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Applying CLL Guidelines

CE / CME

Applying the Latest Evidence and NCCN Guideline Recommendations in Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Physician Assistants: maximum of 1.00 hour of AAPA Category 1 CME credit

Registered Nurses: 1.00 Nursing contact hour

Pharmacists: 1.00 contact hour (0.1 CEUs)

Physicians: maximum of 1.00 AMA PRA Category 1 Credit

Released: May 09, 2024

Expiration: May 08, 2025

Danielle M. Brander
Danielle M. Brander, MD
Brian T. Hill
Brian T. Hill, MD, PhD
Deborah M Stephens
Deborah M Stephens, DO
CME/CE Information

Pretest

Progress
1 2 3
Course Completed
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1.

A 67-year-old woman was diagnosed incidentally 3 years ago after a screening mammogram identified small LAD and a biopsy was consistent with CLL/SLL. Markers that were identified at diagnosis were FISH: 36% deletion of 17p, IGHV unmutated, and TP53 mutation. She has a history of hypertension but was otherwise very active and asymptomatic.


She progresses over 3 years with lymphocytosis (45,000-104,000 over past 6 months), anemia (12.1 g/dL at baseline to 9.7 g/dL), and thrombocytopenia (165K at baseline to 87K); no other causes for lymphocytosis or anemia were identified. Her spleen measured 17 cm CC on scans; all LNs ≤3 cm. She is now symptomatic with fatigue but continues to work full time and travels frequently.

In your current practice, which of the following would you consider optimal for this patient?

2.

Based on evidence from the phase III ELEVATE-RR trial, which of the following accurately describes the relative incidence of any-grade cardiovascular toxicities with acalabrutinib vs ibrutinib?

3.

A 62-year-old male with CLL was treated with ibrutinib with excellent disease control but developed progressive disease after 4 years. He was found to have the BTK C481S mutation on further testing. He subsequently received treatment with venetoclax + rituximab but developed progressive disease at the conclusion of his planned 24 months of treatment.

In your current practice, which therapeutic approach would you consider optimal for this patient?

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