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Precision choices in CLL

CE / CME

Precision Choices in CLL: Tailoring Treatment Strategies Across Disease Stages

ABIM MOC: maximum of 0.25 Medical Knowledge MOC point

Physician Assistants: maximum of 0.25 hour of AAPA Category 1 CME credit

Registered Nurses: 0.25 Nursing contact hour

Pharmacists: 0.25 contact hour (0.025 CEUs)

Physicians: maximum of 0.25 AMA PRA Category 1 Credit

Released: August 07, 2025

Expiration: February 06, 2026

Danielle M. Brander
Danielle M. Brander, MD
Brad Kahl
Brad Kahl, MD
Sameer A. Parikh
Sameer A. Parikh, MBBS
CME/CE Information

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Course Completed
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1.

A 63-year-old man was diagnosed with CLL​ with del17p/TP53 wild type and IGHV mutation​. The patient has a past medical history of hypertension and diabetes​ and needs to initiate therapy because of symptoms and cytopenias​. He desires a fixed-duration, all-oral regimen because of his career as a truck driver​. 

Which of the following would you recommend as the best first-line therapy for this patient?

2.

An 86-year-old man was diagnosed with CLL in 2013 and has experienced multiple relapses since that time. He has received bendamustine + rituximab, followed by venetoclax + rituximab, and acalabrutinib. He has remained on acalabrutinib for almost 5 years, but recently developed worsening lymphocytosis and rapidly enlarging lymph nodes, consistent with progressing CLL but without clinical or laboratory signs of Richter transformation​. NGS revealed acquired BTK C481S mutation​. He states that he would prefer another oral therapy in his next line of treatment​​.

Which of the following would you recommend as the best next-line therapy for this 86-year-old patient?​

3.

A 72-year-old woman was initially treated for CLL with bendamustine + rituximab, resulting in a 7-year remission​. She then develops symptomatic progression and is treated with venetoclax + rituximab, resulting in a 2-year remission. She again requires treatment due to progressive lymphocytosis, cytopenia,and fatigue and receives zanubrutinib. She tolerates treatment well but experiences disease progression ​3 years later, after which she receives pirtobrutinib​. Now, she is experiencing symptomatic disease progression 9 months after beginning pirtobrutinib therapy.​

Which of the following would you recommend as the next best therapy for this patient with CLL and multiple relapses?

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