iwCLL 2025 | Health maintenance for patients with CLL

It’s a very important question and a question that’s becoming increasingly relevant in the care of CLL, and while I think every hematologist oncologist looks at their patients as a whole and tries to address all the issues in front of that patient, it’s becoming increasingly relevant in CLL as our treatments have improved. To begin with, as we all know, the CLL population tends to be elderly, you know, presenting in their early 70s, and often they already have comorbidities. But the treatments have become so excellent and generally very well tolerated that most patients are now dying with their CLL, not from their CLL. And as a result of that, understanding their comorbidities, possible drug interactions can influence not only the choice of therapy, but can also influence their care beyond just choosing what the right management of their CLL is. For example, all CLL patients, regardless of their treatment status, are immunocompromised. So being aware of that, making sure patients are up to date with their vaccinations, making sure they have appropriate prophylaxis, making sure that they’re taking proper precautions is critically important. We know that CLL patients have a much higher incidence of secondary malignancies, especially non-melanoma skin cancers. So appropriate skin checks, sunscreen, but also getting age and gender appropriate screening, colonoscopies, perhaps mammograms, PSAs, things like this, become critically important. CLL patients are at higher risk for fragility fractures in their bones. So paying attention to bone density and fall prevention is important. Cardiovascular issues are important, and some of the medications can make that worse. And of course, like any patient with a cancer diagnosis, especially a generally incurable cancer diagnosis, there’s a whole plethora of psychological issues the patients go through. So again, as good clinicians, we want to be aware of those things and address all these issues as they’re rising in importance and sometimes are more important to the patient than what their actual treatment is.

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