Bottom Line: This meta-analysis or combination of 61 trials demonstrated that atrial fibrillation, hypertension, and diarrhea were more common with ibrutinib, and some bleeding and infection events were more common with acalabrutinib and zanubrutinib. Who Performed the Research and Where Was it Presented: A consortium of doctors led by Dr. Jacqueline Wang of NYU Langone Health presented the abstract at ASH 2022. Background: We are aware of how Bruton’s tyrosine kinase inhibitors (BTKi’s) have revolutionized the therapeutic landscape of B-cell malignancies, including chronic lymphocytic le ..read more

Medically reviewed and interview by Dr. Brian Koffman. The Bottom Line: This new research identifies some of the genetic changes that drive the evolution of CLL to Richter’s syndrome. Researchers hope this information can be used to develop better treatments for Richter’s syndrome. Who Performed the Research and Where Was it Presented: Dr. Stephen Stilgenbauer from Ulm University and colleagues presented the results at the American Society for Hematology (ASH) Annual Meeting 2022. Background: Richter’s syndrome (a.k.a. Richter’s transformation) is a rare complication of chronic lymph ..read more

At the American Society of Hematology (ASH) 2021 Annual Conference and Exhibition, I interviewed Dr. Jeff Sharman, a hematologist/oncologist at Willamette Valley Cancer Institute in Eugene, OR. We discussed zanubrutinib and its use in patients who could not tolerate previous BTK inhibitors. Chemotherapy was until recently the only treatment available to CLL/SLL patients until the BTK inhibitor ibrutinib revolutionized the treatment of CLL/SLL. Bruton tyrosine kinase (BTK) inhibitors such as ibrutinib are very effective for treating chronic lymphocytic leukemia ..read more

 In an oral presentation during ASH 2020, Dr. Anthony Mato discussed LOXO-305, a new generation BTKi (Bruton Tyrosine Kinase Inhibitor) that blocks a key step in the B cell receptor (BCR) pathway. In doing so, it blocks pro-survival and “homing” messages to the CLL cells, forcing the cancer cells to leave their protective niches in the lymph nodes and bone marrow, and float out into the blood stream, eventually dying. Ibrutinib was the first approved BTKi and it revolutionized the treatment of CLL because of its ability to provide a durable response in most patients, including those with ..read more

At the virtual ASH 2020 Annual Conference and Exposition, Dr. John Pagel of Swedish Hospital and one of CLL Society’s directors interviewed Dr. Arnon Nagler of Sheba Medical Center in Israel concerning using “in-house” CAR-T cells made locally at his medical center for Richter’s Transformation patients.   Richter’s Transformation (RT) is usually an aggressive transformation of chronic lymphocytic leukemia into a fast-moving lymphoma, usually clonally related, DLBCL (diffuse large B-cell lymphoma). RT is associated with a very poor response to most therapies and ha ..read more

Richter’s transformation (a.k.a. Richter’s syndrome) is a rare complication of chronic lymphocytic leukemia (CLL) where the cancer cells transform into a much more aggressive lymphoma. It occurs in 2-10% of CLL patients, and it is associated with very rapid disease progression, limited therapeutic options, and poor survival. Outcomes have generally been poor because the lymphoma does not respond well to traditional treatments. While chemotherapy is often used to treat Richter’s transformation, it is not very effective.    At the annual meeting of the European Hematology Association ..read more

    The Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib and BCL2 inhibitor venetoclax have been very successful as individual therapies for treating chronic lymphocytic leukemia (CLL), but on their own they rarely lead to the eradication of measurable (a.k.a. minimal) residual disease (MRD). Researchers have been very interested in whether they can combine these therapies to improve outcomes for patients and achieve better remissions. They also want to determine how long would patients need to take the combination for to achieve deep remissions.   At the annual meeting of th ..read more

I have known Dr. John Byrd since we met at ASH in 2011 and he has been my chronic lymphocytic leukemia (CLL) doctor most of that time. It would not be a stretch to say that his care in a Phase I/II trial of PCI-32765 (ibrutinib) at Ohio State University in Columbus saved my life. It would also not be fair if it weren’t mentioned that I have been blessed with excellent care from several other doctors. These have included superstar Dr. Tom Kipps, Drs. Sanjay Sharma (hematology), David Rhodes (family medicine), many local healthcare providers, and a recent addition to my team, CLL expert Dr. Alex ..read more

Sad news.   My long time CLL buddy and a founding member of the CLL Society Patient Advisory Board, Joe Greenblatt sailed away on January 23, 2021 after a long struggle with COVID-19. Joe had beaten a coma-inducing West Nile Virus encephalitis years ago, learnt to walk again, but his 3rd time on a ventilator proved too much when his lungs and kidneys ultimately failed him.   I met Joe more than a dozen years ago when he had the great notion to meet up with fellow CLLers at our homes and share our war stories and insider tips. He realized the uniqueness of CLL and fe ..read more

There has been much discussion, but little data on what is the best order of medications to treat CLL and whether combining drugs is better than sequencing them in the long run. In other words, what is the best way to use all this great drugs to keep us alive the longest. At ASH 2019, in Orlando, FL, I interviewed Dr. Jennifer Brown, Director of CLL Research at Dana Farber Cancer Institute in Boston and a Professor at Harvard Medical School about her real-world research to gather some data to inform these discussions. Specifically, Dr. Brown looked at the data for those patients who had ..read more