Editor’s Special Episode: Progress and Prospects in CLL Management

In an Editor’s Special Episode of The Hem Onc Pulse, William G. Wierda, MD, PhD, professor of medicine, deputy department chair, and chronic lymphocytic leukemia (CLL) section chief, Department of Leukemia at the University of Texas MD Anderson Cancer Center explores the evolving treatment protocols for CLL. Over the past decade, CLL research has accelerated dramatically, transforming outcomes for patients and reshaping what remission means in both frontline and relapsed disease.

Dr. Wierda highlights the promise of targeted therapies, including the potential for combined regimens to provide long-term remission, especially for older patients with mutated immunoglobulin genes who may only need one course of therapy in their lifetime. The discussion also addresses one of the field’s most pressing challenges: resistance to covalent BTK inhibitors. Dr. Wierda explains how non-covalent inhibitors, degraders, and bispecific antibodies are showing early signs of success in overcoming resistance and providing new options for patients with refractory disease.

But treating CLL goes beyond achieving remission. Dr. Wierda underscores the importance of addressing immune dysfunction, which continues to place patients at elevated risk for infection and second cancers such as breast, prostate, colon, and skin cancers. Preventive care, including vaccinations, diligent cancer screening, and infection monitoring, remains an essential part of long-term patient management.

With optimism, Dr. Wierda reflects on the progress made and the future ahead. From innovative combination strategies to deeper understanding of immune dysregulation, research is paving the way for better patient outcomes and quality of life.