This site complies with the HONcode standard for trustworthy health information:
verify here.

ERIC recommends TP53 gene mutation analysis prior to treatment

A recommendation in the journal Leukemia by members of the European Research Initiative on CLL (ERIC) suggests that, in addition to 17p deletion, TP53 mutation is an independent prognostic factor in CLL.

Data from retrospective analyses and prospective clinical trials show that about 5% of untreated CLL patients with treatment indication, have a TP53 mutation in the absence of 17p deletion.

Patients with treatment indications should be investigated for TP53 mutations in addition to the work-up recommended by the IWCLL guidelines. Patients with TP53 mutation may be considered for allogeneic SCT in first remission since these patients have a poor response and reduced progression-free survival (PFS) and overall survival (OS) with standard treatment approaches.

While alemtuzumab-based regimens (CAMPATH) can yield a substantial proportion of complete responses they are of short duration.

Ideally, TP53 mutated patients should be treated within clinical trials exploring new therapeutic agents.
LINK HERE

---

Kancera files patents for ROR inhibitors

Kancera reports that the company has registered a patent application (EP12153357) for new substances that prevents the ability of the cancer to survive. The new patent is based on Kancera’s ROR technology directed against both leukemia and solid tumours.

Kancera has previously reported that the company's active ingredients against ROR is 25 times more specific than Fludarabine which is the most common drug used today to treat CLL.
LINK HERE

---

Italian long term study of prognostic indicators in CLL

This study looked at 620 CLL patients with CLL from various centres in Italy from 1996 to 2008 specifically looking at data on time to treatment (TTT) and overall survival (OS) to determine which prognostic indicators really matter. This was a retrospective analysis to evaluate the independent predictive power of mutational status of immunoglobulin heavy chain variable gene segments (IGHV), high-risk chromosomal aberration such as 17p or 11q deletions, CD38 and ZAP-70 expression, age, gender, Binet stage, beta2-microglobulin levels, absolute lymphocyte count and number of lymph node regions.

The study found that:

"IGHV mutational status and 17p deletion, but NOT CD38 and ZAP-70 expression, were independent prognostic biological variables in a multivariate model for overall survival, which included demographic (age and gender) and clinical parameters (Binet staging, beta2-microglobulin levels)."

A novel 6-variable clinical-biological prognostic index was developed and internally validated, which assigned 3 points for Binet C stage, 2 points/each for Binet B stage and for age > 65 years, 1 point/each for male gender, high beta2-microglobulin levels, presence of an unmutated IGHV gene status or 17p deletion.

Patients were classified at low-risk (21%), intermediate-risk (63% ), high-risk 16% ) of cases. Projected 5-year overall survival was

98% - low risk

90% - intermediate risk

58% - high-risk

For time to treatment only IGHV and β2 M confirmed their role, with IGHV the most important. CD38 and ZAP-70 were again not significant, in spite of a good representation of positive cases (respectively 21% and 36%). The authors caution that these statistical models while internally verified in the study, "should be used with caution until externally validated on independent, prospective patient series"

The entire paper with graphs etc can be obtained by Open Access here:

LINK HERE

---

Bendamustine Clinical Trial comes to Canada

The purpose of the current study (BENDACT) is to evaluate additional safety data of bendamustine in up to 100 patients relapsing from a rituximab regimen or first line treatment for Chronic Lymphocytic Leukemia (CLL).

Lead Sponsor is Lundbeck Canada Inc and the first site is Windsor Ontario Cancer Centre.

LINK HERE

---

CD69 ~ New prognostic indicator in CLL?

CD69 is expressed in several hemopoietic cells and is an early activation marker in chronic lymphocytic leukemia.

This study from Italy investigated CD69 by flow cytometry in a series of 417 CLL patients and compared this to other biological and clinical prognostic indicators.

The study concluded:

"As shown by multivariate analysis, CD69 had an independent prognostic value with regard both to PFS and OS along with ZAP-70 and the 3 markers of tumour burden. Additional multivariate analysis, including also CD49d, FISH cytogenetics and IGHV mutational status, confirmed CD69 as an independent prognostic indicator"

"Our data indicate that CD69 is significantly correlated with poor clinical and biological prognostic factors and is confirmed to be an independent disease prognosticator. This supports its introduction in a routine laboratory assessment and, possibly, in a prognostic scoring system for chronic lymphocytic leukemia, after an adequate standardization process."

No standard tests are available for this yet...

Full study paper: LINK HERE

---

W&W ~ Watch and loose the Weight

If you are clinically obese (not just overweight) you may want to loose the pounds/kilos...

A recent study found that people who are obese have a higher relative risk of CLL as well as other leukemias.

The study also concluded that
"The risk of incidence and mortality of leukemia in adults was consistently higher in obese men."
PubMed LINK HERE

Earlier study, 2008: LINK HERE

---

Sepsis

An article in The Lancet Infectious Diseases (Feb 2012) discusses problems with current drug therapies for sepsis and the withdraw of new drug by Eli Lilly.

As the article points out the clinical and economic burden imposed by sepsis is large with an estimated 15—19 million cases occur worldwide per year.

Sepsis is a severe illness in which the bloodstream is overwhelmed by bacteria. Gram negative bacteria account for most cases of sepsis, but the disorder can also be caused by Gram positive organisms and fungi. Sepsis manifests in its most severe form as septic shock, when patients display hypotension and organ failure, caused by failure of the immune response to infection.

In the later stages of CLL sepsis can become a serious complication and is sometimes life threatening.
Full article with other links: LINK HERE

---

Bendamustine batch recall in The US

Cephalon, Inc. issues a voluntary nationwide recall of Treanda® (bendamustine HCL) for Injection 25mg/Vial Due to Particulate Matter.

"Treanda (bendamustine HCL) for Injection 25mg/8mL is indicated for the treatment of chronic lymphocytic leukemia (CLL). Efficacy relative to first-line therapies other than chlorambucil has not been established. Treanda (bendamustine HCL) for Injection 25mg/8mL is indicated for the treatment of patients with indolent B-cell non-Hodgkin's lymphoma (NHL) that has progressed during or within 6 months of treatment with rituximab-containing regimen.

This recall is being conducted in consideration of the potential safety issue and risk associated with administration of this product lot. Potential adverse events after intravenous administration of solutions containing particulates may present as an emboli and result in disruption of blood flow causing tissue/organ damage, especially in vulnerable patients such as those undergoing surgery, immunosuppressed individuals, and the elderly, as well as patients with micro or macrovasular disease, such as cardiac and renal disease, who may be more at risk since their vasculature and end organs are already compromised. To date, Cephalon, Inc. has not received any adverse events associated with the use of this product lot that could be attributed to particulate matter. "
FDA LINK HERE

---

Dr. Gridden on CARs

Dr. John Gribben, a leading CLL Expert from the UK, explains CARs or chimeric antigen receptors like the ones that made news from Univ. of Penn last summer. He puts it all in perspective.

Patient Power video here: LINK HERE

---

CD to Support Leukemia Patients

All proceeds support leukemia patients at the QEII Health Sciences Centre.

Enjoy a musical journey of great R & B hits as well as some tried and true rock 'n roll. Listen to the hit single, You Don’t Understand,VIDEO HERE the story of Derek Caine's journey with CLL/SLL.

"One day it will win and I will lose but until that day I revel in the joy of life and in my family, friends and of course, music." - Derek Caine

ORDER TODAY: $20 CDN LINK HERE

Derek's Story on Video: CTV

---

Flavopiridol treatment of patients aged 70 or older

Dr. J. Byrd etc al, of OSU-James C.C., have studied flavopiridol in refractory and relapsed patients aged 70 years and older in a small clinical trial.

Flavopiridol, is a pan cyclin-dependent kinase inhibitor which has demonstrated noteworthy clinical activity in relapsed and refractory CLL patients including those with del(17p13.1) The common side effects observed with flavopiridol, including hyperacute tumour lysis syndrome (TLS), cytokine release syndrome (CRS), neutropenia, diarrhea and fatigue, are often seen but are manageable.

The study concluded, "Although our results are based on a relatively small cohort of patients aged 70 and older, there is currently no strong evidence that these older patients cannot tolerate or respond favourably to treatment with flavopiridol. Future development of treatment approaches with both single-agent flavopiridol and combination strategies of flavopiridol should be considered for older CLL patients. "

FULL PDF LINK HERE

---

Highlights of ASH 2011 ~ CLL

Clinical Care Options has a review of ASH 2011 by John C. Byrd, MD, and Kanti Rai, MD, They highlight the most compelling data in the treatment of CLL presented at the 2011 American Society of Hematology Annual Meeting.

Summaries: LINK HERE
Slide set in PowerPoint: DOWNLOAD HERE

---

Flow Cytometry ~ Everything you need to know and more...

Flow Cytometry is a blood test used to diagnose CLL. This video tutorial education program explains how flow cytometry actually works.

This takes about 12 minutes to view...

Flow Tutorial LINK HERE

Many other tutorials : LINK HERE

Also see the "How does FISH work?" LINK HERE

---

Click Image Above

---

One of the most complete up-to-date website about blood tests can be found at this link. Well worth bookmarking for future reference.

Lab Tests Online

---

Special Access Programme for Canadians

The Special Access Programme (SAP) allows practitioners to request access to drugs that are unavailable for sale in Canada. This access is limited to patients with serious or life-threatening conditions on a compassionate or emergency basis when conventional therapies have failed, are unsuitable, or are unavailable.

PDF INFO: LINK HERE

SAP Website

---

"There are lots of anecdotal successes but the plural of anecdote is not evidence."
Dr.T. Hamblin

European CLL Guidelines

The European Society for Medical Oncology (ESMO) Guidelines Working Group have updated their clinical practice guidelines for CLL. These are the treatment guidelines often used throughout Europe
B. Eichhorst, M. Dreyling, T. Robak, E. Montserrat & M. Hallek
PDF Here: LINK HERE

Also see the 2008
CLL Treatment Guidelines: LINK HERE

NCI-WG 1996 treatment/diagnosis guide of CLL. This has been largely replaced by the 2008 Guidlines LINK HERE PDF

HOVON – the Haemato Oncology Foundation for Adults in the Netherlands Guidelines
LINK HERE PDF

---

CLL Support Association ~ UK

Oxford meeting 16th March 2012

We would like to invite you to a Members' meeting of the CLLSA at: The Oxford Belfry, Milton Common, Nr Thame, Oxfordshire, OX9 2JW , UK

16th March 2012, 10:30am to 4:00pm The main purpose of all the patient meetings is for you, the patient, carer or friend to meet other people with CLL, and to exchange experiences.

We are fortunate to have Dr Anna Schuh as a guest speaker. Dr Schuh MD, PhD, MRCP, FRCPath is a consultant haematologist in Oxford with a specialist experience in CLL. MORE INFO HERE

The Leukemia Association of Ottawa

A support group based in Ottawa, Ontario dedicated to helping people with Leukemia and their care-givers, friends, and family.

Meetings are the 4th Tuesday of every month
7:00pm - 9:00pm
Riverside United Church,
3191 Riverside Drive (south of Walkley Rd)
Ottawa


Link to Website

---