26,437 results match your criteria Chronic Lymphocytic Leukemia


Taking therapeutic apheresis services to patients in South Africa: An eight year review of SANBS mobile therapeutic apheresis service, 2013-2020.

Transfus Apher Sci 2021 May 21:103167. Epub 2021 May 21.

Sanquin Blood Supply, The Netherlands.

Introduction: A 20 year review of health and health care presents the multiple challenges faced by South Africans. Health and poverty is highlighted with 45% of population living on approximately US$ 2 per day and 10 million living on less than US$ 1 per day. Widening disparities in health care provision between public and private sector hospital services exist. Read More

View Article and Full-Text PDF

Smudge cells percentage on blood smear is a reliable prognostic marker in chronic lymphocytic leukemia.

Hematol Transfus Cell Ther 2021 May 27. Epub 2021 May 27.

University Paris Sarclay, Paris, France.

Objective: We evaluated the relevance of using the smudge cell percentage in the blood smear as a prognostic marker in CLL.

Methods: In this prospective study, 42 untreated Senegalese patients with CLL were enrolled. The diagnosis was established, based on the peripheral blood count and flow cytometry using the Matutes score. Read More

View Article and Full-Text PDF

Efficacy of venetoclax plus rituximab for relapsed CLL: Five-year follow-up of continuous or limited-duration therapy.

Blood 2021 Jun 3. Epub 2021 Jun 3.

Department of Hematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital; University of Melbourne, Australia.

We report long-term follow-up of the phase 1b study of venetoclax and rituximab (VenR) in patients with relapsed chronic lymphocytic leukemia (CLL), including outcomes with continuous or limited-duration therapy. Patients received venetoclax daily (200-600 mg) and rituximab over 6 months, then venetoclax monotherapy. Patients achieving complete response (CR), CR with incomplete marrow recovery (CRi), or undetectable minimal residual disease (uMRD) assessed by flow cytometry (<10-4 cutoff) were allowed, but not required, to discontinue therapy, while remaining on study and could be re-treated with VenR upon progression. Read More

View Article and Full-Text PDF

Post-Transformation IGHV-IGHD-IGHJ Mutations in Chronic Lymphocytic Leukemia B Cells: Implications for Mutational Mechanisms and Impact on Clinical Course.

Front Oncol 2021 25;11:640731. Epub 2021 May 25.

The Feinstein Institutes for Medical Research, Institute for Molecular Medicine, Northwell Health, Manhasset, NY, United States.

Analyses of IGHV gene mutations in chronic lymphocytic leukemia (CLL) have had a major impact on the prognostication and treatment of this disease. A hallmark of IGHV-mutation status is that it very rarely changes clonally over time. Nevertheless, targeted and deep DNA sequencing of IGHV-IGHD-IGHJ regions has revealed intraclonal heterogeneity. Read More

View Article and Full-Text PDF

Post-transplant relapse of therapy-related MDS as gastric myeloid sarcoma: Case report and review of literature.

Leuk Res Rep 2021 14;15:100244. Epub 2021 May 14.

Department of Hematopathology and Lab Medicine, Moffitt Cancer Center, Tampa, FL, USA.

Introduction: Myelodysplastic syndrome (MDS) are hematologic neoplasms characterized by morphologic dysplasia and ineffective hematopoiesis in the bone marrow. The only potentially curative therapy is stem cell transplant. However, relapse remains a major challenge and is seen in about 25-40% of cases. Read More

View Article and Full-Text PDF

Targeted PI3K/AKT-hyperactivation induces cell death in chronic lymphocytic leukemia.

Nat Commun 2021 06 10;12(1):3526. Epub 2021 Jun 10.

Institute of Clinical Chemistry and Pathobiochemistry, School of Medicine, Technical University of Munich, Munich, Germany.

Current therapeutic approaches for chronic lymphocytic leukemia (CLL) focus on the suppression of oncogenic kinase signaling. Here, we test the hypothesis that targeted hyperactivation of the phosphatidylinositol-3-phosphate/AKT (PI3K/AKT)-signaling pathway may be leveraged to trigger CLL cell death. Though counterintuitive, our data show that genetic hyperactivation of PI3K/AKT-signaling or blocking the activity of the inhibitory phosphatase SH2-containing-inositol-5'-phosphatase-1 (SHIP1) induces acute cell death in CLL cells. Read More

View Article and Full-Text PDF

Longitudinal single-cell dynamics of chromatin accessibility and mitochondrial mutations in chronic lymphocytic leukemia mirror disease history.

Cancer Discov 2021 Jun 10. Epub 2021 Jun 10.

Department of Medical Oncology, Dana-Farber Cancer Institute

While cancers evolve during disease progression and in response to therapy, temporal dynamics remain difficult to study in humans due to the lack of consistent barcodes marking individual clones in vivo. We employ mitochondrial single-cell assay for transposase-accessible chromatin with sequencing to profile 163,279 cells from 9 patients with chronic lymphocytic leukemia (CLL) collected across disease course and utilize mitochondrial DNA (mtDNA) mutations as natural genetic markers of cancer clones. We observe stable propagation of mtDNA mutations over years in the absence of strong selective pressure indicating clonal persistence, but dramatic changes following tight bottlenecks including disease transformation and relapse post-therapy, paralleled by acquisition of copy number variants, changes in chromatin accessibility and gene expression. Read More

View Article and Full-Text PDF

BCL-2 Inhibition as Treatment for Chronic Lymphocytic Leukemia.

Curr Treat Options Oncol 2021 Jun 10;22(8):66. Epub 2021 Jun 10.

Bone Marrow Transplantation Unit, Hospital Israelita Albert Einstein, Av. Albert Einstein (SP), São Paulo, 627/520, Brazil.

Opinion Statement: At the end of the 1990s, with the advent of imatinib for chronic myeloid leukemia and rituximab for B cell lymphoproliferative diseases with CD20 expression, there was a great conceptual evolution in the treatment of onco-hematological diseases. Researchers from around the world and the pharmaceutical industry began to focus their efforts on the so-called target therapy used alone or associated with classic chemotherapeutic drugs. In chronic lymphocytic leukemia, the development of second-generation anti-CD20 antibodies, biosimilars, PI3K (phosphatidylinositol 3-kinases) inhibitors, BTK (Bruton's tyrosine kinase) inhibitors, and anti-bcl 2 drugs represented mainly by venetoclax brought new, broader, and more effective opportunities in the treatment of this disease. Read More

View Article and Full-Text PDF

Ibrutinib Plus Venetoclax for First-line Treatment of Chronic Lymphocytic Leukemia: A Nonrandomized Phase 2 Trial.

JAMA Oncol 2021 Jun 10. Epub 2021 Jun 10.

Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston.

Importance: Oral targeted therapies have advanced the treatment of chronic lymphocytic leukemia (CLL). These therapies include Bruton tyrosine kinase inhibitors, used as monotherapy, and the Bcl-2 inhibitor venetoclax, typically combined with the CD20 monoclonal antibody. Preclinical studies have shown synergy between Bruton tyrosine kinase inhibitors and the Bcl-2 inhibitor venetoclax. Read More

View Article and Full-Text PDF

Population Pharmacokinetic And Exposure-Response Analyses Of Intravenous And Subcutaneous Rituximab In Patients With Chronic Lymphocytic Leukemia.

CPT Pharmacometrics Syst Pharmacol 2021 Jun 10. Epub 2021 Jun 10.

Roche Innovation Center Basel, Basel, Switzerland.

A subcutaneous formulation of the anti-CD20 antibody rituximab has been developed. Fixed-dose subcutaneous rituximab delivers non-inferior serum trough concentrations (C ), ensuring similar target saturation and comparable efficacy/safety to intravenous rituximab, but with simplified and shortened preparation and administration. We aimed to characterize the pharmacokinetic and exposure-response properties of subcutaneous rituximab. Read More

View Article and Full-Text PDF

Concomitant autoimmune hemolytic anemia and pure red cell aplasia in a patient with chronic lymphocytic leukemia successfully treated with ibrutinib.

Ann Hematol 2021 Jun 10. Epub 2021 Jun 10.

Department of Internal Medicine, General Hospital of Šibenik-Knin County, Stjepana Radića 83, 22000, Šibenik, Croatia.

View Article and Full-Text PDF

Intrinsic Resistance of Chronic Lymphocytic Leukemia Cells to NK Cell-Mediated Lysis Can Be Overcome by Pharmacological Inhibition of Cdc42-Induced Actin Cytoskeleton Remodeling.

Front Immunol 2021 24;12:619069. Epub 2021 May 24.

Cytoskeleton and Cancer Progression, Department of Oncology, Luxembourg Institute of Health, Luxembourg City, Luxembourg.

Natural killer (NK) cells are innate effector lymphocytes with strong antitumor effects against hematologic malignancies such as chronic lymphocytic leukemia (CLL). However, NK cells fail to control CLL progression on the long term. For effective lysis of their targets, NK cells use a specific cell-cell interface, known as the immunological synapse (IS), whose assembly and effector function critically rely on dynamic cytoskeletal changes in NK cells. Read More

View Article and Full-Text PDF

Ibrutinib Restores Tumor Specific Adaptive Immunity in Chronic Lymphocytic Leukemia.

Authors:
Clive S Zent

Clin Cancer Res 2021 Jun 9. Epub 2021 Jun 9.

Wilmot Cancer Institute, University of Rochester Medical Center

CLL is characterized by early and profound immune suppression and reversal of these effects is essential to improve patient outcome. Targeted therapy with small molecule inhibitors such as ibrutinib is highly effective and tolerable. Emerging data suggests that CLL patients responding to ibrutinib therapy can recover anti-CLL innate immune cytotoxicity. Read More

View Article and Full-Text PDF

How I manage chronic lymphocytic leukemia.

Authors:
Nitin Jain

Clin Adv Hematol Oncol 2021 Jun;19(6):360-364

Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas.

View Article and Full-Text PDF

Specific features of T- and NK-cellular immunity in chronic lymphocytic leukemia.

Klin Lab Diagn 2021 Jun;66(6):345-352

Russian Medical Academy of professional continuous education.

Profound immunological dysfunction is the key factor determining the development of infectious complications in chronic lymphocytic leukemia (CLL). The aim of this work is to assess the features of the subpopulation composition of T-lymphocytes (T-helpers (Th), cytotoxic T-lymphocytes (Tcyt), T regulatory cells (Treg), T-NK cells, naive Th, Th-memory, activated T-lymphocytes, TCRγδ cells) and NK cells in peripheral blood of patients with newly diagnosed chronic lymphocytic leukemia (CLL) and receiving ibrutinib therapy. Hematological and immunophenotypic studies have been performed in 30 patients with previously untreated CLL, 122 patients on ibrutinib therapy and 20 healthy donors. Read More

View Article and Full-Text PDF

[Efficacy and Relapse Prediction Model of Allogeneic Peripheral Blood Stem Cell Transplantation in Adult Acute Leukemia].

Zhongguo Shi Yan Xue Ye Xue Za Zhi 2021 Jun;29(3):696-702

Department of Hematology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China,E-mail:

Objective: To observe the clinical efficacy of allogeneic peripheral blood stem cell transplantation(allo-HSCT) on the treatment of adult acute leukemia patients, moreover, to establish and evaluate a Logistic model to predict the risk of relapse in adult acute leukemia patients after allo-HSCT.

Methods: The clinical data of 145 adult acute leukemia patients treated by peripheral blood stem cell transplantation in the First Affiliated Hospital of Xi'an Jiaotong University from January 2010 to December 2019 was enrolled and analyzed retrospectively. Complications and survival of patients were observed. Read More

View Article and Full-Text PDF

Should Undetectable Minimal Residual Disease Be the Goal of Chronic Lymphocytic Leukemia Therapy?

Hematol Oncol Clin North Am 2021 May 15. Epub 2021 May 15.

Department of Internal Medicine, Center of Integrated Oncology Cologne Bonn, University Hospital, German CLL Study Group, Gleueler Strasse 176, 50935 Cologne, Germany.

With the advent of highly effective novel therapies for chronic lymphocytic leukemia, conventional response assessment is not able to sensitively capture depth of response. To achieve a more precise assessment of response, minimal residual disease has been introduced to more accurately classify and quantify treatment outcomes. It is now considered a strong predictor of outcome in chronic lymphocytic leukemia, although its interpretation depends on the therapeutic context. Read More

View Article and Full-Text PDF

Mantle cell lymphoma, malt lymphoma, small lymphocytic lymphoma and follicular lymphoma of the oral cavity: an update.

J Oral Pathol Med 2021 Jun 8. Epub 2021 Jun 8.

Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.

Although uncommon, mature small B-cell lymphomas may arise in the oral/maxillofacial area and oral pathologists must be aware of the key characteristics of these neoplasms to perform an accurate diagnosis. In this manuscript we attempted to integrate the currently available data on the clinicopathological features of Follicular Lymphoma (FL), Mantle Cell Lymphoma (MCL), Extranodal Marginal Zone Lymphoma of Mucosa-Associated Lymphoid Tissue (MALT-L), and Chronic Lymphocytic Leukaemia/ Small Lymphocytic Lymphoma (CLL/SLL) affecting these anatomical regions. An updated descriptive literature review was carried out and a detailed electronic search was done in multiple databases to gather all cases affecting the oral/maxillofacial region and palatine tonsils. Read More

View Article and Full-Text PDF

Using the Computer-based Health Evaluation System (CHES) to Support Self-management of Symptoms and Functional Health: Evaluation of Hematological Patient Use of a Web-Based Patient Portal.

J Med Internet Res 2021 Jun 8;23(6):e26022. Epub 2021 Jun 8.

University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.

Background: Patient portals offer the possibility to assess patient-reported outcome measures (PROMs) remotely, and first evidence has demonstrated their potential benefits.

Objective: In this study, we evaluated patient use of a web-based patient portal that provides patient information and allows online completion of PROMs. A particular focus was on patient motivation for (not) using the portal. Read More

View Article and Full-Text PDF

Impaired Humoral Immunity to SARS-CoV-2 Vaccination in Non-Hodgkin Lymphoma and CLL Patients.

medRxiv 2021 Jun 3. Epub 2021 Jun 3.

Patients with hematologic malignancies are a high priority for SARS-CoV-2 vaccination, yet the benefit they will derive is uncertain. We investigated the humoral response to vaccination in 53 non-Hodgkin lymphoma (NHL), Hodgkin lymphoma (HL), or CLL patients. Peripheral blood was obtained 2 weeks after first vaccination and 6 weeks after second vaccination for antibody profiling using the multiplex bead-binding assay. Read More

View Article and Full-Text PDF

Ibrutinib does not prevent kidney fibrosis following acute and chronic injury.

Sci Rep 2021 Jun 7;11(1):11985. Epub 2021 Jun 7.

UMR 1297, Institut Des Maladies Métaboliques Et Cardiovasculaires, Institut National de La Santé Et de La Recherche Médicale (INSERM), Toulouse, France.

Recent studies suggested that ibrutinib, a Bruton tyrosine kinase (BTK) inhibitor, developed for the treatment of chronic lymphocytic leukemia, may prevent NLRP3 inflammasome activation in macrophages, IL-1β secretion and subsequent development of inflammation and organ fibrosis. The role of NLRP3 has been underlined in the various causes of acute kidney injury (AKI), a pathology characterized by high morbimortality and risk of transition toward chronic kidney disease (CKD). We therefore hypothesized that the BTK-inhibitor ibrutinib could be a candidate drug for AKI treatment. Read More

View Article and Full-Text PDF

Increased Thyroid-Hormone Requirements Consistent With Type 3 Deiodinase Induction Related to Ibrutinib in a Thyroidectomized Woman.

AACE Clin Case Rep 2021 Mar-Apr;7(2):121-123. Epub 2020 Dec 28.

Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Objective: Tyrosine-kinase inhibitors (TKIs) are chemotherapeutic agents associated with increased thyroid-hormone requirements and altered deiodinase activity. We present the first case to link these findings to the TKI ibrutinib.

Methods: Serial thyroid-stimulating hormone (TSH), free-thyroxine (FT4), free-triiodothyronine (FT3), and reverse-triiodothyronine (rT3) levels were assessed. Read More

View Article and Full-Text PDF
December 2020

Acute coronary syndrome secondary to cardiac infiltration and coronary occlusion of chronic lymphocytic leukemia - A case report.

J Cardiol Cases 2021 Jun 11;23(6):257-260. Epub 2020 Dec 11.

Royal Stoke University Hospital, Stoke-on-Trent ST4 6QG, United Kingdom.

A 72-year-old male with a history of chronic lymphocytic leukemia (CLL) was admitted to hospital with a productive cough and an episode of diarrhea and vomiting. He was initially treated for pneumonitis and sepsis. On the 12th day of his admission, he reported chest pain. Read More

View Article and Full-Text PDF

Real World Treatment Practices for Mantle Cell Lymphoma in Japan: An Observational Database Research Study (CLIMBER-DBR).

J Clin Exp Hematop 2021 Jun 5. Epub 2021 Jun 5.

Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.

Mantle cell lymphoma (MCL) accounts for approximately 3% of all cases of malignant lymphoma in Japan. The CLIMBER-DBR (Treatment practices and patient burden in chronic lymphocytic leukemia and mantle cell lymphoma patients in the real world: An observational database research in Japan) study examined the clinical characteristics, treatment patterns, and healthcare resource utilization of MCL in a real-world clinical setting in Japan. Using the Japanese Medical Data Vision database, we extracted data for 1130 patients with MCL (ICD-10 code C83. Read More

View Article and Full-Text PDF

Real World Treatment Practices for Chronic Lymphocytic Leukemia in Japan: An Observational Database Research Study (CLIMBER-DBR).

J Clin Exp Hematop 2021 Jun 5. Epub 2021 Jun 5.

Innovative Cancer Center, Shimane University Hospital, Izumo, Japan.

There are limited real-world data on the treatment practices and healthcare resource utilization associated with chronic lymphocytic leukemia (CLL) in Japan. In this study (CLIMBER-DBR), we performed retrospective analyses of the Japanese Medical Data Vision database, and extracted data for 2562 patients with newly diagnosed CLL (CLL-1 cohort) and 930 patients receiving CLL treatment (CLL-2 cohort) registered between March 1, 2013 and February 28, 2018. The median follow-up in the CLL-1 cohort was 721 (quartile 1-3: 363-1267) days and the median time to initial (first-line) treatment was 1331 (quartile 1-3: 189-not reached) days. Read More

View Article and Full-Text PDF

-associated methylation signatures more accurately predict clinical outcomes of chronic lymphocytic leukemia patients than mutation load.

Haematologica 2021 Jun 3. Epub 2021 Jun 3.

Department of Biomedicine, Aarhus University, Aarhus, Denmark; Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark; Independent Clinical Epigenetics Laboratory, Pomeranian Medical University, Szczecin.

Currently, no molecular biomarker indexes are used in standard care to make treatment decisions at diagnosis of chronic lymphocytic leukemia (CLL). We used Infinium MethylationEPIC array data from diagnostic blood samples of 114 CLL patients, and developed a patient stratification procedure based on methylation signatures associated with mutation load of the IGHV gene. This procedure allowed us to predict the time to treatment (TTT) with HR 8. Read More

View Article and Full-Text PDF

The complex karyotype landscape in chronic lymphocytic leukemia allows to refine the risk of Richter syndrome transformation.

Haematologica 2021 Jun 3. Epub 2021 Jun 3.

Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padua, Italy; Veneto Institute of Molecular Medicine, Padua.

Complex karyotype (CK) at chronic lymphocytic leukemia (CLL) diagnosis is a negative biomarker of adverse outcome. Since the impact of CK and its subtypes, namely type-2 CK (CK with major structural abnormalities) or high-CK (CK with C5 chromosome abnormalities), on the risk of developing Richter syndrome (RS) is unknown, we carried out a multicenter reallife retrospective study to test its prognostic impact. Among 540 CLL patients, 107 harbored a CK at CLL diagnosis, 78 were classified as CK2 and 52 as high-CK. Read More

View Article and Full-Text PDF

Venetoclax-based rational combinations are effective in models of MYCN-amplified neuroblastoma.

Mol Cancer Ther 2021 Jun 4. Epub 2021 Jun 4.

Virginia Commonwealth University

Venetoclax is a small molecule inhibitor of the pro-survival protein BCL-2 that has gained market approval in BCL-2 dependent hematological cancers including chronic lymphocytic leukemia and acute myeloid leukemia. Neuroblastoma (NB) is a heterogenous pediatric cancer with a five-year survival rate of less than 50% for high-risk patients, which include nearly all cases with amplified MYCN. We previously demonstrated that venetoclax is active in MYCN-amplified NB but has limited single-agent activity in most models, presumably the result of other pro-survival BCL-2 family protein expression or insufficient pro-death protein mobilization. Read More

View Article and Full-Text PDF

Histopathologic and Machine Deep Learning Criteria to Predict Lymphoma Transformation in Bone Marrow Biopsies.

Arch Pathol Lab Med 2021 Jun 4. Epub 2021 Jun 4.

From the Department of Pathology (Irshaid, Garritano, Patsenker, Kluger, Katz, Xu), Yale New Haven Hospital, Yale School of Medicine, New Haven, Connecticut.

Context.—: Large-cell transformation (LCT) of indolent B-cell lymphomas, such as follicular lymphoma (FL) and chronic lymphocytic leukemia (CLL), signals a worse prognosis, at which point aggressive chemotherapy is initiated. Although LCT is relatively straightforward to diagnose in lymph nodes, a marrow biopsy is often obtained first given its ease of procedure, low cost, and low morbidity. Read More

View Article and Full-Text PDF

Optimizing Treatment of Chronic Lymphocytic Leukemia.

Authors:
Sandra E Kurtin

J Adv Pract Oncol 2021 Apr 1;12(3):325-328. Epub 2021 Apr 1.

The University of Arizona Cancer Center, Tucson, Arizona.

During JADPRO Live Virtual 2020, Sandra Kurtin, PhD, ANP-C, AOCN®, described personalization of the treatment of chronic lymphocytic leukemia (CLL) using molecular attributes of the disease, as well as patient characteristics. Dr. Kurtin discussed front-line treatment in previously untreated patients, treatment for relapsed or refractory CLL, and how to prevent, mitigate, and manage adverse events in order to optimize treatment. Read More

View Article and Full-Text PDF