Chronic Lymphocytic Leukemia (CLL) Resources

Treatment of patients with chronic lymphocytic leukemia (CLL)—the most common form of leukemia found in adults in Western countries—has undergone a dramatic transformation with the approval of multiple novel oral oncolytics. Oral oncolytic treatment represents a new wave of intervention by providing patients with cancer the means to self-administer medications at home, allowing patients a degree of control over their treatment experience while also reducing clinical visit commutes which, in turn, grant precious time to oncology nurses to focus on other clinical duties.

With the introduction of oral agents, cancer care teams face new challenges (e.g., medication adherence, prescription interactions, toxicity management) in ensuring high-quality care for patients with cancer. The significant variations in oral oncolytic treatments in patients with chronic lymphocytic leukemia has experts urging clinicians to extend the quality and safety agenda from parenteral to oral oncolytics.

Through the Steps to Success: Integrating Oral Oncolytics into Chronic Lymphocytic Leukemia (CLL) Practice project, the Association of Community Cancer Centers (ACCC) will:

• Showcase programs that have effectively integrated oral oncolytics into the cancer care continuum, inclusive of tools and resources
• Review process improvement strategies learned from cancer programs that have successfully integrated oral oncolytics
• Review regional/state disparities and identify educational gaps and barriers to further inform educational initiatives
• Discuss successful operational pathways for integration of oral oncolytics
• Develop educational resources that promote the integration of oral oncolytics.

Patient Journey Infographic

The Oral Oncolytic Clinical Workflow for Treatment of Patients with Chronic Lymphocytic Leukemia tool outlines the general workflow and considerations for oral oncolytics that can be adapted for any practice setting.
Download

Effective Practice Guide

ACCC’s Effective Practice Guide highlights case studies profiling effective practices in the integration of oral oncolytics into the cancer continuum. The case studies outline key roles, address specific challenges, and discuss current solutions and plans for oral oncolytic integration. The guide also provides practical tools for program development and features an Oral Oncolytic Clinical Workflow for the treatment of Chronic Lymphocytic Leukemia. Improve patient outcomes and streamline integration with our comprehensive guide.
Download

Monitoring a patient’s measurable residual disease (MRD) at various points throughout active treatment and into remission provides important personalized insights into the effectiveness of a given therapy and may be used to predict which patients are at risk of relapse. Testing for MRD can shape treatment choices and overall patient management to achieve better outcomes.

The Association of Community Cancer Centers (ACCC) is hosting a webinar with faculty who are experts in the field of hematologic malignancies.

This webinar will provide the multidisciplinary cancer team with important and practical information for the assessment of measurable residual disease (MRD) as part of routine clinical practice for their patients with chronic lymphocytic leukemia (CLL).

The presentation will be valuable for understanding the impact of MRD on treatment decisions and practice patterns, which has promise to lead to major improvements in outcomes for CLL patients in the very near future.

Faculty:

• John M. Pagel, MD, PhD, Chief of Hematologic Malignancies; Director, Stem Cell Transplantation, Swedish Cancer Institute
• Cecilia Arana Yi, MD, Senior Associate Consultant; Director of Leukemia Services, Hematology/Oncology, Department of Internal Medicine, Mayo Clinic
• Amy Goodrich, RN, MSN, CRNP-AC, Research Associate, The Johns Hopkins School of Medicine; Nurse Practitioner, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University (Moderator)

Register for this Webinar

Chronic lymphocytic leukemia is often slow to grow or indolent and symptomless.  It is typically found accidentally during routine blood tests. Depending on the factors involved, many patients are put on a "watch and wait" treatment approach and are monitored by their hematologist/oncologist and primary care provider until symptoms become significant and require treatment. Many clinical trials are exploring the efficacy of starting treatment before symptoms present.

ACCC offers a portfolio of practical resources for multidisciplinary care teams to explore and consider implementing.
Explore Resource Library

Featured Publications

Are We Speaking the Same Language? Insights from a Patient and Provider Survey on CLL

While treatment options have improved outcomes for patients with CLL, it is important to consider other aspects of the patient journey to gain insight as to how providers may better understand and serve their patients. ACCC conducted an educational initiative focused on gaining insights into the journey of patients with CLL by exploring conversations and perceptions of patients and providers across a broad spectrum of issues, including knowledge sharing and support on diagnosis and treatment, the use of telehealth, biomarkers, the impact of the COVID-19 pandemic on disease management, and quality of life (QOL).

Multidisciplinary Chronic Lymphocytic Leukemia Care: Quality Improvement Case Studies

Three ACCC Cancer Program Members were selected to participate in custom-tailored quality improvement workshops. This publication highlights the quality improvement projects the participating ACCC Cancer Program Members developed as a result of the workshops. Learn about the various efforts of each site to improve care for patients with CLL in their respective settings—and during the COVID-19 pandemic.

Thank you to the following ACCC Cancer Program Member sites for their participation:

• The Outer Banks Hospital, Nags Head, NC
• Billings Clinic Cancer Center, Billings, MT
• The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, Columbus, OH 

Multidisciplinary Chronic Lymphocytic Leukemia Care: Models of Effective Care Delivery

Chronic lymphocytic leukemia (CLL) is a heterogeneous disease, and a number of factors affect patients’ treatment options including age, overall health, whether the disease is high-risk for progression, and what symptom is being treated and why. This publication presents highlights of the current CLL treatment landscape and includes examples of effective delivery of patient-focused multidisciplinary care for patients with CLL across different care settings.

ACCC thanks the following Cancer Program Members for their contributions to this publication:

• Self Regional Healthcare Cancer Center
  Greenwood, South Carolina
• The University of Kansas Cancer Center
  Westwood, Kansas
• Sunrise Hospital and Medical Center
  Las Vegas, Nevada

News & Media

CAR Therapy for Solid Tumors Draws Attention at Annual Cancer Conference
CURE, June 18, 2019

Multidisciplinary project aims to educate physicians, patients about best practices in CLL care
Healio.com, June 09, 2019

The COVID-19 pandemic has led to sharp declines in cancer screenings and diagnoses across the board, and it has interrupted the ongoing treatment and monitoring of many existing patients. Indeed, cancer diagnoses are down remarkably, but not because of less prevalence. Many patients—particularly the elderly and other groups at high risk for complications due to COVID-19—have chosen not to actively engage with their healthcare providers during this time.

Traditional treatment approaches to chronic lymphocytic leukemia (CLL) have made treating this disease particularly compromised by the restrictions brought on by COVID-19. Given that CLL can spread very slowly, asymptomatic patients diagnosed with it are often monitored over time (also called “watchful waiting”). The long duration of the pandemic has led many patients to continually postpone regular office appointments, potentially contributing to unmonitored disease. And given that CLL mostly affects older people, they may be even less likely to keep office appointments during a pandemic. Many fear that when most patients begin to feel safe enough to access regular in-person care, practices may be deluged with patients with advanced disease requiring immediate treatment.

To help cancer practices prepare for an expected increase in undiagnosed patients and a surge in upstaged patients, this project aims to teach care team members short- and long-term solutions to operational challenges as the pandemic recedes, paying special attention to traditionally underserved patient populations. The Association of Community Cancer Centers will reach out to its members with webinars, podcasts, tools, publications, and case studies to share lessons learned from practices that have succeeded in maintaining their services to at-risk patient populations during a time of national crisis.

Explore Resource Library