Chronic lymphocytic leukemia (CLL) patients are still awaiting access to treatment

Chronic lymphocytic leukemia (CLL) is a blood cancer characterized by an excessive accumulation of abnormal, monoclonal B lymphocytes. People over the age of 65 are particularly at risk, although approximately 10-15% of patients are under 50 years of age. In the vast majority of cases, it is an incurable disease, and the aims of therapy are to control disease progression, extend life and improve its quality.

As indicated in the guidelines, only BTK inhibitors (akalabrutinib, ibrutinib) fully meet the therapeutic needs of the entire group at high risk of progression. In the case of refractory/recurrent CLL, the use of new targeted therapies is recommended, while immunochemotherapy is indicated primarily in patients with a long response to first-line therapy.

In recent years, tremendous progress has been made in the treatment of CLL through the use of highly effective targeted therapies and immunotherapy. According to the latest guidelines of the Polish Society of Hematologists and Transfusionists, immunochemotherapy in the first-line treatment is recommended only in patients without 17p deletion/TP53 mutation, with mutated genes for IGVH. Due to a worse prognosis, the remaining patients should receive new targeted therapies. On the list of reimbursement priorities in this area developed in 2020 by the hematologists community, the top five include as many as 3 therapies dedicated to chronic lymphocytic leukemia: ibrutinib, akalabrutinib, and venetoclax. Reimbursement decisions introduced in recent years allow for medical treatment only in the case of venetoclax. Currently, apart from the reimbursement list, there are: akalabrutinib, idelalisib and ibrutinib.
- Each patient is different and therefore the physician should be able to choose the most appropriate therapy for a particular patient. Advances in recent years have made treatment for chronic lymphocytic leukemia increasingly personalized. Unfortunately, this does not mean that it is available to every patient. In the case of patients with 17p deletion/TP53 mutation, the lack of effectiveness of chemotherapy means that they should not be treated with chemotherapy at all and new targeted therapies should be applied to them from the very beginning and we still appeal for such solutions for patients - comments Anna Kupiecka, founder and President of the OnkoCafe Foundation - Better Together.

The need to supplement the first line of treatment in the case of chronic lymphocytic leukemia is one of the priorities indicated by the authors of the "Report on the situation of haemat-oncological patients in Poland". The report also presents the needs of patients related not only to pharmacotherapy, but also other elements of the therapeutic process, and one of the most important is psychological support both for patients and their relatives. Such a need was indicated by patients, their caregivers and doctors dealing with the treatment of haematolooncological diseases. As many as 82% of patients believe that access to psycho-oncological care is a key element determining the effectiveness of treatment.

The report was issued by HematoKoalicja - an agreement of four active patient organizations: the Alivia Oncology Foundation, the Carita Foundation. Wiesława Adamiec, PARS - Polish Amazons of the Social Movement and the OnkoCafe Foundation - Better Together.

Source: Press material