Dr. Bruce Levine

Dr. Bruce Levine at the University of Pennsylvania recently provided an update on his CLL Global project which is based on the hypothesis that activated T-cells can repair a CLL patient's immune system following chemotherapy. T-cells are immune cells that circulate throughout the body fighting off infections. Researchers have been testing the feasibility of removing patients' T-cells and activating them with special microbeads (CD3/CD28 microbeads) that make the T-cell more effective. The goal is to reduce the rate of infectious complications and potentially delay the time to disease progression.

CLL Global is funding the multi-center trial at MD Anderson Cancer Center and UPenn. The basis of the trial is to evaluate the efficacy of administering CD3/CD28 activated T-cells to CLL patients following treatment with fludarabine or alemtuzumab-based chemo-immunotherapy. To date, a total of 21 patients have been infused with the T-cells, and the infusions have been well tolerated. There have not been any treatment-related adverse events.

Immune assessments are being conducted on days +30, +90 and +365 after the T-cell infusion. There is data on 16 of the 21 patients +90 days after infusion. Increase in both CD4 and CD8 T-cell counts have been observed in these patients. Higher levels of CD4 and CD8 indicate an increase in the strength of the immune system. The current data suggests that infusions of autologous CD3/CD28-activated T-cells expanded in the laboratory are feasible and safe. Additional findings from this study will be provided upon availability.

PARTNER PERSPECTIVE

To Vaccinate or Not to Vaccinate

It is no secret that CLL patients have defects in their immune system and therefore suffer from weakened immunity. This causes several problems for patients. They are more prone to infections, yet their defunct immune system also makes the vaccines given to prevent infections less effective. As the cold weather draws near, patients should start to consider their protection strategies.   (For those of you experiencing the heat wave, it may be hard to believe that we are suggesting preparation for cold weather strategies.)

CLL doctors will begin fielding phone calls from patients asking if the flu shot is safe. While it is safe, the flu shot seems to be effective approximately half of the time in patients who have not received any treatment. If a patient has had treatment, the likelihood of the influenza vaccine working is significantly decreased, to the tune of roughly 10-25%. Current standard treatments further reduce the effectiveness of the immune system because while eradicating the CLL, treatments also deplete the body of healthy immune cells. Although the benefits may be reduced, doctors generally recommend that their patients receive the flu shot because there is little risk. Limited protection is better than none.

In addition to the flu vaccine, inactivated vaccines such as tetanus, pneumococcus (pneumonia vaccine), and Hepatitis A and B can be of benefit for CLL patients. Live attenuated vaccines such as polio, yellow fever and zoster (shingles vaccine) are NOT recommended for CLL patients. A live vaccine contains a weakened form of the actual virus which normally creates a more robust immune response than an inactivated, or killed, vaccine. But the combination of a live vaccine and the dysfunctional immune system of a CLL patient can cause harm.

Please consult with your physician before making a decision on the flu shot or any other vaccine. Every CLL patient has a different immune system, and your doctor knows what is best for you. You should also encourage family and friends to get the flu shot so that they are less likely to pass on anything. Frequent hand washing is always a good measure to prevent and protect.

We hope this issue was informational and inspirational. Good luck staying cool! Be happy and well.     

Sincerely,

CLL Global Research Foundation