THE Chronic lymphocytic leukemia (CLL) It is the most common type of leukemia in adults, accounting for up to 30% of cases, and it is a pathology that mainly affects older people. In Spain, an average of 4 cases per 100,000 inhabitants among men and approximately 3 cases per 100,000 inhabitants among womenwith a median age at diagnosis of 72 years. In addition, this type of patient may suffer from one or more associated comorbidities. Therefore, even though it is a slow-growing disease, CLL can affect your quality of life.
Fernanda Ibánez Camachohematologist at the Orihuela Hospital in Alicante, has been treating patients with oncohematological tumors or CLL for 13 years. “Stay active It is essential to live with Chronic Lymphocytic Leukemiabecause it improves coordination ability, neuromotor response, bones, digestive system and joints. Being active through work or hobbies is highly recommended. All patients should have shelter. Although we are your medical refuge, your attitude is fundamental,” he emphasized, among other considerations, in this interview for OKHEALTH.
Question.-What is the typical profile of the patient with chronic lymphocytic leukemia?
Answer.-The profile of the patient with CLL is that of an older patient, it is also more common in men and it generally occurs in people in a fragile state. On the other hand, when we already know the stage of the patient’s illness, we must evaluate the different comorbidities that the patient presents, because at a certain age, there are associated pathologies that must continue to be treated and from there, the importance of a precise diagnosis.
Q.- What are the main challenges in the diagnosis and treatment of this disease?
A.- To ensure adequate treatment, it is essential to make an accurate diagnosis, since sometimes errors can occur when confusing this type of lymphoma with others. The use of cytometry is essential to confirm the diagnosis of CLL. In addition, treatment should be as effective as possible, minimizing side effects. This is particularly important in elderly patients who, due to their multiple comorbidities, as previously indicated, require a therapeutic approach that is taken into account with other previous pathologies.
Q.-How has the treatment of CLL evolved in recent years?
A.- The change in treatment has been one of the most significant advances in hematology over the last 15 years. These advances are fundamental and mark an important step in the approach to different diseases. Until recently, treatment was limited to chemotherapy and immunotherapy, without taking into account factors such as the patient’s age or genetics. However, since 2015, the introduction of targeted therapies, such as BTK drugs, has significantly transformed the landscape. These therapies specifically target disease targets, which not only improves their effectiveness but also significantly reduces side effects. This approach is particularly beneficial for patients with multiple comorbidities, as many of these treatments are oral, avoiding the need for frequent clinic visits. In short, the change has been really positive.
Q.- What advances have made a difference in patients’ survival and quality of life?
A. -Progress in terms of survival and quality of life of patients has been possible thanks to recent therapeutic developments. These are BTKi (i-inhibition) drugs that inhibit Bruton’s tyrosine and represent a more specific and targeted form of oral immunotherapy. These treatments are well tolerated and offer significantly good responses.
Q.- How does CLL affect the long-term emotional and psychological state of patients?
A.-Leukemia is a type of cancer that affects lymphocytes and can be of particular concern in children, because if not treated properly it can have life-threatening consequences. However, there are forms of chronic leukemia that allow adult patients to live a virtually normal life, similar to that of the general population. These treatments are generally well tolerated and several options are available depending on the individual characteristics of each patient. By informing them of their good prognosis and noting that they do not need to visit the hospital frequently, patients’ quality of life improves significantly.
Q.- In your experience, how important is emotional support for CLL patients and their families?
A.-Emotional support is crucial, as patients often face uncertainty and ignorance regarding their condition. It is essential that the medical team takes the time to clearly explain the diagnosis and the treatment that will be followed. Good communication can draw a clear and hopeful image for the patient. In particular, advances in the treatment of patients with lymphocytic leukemia (LG) have significantly transformed progression-free survival and overall survival rates, providing improved prospects for quality of life.
Q.- The AstraZeneca campaign talks about the need for emotional refuge for patients. Could you explain to us what this concept means and how it impacts the lives of the people concerned?
A.- It is essential to educate patients about their illness. When they receive a clear explanation, they feel calmer. It is important that they understand that they can lead a normal life, like everyone else, and that they have positive life prospects. This emotional refuge is reinforced by well-tolerated and comfortable treatments, which will also provide effective responses to the disease. For example, if a 50-year-old patient is a mountain climber, he should be able to continue enjoying this activity in his daily life, because his treatment is working and his quality of life resembles that of a person without this pathology.
Q.- What other resources do you think are needed for CLL patients?
A.- That of an open and complete relationship with the doctor, because it is natural for patients to have doubts when faced with so many new things. I think we need to give visibility to the disease in a hospital setting and assess its general condition as well as any possible cardiac or renal complications that it may cause (before starting any treatment). In addition, it is important that the patient is well informed and understands that with these treatments the prognosis is generally good. Currently, we have multiple treatment options that can be tailored to the patient’s needs. The progress in recent years in our field has been fundamental so that this disease is not a major obstacle to the pursuit of a normal life.
