Materiały źródłowe

• #1 1226 – Outcomes of Tixagevimab/cilgavimab pre-exposure prophylaxis in Chronic lymphocytic leukemia patients- a single center experience

  https://iwcll2023.eventscribe.net/ajaxcalls/PosterInfo.asp?efp=RklMQldPQ0QxOTM1OQ&PosterID=614999&rnd=0.4237933

  Patients with CLL have an increased susceptibility to infections secondary to complex immune interactions, innate immunity dysfunction, and with treatment with immunosuppressants. This leads to infections accounting for the majority (60%) of deaths in CLL (Morrison VA, 2014). […] Tixagevimab/cilgavamib has been part of the advances in SARS-CoV-2 pre-exposure prophylaxis for immunocompromised patients including CLL patients. As our data suggests we have observed a general trend towards decreased rates of infections in patients that were treated with tixagevimab/cilgavimab. […] While tixagevimab/cilgavimab is not currently approved for use given its lack of efficacy to current strains, previous RCTs and the data that we have observed in our study does appear to indicate that a pre-exposure prophylaxis strategy may be beneficial in CLL patients, and warrants continue exploration in clinical studies (Food and Drug Administration, 2023).

• #2 Managing the Risk of Infection in Chronic Lymphocytic Leukemia in the Era of New Therapies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8976213/

  Patients diagnosed with CLL have an increased susceptibility to infections. […] Infections continue to represent a significant complication in the era of novel therapies. […] Evidence supporting infection prevention strategies is scarce. We will review the available recommendations to prevent infections in patients with CLL treated with novel therapies. […] Timely prevention, recognition, and treatment of infections should remain an important aspect of the standard management of a patient with CLL. […] There is no standard recommended antibacterial prophylaxis in patients with CLL treated with modern therapies. […] The use of immunoglobulin (Ig) replacement therapy can be helpful in reducing the frequency of infections. However, it should only be administered to patients with severe hypogammaglobulinemia (400 mg/dL) and/or recurrent or severe infections.

• #3 CLL Causes, Risk Factors, and Prevention | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/causes-risks-prevention.html

  There are very few known risk factors for chronic lymphocytic leukemia (CLL), and most of these cannot be avoided. […] Most people with CLL have no known risk factors, and there’s no way to prevent these cancers.

• #4 Can CLL Be Prevented? | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/causes-risks-prevention/prevention.html

  Most people with chronic lymphocytic leukemia (CLL) have no known risk factors that can be changed, so there is no clear way to prevent CLL at this time. […] The risk of many types of cancer can be lowered by making lifestyle changes to avoid or limit exposure to certain risk factors. But there are only a handful of known risk factors for chronic lymphocytic leukemia (CLL), and most of these cant be avoided. […] Some studies have suggested that farming and long-term exposure to certain pesticides and other chemicals may be linked to an increased risk of CLL. But more research is needed to be sure, so its not clear if avoiding these can lower a persons risk.

• #5 https://www.lls.org/leukemia/chronic-lymphocytic-leukemia

  https://www.lls.org/leukemia/chronic-lymphocytic-leukemia

  CLL has generally not been associated with any environmental or external risk factors with an exception of Agent Organge (see „A Risk for Vietnam Veterans,” below). […] There are no known ways to prevent CLL. […] You can’t catch CLL from someone else.

• #6 What Is Chronic Lymphocytic Leukemia (CLL)?

  https://my.clevelandclinic.org/health/diseases/6210-chronic-lymphocytic-leukemia

  Theres no known way to prevent CLL.

• #7 Prevention of infections in patients with chronic lymphocytic leukemia – UpToDate

  https://www.uptodate.com/contents/prevention-of-infections-in-patients-with-chronic-lymphocytic-leukemia/print

  Prevention of infections in patients with chronic lymphocytic leukemia […] Infections have a major impact on the clinical course of patients with chronic lymphocytic leukemia (CLL). Patients with CLL have underlying abnormalities in immune function related to the primary disease process in addition to defects in immune function related to the specific antileukemic therapies administered. The approach to infection prevention will be reviewed here. […] General approach — As the immune defects caused by specific chronic lymphocytic leukemia (CLL) therapies have significant impact on subsequent infectious complications, our prophylaxis recommendations vary depending upon the type of therapy used (table 1). Additional considerations that impact antimicrobial prophylaxis in individual patients are treatment status (treatment naïve versus heavily pretreated) and past history of infections. […] There have been no randomized trials evaluating the use of prophylactic antimicrobials in patients with CLL, and there are no evidence-based guidelines for antimicrobial prophylaxis in this population. Most recommendations for antimicrobial prophylaxis have been extrapolated from prophylactic regimens used in treatment trials as well as from anecdotal reports.

• #8 Chronic Lymphocytic Leukemia (CLL) prevention | UK Healthcare

  https://ukhealthcare.uky.edu/markey-cancer-center/cancer-types/cll/prevention

  You can lower your risk of cancer by committing to practices that build a healthy lifestyle. These recommendations can lower your risk for this disease, as well as improve your overall basic health. […] Avoid using tobacco products. Tobacco has been tied to multiple cancers, and it is responsible for 90 percent of lung cancer deaths. […] Stay physically active. Your physical activity is related to risk for colon and breast cancer. Excess weight gained from inactivity increases the risk of multiple cancers. […] Limit alcohol consumption. It is important to be mindful of your alcohol consumption. Alcohol intake, even in moderate amounts, can increase the risk for colon, breast, esophageal, and oropharyngeal cancer.

• #9 Chronic Lymphocytic Leukemia (CLL) Risk Factors

  https://www.healthline.com/health/leukemia/cll-risk-factors

  Is there a way to prevent or reduce your risk for CLL? […] You may be able to lower your chances of developing CLL by: avoiding contact with benzene, maintaining a healthy body weight, minimizing contact with some herbicides or pesticides, wearing protective clothing when you do come into contact with herbicides, pesticides, or other potentially carcinogenic chemicals. […] Avoiding or minimizing exposure to pesticides, herbicides, and other potentially carcinogenic chemicals may help reduce your odds of developing CLL and some other cancers.

• #10 Chronic Lymphocytic Leukemia (CLL) Treatment in Delhi, India | Symptoms, Causes & Diagnosis

  https://www.maxhealthcare.in/our-specialities/hematology-oncology/conditions-treatments/chronic-lymphocytic-leukaemia

  Chronic Lymphocytic Leukaemia Prevention […] As there are few risk factors for CLL and most of them cannot be avoided, there is no known way to prevent CLL. However, minimising chemical exposure can prove to be beneficial. Maintaining a healthy lifestyle by exercising regularly, eating a balanced diet and stress management can help keep the immune system strong and more resilient to disease.

• #11 Can CLL Be Prevented? | American Cancer Society

  https://www.cancer.org/cancer/types/chronic-lymphocytic-leukemia/causes-risks-prevention/prevention.html

  Most people with chronic lymphocytic leukemia (CLL) have no known risk factors that can be changed, so there is no clear way to prevent CLL at this time. […] The risk of many types of cancer can be lowered by making lifestyle changes to avoid or limit exposure to certain risk factors. But there are only a handful of known risk factors for chronic lymphocytic leukemia (CLL), and most of these cant be avoided. […] Some studies have suggested that farming and long-term exposure to certain pesticides and other chemicals may be linked to an increased risk of CLL. But more research is needed to be sure, so its not clear if avoiding these can lower a persons risk.

• #12 Chronic Lymphocytic Leukemia Diagnosis & Treatment in Mumbai, India

  https://www.nanavatimaxhospital.org/our-specialities/centre-for-bone-marrow-transplant/conditions-treatments/chronic-lymphocytic-leukemia

  CLL can be cured or prevented at the early stages itself. […] Try keeping yourself at a distance from pesticides and herbicides. […] Benzene exposure must be limited or avoided. […] Correct body weight must be maintained throughout. […] Though recurrence of CLL is not very common, taking care of certain things is vital. […] Avoid intake of raw sprouts or unpasteurized drinks. […] Make sure to keep your immune system on the right track.

• #13 Chronic Lymphocytic Leukemia (CLL) Risk Factors

  https://www.healthline.com/health/leukemia/cll-risk-factors

  Is there a way to prevent or reduce your risk for CLL? […] You may be able to lower your chances of developing CLL by: avoiding contact with benzene, maintaining a healthy body weight, minimizing contact with some herbicides or pesticides, wearing protective clothing when you do come into contact with herbicides, pesticides, or other potentially carcinogenic chemicals. […] Avoiding or minimizing exposure to pesticides, herbicides, and other potentially carcinogenic chemicals may help reduce your odds of developing CLL and some other cancers.

• #14 Chronic Lymphocytic Leukemia Diagnosis & Treatment in Mumbai, India

  https://www.nanavatimaxhospital.org/our-specialities/centre-for-bone-marrow-transplant/conditions-treatments/chronic-lymphocytic-leukemia

  CLL can be cured or prevented at the early stages itself. […] Try keeping yourself at a distance from pesticides and herbicides. […] Benzene exposure must be limited or avoided. […] Correct body weight must be maintained throughout. […] Though recurrence of CLL is not very common, taking care of certain things is vital. […] Avoid intake of raw sprouts or unpasteurized drinks. […] Make sure to keep your immune system on the right track.

• #15 Chronic Lymphocytic Leukemia (CLL) prevention | UK Healthcare

  https://ukhealthcare.uky.edu/markey-cancer-center/cancer-types/cll/prevention

  You can lower your risk of cancer by committing to practices that build a healthy lifestyle. These recommendations can lower your risk for this disease, as well as improve your overall basic health. […] Avoid using tobacco products. Tobacco has been tied to multiple cancers, and it is responsible for 90 percent of lung cancer deaths. […] Stay physically active. Your physical activity is related to risk for colon and breast cancer. Excess weight gained from inactivity increases the risk of multiple cancers. […] Limit alcohol consumption. It is important to be mindful of your alcohol consumption. Alcohol intake, even in moderate amounts, can increase the risk for colon, breast, esophageal, and oropharyngeal cancer.

• #16 Acute vs. chronic lymphocytic leukemia: Differences and more

  https://www.medicalnewstoday.com/articles/acute-lymphocytic-leukemia-vs-chronic-lymphocytic-leukemia

  ALL and CLL are cancers that develop due to genetic mutations that are difficult to prevent. However, avoiding exposure to radiation, tobacco products, and benzene could help lower the risk. […] For example, a 2021 study found that children with parents who smoked were more likely to develop ALL. Another study from the same year found that most acute cases that develop in infants begin before birth. […] A 2020 review indicates that most children who have a genetic mutation that increases the risk of leukemia do not develop the condition. This finding suggests a second mutation or certain environmental factors may be important in triggering leukemia.

• #17 Chronic Lymphocytic Leukemia (CLL) prevention | UK Healthcare

  https://ukhealthcare.uky.edu/markey-cancer-center/cancer-types/cll/prevention

  You can lower your risk of cancer by committing to practices that build a healthy lifestyle. These recommendations can lower your risk for this disease, as well as improve your overall basic health. […] Avoid using tobacco products. Tobacco has been tied to multiple cancers, and it is responsible for 90 percent of lung cancer deaths. […] Stay physically active. Your physical activity is related to risk for colon and breast cancer. Excess weight gained from inactivity increases the risk of multiple cancers. […] Limit alcohol consumption. It is important to be mindful of your alcohol consumption. Alcohol intake, even in moderate amounts, can increase the risk for colon, breast, esophageal, and oropharyngeal cancer.

• #18 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  Living with chronic lymphocytic leukemia can be challenging, but you can take steps to feel better and enjoy a high quality of life. […] Healthy lifestyle changes and basic precautions can protect your health and well-being. […] A nutritious diet and healthy weight can also improve your strength during cancer treatment and help you better tolerate side effects. […] Research shows that a nutritious diet can help improve immune function and support healthy gut bacteria, which is associated with an effective immune system. […] Avoid smoking. By staying away from cigarettes, you improve cancer treatment outcomes, reduce side effects from treatment, and lower the risk of cancer returning or spreading to secondary cancers. […] People with CLL tend to get sick a lot. […] CLL and its treatments can affect the immune system.

• #19 Chronic Lymphocytic Leukemia (CLL) prevention | UK Healthcare

  https://ukhealthcare.uky.edu/markey-cancer-center/cancer-types/cll/prevention

  You can lower your risk of cancer by committing to practices that build a healthy lifestyle. These recommendations can lower your risk for this disease, as well as improve your overall basic health. […] Avoid using tobacco products. Tobacco has been tied to multiple cancers, and it is responsible for 90 percent of lung cancer deaths. […] Stay physically active. Your physical activity is related to risk for colon and breast cancer. Excess weight gained from inactivity increases the risk of multiple cancers. […] Limit alcohol consumption. It is important to be mindful of your alcohol consumption. Alcohol intake, even in moderate amounts, can increase the risk for colon, breast, esophageal, and oropharyngeal cancer.

• #20 Self-Care With Chronic Lymphocytic Leukemia

  https://www.webmd.com/cancer/lymphoma/taking-care-of-yourself-cll

  Routine workouts can bring you lots of benefits. […] If youre not active already, ask your doctor to help you get started. […] You might need to juggle all of your usual responsibilities — like work, school, or parenting — while youre managing your leukemia. Its important to give yourself some me time. […] This is a good way to meet other people with leukemia who can understand what youre going through. […] Its normal to feel down or overwhelmed at times when youre living with cancer. But if youre sad, depressed, or anxious every day for 2 weeks or more, reach out to your doctor for help. […] Chronic lymphocytic leukemia and its treatments can make you feel tired and more tense at times. Enough shut-eye every night can help you recover your energy and ease stress. Talk to your doctor if youre having a hard time falling or staying asleep. […] You can ask your doctor to help you kick the habit. […] In general, experts recommend that you limit yourself to one drink a day if youre a woman and two if youre a man. Ask your doctor whats safe for you.

• #21

  https://www.healio.com/news/infectious-disease/20120225/prevention-of-infectious-complications-in-patients-with-chronic-lymphocytic-leukemia

  One of the most common supportive care challenges faced by the chronic lymphocytic leukemia patient is infectious complications. The increased risk for infectious complications compared with other malignancies arises from disease- and treatment-related factors. […] Some of these opportunistic infections can be easily prevented. The National Comprehensive Cancer Network (NCCN) guidelines on prevention and treatment of cancer-related infections consider CLL patients receiving purine analogs or alemtuzumab (Campath, Genzyme) at intermediate- or high-risk, respectively, for developing infections. The guidelines recommend that patients receiving purine analog and/or alemtuzumab-containing regimens should be given prophylactic medications against viral infections and Pneumocystis infections, at a minimum.

• #22 Prevention of infections in patients with chronic lymphocytic leukemia – UpToDate

  https://www.uptodate.com/contents/prevention-of-infections-in-patients-with-chronic-lymphocytic-leukemia

  Prevention of infections in patients with chronic lymphocytic leukemia […] The approach to infection prevention will be reviewed here. […] General approach — As the immune defects caused by specific chronic lymphocytic leukemia (CLL) therapies have significant impact on subsequent infectious complications, our prophylaxis recommendations vary depending upon the type of therapy used (table 1). […] There have been no randomized trials evaluating the use of prophylactic antimicrobials in patients with CLL, and there are no evidence-based guidelines for antimicrobial prophylaxis in this population. Most recommendations for antimicrobial prophylaxis have been extrapolated from prophylactic regimens used in treatment trials as well as from anecdotal reports.

• #23 Prevention of infections in patients with chronic lymphocytic leukemia – UpToDate

  https://www.uptodate.com/contents/prevention-of-infections-in-patients-with-chronic-lymphocytic-leukemia/print

  Prevention of infections in patients with chronic lymphocytic leukemia […] Infections have a major impact on the clinical course of patients with chronic lymphocytic leukemia (CLL). Patients with CLL have underlying abnormalities in immune function related to the primary disease process in addition to defects in immune function related to the specific antileukemic therapies administered. The approach to infection prevention will be reviewed here. […] General approach — As the immune defects caused by specific chronic lymphocytic leukemia (CLL) therapies have significant impact on subsequent infectious complications, our prophylaxis recommendations vary depending upon the type of therapy used (table 1). Additional considerations that impact antimicrobial prophylaxis in individual patients are treatment status (treatment naïve versus heavily pretreated) and past history of infections. […] There have been no randomized trials evaluating the use of prophylactic antimicrobials in patients with CLL, and there are no evidence-based guidelines for antimicrobial prophylaxis in this population. Most recommendations for antimicrobial prophylaxis have been extrapolated from prophylactic regimens used in treatment trials as well as from anecdotal reports.

• #24 Prevention of infections in patients with chronic lymphocytic leukemia – UpToDate

  https://www.uptodate.com/contents/prevention-of-infections-in-patients-with-chronic-lymphocytic-leukemia

  Prevention of infections in patients with chronic lymphocytic leukemia […] The approach to infection prevention will be reviewed here. […] General approach — As the immune defects caused by specific chronic lymphocytic leukemia (CLL) therapies have significant impact on subsequent infectious complications, our prophylaxis recommendations vary depending upon the type of therapy used (table 1). […] There have been no randomized trials evaluating the use of prophylactic antimicrobials in patients with CLL, and there are no evidence-based guidelines for antimicrobial prophylaxis in this population. Most recommendations for antimicrobial prophylaxis have been extrapolated from prophylactic regimens used in treatment trials as well as from anecdotal reports.

• #25 Managing the Risk of Infection in Chronic Lymphocytic Leukemia in the Era of New Therapies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8976213/

  Patients diagnosed with CLL have an increased susceptibility to infections. […] Infections continue to represent a significant complication in the era of novel therapies. […] Evidence supporting infection prevention strategies is scarce. We will review the available recommendations to prevent infections in patients with CLL treated with novel therapies. […] Timely prevention, recognition, and treatment of infections should remain an important aspect of the standard management of a patient with CLL. […] There is no standard recommended antibacterial prophylaxis in patients with CLL treated with modern therapies. […] The use of immunoglobulin (Ig) replacement therapy can be helpful in reducing the frequency of infections. However, it should only be administered to patients with severe hypogammaglobulinemia (400 mg/dL) and/or recurrent or severe infections.

• #26 Managing the Risk of Infection in Chronic Lymphocytic Leukemia in the Era of New Therapies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8976213/

  It has been suggested that prophylaxis should be considered in frail older patients (75 years) with R/R CLL and/or prolonged neutropenia (6 months). […] For patients receiving BTK inhibitors or BCL-2 inhibitors along with chronic steroid therapy, i.e., to treat autoimmune cytopenias or with a previous history of fungal infections, prophylaxis may be advised. […] It is recommended that CLL patients treated with idelalisib or duvelisib start prophylaxis at the beginning of the CLL therapy, maintaining it for as long as 2 to 6 months after the end of the PI3K inhibitor treatment. […] Vaccination against COVID-19 is recommended for patients with CLL.

• #27 Prevention and management of infectious complications in patients with chronic lymphocytic leukemia (CLL) treated with BTK and BCL-2 inhibitors, focus on current guidelines – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38331696/

  CLL is associated with an increased risk of infectious complications. […] Treatment with BTK or BCL-2 inhibitors does not seem to increase significantly the risk of opportunistic infections, but the role of combination therapies including BTK and/or BCL-2 inhibitors remains to be established. […] Various infectious complications can be successfully prevented with appropriate risk management strategies. […] Universal pharmacological anti-herpes, antibacterial or antifungal prophylaxis is not warranted. […] Reactivation of HBV should be prevented in HBsAg-positive subjects. […] For HBsAg-negative/HBcAb-positive patients recommendations differ, but in case of combination treatment should follow those for other, particularly anti-CD20, agent. […] Immunization should be provided preferably before the onset of treatment.

• #28

  https://www.healio.com/news/infectious-disease/20120225/prevention-of-infectious-complications-in-patients-with-chronic-lymphocytic-leukemia

  One of the most common supportive care challenges faced by the chronic lymphocytic leukemia patient is infectious complications. The increased risk for infectious complications compared with other malignancies arises from disease- and treatment-related factors. […] Some of these opportunistic infections can be easily prevented. The National Comprehensive Cancer Network (NCCN) guidelines on prevention and treatment of cancer-related infections consider CLL patients receiving purine analogs or alemtuzumab (Campath, Genzyme) at intermediate- or high-risk, respectively, for developing infections. The guidelines recommend that patients receiving purine analog and/or alemtuzumab-containing regimens should be given prophylactic medications against viral infections and Pneumocystis infections, at a minimum.

• #29

  https://www.healio.com/news/infectious-disease/20120225/prevention-of-infectious-complications-in-patients-with-chronic-lymphocytic-leukemia

  Prophylaxis, if given, should continue for at least two months after completion of therapy or until the CD4 lymphocyte count is greater than 200 cells/mcL. […] It is recommended that patients being considered for immunosuppressive therapy should be screened for hepatitis B, particularly if thought to be at high-risk of infection. […] Data support the use of prophylactic antiviral therapy with lamivudine (Epivir, GlaxoSmithKline) during rituximab treatment to prevent hepatitis B reactivation in seropositive patients. […] Patients with CLL should receive the annual influenza vaccine, although complete immunity should not be assumed. […] One of the biggest challenges facing the CLL patient after considering the challenge of finding a cure for this malignancy is the morbidity and mortality of infectious complications. As chemotherapy regimens become increasingly myelosuppressive and immunosuppressive, appropriate prophylactic antimicrobials become necessary to help prevent infectious complications.

• #30 Managing the Risk of Infection in Chronic Lymphocytic Leukemia in the Era of New Therapies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8976213/

  It has been suggested that prophylaxis should be considered in frail older patients (75 years) with R/R CLL and/or prolonged neutropenia (6 months). […] For patients receiving BTK inhibitors or BCL-2 inhibitors along with chronic steroid therapy, i.e., to treat autoimmune cytopenias or with a previous history of fungal infections, prophylaxis may be advised. […] It is recommended that CLL patients treated with idelalisib or duvelisib start prophylaxis at the beginning of the CLL therapy, maintaining it for as long as 2 to 6 months after the end of the PI3K inhibitor treatment. […] Vaccination against COVID-19 is recommended for patients with CLL.

• #31 Managing the Risk of Infection in Chronic Lymphocytic Leukemia in the Era of New Therapies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8976213/

  It has been suggested that prophylaxis should be considered in frail older patients (75 years) with R/R CLL and/or prolonged neutropenia (6 months). […] For patients receiving BTK inhibitors or BCL-2 inhibitors along with chronic steroid therapy, i.e., to treat autoimmune cytopenias or with a previous history of fungal infections, prophylaxis may be advised. […] It is recommended that CLL patients treated with idelalisib or duvelisib start prophylaxis at the beginning of the CLL therapy, maintaining it for as long as 2 to 6 months after the end of the PI3K inhibitor treatment. […] Vaccination against COVID-19 is recommended for patients with CLL.

• #32 Managing the Risk of Infection in Chronic Lymphocytic Leukemia in the Era of New Therapies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8976213/

  It has been suggested that prophylaxis should be considered in frail older patients (75 years) with R/R CLL and/or prolonged neutropenia (6 months). […] For patients receiving BTK inhibitors or BCL-2 inhibitors along with chronic steroid therapy, i.e., to treat autoimmune cytopenias or with a previous history of fungal infections, prophylaxis may be advised. […] It is recommended that CLL patients treated with idelalisib or duvelisib start prophylaxis at the beginning of the CLL therapy, maintaining it for as long as 2 to 6 months after the end of the PI3K inhibitor treatment. […] Vaccination against COVID-19 is recommended for patients with CLL.

• #33

  https://haematologica.org/article/view/haematol.2021.280325

  Several reports have highlighted the risk of hepatitis B virus (HBV) reactivation in patients with lymphoproliferative disorders undergoing cytotoxic treatment. This risk is particularly relevant in chronic lymphocytic leukemia (CLL) patients with occult HBV infection (OBI), especially during treatment with anti-CD20 monoclonal antibodies. Moreover, CLL is one of the B-cell lymphoproliferative diseases with the highest risk of HBV reactivation. Since chemo-immunotherapy treatments (CIT) of CLL patients with OBI are associated with an intermediate to high risk of HBV reactivation, antiviral therapy as prophylaxis is recommended. Currently, lamivudine is universally used as prophylaxis due to its low cost and toxicity profile. As HBV reactivation can occur up to 12-18 months after the end of the chemotherapy, the antiviral prophylaxis is indicated from the beginning of the specific CLL chemotherapy up to 18 months after the end of treatment.

• #34

  https://www.healio.com/news/infectious-disease/20120225/prevention-of-infectious-complications-in-patients-with-chronic-lymphocytic-leukemia

  Prophylaxis, if given, should continue for at least two months after completion of therapy or until the CD4 lymphocyte count is greater than 200 cells/mcL. […] It is recommended that patients being considered for immunosuppressive therapy should be screened for hepatitis B, particularly if thought to be at high-risk of infection. […] Data support the use of prophylactic antiviral therapy with lamivudine (Epivir, GlaxoSmithKline) during rituximab treatment to prevent hepatitis B reactivation in seropositive patients. […] Patients with CLL should receive the annual influenza vaccine, although complete immunity should not be assumed. […] One of the biggest challenges facing the CLL patient after considering the challenge of finding a cure for this malignancy is the morbidity and mortality of infectious complications. As chemotherapy regimens become increasingly myelosuppressive and immunosuppressive, appropriate prophylactic antimicrobials become necessary to help prevent infectious complications.

• #35 Prevention and management of infectious complications in patients with chronic lymphocytic leukemia (CLL) treated with BTK and BCL-2 inhibitors, focus on current guidelines – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38331696/

  CLL is associated with an increased risk of infectious complications. […] Treatment with BTK or BCL-2 inhibitors does not seem to increase significantly the risk of opportunistic infections, but the role of combination therapies including BTK and/or BCL-2 inhibitors remains to be established. […] Various infectious complications can be successfully prevented with appropriate risk management strategies. […] Universal pharmacological anti-herpes, antibacterial or antifungal prophylaxis is not warranted. […] Reactivation of HBV should be prevented in HBsAg-positive subjects. […] For HBsAg-negative/HBcAb-positive patients recommendations differ, but in case of combination treatment should follow those for other, particularly anti-CD20, agent. […] Immunization should be provided preferably before the onset of treatment.

• #36 Prevention and management of infectious complications in patients with chronic lymphocytic leukemia (CLL) treated with BTK and BCL-2 inhibitors, focus on current guidelines – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38331696/

  CLL is associated with an increased risk of infectious complications. […] Treatment with BTK or BCL-2 inhibitors does not seem to increase significantly the risk of opportunistic infections, but the role of combination therapies including BTK and/or BCL-2 inhibitors remains to be established. […] Various infectious complications can be successfully prevented with appropriate risk management strategies. […] Universal pharmacological anti-herpes, antibacterial or antifungal prophylaxis is not warranted. […] Reactivation of HBV should be prevented in HBsAg-positive subjects. […] For HBsAg-negative/HBcAb-positive patients recommendations differ, but in case of combination treatment should follow those for other, particularly anti-CD20, agent. […] Immunization should be provided preferably before the onset of treatment.

• #37 Prevention and management of infectious complications in patients with chronic lymphocytic leukemia (CLL) treated with BTK and BCL-2 inhibitors, focus on current guidelines – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38331696/

  CLL is associated with an increased risk of infectious complications. […] Treatment with BTK or BCL-2 inhibitors does not seem to increase significantly the risk of opportunistic infections, but the role of combination therapies including BTK and/or BCL-2 inhibitors remains to be established. […] Various infectious complications can be successfully prevented with appropriate risk management strategies. […] Universal pharmacological anti-herpes, antibacterial or antifungal prophylaxis is not warranted. […] Reactivation of HBV should be prevented in HBsAg-positive subjects. […] For HBsAg-negative/HBcAb-positive patients recommendations differ, but in case of combination treatment should follow those for other, particularly anti-CD20, agent. […] Immunization should be provided preferably before the onset of treatment.

• #38

  https://haematologica.org/article/view/haematol.2021.280325

  Several reports have highlighted the risk of hepatitis B virus (HBV) reactivation in patients with lymphoproliferative disorders undergoing cytotoxic treatment. This risk is particularly relevant in chronic lymphocytic leukemia (CLL) patients with occult HBV infection (OBI), especially during treatment with anti-CD20 monoclonal antibodies. Moreover, CLL is one of the B-cell lymphoproliferative diseases with the highest risk of HBV reactivation. Since chemo-immunotherapy treatments (CIT) of CLL patients with OBI are associated with an intermediate to high risk of HBV reactivation, antiviral therapy as prophylaxis is recommended. Currently, lamivudine is universally used as prophylaxis due to its low cost and toxicity profile. As HBV reactivation can occur up to 12-18 months after the end of the chemotherapy, the antiviral prophylaxis is indicated from the beginning of the specific CLL chemotherapy up to 18 months after the end of treatment.

• #39

  https://www.healio.com/news/infectious-disease/20120225/prevention-of-infectious-complications-in-patients-with-chronic-lymphocytic-leukemia

  Prophylaxis, if given, should continue for at least two months after completion of therapy or until the CD4 lymphocyte count is greater than 200 cells/mcL. […] It is recommended that patients being considered for immunosuppressive therapy should be screened for hepatitis B, particularly if thought to be at high-risk of infection. […] Data support the use of prophylactic antiviral therapy with lamivudine (Epivir, GlaxoSmithKline) during rituximab treatment to prevent hepatitis B reactivation in seropositive patients. […] Patients with CLL should receive the annual influenza vaccine, although complete immunity should not be assumed. […] One of the biggest challenges facing the CLL patient after considering the challenge of finding a cure for this malignancy is the morbidity and mortality of infectious complications. As chemotherapy regimens become increasingly myelosuppressive and immunosuppressive, appropriate prophylactic antimicrobials become necessary to help prevent infectious complications.

• #40

  https://haematologica.org/article/view/haematol.2021.280325

  The current guidelines of the European Conference on Infection in Leukemia (ECIL-5) and the American Gastroenterology Association (AGA) on the prevention of HBV reactivation provide no recommendations with regard to the management and the need for antiviral prophylaxis of patients with seropositive occult HBV infection treated with a BCRi. A recent recommendation has been issued by acknowledging the intermediate risk of HBV reactivation and advising prophylaxis with lamivudine in HBsAg-negative, anti-HBc-positive patients starting ibrutinib treatment. However, given that ibrutinib may be administered continuously for years, the toxicity associated with prolonged antiviral prophylaxis and drug-resistance may be significant. […] In conclusion, we confirm that HBV reactivation may rarely occur during ibrutinib treatment in OBI/CLL patients, mainly if not only in patients previously treated with CIT. Based on the easy management with entecavir in case of HBV reactivation, we recommend, for CLL patients with OBI during ibrutinib treatment, 3-months interval monitoring of HBV serum markers rather than HBV prophylaxis.

• #41 Managing the Risk of Infection in Chronic Lymphocytic Leukemia in the Era of New Therapies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8976213/

  Patients diagnosed with CLL have an increased susceptibility to infections. […] Infections continue to represent a significant complication in the era of novel therapies. […] Evidence supporting infection prevention strategies is scarce. We will review the available recommendations to prevent infections in patients with CLL treated with novel therapies. […] Timely prevention, recognition, and treatment of infections should remain an important aspect of the standard management of a patient with CLL. […] There is no standard recommended antibacterial prophylaxis in patients with CLL treated with modern therapies. […] The use of immunoglobulin (Ig) replacement therapy can be helpful in reducing the frequency of infections. However, it should only be administered to patients with severe hypogammaglobulinemia (400 mg/dL) and/or recurrent or severe infections.

• #42 Prevention and management of infectious complications in patients with chronic lymphocytic leukemia (CLL) treated with BTK and BCL-2 inhibitors, focus on current guidelines – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38331696/

  Immunoglobulin therapy has favourable impact on morbidity but not mortality in patients with hypogammaglobulinemia and severe or recurrent infections. […] Lack of high-quality data and heterogeneity of patients or protocols included in the studies might explain differences among the main guidelines. […] Better data collection is warranted.

• #43 Managing the Risk of Infection in Chronic Lymphocytic Leukemia in the Era of New Therapies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8976213/

  Patients diagnosed with CLL have an increased susceptibility to infections. […] Infections continue to represent a significant complication in the era of novel therapies. […] Evidence supporting infection prevention strategies is scarce. We will review the available recommendations to prevent infections in patients with CLL treated with novel therapies. […] Timely prevention, recognition, and treatment of infections should remain an important aspect of the standard management of a patient with CLL. […] There is no standard recommended antibacterial prophylaxis in patients with CLL treated with modern therapies. […] The use of immunoglobulin (Ig) replacement therapy can be helpful in reducing the frequency of infections. However, it should only be administered to patients with severe hypogammaglobulinemia (400 mg/dL) and/or recurrent or severe infections.

• #44 Prevention and management of infectious complications in patients with chronic lymphocytic leukemia (CLL) treated with BTK and BCL-2 inhibitors, focus on current guidelines – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38331696/

  Immunoglobulin therapy has favourable impact on morbidity but not mortality in patients with hypogammaglobulinemia and severe or recurrent infections. […] Lack of high-quality data and heterogeneity of patients or protocols included in the studies might explain differences among the main guidelines. […] Better data collection is warranted.

• #45

  https://expertperspectives.com/prevention-of-infections-in-patients-with-chronic-lymphocytic-leukemia/

  The only patients who benefit from IVIG are patients who have recurrent bacterial infection with their low IgG levels or who have trouble clearing bacterial infections (eg, sinus infections can sometimes be a big problem). […] Strategies to decrease the risk of infection include vaccination and IVIG, and prophylaxis when appropriate. […] I think that a large body of scientific work in CLL demonstrates that there are inherent immune deficiencies to address, such as B-cell dysfunction and the use of IVIG as well as T-cell dysfunction (most likely related to prior therapies) and the use of appropriate antimicrobial prophylaxis.

• #46 Preventing Infectious Complications in Chronic Lymphocytic Leukemia – Hematology & Oncology

  https://www.hematologyandoncology.net/archives/december-2023/preventing-infectious-complications-in-chronic-lymphocytic-leukemia/

  Patients who have CLL fall under the immunocompromised designation in the Centers for Disease Control adult immunization schedule. […] For this upcoming cold season, I have been recommending the COVID booster vaccine and the flu shot to my patients with CLL. […] Vaccines are one of our most cost-effective measures for preventing infection. The key for CLL patients is to immunize early, when their immune system is best able to mount a good response. […] A final note regarding vaccines is that live vaccines are contraindicated for patients with CLL. […] We have additional strategies for preventing infections, such as immunoglobulin replacement with intravenous immunoglobulin (IVIG) for patients with hypogammaglobulinemia. […] Another approach is the use of antimicrobial prophylaxis during treatment. […] There are some special considerations when it comes to vaccines in patients who are on anti-CD20 monoclonal antibodies.

• #47 How Can I Prevent Infections as a CLL Patient? – HealthTree for Chronic Lymphocytic Leukemia

  https://healthtree.org/cll/community/articles/cll-infection-prevention-dr-meghan-thompson

  Chronic lymphocytic leukemia (CLL) is a type of cancer that affects the immune system, making it easier for patients to contract infections. To maintain good health, it is important for patients to receive non-live versions of vaccines, receive immunoglobulin infusions if they have a history of recurrent infections, be checked for other types of cancers like skin cancer, keep an eye on their blood pressure and cholesterol, and consider participating in clinical trials. […] Vaccines help prevent infections in CLL patients. Safe vaccine options for patients include non-live versions such as the flu vaccine, the new RSV vaccine (for those over the age of 60), COVID-19 vaccines, pneumococcal vaccines (like Prevnar 20 or Prevnar 15, followed by Pneumovax 20), and the Shingrix vaccine series. […] CLL patients should try to get all their vaccines completed before they start any treatments. Dr. Thompson mentioned that patients should wait six months before getting a vaccine after receiving rituximab or obinutuzumab. This is because these treatments lower B-cells which impacts how well a patients body can make antibodies after receiving a vaccine.

• #48

  https://www.healio.com/news/infectious-disease/20120225/prevention-of-infectious-complications-in-patients-with-chronic-lymphocytic-leukemia

  Prophylaxis, if given, should continue for at least two months after completion of therapy or until the CD4 lymphocyte count is greater than 200 cells/mcL. […] It is recommended that patients being considered for immunosuppressive therapy should be screened for hepatitis B, particularly if thought to be at high-risk of infection. […] Data support the use of prophylactic antiviral therapy with lamivudine (Epivir, GlaxoSmithKline) during rituximab treatment to prevent hepatitis B reactivation in seropositive patients. […] Patients with CLL should receive the annual influenza vaccine, although complete immunity should not be assumed. […] One of the biggest challenges facing the CLL patient after considering the challenge of finding a cure for this malignancy is the morbidity and mortality of infectious complications. As chemotherapy regimens become increasingly myelosuppressive and immunosuppressive, appropriate prophylactic antimicrobials become necessary to help prevent infectious complications.

• #49 Preventing Infectious Complications in Chronic Lymphocytic Leukemia – Hematology & Oncology

  https://www.hematologyandoncology.net/archives/december-2023/preventing-infectious-complications-in-chronic-lymphocytic-leukemia/

  Patients who have CLL fall under the immunocompromised designation in the Centers for Disease Control adult immunization schedule. […] For this upcoming cold season, I have been recommending the COVID booster vaccine and the flu shot to my patients with CLL. […] Vaccines are one of our most cost-effective measures for preventing infection. The key for CLL patients is to immunize early, when their immune system is best able to mount a good response. […] A final note regarding vaccines is that live vaccines are contraindicated for patients with CLL. […] We have additional strategies for preventing infections, such as immunoglobulin replacement with intravenous immunoglobulin (IVIG) for patients with hypogammaglobulinemia. […] Another approach is the use of antimicrobial prophylaxis during treatment. […] There are some special considerations when it comes to vaccines in patients who are on anti-CD20 monoclonal antibodies.

• #50 How Can I Prevent Infections as a CLL Patient? – HealthTree for Chronic Lymphocytic Leukemia

  https://healthtree.org/cll/community/articles/cll-infection-prevention-dr-meghan-thompson

  Chronic lymphocytic leukemia (CLL) is a type of cancer that affects the immune system, making it easier for patients to contract infections. To maintain good health, it is important for patients to receive non-live versions of vaccines, receive immunoglobulin infusions if they have a history of recurrent infections, be checked for other types of cancers like skin cancer, keep an eye on their blood pressure and cholesterol, and consider participating in clinical trials. […] Vaccines help prevent infections in CLL patients. Safe vaccine options for patients include non-live versions such as the flu vaccine, the new RSV vaccine (for those over the age of 60), COVID-19 vaccines, pneumococcal vaccines (like Prevnar 20 or Prevnar 15, followed by Pneumovax 20), and the Shingrix vaccine series. […] CLL patients should try to get all their vaccines completed before they start any treatments. Dr. Thompson mentioned that patients should wait six months before getting a vaccine after receiving rituximab or obinutuzumab. This is because these treatments lower B-cells which impacts how well a patients body can make antibodies after receiving a vaccine.

• #51 Chronic Lymphocytic Leukemia: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.chronic-lymphocytic-leukemia-care-instructions.uf8168

  Avoid infections such as COVID-19, colds, and the flu. Wash your hands often. Get a pneumococcal vaccine. If you have had one before, ask your doctor whether you need another dose. Get a flu shot every year. Stay up to date on your COVID-19 vaccines. […] Do not smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

• #52 How Can I Prevent Infections as a CLL Patient? – HealthTree for Chronic Lymphocytic Leukemia

  https://healthtree.org/cll/community/articles/cll-infection-prevention-dr-meghan-thompson

  Chronic lymphocytic leukemia (CLL) is a type of cancer that affects the immune system, making it easier for patients to contract infections. To maintain good health, it is important for patients to receive non-live versions of vaccines, receive immunoglobulin infusions if they have a history of recurrent infections, be checked for other types of cancers like skin cancer, keep an eye on their blood pressure and cholesterol, and consider participating in clinical trials. […] Vaccines help prevent infections in CLL patients. Safe vaccine options for patients include non-live versions such as the flu vaccine, the new RSV vaccine (for those over the age of 60), COVID-19 vaccines, pneumococcal vaccines (like Prevnar 20 or Prevnar 15, followed by Pneumovax 20), and the Shingrix vaccine series. […] CLL patients should try to get all their vaccines completed before they start any treatments. Dr. Thompson mentioned that patients should wait six months before getting a vaccine after receiving rituximab or obinutuzumab. This is because these treatments lower B-cells which impacts how well a patients body can make antibodies after receiving a vaccine.

• #53 Coronavirus and Chronic Lymphocytic Leukemia | COVID-19 and CLL Leukemia

  https://resources.healthgrades.com/right-care/coronavirus/coronavirus-what-cll-leukemia-patients-need-to-know

  Chronic lymphocytic leukemia is cancer of your blood and bone marrow that mostly affects older adults. It affects your lymphocytes, a type of white blood cell, and lowers your body’s ability to fight infections. People with CLL tend to have more frequent infections, especially involving the respiratory tract. […] The CDC recommends that high risk individuals, like those with chronic lymphocytic leukemia, take steps to reduce their exposure to the coronavirus: […] Get vaccinated against COVID-19 and receive booster immunizations as recommended by your doctor. […] The CLL Society suggests taking it a step further by “sheltering in place.” This means: […] Immunocompromised patients, including people with CLL, are generally advised to postpone routine medical visits to avoid potential exposure to COVID-19. […] Keep in mind, this is a rapidly evolving situation. Specific guidance and recommendations for CLL patients who are affected by the coronavirus may change over time.

• #54 Managing the Risk of Infection in Chronic Lymphocytic Leukemia in the Era of New Therapies

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8976213/

  It has been suggested that prophylaxis should be considered in frail older patients (75 years) with R/R CLL and/or prolonged neutropenia (6 months). […] For patients receiving BTK inhibitors or BCL-2 inhibitors along with chronic steroid therapy, i.e., to treat autoimmune cytopenias or with a previous history of fungal infections, prophylaxis may be advised. […] It is recommended that CLL patients treated with idelalisib or duvelisib start prophylaxis at the beginning of the CLL therapy, maintaining it for as long as 2 to 6 months after the end of the PI3K inhibitor treatment. […] Vaccination against COVID-19 is recommended for patients with CLL.

• #55 How Can I Prevent Infections as a CLL Patient? – HealthTree for Chronic Lymphocytic Leukemia

  https://healthtree.org/cll/community/articles/cll-infection-prevention-dr-meghan-thompson

  Chronic lymphocytic leukemia (CLL) is a type of cancer that affects the immune system, making it easier for patients to contract infections. To maintain good health, it is important for patients to receive non-live versions of vaccines, receive immunoglobulin infusions if they have a history of recurrent infections, be checked for other types of cancers like skin cancer, keep an eye on their blood pressure and cholesterol, and consider participating in clinical trials. […] Vaccines help prevent infections in CLL patients. Safe vaccine options for patients include non-live versions such as the flu vaccine, the new RSV vaccine (for those over the age of 60), COVID-19 vaccines, pneumococcal vaccines (like Prevnar 20 or Prevnar 15, followed by Pneumovax 20), and the Shingrix vaccine series. […] CLL patients should try to get all their vaccines completed before they start any treatments. Dr. Thompson mentioned that patients should wait six months before getting a vaccine after receiving rituximab or obinutuzumab. This is because these treatments lower B-cells which impacts how well a patients body can make antibodies after receiving a vaccine.

• #56 Preventing Infectious Complications in Chronic Lymphocytic Leukemia – Hematology & Oncology

  https://www.hematologyandoncology.net/archives/december-2023/preventing-infectious-complications-in-chronic-lymphocytic-leukemia/

  Patients who have CLL fall under the immunocompromised designation in the Centers for Disease Control adult immunization schedule. […] For this upcoming cold season, I have been recommending the COVID booster vaccine and the flu shot to my patients with CLL. […] Vaccines are one of our most cost-effective measures for preventing infection. The key for CLL patients is to immunize early, when their immune system is best able to mount a good response. […] A final note regarding vaccines is that live vaccines are contraindicated for patients with CLL. […] We have additional strategies for preventing infections, such as immunoglobulin replacement with intravenous immunoglobulin (IVIG) for patients with hypogammaglobulinemia. […] Another approach is the use of antimicrobial prophylaxis during treatment. […] There are some special considerations when it comes to vaccines in patients who are on anti-CD20 monoclonal antibodies.

• #57 How Can I Prevent Infections as a CLL Patient? – HealthTree for Chronic Lymphocytic Leukemia

  https://healthtree.org/cll/community/articles/cll-infection-prevention-dr-meghan-thompson

  Chronic lymphocytic leukemia (CLL) is a type of cancer that affects the immune system, making it easier for patients to contract infections. To maintain good health, it is important for patients to receive non-live versions of vaccines, receive immunoglobulin infusions if they have a history of recurrent infections, be checked for other types of cancers like skin cancer, keep an eye on their blood pressure and cholesterol, and consider participating in clinical trials. […] Vaccines help prevent infections in CLL patients. Safe vaccine options for patients include non-live versions such as the flu vaccine, the new RSV vaccine (for those over the age of 60), COVID-19 vaccines, pneumococcal vaccines (like Prevnar 20 or Prevnar 15, followed by Pneumovax 20), and the Shingrix vaccine series. […] CLL patients should try to get all their vaccines completed before they start any treatments. Dr. Thompson mentioned that patients should wait six months before getting a vaccine after receiving rituximab or obinutuzumab. This is because these treatments lower B-cells which impacts how well a patients body can make antibodies after receiving a vaccine.

• #58 Prevention and management of infectious complications in patients with chronic lymphocytic leukemia (CLL) treated with BTK and BCL-2 inhibitors, focus on current guidelines – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38331696/

  CLL is associated with an increased risk of infectious complications. […] Treatment with BTK or BCL-2 inhibitors does not seem to increase significantly the risk of opportunistic infections, but the role of combination therapies including BTK and/or BCL-2 inhibitors remains to be established. […] Various infectious complications can be successfully prevented with appropriate risk management strategies. […] Universal pharmacological anti-herpes, antibacterial or antifungal prophylaxis is not warranted. […] Reactivation of HBV should be prevented in HBsAg-positive subjects. […] For HBsAg-negative/HBcAb-positive patients recommendations differ, but in case of combination treatment should follow those for other, particularly anti-CD20, agent. […] Immunization should be provided preferably before the onset of treatment.

• #59 How Can I Prevent Infections as a CLL Patient? – HealthTree for Chronic Lymphocytic Leukemia

  https://healthtree.org/cll/community/articles/cll-infection-prevention-dr-meghan-thompson

  Chronic lymphocytic leukemia (CLL) is a type of cancer that affects the immune system, making it easier for patients to contract infections. To maintain good health, it is important for patients to receive non-live versions of vaccines, receive immunoglobulin infusions if they have a history of recurrent infections, be checked for other types of cancers like skin cancer, keep an eye on their blood pressure and cholesterol, and consider participating in clinical trials. […] Vaccines help prevent infections in CLL patients. Safe vaccine options for patients include non-live versions such as the flu vaccine, the new RSV vaccine (for those over the age of 60), COVID-19 vaccines, pneumococcal vaccines (like Prevnar 20 or Prevnar 15, followed by Pneumovax 20), and the Shingrix vaccine series. […] CLL patients should try to get all their vaccines completed before they start any treatments. Dr. Thompson mentioned that patients should wait six months before getting a vaccine after receiving rituximab or obinutuzumab. This is because these treatments lower B-cells which impacts how well a patients body can make antibodies after receiving a vaccine.

• #60 Coronavirus and Chronic Lymphocytic Leukemia | COVID-19 and CLL Leukemia

  https://resources.healthgrades.com/right-care/coronavirus/coronavirus-what-cll-leukemia-patients-need-to-know

  Chronic lymphocytic leukemia is cancer of your blood and bone marrow that mostly affects older adults. It affects your lymphocytes, a type of white blood cell, and lowers your body’s ability to fight infections. People with CLL tend to have more frequent infections, especially involving the respiratory tract. […] The CDC recommends that high risk individuals, like those with chronic lymphocytic leukemia, take steps to reduce their exposure to the coronavirus: […] Get vaccinated against COVID-19 and receive booster immunizations as recommended by your doctor. […] The CLL Society suggests taking it a step further by “sheltering in place.” This means: […] Immunocompromised patients, including people with CLL, are generally advised to postpone routine medical visits to avoid potential exposure to COVID-19. […] Keep in mind, this is a rapidly evolving situation. Specific guidance and recommendations for CLL patients who are affected by the coronavirus may change over time.

• #61 Coronavirus and Chronic Lymphocytic Leukemia | COVID-19 and CLL Leukemia

  https://resources.healthgrades.com/right-care/coronavirus/coronavirus-what-cll-leukemia-patients-need-to-know

  Chronic lymphocytic leukemia is cancer of your blood and bone marrow that mostly affects older adults. It affects your lymphocytes, a type of white blood cell, and lowers your body’s ability to fight infections. People with CLL tend to have more frequent infections, especially involving the respiratory tract. […] The CDC recommends that high risk individuals, like those with chronic lymphocytic leukemia, take steps to reduce their exposure to the coronavirus: […] Get vaccinated against COVID-19 and receive booster immunizations as recommended by your doctor. […] The CLL Society suggests taking it a step further by “sheltering in place.” This means: […] Immunocompromised patients, including people with CLL, are generally advised to postpone routine medical visits to avoid potential exposure to COVID-19. […] Keep in mind, this is a rapidly evolving situation. Specific guidance and recommendations for CLL patients who are affected by the coronavirus may change over time.

• #62 Preventing Infectious Complications in Chronic Lymphocytic Leukemia – Hematology & Oncology

  https://www.hematologyandoncology.net/archives/december-2023/preventing-infectious-complications-in-chronic-lymphocytic-leukemia/

  Patients who have CLL fall under the immunocompromised designation in the Centers for Disease Control adult immunization schedule. […] For this upcoming cold season, I have been recommending the COVID booster vaccine and the flu shot to my patients with CLL. […] Vaccines are one of our most cost-effective measures for preventing infection. The key for CLL patients is to immunize early, when their immune system is best able to mount a good response. […] A final note regarding vaccines is that live vaccines are contraindicated for patients with CLL. […] We have additional strategies for preventing infections, such as immunoglobulin replacement with intravenous immunoglobulin (IVIG) for patients with hypogammaglobulinemia. […] Another approach is the use of antimicrobial prophylaxis during treatment. […] There are some special considerations when it comes to vaccines in patients who are on anti-CD20 monoclonal antibodies.

• #63 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  The risk of infection rises the longer you have CLL, and infections among people living with CLL can be life-threatening. […] You can take simple steps to avoid infections and help protect your health. […] Risk of infections goes up the longer you live with CLL, so its important to take precautions. […] Wash your hands carefully and frequently. […] Keep up to date with appropriate vaccines, particularly flu and pneumonia vaccines. […] People with CLL are advised to get vaccinated against COVID-19. […] Take extra precautions, wear N95 masks indoors and in crowded environments, and maintain social distancing. […] Get medical advice on how to mitigate risks if youre thinking about attending a crowded event, especially if youre currently in treatment.

• #64 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  The risk of infection rises the longer you have CLL, and infections among people living with CLL can be life-threatening. […] You can take simple steps to avoid infections and help protect your health. […] Risk of infections goes up the longer you live with CLL, so its important to take precautions. […] Wash your hands carefully and frequently. […] Keep up to date with appropriate vaccines, particularly flu and pneumonia vaccines. […] People with CLL are advised to get vaccinated against COVID-19. […] Take extra precautions, wear N95 masks indoors and in crowded environments, and maintain social distancing. […] Get medical advice on how to mitigate risks if youre thinking about attending a crowded event, especially if youre currently in treatment.

• #65 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  The risk of infection rises the longer you have CLL, and infections among people living with CLL can be life-threatening. […] You can take simple steps to avoid infections and help protect your health. […] Risk of infections goes up the longer you live with CLL, so its important to take precautions. […] Wash your hands carefully and frequently. […] Keep up to date with appropriate vaccines, particularly flu and pneumonia vaccines. […] People with CLL are advised to get vaccinated against COVID-19. […] Take extra precautions, wear N95 masks indoors and in crowded environments, and maintain social distancing. […] Get medical advice on how to mitigate risks if youre thinking about attending a crowded event, especially if youre currently in treatment.

• #66 COVID-19 Pre-Exposure Prophylaxis – CLL Society

  https://cllsociety.org/2024/03/new-covid-19-pre-exposure-prophylaxis-option-for-cll-patients/

  On 3/22/2024, the US FDA authorized a new pre-exposure prophylaxis (PrEP) to prevent COVID-19 infection in those with CLL and other immune-compromising conditions. […] While outcomes for COVID-19 infection have significantly improved for all, including the immunocompromised, the risks of severe disease, hospitalizations, long-COVID, and even death remain higher for those with chronic lymphocytic leukemia /small lymphocytic lymphoma (CLL / SLL), and others with impaired immunity. […] Receiving a COVID-19 PrEP monoclonal antibody such as pemivibart serves as an added layer of protection in addition to vaccination, masking, and handwashing. It is another way to feel safer in the world despite our impaired immunity, similar to what was enjoyed when EVUSHELD was effective. PEMGARDA holds promise to be a durable way to improve our odds against symptomatic COVID-19.

• #67 1226 – Outcomes of Tixagevimab/cilgavimab pre-exposure prophylaxis in Chronic lymphocytic leukemia patients- a single center experience

  https://iwcll2023.eventscribe.net/ajaxcalls/PosterInfo.asp?efp=RklMQldPQ0QxOTM1OQ&PosterID=614999&rnd=0.4237933

  Patients with CLL have an increased susceptibility to infections secondary to complex immune interactions, innate immunity dysfunction, and with treatment with immunosuppressants. This leads to infections accounting for the majority (60%) of deaths in CLL (Morrison VA, 2014). […] Tixagevimab/cilgavamib has been part of the advances in SARS-CoV-2 pre-exposure prophylaxis for immunocompromised patients including CLL patients. As our data suggests we have observed a general trend towards decreased rates of infections in patients that were treated with tixagevimab/cilgavimab. […] While tixagevimab/cilgavimab is not currently approved for use given its lack of efficacy to current strains, previous RCTs and the data that we have observed in our study does appear to indicate that a pre-exposure prophylaxis strategy may be beneficial in CLL patients, and warrants continue exploration in clinical studies (Food and Drug Administration, 2023).

• #68 Self-Care With Chronic Lymphocytic Leukemia

  https://www.webmd.com/cancer/lymphoma/taking-care-of-yourself-cll

  When you live with chronic lymphocytic leukemia, you can feel your best by embracing a healthy lifestyle, getting emotional support, and planning ahead with your cancer doctor or oncologist. These steps can help you take charge of problems that can come up, like pain, stress, and treatment side effects. […] Your doctor can prescribe medications that either give you relief from side effects or prevent them from happening in the first place. If you have serious side effects, they could recommend a change in your treatment plan. Ask your doctor about expected side effects and prevention meds before you start a new treatment. […] Its extra important to eat well while youre getting treatment for chronic lymphocytic leukemia. […] You can ask your doctor, a nutritionist, or a dietitian to come up with an eating plan thats right for you.

• #69 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  Living with chronic lymphocytic leukemia can be challenging, but you can take steps to feel better and enjoy a high quality of life. […] Healthy lifestyle changes and basic precautions can protect your health and well-being. […] A nutritious diet and healthy weight can also improve your strength during cancer treatment and help you better tolerate side effects. […] Research shows that a nutritious diet can help improve immune function and support healthy gut bacteria, which is associated with an effective immune system. […] Avoid smoking. By staying away from cigarettes, you improve cancer treatment outcomes, reduce side effects from treatment, and lower the risk of cancer returning or spreading to secondary cancers. […] People with CLL tend to get sick a lot. […] CLL and its treatments can affect the immune system.

• #70 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  Living with chronic lymphocytic leukemia can be challenging, but you can take steps to feel better and enjoy a high quality of life. […] Healthy lifestyle changes and basic precautions can protect your health and well-being. […] A nutritious diet and healthy weight can also improve your strength during cancer treatment and help you better tolerate side effects. […] Research shows that a nutritious diet can help improve immune function and support healthy gut bacteria, which is associated with an effective immune system. […] Avoid smoking. By staying away from cigarettes, you improve cancer treatment outcomes, reduce side effects from treatment, and lower the risk of cancer returning or spreading to secondary cancers. […] People with CLL tend to get sick a lot. […] CLL and its treatments can affect the immune system.

• #71 Self-Care With Chronic Lymphocytic Leukemia

  https://www.webmd.com/cancer/lymphoma/taking-care-of-yourself-cll

  When you live with chronic lymphocytic leukemia, you can feel your best by embracing a healthy lifestyle, getting emotional support, and planning ahead with your cancer doctor or oncologist. These steps can help you take charge of problems that can come up, like pain, stress, and treatment side effects. […] Your doctor can prescribe medications that either give you relief from side effects or prevent them from happening in the first place. If you have serious side effects, they could recommend a change in your treatment plan. Ask your doctor about expected side effects and prevention meds before you start a new treatment. […] Its extra important to eat well while youre getting treatment for chronic lymphocytic leukemia. […] You can ask your doctor, a nutritionist, or a dietitian to come up with an eating plan thats right for you.

• #72 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  Living with chronic lymphocytic leukemia can be challenging, but you can take steps to feel better and enjoy a high quality of life. […] Healthy lifestyle changes and basic precautions can protect your health and well-being. […] A nutritious diet and healthy weight can also improve your strength during cancer treatment and help you better tolerate side effects. […] Research shows that a nutritious diet can help improve immune function and support healthy gut bacteria, which is associated with an effective immune system. […] Avoid smoking. By staying away from cigarettes, you improve cancer treatment outcomes, reduce side effects from treatment, and lower the risk of cancer returning or spreading to secondary cancers. […] People with CLL tend to get sick a lot. […] CLL and its treatments can affect the immune system.

• #73 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  Living with chronic lymphocytic leukemia can be challenging, but you can take steps to feel better and enjoy a high quality of life. […] Healthy lifestyle changes and basic precautions can protect your health and well-being. […] A nutritious diet and healthy weight can also improve your strength during cancer treatment and help you better tolerate side effects. […] Research shows that a nutritious diet can help improve immune function and support healthy gut bacteria, which is associated with an effective immune system. […] Avoid smoking. By staying away from cigarettes, you improve cancer treatment outcomes, reduce side effects from treatment, and lower the risk of cancer returning or spreading to secondary cancers. […] People with CLL tend to get sick a lot. […] CLL and its treatments can affect the immune system.

• #74 Chronic Lymphocytic Leukemia Diagnosis & Treatment in Mumbai, India

  https://www.nanavatimaxhospital.org/our-specialities/centre-for-bone-marrow-transplant/conditions-treatments/chronic-lymphocytic-leukemia

  CLL can be cured or prevented at the early stages itself. […] Try keeping yourself at a distance from pesticides and herbicides. […] Benzene exposure must be limited or avoided. […] Correct body weight must be maintained throughout. […] Though recurrence of CLL is not very common, taking care of certain things is vital. […] Avoid intake of raw sprouts or unpasteurized drinks. […] Make sure to keep your immune system on the right track.

• #75 Self-Care With Chronic Lymphocytic Leukemia

  https://www.webmd.com/cancer/lymphoma/taking-care-of-yourself-cll

  When you live with chronic lymphocytic leukemia, you can feel your best by embracing a healthy lifestyle, getting emotional support, and planning ahead with your cancer doctor or oncologist. These steps can help you take charge of problems that can come up, like pain, stress, and treatment side effects. […] Your doctor can prescribe medications that either give you relief from side effects or prevent them from happening in the first place. If you have serious side effects, they could recommend a change in your treatment plan. Ask your doctor about expected side effects and prevention meds before you start a new treatment. […] Its extra important to eat well while youre getting treatment for chronic lymphocytic leukemia. […] You can ask your doctor, a nutritionist, or a dietitian to come up with an eating plan thats right for you.

• #76 Self-Care With Chronic Lymphocytic Leukemia

  https://www.webmd.com/cancer/lymphoma/taking-care-of-yourself-cll

  Routine workouts can bring you lots of benefits. […] If youre not active already, ask your doctor to help you get started. […] You might need to juggle all of your usual responsibilities — like work, school, or parenting — while youre managing your leukemia. Its important to give yourself some me time. […] This is a good way to meet other people with leukemia who can understand what youre going through. […] Its normal to feel down or overwhelmed at times when youre living with cancer. But if youre sad, depressed, or anxious every day for 2 weeks or more, reach out to your doctor for help. […] Chronic lymphocytic leukemia and its treatments can make you feel tired and more tense at times. Enough shut-eye every night can help you recover your energy and ease stress. Talk to your doctor if youre having a hard time falling or staying asleep. […] You can ask your doctor to help you kick the habit. […] In general, experts recommend that you limit yourself to one drink a day if youre a woman and two if youre a man. Ask your doctor whats safe for you.

• #77 Chronic Lymphocytic Leukemia (CLL) prevention | UK Healthcare

  https://ukhealthcare.uky.edu/markey-cancer-center/cancer-types/cll/prevention

  You can lower your risk of cancer by committing to practices that build a healthy lifestyle. These recommendations can lower your risk for this disease, as well as improve your overall basic health. […] Avoid using tobacco products. Tobacco has been tied to multiple cancers, and it is responsible for 90 percent of lung cancer deaths. […] Stay physically active. Your physical activity is related to risk for colon and breast cancer. Excess weight gained from inactivity increases the risk of multiple cancers. […] Limit alcohol consumption. It is important to be mindful of your alcohol consumption. Alcohol intake, even in moderate amounts, can increase the risk for colon, breast, esophageal, and oropharyngeal cancer.

• #78 Self-Care With Chronic Lymphocytic Leukemia

  https://www.webmd.com/cancer/lymphoma/taking-care-of-yourself-cll

  Routine workouts can bring you lots of benefits. […] If youre not active already, ask your doctor to help you get started. […] You might need to juggle all of your usual responsibilities — like work, school, or parenting — while youre managing your leukemia. Its important to give yourself some me time. […] This is a good way to meet other people with leukemia who can understand what youre going through. […] Its normal to feel down or overwhelmed at times when youre living with cancer. But if youre sad, depressed, or anxious every day for 2 weeks or more, reach out to your doctor for help. […] Chronic lymphocytic leukemia and its treatments can make you feel tired and more tense at times. Enough shut-eye every night can help you recover your energy and ease stress. Talk to your doctor if youre having a hard time falling or staying asleep. […] You can ask your doctor to help you kick the habit. […] In general, experts recommend that you limit yourself to one drink a day if youre a woman and two if youre a man. Ask your doctor whats safe for you.

• #79 Chronic Lymphocytic Leukemia (CLL) prevention | UK Healthcare

  https://ukhealthcare.uky.edu/markey-cancer-center/cancer-types/cll/prevention

  You can lower your risk of cancer by committing to practices that build a healthy lifestyle. These recommendations can lower your risk for this disease, as well as improve your overall basic health. […] Avoid using tobacco products. Tobacco has been tied to multiple cancers, and it is responsible for 90 percent of lung cancer deaths. […] Stay physically active. Your physical activity is related to risk for colon and breast cancer. Excess weight gained from inactivity increases the risk of multiple cancers. […] Limit alcohol consumption. It is important to be mindful of your alcohol consumption. Alcohol intake, even in moderate amounts, can increase the risk for colon, breast, esophageal, and oropharyngeal cancer.

• #80 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  Living with chronic lymphocytic leukemia can be challenging, but you can take steps to feel better and enjoy a high quality of life. […] Healthy lifestyle changes and basic precautions can protect your health and well-being. […] A nutritious diet and healthy weight can also improve your strength during cancer treatment and help you better tolerate side effects. […] Research shows that a nutritious diet can help improve immune function and support healthy gut bacteria, which is associated with an effective immune system. […] Avoid smoking. By staying away from cigarettes, you improve cancer treatment outcomes, reduce side effects from treatment, and lower the risk of cancer returning or spreading to secondary cancers. […] People with CLL tend to get sick a lot. […] CLL and its treatments can affect the immune system.

• #81 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  Living with chronic lymphocytic leukemia can be challenging, but you can take steps to feel better and enjoy a high quality of life. […] Healthy lifestyle changes and basic precautions can protect your health and well-being. […] A nutritious diet and healthy weight can also improve your strength during cancer treatment and help you better tolerate side effects. […] Research shows that a nutritious diet can help improve immune function and support healthy gut bacteria, which is associated with an effective immune system. […] Avoid smoking. By staying away from cigarettes, you improve cancer treatment outcomes, reduce side effects from treatment, and lower the risk of cancer returning or spreading to secondary cancers. […] People with CLL tend to get sick a lot. […] CLL and its treatments can affect the immune system.

• #82 Chronic Lymphocytic Leukemia: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.chronic-lymphocytic-leukemia-care-instructions.uf8168

  Avoid infections such as COVID-19, colds, and the flu. Wash your hands often. Get a pneumococcal vaccine. If you have had one before, ask your doctor whether you need another dose. Get a flu shot every year. Stay up to date on your COVID-19 vaccines. […] Do not smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

• #83 Self-Care With Chronic Lymphocytic Leukemia

  https://www.webmd.com/cancer/lymphoma/taking-care-of-yourself-cll

  Routine workouts can bring you lots of benefits. […] If youre not active already, ask your doctor to help you get started. […] You might need to juggle all of your usual responsibilities — like work, school, or parenting — while youre managing your leukemia. Its important to give yourself some me time. […] This is a good way to meet other people with leukemia who can understand what youre going through. […] Its normal to feel down or overwhelmed at times when youre living with cancer. But if youre sad, depressed, or anxious every day for 2 weeks or more, reach out to your doctor for help. […] Chronic lymphocytic leukemia and its treatments can make you feel tired and more tense at times. Enough shut-eye every night can help you recover your energy and ease stress. Talk to your doctor if youre having a hard time falling or staying asleep. […] You can ask your doctor to help you kick the habit. […] In general, experts recommend that you limit yourself to one drink a day if youre a woman and two if youre a man. Ask your doctor whats safe for you.

• #84 Self-Care With Chronic Lymphocytic Leukemia

  https://www.webmd.com/cancer/lymphoma/taking-care-of-yourself-cll

  Routine workouts can bring you lots of benefits. […] If youre not active already, ask your doctor to help you get started. […] You might need to juggle all of your usual responsibilities — like work, school, or parenting — while youre managing your leukemia. Its important to give yourself some me time. […] This is a good way to meet other people with leukemia who can understand what youre going through. […] Its normal to feel down or overwhelmed at times when youre living with cancer. But if youre sad, depressed, or anxious every day for 2 weeks or more, reach out to your doctor for help. […] Chronic lymphocytic leukemia and its treatments can make you feel tired and more tense at times. Enough shut-eye every night can help you recover your energy and ease stress. Talk to your doctor if youre having a hard time falling or staying asleep. […] You can ask your doctor to help you kick the habit. […] In general, experts recommend that you limit yourself to one drink a day if youre a woman and two if youre a man. Ask your doctor whats safe for you.

• #85 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  The risk of infection rises the longer you have CLL, and infections among people living with CLL can be life-threatening. […] You can take simple steps to avoid infections and help protect your health. […] Risk of infections goes up the longer you live with CLL, so its important to take precautions. […] Wash your hands carefully and frequently. […] Keep up to date with appropriate vaccines, particularly flu and pneumonia vaccines. […] People with CLL are advised to get vaccinated against COVID-19. […] Take extra precautions, wear N95 masks indoors and in crowded environments, and maintain social distancing. […] Get medical advice on how to mitigate risks if youre thinking about attending a crowded event, especially if youre currently in treatment.

• #86 CLL and Urinary Tract Infections: Prevention and Treatment | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/cll-and-urinary-tract-infections-prevention-and-treatment

  Chronic lymphocytic leukemia (CLL) is a type of blood cancer that affects the white blood cells, which are crucial for fighting infections like urinary tract infections (UTIs). […] For people living with CLL, UTIs can quickly become serious. It’s essential to seek prompt medical attention if you suspect a UTI. […] Being mindful of this elevated risk of infection is essential. Early recognition and prompt treatment of UTIs can help prevent more serious complications. […] Though not all UTIs are preventable, there are some steps people can take to lower their risk. With the heightened risk of infections in those with CLL, prevention is important. […] You can reduce your risk for UTIs by drinking plenty of water, wearing loose cotton underwear, and keeping your genital area clean. […] Your doctor can help identify the factors that may have contributed to your UTI and provide guidance on how to reduce your risk of future infections, which can help you feel your best with CLL.

• #87 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  The risk of infection rises the longer you have CLL, and infections among people living with CLL can be life-threatening. […] You can take simple steps to avoid infections and help protect your health. […] Risk of infections goes up the longer you live with CLL, so its important to take precautions. […] Wash your hands carefully and frequently. […] Keep up to date with appropriate vaccines, particularly flu and pneumonia vaccines. […] People with CLL are advised to get vaccinated against COVID-19. […] Take extra precautions, wear N95 masks indoors and in crowded environments, and maintain social distancing. […] Get medical advice on how to mitigate risks if youre thinking about attending a crowded event, especially if youre currently in treatment.

• #88 Chronic Lymphocytic Leukemia: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.chronic-lymphocytic-leukemia-care-instructions.uf8168

  Avoid infections such as COVID-19, colds, and the flu. Wash your hands often. Get a pneumococcal vaccine. If you have had one before, ask your doctor whether you need another dose. Get a flu shot every year. Stay up to date on your COVID-19 vaccines. […] Do not smoke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

• #89 CLL and Urinary Tract Infections: Prevention and Treatment | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/cll-and-urinary-tract-infections-prevention-and-treatment

  Chronic lymphocytic leukemia (CLL) is a type of blood cancer that affects the white blood cells, which are crucial for fighting infections like urinary tract infections (UTIs). […] For people living with CLL, UTIs can quickly become serious. It’s essential to seek prompt medical attention if you suspect a UTI. […] Being mindful of this elevated risk of infection is essential. Early recognition and prompt treatment of UTIs can help prevent more serious complications. […] Though not all UTIs are preventable, there are some steps people can take to lower their risk. With the heightened risk of infections in those with CLL, prevention is important. […] You can reduce your risk for UTIs by drinking plenty of water, wearing loose cotton underwear, and keeping your genital area clean. […] Your doctor can help identify the factors that may have contributed to your UTI and provide guidance on how to reduce your risk of future infections, which can help you feel your best with CLL.

• #90 CLL and Urinary Tract Infections: Prevention and Treatment | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/cll-and-urinary-tract-infections-prevention-and-treatment

  Chronic lymphocytic leukemia (CLL) is a type of blood cancer that affects the white blood cells, which are crucial for fighting infections like urinary tract infections (UTIs). […] For people living with CLL, UTIs can quickly become serious. It’s essential to seek prompt medical attention if you suspect a UTI. […] Being mindful of this elevated risk of infection is essential. Early recognition and prompt treatment of UTIs can help prevent more serious complications. […] Though not all UTIs are preventable, there are some steps people can take to lower their risk. With the heightened risk of infections in those with CLL, prevention is important. […] You can reduce your risk for UTIs by drinking plenty of water, wearing loose cotton underwear, and keeping your genital area clean. […] Your doctor can help identify the factors that may have contributed to your UTI and provide guidance on how to reduce your risk of future infections, which can help you feel your best with CLL.

• #91 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  The risk of infection rises the longer you have CLL, and infections among people living with CLL can be life-threatening. […] You can take simple steps to avoid infections and help protect your health. […] Risk of infections goes up the longer you live with CLL, so its important to take precautions. […] Wash your hands carefully and frequently. […] Keep up to date with appropriate vaccines, particularly flu and pneumonia vaccines. […] People with CLL are advised to get vaccinated against COVID-19. […] Take extra precautions, wear N95 masks indoors and in crowded environments, and maintain social distancing. […] Get medical advice on how to mitigate risks if youre thinking about attending a crowded event, especially if youre currently in treatment.

• #92

  https://www.prevention.com/health/health-conditions/a41835361/what-makes-being-diagnosed-with-cll-so-surprising/

  You read that right. A common approach to managing CLL is called watch and wait. It means that instead of being rushed into radiation or chemotherapy, you will probably be monitored closely and only treated when its deemed necessary by your care team. […] There is no evidence that treating CLL early is better than treating it at the time of symptom onset. […] Even if one has the CLL variety which ultimately will require treatment, there is no evidence that treating it early is better than treating it at the time of symptom onset. […] There are things you can do in terms of living a healthier lifestyle that can make you stronger and build resilience, says Dr. Koffman. Eating a healthy diet, exercising, not smokingthese kinds of things will protect your heart and other organs so that when you have to start treatment, youre in the best shape.

• #93 Tertiary Prevention and Treatment for Reducing Leukemia Relapse

  https://www.scientificarchives.com/article/tertiary-prevention-and-treatment-for-reducing-leukemia-relapse

  We have found little available information in the medical literature on the prevention and treatment of tertiary leukemia or patients’ prognosis. […] From the perspective of prevention, there are four levels of disease onset and progression: primary, secondary, tertiary, and quaternary. Primary prevention aims to prevent the initiation of illness or injury; examples include immunization to prevent infections associated with the development of leukemia and avoiding exposure to known risk factors, such as certain chemicals or ionizing radiation. […] Tertiary prevention focuses on reducing the effects of the disease once it has been established, rehabilitation after significant illness, and prevention of comorbidity. […] Tertiary prevention of leukemia includes the use of chemotherapy and other treatments aiming for its control or remission, as well as supportive care measures to minimize the side effects of treatment and improve the patients overall well-being.

• #94

  https://www.prevention.com/health/health-conditions/a41835361/what-makes-being-diagnosed-with-cll-so-surprising/

  You read that right. A common approach to managing CLL is called watch and wait. It means that instead of being rushed into radiation or chemotherapy, you will probably be monitored closely and only treated when its deemed necessary by your care team. […] There is no evidence that treating CLL early is better than treating it at the time of symptom onset. […] Even if one has the CLL variety which ultimately will require treatment, there is no evidence that treating it early is better than treating it at the time of symptom onset. […] There are things you can do in terms of living a healthier lifestyle that can make you stronger and build resilience, says Dr. Koffman. Eating a healthy diet, exercising, not smokingthese kinds of things will protect your heart and other organs so that when you have to start treatment, youre in the best shape.

• #95

  https://www.prevention.com/health/health-conditions/a41835361/what-makes-being-diagnosed-with-cll-so-surprising/

  You read that right. A common approach to managing CLL is called watch and wait. It means that instead of being rushed into radiation or chemotherapy, you will probably be monitored closely and only treated when its deemed necessary by your care team. […] There is no evidence that treating CLL early is better than treating it at the time of symptom onset. […] Even if one has the CLL variety which ultimately will require treatment, there is no evidence that treating it early is better than treating it at the time of symptom onset. […] There are things you can do in terms of living a healthier lifestyle that can make you stronger and build resilience, says Dr. Koffman. Eating a healthy diet, exercising, not smokingthese kinds of things will protect your heart and other organs so that when you have to start treatment, youre in the best shape.

• #96 How Can I Prevent Infections as a CLL Patient? – HealthTree for Chronic Lymphocytic Leukemia

  https://healthtree.org/cll/community/articles/cll-infection-prevention-dr-meghan-thompson

  Chronic lymphocytic leukemia (CLL) is a type of cancer that affects the immune system, making it easier for patients to contract infections. To maintain good health, it is important for patients to receive non-live versions of vaccines, receive immunoglobulin infusions if they have a history of recurrent infections, be checked for other types of cancers like skin cancer, keep an eye on their blood pressure and cholesterol, and consider participating in clinical trials. […] Vaccines help prevent infections in CLL patients. Safe vaccine options for patients include non-live versions such as the flu vaccine, the new RSV vaccine (for those over the age of 60), COVID-19 vaccines, pneumococcal vaccines (like Prevnar 20 or Prevnar 15, followed by Pneumovax 20), and the Shingrix vaccine series. […] CLL patients should try to get all their vaccines completed before they start any treatments. Dr. Thompson mentioned that patients should wait six months before getting a vaccine after receiving rituximab or obinutuzumab. This is because these treatments lower B-cells which impacts how well a patients body can make antibodies after receiving a vaccine.

• #97 8 Ways To Live Better With CLL | MyLeukemiaTeam

  https://www.myleukemiateam.com/resources/8-ways-to-live-better-with-cll

  The risk of infection rises the longer you have CLL, and infections among people living with CLL can be life-threatening. […] You can take simple steps to avoid infections and help protect your health. […] Risk of infections goes up the longer you live with CLL, so its important to take precautions. […] Wash your hands carefully and frequently. […] Keep up to date with appropriate vaccines, particularly flu and pneumonia vaccines. […] People with CLL are advised to get vaccinated against COVID-19. […] Take extra precautions, wear N95 masks indoors and in crowded environments, and maintain social distancing. […] Get medical advice on how to mitigate risks if youre thinking about attending a crowded event, especially if youre currently in treatment.

• #98 Prevention and management of infectious complications in patients with chronic lymphocytic leukemia (CLL) treated with BTK and BCL-2 inhibitors, focus on current guidelines – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38331696/

  Immunoglobulin therapy has favourable impact on morbidity but not mortality in patients with hypogammaglobulinemia and severe or recurrent infections. […] Lack of high-quality data and heterogeneity of patients or protocols included in the studies might explain differences among the main guidelines. […] Better data collection is warranted.

• #99 Tertiary Prevention and Treatment for Reducing Leukemia Relapse

  https://www.scientificarchives.com/article/tertiary-prevention-and-treatment-for-reducing-leukemia-relapse

  Given the nature of leukemia, it is difficult to follow the standards of each level of prevention perfectly. However, the primary and tertiary levels have been substantially addressed. […] It is recommended that high doses of radiation, exposure to benzene, smoking or other tobacco use, and obesity/obesity-related lifestyles be avoided to decrease ones chances of developing leukemia. […] Although we found limited information in our literature search specific to tertiary prevention of leukemia and its relapse, we understand the potential bias of the search strategy we used in terms of the possibility of missing relevant articles with the limited data sources we searched. However, continuing research into more innovative treatments is needed to prolong the lifespan for all patients with leukemia. Further, we call for more research on immunotherapies to explore their effectiveness in tertiary and quaternary prevention of leukemias in populations of even more diverse age groups, including the elderly.

• #100 Prevention and management of infectious complications in patients with chronic lymphocytic leukemia (CLL) treated with BTK and BCL-2 inhibitors, focus on current guidelines – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38331696/

  Immunoglobulin therapy has favourable impact on morbidity but not mortality in patients with hypogammaglobulinemia and severe or recurrent infections. […] Lack of high-quality data and heterogeneity of patients or protocols included in the studies might explain differences among the main guidelines. […] Better data collection is warranted.

• #101 Tertiary Prevention and Treatment for Reducing Leukemia Relapse

  https://www.scientificarchives.com/article/tertiary-prevention-and-treatment-for-reducing-leukemia-relapse

  Given the nature of leukemia, it is difficult to follow the standards of each level of prevention perfectly. However, the primary and tertiary levels have been substantially addressed. […] It is recommended that high doses of radiation, exposure to benzene, smoking or other tobacco use, and obesity/obesity-related lifestyles be avoided to decrease ones chances of developing leukemia. […] Although we found limited information in our literature search specific to tertiary prevention of leukemia and its relapse, we understand the potential bias of the search strategy we used in terms of the possibility of missing relevant articles with the limited data sources we searched. However, continuing research into more innovative treatments is needed to prolong the lifespan for all patients with leukemia. Further, we call for more research on immunotherapies to explore their effectiveness in tertiary and quaternary prevention of leukemias in populations of even more diverse age groups, including the elderly.

• #102 Prevention of infections in patients with chronic lymphocytic leukemia – UpToDate

  https://www.uptodate.com/contents/prevention-of-infections-in-patients-with-chronic-lymphocytic-leukemia

  Prevention of infections in patients with chronic lymphocytic leukemia […] The approach to infection prevention will be reviewed here. […] General approach — As the immune defects caused by specific chronic lymphocytic leukemia (CLL) therapies have significant impact on subsequent infectious complications, our prophylaxis recommendations vary depending upon the type of therapy used (table 1). […] There have been no randomized trials evaluating the use of prophylactic antimicrobials in patients with CLL, and there are no evidence-based guidelines for antimicrobial prophylaxis in this population. Most recommendations for antimicrobial prophylaxis have been extrapolated from prophylactic regimens used in treatment trials as well as from anecdotal reports.

• #103 1226 – Outcomes of Tixagevimab/cilgavimab pre-exposure prophylaxis in Chronic lymphocytic leukemia patients- a single center experience

  https://iwcll2023.eventscribe.net/ajaxcalls/PosterInfo.asp?efp=RklMQldPQ0QxOTM1OQ&PosterID=614999&rnd=0.4237933

  Patients with CLL have an increased susceptibility to infections secondary to complex immune interactions, innate immunity dysfunction, and with treatment with immunosuppressants. This leads to infections accounting for the majority (60%) of deaths in CLL (Morrison VA, 2014). […] Tixagevimab/cilgavamib has been part of the advances in SARS-CoV-2 pre-exposure prophylaxis for immunocompromised patients including CLL patients. As our data suggests we have observed a general trend towards decreased rates of infections in patients that were treated with tixagevimab/cilgavimab. […] While tixagevimab/cilgavimab is not currently approved for use given its lack of efficacy to current strains, previous RCTs and the data that we have observed in our study does appear to indicate that a pre-exposure prophylaxis strategy may be beneficial in CLL patients, and warrants continue exploration in clinical studies (Food and Drug Administration, 2023).

• #104 Prevention of infections in patients with chronic lymphocytic leukemia – UpToDate

  https://www.uptodate.com/contents/prevention-of-infections-in-patients-with-chronic-lymphocytic-leukemia/print

  Prevention of infections in patients with chronic lymphocytic leukemia […] Infections have a major impact on the clinical course of patients with chronic lymphocytic leukemia (CLL). Patients with CLL have underlying abnormalities in immune function related to the primary disease process in addition to defects in immune function related to the specific antileukemic therapies administered. The approach to infection prevention will be reviewed here. […] General approach — As the immune defects caused by specific chronic lymphocytic leukemia (CLL) therapies have significant impact on subsequent infectious complications, our prophylaxis recommendations vary depending upon the type of therapy used (table 1). Additional considerations that impact antimicrobial prophylaxis in individual patients are treatment status (treatment naïve versus heavily pretreated) and past history of infections. […] There have been no randomized trials evaluating the use of prophylactic antimicrobials in patients with CLL, and there are no evidence-based guidelines for antimicrobial prophylaxis in this population. Most recommendations for antimicrobial prophylaxis have been extrapolated from prophylactic regimens used in treatment trials as well as from anecdotal reports.

• #105 How Can I Prevent Infections as a CLL Patient? – HealthTree for Chronic Lymphocytic Leukemia

  https://healthtree.org/cll/community/articles/cll-infection-prevention-dr-meghan-thompson

  CLL patients who have had a lot of infections, such as serious lung infections, might need extra help to prevent additional infections. One way to help is by receiving immunoglobulin infusions (IVIG). This therapy is mainly for patients with low immunoglobulin G levels (IgG). IVIG gives patients extra antibodies from donors and can help reduce future infections. […] It’s essential for patients to follow a personalized care plan, which includes getting the right vaccines, receiving immunoglobulin infusions if patients have a history of recurrent infections, and possibly participating in clinical trials. Regular health check-ups and consultations with healthcare professionals are important to address not only CLL but also other health concerns, ensuring comprehensive care is tailored to each patient’s unique needs.

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