CLL Topics Home Page

News you can use
(08/31/2012)

Important Notice About this Site

We suffered a transfiguring loss when Mr. P. C. Venkat, our Editor, Publisher and Chief Financial Officer, passed away from complications after an allogenic cord blood stem cell transplant in June of 2024.

It took a tremendous effort on his part to keep the non-profit organization running. Without his singular expertise and dedication, we knew we would be unable to fulfill the government regulatory requirements needed to maintain our non-profit status.

As of 2024, CLL Topics Inc., a non-profit 501(c) was dissolved and all its funds disbursed. We are now operating as CLL Topics LLC, a for-profit company incorporated in the state of Maryland. This, our former flagship site, is being retained on the Web as a resource to the public and to maintain historical continuity but is no longer actively updated.

We invite you to join us at our new, up-to-date site: CLL Topics Updates. It is an interactive site with an emphasis on current developments in the field.

We can think of no better testament to his life than to continue our mission in P.C.'s honor — and yours.

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Topic: CLL Topics Home

Clinical Research
Sponsored by
CLL Topics

Ever wonder what we do with the money we raise from your donations? cassino online

You can read about the clinical trials we have sponsored by clicking here: CLL Topics Sponsored Clinical Trials.

We explain the thinking behind these projects in an article titled Our Sponsorship Philosophy.

Thanks to dedicated clinical researchers and brave volunteers enlisting in clinical trials, diagnostic tools and therapy options are changing fast in the treatment of CLL. We hope to assist you in understanding the type of CLL you have, the therapy options out there and some of the basic considerations in choosing how to proceed. The expression “living to fight another day” gains a special meaning when the whole ball game may change tomorrow.

Here are some of the therapies and agents we have discussed in our past articles:

Please do remember that the writers of the articles on CLLTopics.org are not medical professionals and do not provide medical advice or recommendations for treatment. Please consult and follow the advice of your own healthcare providers.

Fundraising

Status of Fundraising

We have reached our fundraising goal for 2024 and as of July 1, 2024 we are temporarily suspending our fundraising efforts. You can look up where we are in our fundraising both on the Donation Status page and the Acknowledgements page on this site. We are proud to acknowledge the generous gifts of many who support us in our work.

Managing Infections

In our Reference section you will find a valuable new addition on managing infections in the immune compromised patient. There is extensive material of particular relevance to CLL patients.

Patients' Corner

In our section called Patients' Corner, you can read other patients' opinions on diverse topics.

Physicians' Corner

In our section called Physicians' Corner, you will find articles and correspondence from physicians, researchers and other experts. Dr. Andrew Pettitt of the Royal Liverpool Hospital discusses the use of steroid-Campath combinations in p53-deleted cases. In Are We There Yet? you can read an article by Professor Terry Hamblin evaluating the progress made to date on finding a cure for CLL. In another article, Dr. Tim Call, a specialist at Mayo Clinic, Rochester, MN offers some facts and insight into the difficult subject of Familial CLL.

Herbs and Supplements

In our Reference section you will find a new link to a valuable resource from Memorial Sloan-Kettering on herbs, botanicals and other products.

The Virtues of Green Tea

In the section on Phytochemicals, Nutrition and Chemoprevention, you will find an article discussing the anti-cancer activity of green tea polyphenols: Do You Like Drinking Green Tea?

Vitamin D₃ or cholecalciferol has multiple functions in human physiology. Some of these functions are critically important in preventing and fighting infections, inflammation and even cancers. Traditionally, the value of this vitamin has been greatly underappreciated — and traditional dosage guidelines are now viewed by experts as seriously inadequate. The risk of hypercalcemia (a serious and even fatal condition) comes into play at high dosage rates: an issue to be carefully considered. There is an impressive body of credible research supporting the new viewpoint. The Vitamin D Council is a well-organized website with comprehensive information on the topic, presented in a straightforward way that patients can understand. The experts behind this organization have impressive credentials. Please do visit this site and read the material presented to decide for yourself whether Vitamin D₃ supplementation should be a part of your regimen.

Of course, we have our own collection of articles and Alerts on the subject of Vitamin D3 and its importance in CLL. You can find links to the entire collection on our Vitamin D₃ page, or start by reading the article below.

Vitamin D₃: Essential for Health

Dosages, Cautions and the Need for Monitoring

Effective Supplementation Can Help Fight Cancer

Vitamin D is a very potent regulator of cellular biochemistry. We review the research literature on the value of an adequate intake of Vitamin D₃ in maintaining general health and in fighting cancer. The literature indicates that the officially recommended dosage (RDA) of the vitamin is barely enough to avoid deficiency diseases and woefully inadequate to provide the multiple health benefits available from this supplement. However, any aggressive supplementation regimen must be carefully monitored and medically supervised since high dosages can lead to systemic toxicity (hypercalcemia) and even death. Our review article, “Vitamin D₃: Essential for Health” explores the benefits, raises the caution flags and explains how to benefit from the vitamin without the risk of sun exposure.

The Price of
Military Service

VA Accepts the Agent Orange Connection to CLL

Veterans Please Note –
Court Ordered Retroactive Benefits

Our Agent Orange Update should be of interest to veterans and others interested in the scientific evidence of the connection between CLL and Agent Orange and in the formal statements of the VA's approach to this subject.

You can read a recent (April 2024) email on how the VA is treating AO veterans.

Mayo Best Practices

Current Approach to Diagnosis and Management of CLL

What You and Your Oncologist Need to Know about CLL

We review and comment on an important new paper from the Mayo Clinic Hematology Team. Authors Shanafelt and Call provide an extremely useful review of recent changes in diagnostic methods and risk assessment and their therapeutic implications for various cytogenetic sub-categories of CLL. This is a must-read paper for both you and your local oncologist. Our editorial comment examines areas in which they could have gone farther in their recommendations. Click here to read "Need to Know".

What Type of CLL Do You Have?

Analyzing CLL by Risk Categories

Defining Risk "Buckets" as a Framework for Therapy Decisions

This article, "What Type of CLL Do You Have?", is a detailed review of a number of important CLL prognostic indicators. It explores a concept for combining the available indicators to assess progression risk in a given case, grouping patient into buckets A, B and C. A higher risk category poses trickier problems in picking a treatment strategy but modern therapeutic options do offer usable approaches.

FISH-ing for Answers

Chromosomal Aberrations Rule the Game

Getting Your FISH Test Done

FISH (fluorescence in-situ hybridization) testing can provide key information to CLL patients and their doctors in making therapy decisions. In " FISH-ing for Answers" we provide some critical information that may be useful in getting your very own FISH test done.

Familial CLL

Genetic Predisposition and Anticipation

To Know or Not to Know: That Is the Question

Not the Worst Day of Your Life is a review of the research findings on the familial aspects of CLL. It is well documented that CLL strikes more than one person in some families, there is clearly a predisposition to the disease that has been passed on from one generation to the next in these families. In addition, the data show that in families where the disease strikes more than one generation, the children of a CLL patient are likely to be diagnosed with the disease at an younger age compared to the parent. Finally, we discuss some of the difficult issues involved in testing children for potential genetic problems.

Campath - Looking Better and Better

Campath Proves Effective in Early Stage and Difficult Cases

Experts Get Better at Using the Anti-CD 52 Monoclonal

We review the current status of research and clinical trials involving Campath-1H. This fully humanized monoclonal antibody has been approved by the FDA for use in relapsed CLL but current research reveals that it could have critical application as a frontline therapy in a subset of high risk cases. It is a powerful therapeutic agent that is slowly finding wider applicability in early stage patients. The techniques of administration have improved and so have the techniques of managing the serious immune suppression attendant to its use. Our review article, Campath Looking Better and Better, explores these and other aspects of Campath therapy.

Prognostic Indicators

Using Modern Tools

Prognosis at Diagnosis - Integrating Molecular Biologic Insights into Clinical Practice

We examine a critically important new Blood First Edition Paper in Prognosis at Diagnosis, our review of the article of the same name from the experts at Mayo Clinic. While much of the research quoted in their paper has been previously reported, what makes the paper unique is that it puts it all together in one irrefutable package: the research, the results, the logic, the recommendations. I have no doubt this paper will be one of the most influential papers in CLL, and will be influencing clinical practice for many years to come."

Chemotherapy Insight

The "How" Is Often as Important as the "What" in Chemotherapy

Methods of Drug Delivery

Physiology offers some insights into the effectiveness of various methods of drug delivery. The same drug can have different effects (and side effects) when administered using novel techniques. You will find our discussion of this subject in The "How" Is Often as Important as the "What".

Adhesion, Homing and Resistance

Why Peripheral Blood Numbers Do Not Tell the Whole Story — and Why CLL Cells Are Hard to Kill.

It's a Tale of Adhesion Factors, Chemokine Trails, Receptors and Blockers

Cellular chemistry drives the behaviour of CLL and determines the characteristics of the different clonal subtypes. We examine a number of critical aspects such as resistance to therapies, bulkiness of lymph nodes, infiltration of bone marrow and the support structure for CLL cells in their preferred environments. We also look at some futuristic possibilities for therapies in this article, Adhesion, Homing and Resistance to Therapy.

Ctyogenetics

Role of the ATM and TP53 Genes in Disease Progression and Response to Therapy

The Science Behind the Grim Statistics Offers the Hope of Better Therapeutic Strategies

The TP53 gene and the ATM gene play a critical role in the behavior of CLL cells. We explore the roles of these genes in the life of a normal cell and their malfunction in cancer. Modern FISH analysis focusing on these genes helps identify the risk characteristics and aggressiveness of a given patient's CLL and is therefore an important prognostic tool. Click here to read Cytogenetics of ATM and TP53.

Chronic Pulmonary Inflammation

Major New Study Indicts Role of Pulmonary Inflammation

Deadly Feedback Cycle of Inflammation and CLL

Widespread anecdotal evidence suggesting pulmonary complications are a major factor in CLL is now supplanted by solid statistical data reported in an article in the journal Cancer by a team led by Dr. Kanti Rai at the Long Island Jewish Medical Center. They confirm that pneumonia is by far the leading cause of mortality and morbidity for CLL patients – and the leading pulmonary complication among patients hospitalized with CLL. Our article, Role of Pulmonary Inflammation in CLL, examines the relationships involved and implications for therapy.

Dying to Get a Tan?

The Danger of Squamous Cell Carcinoma in CLL Patients

Things You Can Do to Avoid SCC

If you have CLL, you have a much higher chance of getting squamous cell carcinoma (SCC), the second most common skin cancer. Further, CLL patients who contract this disease are more likely to have an aggressive form of the disease. We examine some of the possible mechanisms for the onset of this cancer and review a number of steps you can take to protect yourself including a few things you can discuss with your doctor that may help. Click here to read Dying to Get a Tan?

Target Mitochondrion

Promising New Approaches May Level the Playing Field for Bucket C Patients

Attacking Mitochondria in B-CLL Cells

Several recent research articles have opened up exciting new opportunities in the treatment of CLL. These feature new small molecule drugs that take an entirely different approach to targeting CLL cells, bypassing the usual cellular control points. In this new approach to treating CLL, it seems to make no difference if you are IgVH mutated or unmutated, CD38 positive or not, chemo-naïve or have been through the wars with every chemotherapy drug known to man. In fact, there are some indications that heavily pretreated and late Rai stage patients may respond better to this approach. To learn more, read Exciting New Drugs on the Horizon.

AIHA: Auto-Immune Hemolytic Anemia

Important Insight

Causes, Mechanisms & Therapeutic Strategies

AHIA affects a significant part of the CLL population, particularly those with advanced disease. Understanding the causes of the disorder is critical to dealing with it. In AIHA: Auto-Immune Hemolytic Anemia, we review the relevant research and make some suggestions.

Side Effects

EPO Linked to Promotion of Angiogenesis, Tumor Growth and Shorter Survival

The Dark Side of Epoetin

A very recent study casts light on some negative aspects of epoetin therapy. In addition to the desired effect of a rapid increase in red blood cells and hemoglobin and an improvement in quality of life, these drugs have now been shown in a carefully designed study to promote significant angiogenesis and tumor growth. Our article, The Dark Side of Epoetin, gives you an overview of the research on this aspect of an important supporting therapy.

Chronic Inflammation

What You Can Do

Interaction between CLL and Chronic Inflammation

Sinus problems got you down? Here are some conclusions from recent research in cellular biochemistry. The good news is that the linkage between inflammation and CLL offers a hint for a new therapeutic approach. You can read about it in the article CLL, Chronic Inflammation and What You Can Do About It.

Disease Characteristics

Nature of CLL

Clonal Evolution: How the Disease Grows and Evolves

In this article we review important new research into the mechanisms by which clonal B-CLL cells become more aggressive and harder to kill. This is Darwinian selection at the cellular level. We look at the implications for treatment strategy and offer a new approach to managing the disease in Clonal Evolution.

The
Case of
the Round-Headed
Kid

Notes on a Difficult Case

Things Are Never Easy for the Round-Headed Kid.

Choices are Trickier for Patients with Poor Cytogenetic Aberrations

Lucy may never have given Charlie Brown that perfect opportunity to kick a field goal, but we give our own round-headed hero, Harvey, a hand in figuring out what to do when he gets some bad news on the cytogenetics front. Faced with a 11q deletion event, our hero gets down to facing the facts and grappling with some thorny questions. The saga starts with The Difficult Case of the Round-headed Kid — and continues over a number of installments as our hero faces therapy decisions and disease complications. You will find the entire series of articles in our RHK Saga.