Key Takeaways on Infection Risk in CLL Treatment Selection

Closing the OncLive News Network discussion, Danielle M. Brander, MD, of Duke University School of Medicine, asks Marc J. Braunstein, MD, PhD, of NYU Grossman Long Island School of Medicine, for the limitations clinicians should keep in mind when weighing infection risk between regimens in chronic lymphocytic leukemia (CLL) and for a single takeaway. Dr Braunstein frames the main decision as continuous versus fixed-duration therapy, guided by guidelines and biomarkers that identify high-risk patients who may benefit from indefinite therapy or a clinical trial. His takeaway is to counsel patients that even chemotherapy-free regimens carry infection as the important risk, a major cause of morbidity and mortality that can interrupt a fixed-duration course, and to follow guideline recommendations on vaccination and infection prevention. Dr Brander echoes the need to prevent infections and other risks such as second malignancies and highlights the role of nurses, advanced practice providers, pharmacists, and infectious disease colleagues.