ASH News Daily 2013 - Day 2 - (Page A-17)

Sunday, December 8, 2013 LEUKEMIA CLL: A New Beginning to the End BY MARC J. KAHN, MD, MBA C hronic lymphocytic leukemia (CLL) remains the most common leukemia in West- ern countries and predominantly affects older adults. Despite advances in the treatment of CLL, including immunomodulators, monoclonal antibodies, and targeted therapies, CLL remains an incurable disease. However, with newer therapies used alone and in combination, including the use of allogeneic bone marrow transplantation, a true cure for CLL may be near. Yesterday's session, Chronic Lymphocytic Leukemia: A New Treatment Era is Born, detailed some of the advances in treating this common leukemia. To quote the session chair, Dr. Michael Hallek, University of Cologne, Germany, "It is a unique and exciting time to perform clinical research on CLL. With all the new diagnostic and therapeutic tools, we all feel justified to hope to achieve a long-term control, if not cure, of this leukemia in the next few years." Dr. Hallek, director of the Center of Integrated Oncology, the joint comprehensive cancer center of the Universities of Cologne and Bonn, began the session by discussing the current management of CLL including the use of targeted therapies and sequential therapies. He suggested that future treatment to attain long-term control of CLL may include what he referred to as "sequential triple-T," involving three parts: debulking, induction, and minimal residual disease tailored maintenance. Dr. Hallek concluded, "Our major task in CLL research now is to identify the optimal combinations of novel drugs like Bcl2 inhibitors, kinase inhibitors, and monoclonal antibodies to achieve maximal efficacy with minimal toxicity." The next speaker was Dr. John Gribben from Barts Cancer Institute, Queen Mary University, London. He discussed the immunosuppressive nature of CLL and postulated that upregulation of the immune system could potentially offer the greatest likelihood of success in treating this disease. His talk included discussion of CLL vaccines, the use of modified T cells, and the role of allogeneic transplantation. Closing the session was Dr. Tait Shanafelt from the Mayo Clinic. He discussed the proper evaluation and management of older patients with CLL. Specifically, Dr. Shanafelt discussed the role of "pa- tient fitness" in dictating therapies. One take-home message from yesterday's session is that CLL is a complex disease that occurs in older patients with comorbidities. Despite the complexity, with modern treatment approaches that target the immune system, we may be closer to seeing the beginning of the end of CLL as a fatal disease. Dr. Kahn indicated no relevant conflicts of interest. Dr. John Gribben, Barts Cancer Institute, St. Bartholomew's Hospital, Queens Mary University of London, UK, discusses enhancing T-cell-mediated responses in CLL. ASH NEWS DAILY Page A-17 ®

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ASH News Daily 2013 - Day 2

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