CLL Global's To Do List
|Dr. Michael Keating, President & CEO|
Over the last few years, we have witnessed major advances in patient survival, new agents and genetic information. Some call me overly optimistic, but I truly believe the pieces are in place for significant progress to be achieved in the next few years. That being said, we still have many items requiring our attention. Here are a few...
1) Identify better therapeutic options for certain sub-groups.
The elderly, 17pdel- and 11q- are three of the groups that need better therapy options. We need to develop specific approaches for these sub-groups.
2) Expand clinical trial access for patients with comorbidities.
Clinical trial access is often limited to patients who have not had a previous cancer within the last five years. Patients also need to have a favorable performance status which tends to rule out those who have comorbidities such as cardiac disease, chronic obstructive airway disease, diabetes, etc. We need clinical trial options for patients with these comorbidities.
3) Prevent immune system & DNA damage related to therapy.
CLL patients often die of an associated malignant disease which develops after treatment or from serious infections presumably related to the immune system. One of our goals is to remove DNA damaging drugs from the patient's initial therapy. Hopefully, this will keep a number of patients in long-term remission without running the risk of second cancers such as acute leukemia or myelodysplastic syndrome (MDS).
4) Prevent the immune system from destroying cells.
A number of CLL patients develop antibodies that attack and destroy red cells, platelets and to a lesser degree neutrophils. One of these conditions, immune thrombocytopenic purpura (ITP), results in dangerously low blood platelet counts. We need to better understand which patients are likely to experience ITP and which treatments are most effective in overcoming this problem.
5) Reduce the likelihood of CLL patients developing shingles.
No one wants to deal with the itching, tingling and severe pain associated with shingles. Unfortunately, CLL patients have a high likelihood of developing shingles. CLL patients and other individuals with weakened immune systems are advised to avoid the shingles vaccination because it contains a live virus. The concern is that patients may develop modified "shingles" from the vaccine virus strain; no research has been conducted in CLL to evaluate this possibility. Alternative protection strategies need to be developed for CLL patients and others with compromised immune systems.