Molecular Pathology of Chronic Lymphocytic Leukemia and Relevance to Novel Therapies

2014 ◽  
pp. 1664-1676
Author(s):  
J.A. Hemminger ◽  
G. Lozanski
2021 ◽  
Vol 8 ◽  
pp. 237437352110349
Author(s):  
Elissa C Kranzler ◽  
Julie S Olson ◽  
Helen M Nichols ◽  
Eva YN Yuen ◽  
Shauna McManus ◽  
...  

Chronic lymphocytic leukemia (CLL) often requires consideration of multiple treatment options. Shared decision-making (SDM) is important, given the availability of increasingly novel therapies; however, patient–provider treatment conversations vary. We examined relationships between patient–provider discussions of new CLL treatment options and sociodemographic, clinical, and patient–provider communication variables among 187 CLL patients enrolled in Cancer Support Community’s Cancer Experience Registry. Factors significantly associated with self-reports of whether patients’ providers discussed new CLL treatment options with them were examined using χ2 tests, t tests, and hierarchical logistic regression. Fifty-eight percent of patients reported discussing new treatment options with their doctor. Patients with higher education were 3 times more likely to discuss new treatment options relative to those with lower education (OR = 3.06, P < .05). Patients who experienced a cancer recurrence were 7 times more likely to discuss new treatment options compared to those who had not (OR = 7.01, P < .05). Findings offer insights into the correlates of patient–provider discussions of new CLL treatment options. As novel therapies are incorporated into standards of care, opportunities exist for providers to improve patient care through enhanced SDM.


2010 ◽  
pp. 255-291
Author(s):  
Daniela Hoehn ◽  
L. Jeffrey Medeiros ◽  
Sergej Konoplev

Blood Reviews ◽  
2004 ◽  
Vol 18 (2) ◽  
pp. 137-148 ◽  
Author(s):  
Blanche H Mavromatis ◽  
Bruce D Cheson

Author(s):  
Jennifer R. Brown ◽  
David L. Porter ◽  
Susan M. O'Brien

The last several years have seen an explosion of novel therapies for chronic lymphocytic leukemia (CLL). These include the antibody obintutuzumab (GA-101), as well as small-molecule inhibitors of key pathways involved in the pathogenesis of CLL, specifically the B-cell receptor (BCR) pathway (especially Bruton's tyrosine kinase [BTK] and P13K), and the antiapoptotic pathway (especially BCL-2). We will consider each in turn, focusing on the molecules most advanced in clinical development. There has also been extensive development in rewiring the patient's own immune system to treat CLL. This has been done through modifying autologous T cells to express a chimeric antigen receptor (CAR). Thus far all CAR-T preparations have targeted the CD19 antigen. This is a good rational for B-cell malignancies as CD19 expression is limited to B-cell malignancies and normal B cells. The in vivo amplification of the transduced T cells relies on signaling and co-signaling domains and provides significant killing of CLL cells. As exciting as these novel agents and approaches are, they obviously beg the question, will chemotherapy as a treatment for CLL soon be obsolete? Although chemotherapy is associated with known short-term toxicities, it has the advantage of being completed in a short period of time and being relatively inexpensive in comparison to novel therapies. In addition, long-term follow-up of results with chemoimmunotherapy have now identified a group of patients whose remissions are maintained for more than 10 years. An important question that will arise going forward is how to incorporate novel agents without eliminating the long term benefits possible with chemoimmunotherapy in a subset of patients with CLL.


2017 ◽  
Vol 59 (3) ◽  
pp. 625-632 ◽  
Author(s):  
AnnaLynn M. Williams ◽  
Andrea M. Baran ◽  
Philip J. Meacham ◽  
Megan M. Feldman ◽  
Hugo E. Valencia ◽  
...  

2015 ◽  
Vol 15 (11) ◽  
pp. 627-634.e5 ◽  
Author(s):  
Carolyn Owen ◽  
Sarit Assouline ◽  
John Kuruvilla ◽  
Cassandra Uchida ◽  
Catherine Bellingham ◽  
...  

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