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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