PCI-32765 (ibrutinib) is one of the new generation of targeted kinase inhibitors that is getting a lot of attention.  ASCO 2012 had three important papers on this drug.  So far, so good!  But please make sure you read the Editorial section as well, where I highlight some adverse effect concerns based on feedback I got from people taking this drug.

Even for the young at heart, age does make a difference.  This is of particular importance when we consider therapy options for elderly patients.  Here is a review of a “best practices” paper that discusses the special needs of elderly CLL patients.

When too many hematopoietic stem cells die, the body is no longer able to make new blood cells (red blood cells, platelets, neutrophils etc). Patients may become transfusion dependent, just to stay alive.  Aggressive chemotherapy may cause this type of pancytopenia, especially in elderly patients.

Several clinical trials have highlighted the use of FCR in chemo-naive patients.  But who is likely to get most joy from FCR as salvage therapy, after relapsing from other therapies?  When is FCR salvage not worth trying?  Here are some useful pointers  from M. D. Anderson.

Recent European clinical trial results have emphasized the importance of getting up-to-date FISH testing prior to front-line therapy decisions.  Are there situations when FISH results fail to warn us ahead of time?  You bet! 

We know that your genetics influences your chances of getting diagnosed with CLL. But do environmental exposure and lifestyles play a role as well?  How about viruses?

One of the crucial organs that can be infiltrated and damaged by CLL cells  is your liver. It is time you learnt about this very important organ.  If your liver shuts down, that can kill you a lot more quickly than CLL can.

When push comes to shove, what matters most to us  is how long we can live with CLL, and the quality of  that life. How much of a penalty do CLL patients pay if they also get secondary cancers?

Rai and Binet systems have been the bedrock of staging risk status in CLL.  This important ASH2009 paper explains where both of these staging systems fail in predicting specific high risk groups.

When Watch & Wait ends, do you know what to do?  Does your local oncologist know what to do? We will review a truly excellent “Best Practices” article by  Dr. John Gribben – a world-class expert who shares his expertise with us: when, why and what to use as front line therapy in treating CLL patients.