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Improving Outcomes and Encouraging Hope in Older CLL Patients

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Published on February 27, 2020

Key Takeaways

Chronic lymphocytic leukemia specialist Dr. Alessandra Ferrajoli, from The University of Texas MD Anderson Cancer Center, joins Patient Power to share a message of hope for CLL patients. Dr. Ferrajoli discusses the expansion of treatment options for CLL patients and what is important for them to consider when their CLL is well managed or in remission, so that they may live the fullest life possible. Watch now to learn from a CLL expert. 

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Transcript | Improving Outcomes and Encouraging Hope in Older CLL Patients

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Andrew Schorr:       

Hello, and welcome to Patient Power. I’m Andrew Schorr near San Diego and joining us, once again, from Houston, Texas; University of Texas MD Anderson Cancer Center, is Dr. Alessandra Ferrajoli. For 22 years, she’s been at MD Anderson. She’s a noted CLL specialist. Welcome back to Patient Power, doctor.

Dr. Ferrajoli:            

Thank you, Andrew. Happy to be here.

Andrew Schorr:                   

Thank you. So, I want to particularly ask you about something we’ve spoken about before, and that is CLL treatment for the older patient. By definition, many people with CLL tend to be older. Some people have other conditions—heart disease, maybe kidney problems, maybe arthritis, whatever. And even though we learn that there’s an array of medicines to treat CLL now, the patient, or maybe their adult child, must ask you every day, “Do you have good options for me or Mom?”

Dr. Ferrajoli:            

Yes, that’s an excellent question, and I truly believe we do. I even believe that with the novel therapy. The classic definition of therapy for younger patients and therapy for older patients is almost not relevant anymore. The line has blurred because the novel therapy, the targeted therapy, are very well-tolerated in older patients. And the more we refine the target therapy, including the second-generation inhibitors, those are even better tolerated. So, I truly believe that the population that have benefitted the most from all the advantages of the last decade are the older patients. 

Andrew Schorr:                   

Wow. So, it used to be that the older patients were left behind. I was a younger patient to have chemo FC, and then adding the “R.” And, it wasn’t easy, and I know over the years sometimes you’d hesitate to do that with older patients. So, now you feel with these pills, largely, someone can have a kinder, gentler, but yet effective CLL treatment?

Dr. Ferrajoli:            

Definitely. In fact, I think it kind of play to the advantage of the older patient because if you look at where those new treatments, the targeted therapies were used first as first line, was in the older population because there were not good options before. So, they actually got to see the drug first. We used the drug in older patient first and we saw well-tolerated ETS, and it was approved for older patients very quickly.

Andrew Schorr:                   

Okay. So, when someone comes to you, either an older patient themselves or with a family member, and they say, “Oh my God, there’s this CLL now in our family.” Can the patient still lead a full life?

Dr. Ferrajoli:            

Yes, and actually, many patients that come to me don’t realize that they have been living with some symptoms for so long that they now incorporated them in their daily activity. And, many will tell me like a month, two months, or three months into their treatment, “You know, I really feel good. I feel better than I had in years.” Because they had adjusted to a new norm that was really not their norm—was, in part, affected by the disease. 

Andrew Schorr:                   

Okay. So, good news now for I guess, universally in CLL, in including older patients. Would you agree?

Dr. Ferrajoli:            

I agree. Of course, you need to be careful, because there is drug-drug interaction. And especially older patients tend to be on more medications, so it needs to be carefully checked if there is a drug interaction. You need to be careful on those, as you need to monitor very closely, and you may want to dedicate some time to find the best match, to find the best agent for that complicated patient. But, in general, yes, good news.

Andrew Schorr:                   

Okay. And, just lastly, I’d say to our audience, Dr. Ferrajoli is a noted CLL specialist at a major leukemia center—is it’s worth it if you can have a consultation with someone like her, especially if there are complicated conditions. So, if that older patient has a number of other conditions, just as she was mentioning, then maybe drugs you have the weigh against one another.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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