Watch & Wait Article by Dr. Sharman

Watch & Wait   Article by Dr. Sharman

So a few key take home points

1) Watch and wait was historically based on ineffectiveness of therapy

2) Newer treatments have led scientists to revisit #1 but the answers are not in yet

3) One risk of treatment is the emergence of resistance but not all patients experience this

4) We may be able to begin measuring a patients risk for resistance based upon “subclonal driver mutations” soon

5) To date, we do not have much insight into what sorts of therapies influence emergence of resistance

6) Watch and wait is not crazy in appropriate patients – there may have been benefit to it for a long time that we are only just now starting to figure out.

7) Patients should not wait too long otherwise they just feel lousy when they could have been feeling better with treatment.

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6 Replies

  • Thanks for the heads up Chris. a really interesting and thoughtful article. It does help me live with the "dumb" CLL cells in the majority. Great explanation.

  • Hi Chris. Thanks for this link, it made for interesting and positive reading. These are things I need to hear.

    Take care

    sparkler x

  • 'You don't know what you got till its gone'...

    Wish my cells were "dumb"...but they all have PhDs now...

    Cost me a fortune to put them all through Oxford... ;-)

  • I really laughed really hard when I read this just now. Good one, Chris (although it must not have been very funny at the time).

  • What an interesting article. Good to know that there is so much promise if we can gain an improved understanding of what drives subclonal mutations and increases the probability of them becoming dominant. Wouldn't it be a huge breakthrough if we could better predict who can live life with occasional monitoring and who needs earlier intervention and with which drugs?

    Sadly due to the lack of genetic testing, haematologists in Australia and no doubt most other countries are in the awkward position of having to see how patients respond to chemotherapy and can therefore potentially worsen the patient's condition by giving chemotherapy that would be contraindicated if genetic testing was available. Dr Sharman's article further reinforces the importance of being treated by a haematologist experienced with CLL...

  • Thanks for posting - another very clear and useful article from Dr S.

    Mine still have not got been given a basic IQ test, so no idea how bright they are!

    Will make sure I spend all my money, so they have no way of getting to Uni!

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