Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Updated CLL guidelines

Hallek M et al. Blood

Major changes or additions to new guidelines for chronic lymphocytic leukemia include the following:

Molecular genetics: Recognition of the clinical importance of specific genomic alterations/mutations 17p deletion and mutations in TP53 on therapeutic response.

IGHV mutational status: Immunoglobulin variable heavy chain (IGHV) genes offer important prognostic information.

Biomarkers: Soluble CD23, thymidine kinase, and beta-2-microglobulin need to be standardized and used in prospective clinical trials.

MRD: Minimal residual disease should be assessed in clinical trials aimed at maximizing remission depth.

Antiviral prophylaxis: Patients should be tested for HBV serological status before starting on an anti-CD20 agent.

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Hallek M et al. Blood

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Must Reads in CLL

The role of PTPN22 R620W in CLL, Leukemia & Lymphoma 2018

Ibrutinib dosing changes and the impact on survival, Williams AM et al. Clin Lymphoma Myeloma Leuk. 2018 Oct 12. doi: 10.1016/j.clml.2018.10.005

Long-term ibrutinib data in older patients, Barr PM et al. Haematologica. 2018;103(9):1502-10

First-line ibrutinib has long-term survival benefit, Barr PM et al. Haematologica. 2018;103(9):1502-10.

Obinutuzumab plus venetoclax compares well with established CLL therapies, Cramer P et al. Lancet Oncol. 2018 Aug 13. doi: 10.1016/S1470-2045(18)30414-5.