Sequencing in Relapsed/Refractory CLL

CE

Optimal Therapeutic Sequencing in Relapsed/Refractory CLL for Pharmacists

Pharmacists: 1.50 contact hours (0.15 CEUs)

Released: December 11, 2024

Expiration: June 10, 2025

Karen M. Fancher
Karen M. Fancher, PharmD, BCOP
Anthony J. Perissinotti
Anthony J. Perissinotti, PharmD, BCOP
Caitlin R. Rausch
Caitlin R. Rausch, PharmD, BCOP

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

Currently, how confident are you in your ability to inform treatment selection and long-term treatment plans for individual patients with CLL to optimize clinical benefit?

2.

Case 1: Patient With CLL Previously Treated With FCR, Covalent BTKis, and Venetoclax-Based Therapy



  • The patient is a 73-yr-old woman with an extensive history of CLL

  • Previous treatment with FCR, ibrutinib, obinutuzumab, venetoclax + rituximab, and most recently acalabrutinib

    • She has overall done well with acalabrutinib, tolerating it with minimal adverse effects and experiencing noticeable improvement in her lymphadenopathy and blood counts



  • The patient presents to clinic today complaining of worsening fatigue

    • Physical examination reveals palpable lymph nodes 

    • CBC show leukocytosis (WBC 40,000 cells/μL with an ALC of 35,000 cells/μL)

    • Restaging CT chest abdomen pelvis reveals progressive lymphadenopathy

    • Next-generation sequencing is conducted and demonstrates a BTK C481 mutation



In your current practice, what would you consider to be the optimal therapy for this patient?

3.

On Day 5 following an infusion of CAR T-cells, a patient becomes confused and increasingly disoriented and drowsy; the patient is assessed as having grade 2 immune effector cell–associated neurotoxicity syndrome. Which of the following treatment options would you recommend to manage this adverse event?