Transcript:
Hello, my name is Alexey Danilov. I’m a professor in the Department of Hematology, City of Hope, National Medical Center. I’m also the co-director of Tony Stevenson Lymphoma Center and Director for Early Phase Therapeutics at my institution. So when I see a patient who requires treatment for CLL, we review all the options available in their particular circumstance, whether it’s frontline or relapsed therapy of CLL. And that includes explaining all the options, explaining the efficacy of the regimens, the side effects, and what kind of efficacy we can expect long-term. It is also very important to understand what kind of impact on quality-of-life treatment might have, and we discuss that. I also try to engage patient caregivers and explain to them what their participation can contribute and should contribute to treatment of this patients. I also refer patients to resources that are available there to help and connect with other patients with CLL, particularly CLL Society, which has a great resource for patients and is a strong patient advocacy group.
In combination, these are all the factors that have being considered when we discuss treatment. So we are blessed in the sense that the treatments that we currently have for CLL are highly effective and they’re effective across all CLL subsets. However, patients with genetically high risk CLL, such as complex karyotype type P 53 abnormalities still respond maybe a bit less well and have shorter progression-free survival compared to patients who have standard genetic risk. It also appears that prognostic indicators that have been developed in the era of chemoimmunotherapy, such as CLL International Prognostic Index or CLLIPI is also predictive of long-term outcomes. However, again, this decision is very important and often still based on the conversation with a patient, their expectations from treatment, their adverse events, their quality of life, what they expect long-term. While genetic abnormalities, genetic disease composition does contribute to this discussion, this is not a sole defining factor in terms of what treatment to use.
