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The Fellow on Call: The Heme/Onc Podcast
Episode 097: Treatment of Relapsed/Refractory CLL
Mar 27, 2024
Dive into the complexities of managing relapsed chronic lymphocytic leukemia (CLL) with insights on treatment strategies and patient care. Discover the challenges of diagnosing Richter's transformation and the impact of key therapies like obinutuzumab and venetoclax. Learn about the significance of genetic markers in prognosis and the evolving landscape of second-line treatments, including the implications of recent market withdrawals. Nostalgic discussions about childhood animated films add a light-hearted touch to this serious topic.
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Quick takeaways
- Understanding FISH testing and IGHV mutation status is vital for clinicians to predict treatment needs in relapsed/refractory CLL patients.
- Managing relapsed CLL includes restaging with imaging and considering treatment options like BTK inhibitors, especially in duel-refractory cases.
Deep dives
Understanding Treatment Indications in CLL
Treatment for Chronic Lymphocytic Leukemia (CLL) is generally initiated based on specific clinical indications. These include symptoms such as anemia or thrombocytopenia related to CLL infiltration, recurrent autoimmune cytopenias, B symptoms, and a lymphocyte doubling time of less than six months. It's important to note that asymptomatic patients with high white cell counts, sometimes exceeding 100,000, can often be monitored without treatment. The decision to observe rather than treat is crucial in managing patients effectively, especially when high-risk factors are present, indicating a likely need for future therapies.
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Discover
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Listen to the best highlights from the podcasts you love and dive into the full episode