CLL/SLL Part II Flashcards Preview

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Flashcards in CLL/SLL Part II Deck (9):

When should we use prophylactic IVIG in CLL patients?

The use of prophylactic IVIG in CLL patients to restore IgG levels is controversial.

IVIG is used in general for those with:
- recurrent infections and whose serum IgG <500 mg/dL


What is Idelalisib?

Phosphoinositide 3-kinase (PI3K) delta inhibitor


What has Idelalisib been associated with?

Serious, potentially fatal diarrhea and/or colitis
Fatal and/or serious hepato-toxicity
Fatal and/or serious pneumonitis


Anemia in CLL - What are the possible reasons?

1) GI Blood loss
- steroids, thrombocytopenia, mucositis, coagulopathy
2) Marrow infiltration with disease
3) Myelosuppression due to treatment
4) Hemolytic anemia
5) Hypersplenism
6) Red cell aplasia


What is Evan's syndrome

Immune thrombocytopenia + Concurrent autoimmune hemolytic anemia

Up to 1/3 of CLL patients will have Evan's syndrome


What sort of vaccinations is required s/p splenectomy and when?

2-3 weeks prior to splenectomy

H.influenzae B

Inactivated vaccines.


What is Richter's transformation, and how often does it occur?

Richter's transformation = transformation of CLL into an aggressive large-cell lymphoma.

5-10% of CLL patients will have Richter's transformation or prolymphocytic leukemia


Who should not be considered for Fludarabine-based therapy?

Del (17p) mutation
TP53 mutation

Re-consider if pt > 70 yo


What is Venetoclax?

BCL2 inhibitor
An alternative for those with 17p deletion, especially for those who relapsed after Ibrutinib