Previously Treated CLL

CE

Optimal Therapeutic Sequencing in Relapsed/Refractory CLL: Key Information for Pharmacists

Pharmacists: 1.00 contact hour (0.1 CEUs)

Released: November 11, 2024

Expiration: August 05, 2025

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

Currently, how confident are you in your ability to inform treatment selection and long-term treatment plans for individual patients with CLL to optimize clinical benefit?

2.

The patient is a 73-yr-old woman with an extensive history of CLL. She received previous treatment with FCR, ibrutinib, obinutuzumab, venetoclax plus rituximab (relapse 8 months after completing therapy), and most recently acalabrutinib. She has overall done well with acalabrutinib, tolerating it with minimal adverse effects and experiencing noticeable improvement in her lymphadenopathy and blood counts.


The patient presents to clinic today complaining of worsening fatigue. Physical examination reveals palpable lymph nodes. CBC shows leukocytosis (WBC 40,000 cells/μL with an ALC of 35,000 cells/μL). Restaging CT chest abdomen pelvis reveals progressive lymphadenopathy. Next-generation sequencing is conducted and demonstrates a BTK C481 mutation.

In your current practice, what would you consider to be the optimal therapy for this patient?

3.

On Day 5 following an infusion of CAR T-cells, a patient becomes confused and increasingly disoriented and drowsy; the patient is assessed as having grade 2 immune effector cell–associated neurotoxicity syndrome.

Which of the following treatment options would you recommend to manage this adverse event?