John Gribben, MD, DSc, FRCPath, FMed Sci, from Barts Cancer Institute, London, UK discusses treatment options for CLL at the 2017 British Society for Haematology (BSH) Annual Scientific Meeting in Brighton, UK. The optimal way to treat a patient is in a clinical trial. If this is not possible, current guidelines state that patients without a p53 abnormality are candidates for FCR chemotherapy. Patients who also have an immunoglobulin mutation respond particularly well to FCR. Currently, in patients who do have p53 abnormalities, chemoimmunotherapy, BCR inhibitors, and ibrutinib are used, reserving venetoclax for patients who have failed or are intolerant to BCR inhibitors. Stem cell transplantation is currently less commonly used, and it is safe to defer, as long as there is a back up drug available if it fails. However, for patients that have already had chemoimmunotherapy, ibrutinib or venetoclax, there are limited options. The biggest challenge, however, is in treating patients with Richter’s transformation, as there are no current effective treatments. This video has been supported by Napp Pharmaceuticals Ltd through an unrestricted educational grant to Magdalen Medical Publishing.
