Chronic Lymphocytic Leukaemia (CLL)

Chronic lymphocytic leukaemia (CLL) / Small lymphocytic lymphoma (SLL)

CLL is classified by the accumulation and rapid reproduction of clonal B cells in the blood, bone marrow, and lymph nodes. CLL and SLL are essentially the same disease, the only difference being where the cancer primarily occurs. When most of the cancer cells are located in the bloodstream and the bone marrow, the disease is referred to as CLL, although the lymph nodes and spleen are often involved. When the cancer cells are located mostly in the lymph nodes, the disease is called SLL.

The progression of CLL is extremely variable ranging from indolent (slow-growing) disease not requiring treatment to one that progresses rapidly and is resistant to treatment. CLL is one of the most common types of leukemia in adults, usually occurring during or after middle age. It rarely occurs in children.

2022 CLL Subtype Report

The focus of this report is to:

• Provide a current understanding of CLL
• Explain the diagnosis and pre-treatment process
• Outline CLL treatment options and protocols, including:
  • Therapy access in Lymphoma Coalition (LC) member countries
  • Clinical trial access in LC member countries
• Highlight Covid-19-related considerations for patients with CLL
• Explore the experience of patients with CLL

2022 CLL Subtype Report: Conclusions & Recommendations

It is likely that the prevalence and mortality of CLL will continue to increase because the global population is ageing. Therefore, it is important for major gaps in understanding, treatment, and care to be addressed.

Lymphoma Coalition firmly believes that if we, patient organisations, and other key stakeholders work together, we can jointly bring about positive change. Change will take time. There are steps we can take now that, once successfully implemented, will act as a solid foundation for future activities. Well-thought out, consistent effort over time will lead to improved patient experience.

The following are identified priorities from the Lymphoma Coalition’s perspective.

RESEARCH PRIORITIES

1. Cure for CLL.
2. Clinical trials must be accessible for older patients.
3. Optimal therapy sequencing need to be established.
4. Better treatments with reduced toxicity.
5. Role of MRD assessment in clinical practice.
6. Treatment for Richter’s Transformation.

EQUITABLE TREATMENT PRIORITIES

1. Access to novel therapies.
2. Access to testing.
3. Pandemic response.

IMPROVING PATIENT WELLBEING

1. Burden of fatigue.
2. Psychological impact.

More detail on each of these priorities is available in the report.