-19) can be concealed due the coexistence of malignant hemopathies such as chronic lymphocytic leukemia (CLL), according to a case report published in The Pan African Medical Journal.
In this case, an elderly man (76 years) who previously underwent surgery for colon cancer was admitted to intensive care for pneumonia. The patient presented with a dry cough, very high fever (104°F), swollen lymph nodes, and diarrhea. A polymerase chain reaction test was conducted and came back positive for COVID-19. A chest CT scan showed pulmonary opacities with consolidation. During his admission, the authors noted that the patient was conscious and breathing 85% at room air with intercostal retraction, with stable hemodynamics: blood pressure, 140/75mmHg; heart rate, 90 bpm; and 39°C fever. Electrocardiogram showed normal sinus rhythm, fixed duration of PR interval, and QTc at 475. Transthoracic echocardiography was normal, they added.
Lab tests conducted on his first day of admission showed the following: elevated white blood cell count at 140020el/mm3 and lymphocytes 129660el/mm3 (vs. 154000el/mm3 at D7), low hemoglobin at 8.9 g/dL, platelets at 464000el/mm3, prothrombin time at 64%, fibrinogen at 6.77 g/L, C-reactive protein at 130 mg/L, brain natriuretic peptide at 249 pcg/L, procalcitonin at 0.017 μg/L, LDH at 331 UI/L, ferritin at 563 μg/L, and troponin at 8.2 ng/L. A blood smeared displayed small lymphocytes with rounded nucleus and reduced cytoplasm. The patient was treated with four daily noninvasive ventilation sessions, hydroxychloroquine (200 mg, twice a day), azithromycin (500 mg/day), ceftriaxone (2 g/day) and moxifloxacin (400 mg twice a day), human immunoglobulins (0.5 g/kg single dose), anticoagulation, proton pump inhibitor, vitamin C, vitamin D, and zinc.
Venclexta PBS listed as first line therapy for CLL patients unfit for chemotherapy
Venclexta PBS listed as first line therapy for CLL patients unfit for chemotherapy
This article was originally published on Mirage
- VENCLEXTA plus obinutuzumab is a combination, fixed duration therapy for previously untreated patients with CLL who are unfit for chemotherapy
- VENCLEXTA was developed out of the Australian discovery that a protein called BCL-2 helps CLL cells survive. Blocking this protein helps to kill and reduce the number of these cancer cells(1)
- Over 1,800 people are predicted to be diagnosed with CLL in Australia this year making it the most common type of leukaemia diagnosed in Australia
Monday 30 November 2020, Sydney – AbbVie (NYSE: ABBV) Australia has welcomed the Government’s announcement that Venclexta® (venetoclax) in combination with obinutuzumab will be available to eligible Australians with Chronic Lymphocytic Leukaemia (CLL) as a first line therapy via the Pharmaceutical Benefits Scheme (PBS) from the 1st December 2020. This PBS listing will allow CLL patients who cannot be treated with standard chemotherapy-based treatments to have affordable access to this first line combination treatment.
Venclexta in combination with obinutuzumab is a targeted, 12-month duration treatment that is to be reimbursed for patients with previously untreated CLL, who are unfit for conventional chemotherapy. (1,5)
Venclexta works by blocking a protein in the body (BCL-2) that helps these cancer cells survive. Blocking this protein helps to kill and reduce the number of cancer cells. It is an oral tablet that can be taken daily in combination with intravenous obinutuzumab.(1)
ASH 2020 CLL Daily Wrap-Up
ASH 2020 CLL Daily Wrap-Up
This article was originally published on Patient Power
Overview
Join Patient Power on Tuesday, December 8th at 4pm PT/7pm ET for a live recap of the latest chronic lymphocytic leukemia (CLL) news from the 62nd American Society of Hematology (ASH) Annual Meeting. ASH is the world’s most comprehensive hematology event of the year where experts review thousands of scientific abstracts, highlighting updates on the most critical topics in hematology. Some of the field’s top doctors will share their thoughts on emerging research, clinical trials, and how current events such as COVID-19 are impacting cancer patients. Attend live to hear exciting CLL news from ASH 2020!
This program is sponsored by Pharmacyclics. This organization has no editorial control. It is produced by Patient Power. Patient Power is solely responsible for program content.
CLL and COVID-19: What Should Patients Know About Vaccines?
CLL and COVID-19: What Should Patients Know About Vaccines?
This article was originally published on Patient Power
What Vaccinations Should CLL Patients Receive?
With the flu season approaching and whispers of a vaccine for COVID-19 in the works, CLL patients with compromised immune systems may have questions about what vaccines they should be receiving, and if there are any risk factors involved. According to the experts, patients with CLL should schedule their flu shots right away, but what is recommended for a future COVID vaccine?
Listen in to find out more! Carol Preston, host and CLL patient advocate, will speak with Paolo Caimi, MD, Hematologist/Oncologist at University Hospital (UH) Cleveland Medical Center on these important topics.
In the Future, Should CLL Patients Get a Vaccine for COVID-19?
Carol Preston:
There is no vaccine at this time. We don’t know exactly when there will be a vaccine. And we know as CLL patients that we are only supposed to have dead vaccines as opposed to live viruses in a vaccine. So what is your thinking about a future COVID-19 vaccine.
Dr. Caimi:
What I am telling my patients is when the vaccine comes, we will first have to make sure that it’s safe. Second, I have to make sure that it’s safe for you. Meaning that for people with bad immune systems or people with half bad immune systems. Third, we’ll have to figure out with people who are less young, whether the dosing is different, whether the regimen is different. Then third, I’ll say probably what I’ll want them to do is to have everybody else around them vaccinated. Right?
So, in general, our patients are the ones who need to be beneficiaries of herd immunity, meaning everybody else’s immune to virus can’t touch them. And that’s probably what I would recommend them first to say, everybody else around you needs to be your barrier of protection for a vaccine. Once we figure out what the vaccine is going to be of benefit for you, maybe you need a different dosing, then we go ahead with it.
CLL Advocates NZ Newsletter Issue 6
CLL Advocates NZ Newsletter Issue 6
Friends of CLLANZ
Funding has been received, with thanks, from the BOP Medical Research Trust for a research project to be done as a summer studentship, by fifth year medical student, Andrew Weston, on “second primary malignancies in NZ CLL patients”.
Second primary malignancies are important in CLL, where the impaired immune system is not as able to deal to developing malignancies as people with normal immune systems can. As a consequence, about one third of CLL patients die of a second primary malignancy, such as melanoma, colon cancer, and pancreatic cancer. Some of these cancers have well-recognised screening procedures to detect early stage cancers, which can have a better outcomes to treatment then, compared to when they are picked up when symptoms develop.
Regular skin checks, and colonoscopy are two good examples of this screening approach.
I would be interested to hear from any of the CLLANZ Friends who are in this group i.e. have had a second primary malignancy, as it may help with the study.
I encourage you to spread the word about the existence of CLLANZ to any New Zealanders you know who are living with CLL, and encourage them to make contact with us.
The other request is to encourage you all to take an active approach to our Facebook group, and to continue to read HealthUnlocked and Patient Power newsletters , which are both easy groups to join, or can be read on our website.
A CLLANZ trustees meeting will be held this month, to review the year gone by, and to plan for the next twelve months. Please contact me at neil@clladvocates.nz to let me know about any topics you would like considered for the agenda.
Best wishes
Neil Graham
NICE recommends new chemo-free chronic lymphocytic leukaemia treatment
NICE recommends new chemo-free chronic lymphocytic leukaemia treatment
This article was originally published on EPR
The UK’s National Institute for Health and Care Excellence has recommended a new chemotherapy-free treatment for people with untreated chronic lymphocytic leukaemia (CLL). The institute said its recommendation of venetoclax plus obinutuzumab could benefit more than 1,000 people each year.
The innovative 12-month treatment will be offered to people with CLL who have not received any prior treatments. CLL affects white blood cells and is the most common chronic leukaemia, accounting for 30 percent of all adult leukaemias. In England there were 3,157 new cases of CLL in 2017.
Venetoclax plus obinutuzumab will be offered as a first-line treatment to people with CLL, with certain genetic abnormalities (such as a 17p deletion or TP53 mutation). For those without a 17p deletion or TP53 mutation, venetoclax plus obinutuzumab will be offered to patients with untreated CLL for whom fludarabine plus cyclophosphamide and rituximab (FCR) or bendamustine plus rituximab (BR) is unsuitable. The combination has also been made available via the UK’s Cancer Drugs Fund for this indication, so more evidence can be gathered on its cost effectiveness.
When and How CLL, SLL Should Be Treated
When and How CLL, SLL Should Be Treated
This article was originally published on Cure
Treatments for chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL) have drastically improved in recent years, although patients may not need immediate treatment directly after being diagnosed.
Then, once it is decided that a patient will undergo treatment, deciding on the timing and regimen is pivotal.
When to Treat CLL/SLL
To determine if treatment is needed, patients should talk with their providers about symptoms they are experiencing, swollen lymph nodes, and blood cell counts, according to Dr. Locke J. Bryan, associate professor of medicine at the Medical College of Georgia and the hematology/oncology fellowship program director at the Georgia Cancer Center at Augusta University.
Bryan discussed CLL and SLL at the CURE® Educated Patient Leukemia & Lymphoma Summit.
One symptom of CLL and SLL is swollen lymph nodes; the location of the swelling could play a role in whether or not the disease is treated.
“It’s about location … a big node may not be causing any problems, but a smaller node pushing on an organ may cause some problems. Then, yes, the patient may need some treatment,” Bryan said. “And then as those (white blood cell) counts start to drop, that may be another reason.”
Dr. Awan on the Importance of Collaborative Care in CLL
Dr. Awan on the Importance of Collaborative Care in CLL
This article was originally published on Onc Live
The field of CLL continues to excel forward with novel molecular biomarkers, new therapeutic options, and ongoing clinical trials, says Awan.
Despite this, CLL remains a complex disease, Awan adds. As such, closely collaboration between community oncologists and CLL experts is often necessary to ensure patients receive optimal care.
Moreover, individuals who treat many cases of CLL may be able to recommend ongoing clinical trials that community oncologists are not aware of, Awan adds.
Ultimately, collaborative care is needed to identify new treatments and testing options, and to improve upon available therapies, Awan concludes.