Peter W. Marks, MD, PhD
Recently, I had the chance to re-read the seminal article that Dr. Kanti Rai
and his colleagues published in 1975 on the clinical staging of chronic lymphocytic
leukemia (CLL) (Blood. 1975; 46:219-234). This remarkable work, full of clinical
insight, is still relevant more than 30 years later. At the time of its initial
publication, and for quite a number of years to follow, there were few therapeutic
options for the disease. But as presentations at this year’s annual meeting
will show, CLL therapy has come a long way from just chlorambucil and prednisone.
At this morning’s Education Program Session on Chronic Lymphocytic Leukemia
(7:30 to 9:00 a.m. and again from 4:00 to 5:30 p.m. in Hall F of the Ernest
N. Morial Convention Center) three important topics will be discussed. Dr.
Shanafelt from the Mayo Clinic in Rochester, MN, will review prognostic factors
in CLL, with a focus on newer molecular markers that refine the simple prognostic-staging
systems based on clinical factors, such as the Rai classification. Dr. Andy
Rawstron from Leeds Teaching Hospitals NHS in the United Kingdom will then
the significance of monoclonal B-cell lymphocytosis (MBL). MBL is emerging
as a topic of broad interest because an increasing number of individuals with
elevated lymphocyte counts are being found to have monoclonal B-cell populations
when flow cytometry is performed. The appropriate monitoring strategy for such
individuals has yet to be fully determined. Finally, Dr. Michael Hallek from
the University of Cologne, Germany will provide an overview of state-of-the-art
treatment of CLL in both the first- and second-line settings. Topics covered
will include fludarabine, bendamustine, and various monoclonal antibodies,
such as rituximab and alemtuzumab.
Subsequently, today at the Poster Session from 5:30 to 7:30 p.m. in Hall E
there will be the opportunity to learn more about the biology and pathophysiology
CLL, with numerous posters focusing on implications of cytogenetic abnormalities
in CLL and MBL. If you are still looking to learn more about CLL after today’s
sessions, on Sunday from 4:30 to 6:00 p.m. in the La Nouvelle Ballroom AB of
the Ernest N. Morial Convention Center, there will be an Oral Session covering
the biology and pathophysiology of CLL. Then on Monday, there will be continued
coverage of the biology of CLL, focusing on the microenvironment, in an Oral
Session from 10:30 a.m. to 12:00 noon in the La Nouvelle Ballroom AB, followed
by a session focusing on genetic events from 4:30 to 6:00 p.m. in La Nouvelle
In addition to the number of sessions on the biology of CLL, presentations
of results of a number of clinical trials of recently approved and novel agents
are also scheduled. Poster sessions will be held in Hall E on both Sunday and
Monday from 6:00 to 8:00 p.m. Oral sessions will take place in Hall F on Monday
from 2:45 to 4:15 p.m. and on Tuesday morning from 7:30 to 9:00 a.m. in the
Nouvelle Ballroom AB. Monday’s Oral Session will include presentations
examining and comparing a variety of combinations of agents with established
activity in CLL, including combinations of fludarabine with a variety of different
agents. Tuesday’s Oral Session will focus on emerging therapies for both
CLL and hairy cell leukemia, and will include early clinical data on several
novel targeted therapies.
Given the wealth of presentations on CLL, it may be hard not to stumble across
a presentation on this topic during the meeting.
Dr. Marks indicated no relevant conflicts of interest.
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