Best Practices

Infections: Who Is Most at Risk?

Prognostic Indicators Can Identify Infection Risk

Know Your Enemy

Serious infections account for an alarming proportion of deaths among CLL patients. But are some patients more at risk than others? What are the prognostic indicators which can help you assess the risk of serious infections in your own case? In Who Is Most at Risk? we review a very recent article that looks at the different risk buckets and provides some practical pointers to improve your chances of staying out of the hospital.

Super Bugs: Staph

MRSA Is on the Loose — Avoidance is Critical

The Dangers of Drug Resistant Bacterial Infections

Recent reports prove that infections from strains of drug-resistant bacteria are far more prevalent than previously thought, accounting for more than half of all skin infections treated in hospital emergency rooms. Infectious diseases experts are trying hard to get the word out. While this poses a serious threat to public health, CLL patients will do well to pay special attention to this phenomenon and take some precautions — so that they may avoid these difficult and persistent infections which their systems are ill-equipped to fight. Read about these super bugs in The Dangers of Drug Resistant Bacterial Infections.

EBV

The Kiss that Can Kill

The Enemy Within

The Epstein-Barr Virus (EBV) has long been known as a complicating factor in many cancers. Recent research has shown just how serious is the threat posed by this virus in CLL. EBV is estimated to be present in over 90% of adults in the western world but is normally kept in dormancy by active T-cells. Read The Enemy Within to learn how EBV can interfere with normal T-cell function and how T-cell damaging therapy with agents such as fludarabine and Campath can unleash EBV with life-threatening consequences. We also discuss how patients may be able to use a common statin to improve their defenses against this virus.

Infectious Complications

Best Practices

How to Treat and Manage Infections in CLL

Infectious complications are the major cause of mortality in CLL and affect the quality of life of most patients. The best practices in managing infections have changed over time, tracking our knowledge of the molecular mechanisms at work and reflecting the nature of the therapies used to treat the CLL itself. In our article Infectious Complications of CLL, we review the latest expert findings. We also highlight the need for patients to be actively involved in discussing these best practices with their local oncologists, to ensure that they receive appropriate care.

Editorial: Standards for Best Practices

The Rate of Information Trickle-down

How Much Do Local Oncologists Know about CLL?

This article, Standards for Best Practices, is mainly analysis, commentary and editorial. We examine how the key process of continuing medical education takes place in the U.S. health care system. While the experts at the major cancer centers are making their breakthroughs, local oncologists are handicapped by a variety of factors that can result in sub-par heathcare delivery. To close the gap, we advocate the publication of authoritative best practice guidelines by our CLL experts — and greater patient participation in the trickle down of information to the local oncology practices.

Flu Preparedness

Pneumonia Is the Single Biggest Killer of CLL Patients

Some Pointers to Resources and Education

The annual influenza season will soon be upon us. In Flu Preparedness we offer some research findings and practical advice on making it through this season, whether we are faced with the common or garden variety of flu - or a more ominous humanized version of the avian flu.

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.

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?

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 November issue of 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.

Prognosis at Diagnosis

Using Modern Tools

Integrating Molecular Biologic Insights into Clinical Practice

We examine a critically important new Blood First Edition Paper - pre-published online on October 23. Read Prognosis at Diagnosis, our review of the article from the experts at Mayo Clinic. While much of the research quoted in this article has been previously reported, this article will nevertheless be important. In Chaya's opinion, "What makes this 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."