References
Acalabrutinib in the management of chronic lymphocytic leukaemia
Abstract
Chronic lymphocytic leukaemia (CLL) is the most common leukaemia worldwide. This article explores the management of CLL with a particular focus on the role of acalabrutinib in managing patients with CLL under NICE guidelines. Acalabrutinib is a potent bruton tyrosine kinase (BTK) inhibitor. Its use requires careful assessment, monitoring and early intervention to minimise side effects and maintain patients on treatment. Continuity of patient care and promotion of adherence and compliance is essential, particularly in light of the indefinite treatment duration. Patient education is central to therapeutic adherence of oral anti-cancer drugs, and nurses are ideally positioned to educate and support patients with CLL in collaboration with pharmacy colleagues. The benefits of nurse/pharmacy-led oral therapy clinics include continuity of care, consistency in information provision, efficient use of time with patients and carers, improved therapeutic relationships and an enhanced patient experience.
Chronic lymphocytic leukaemia (CLL) is the most common leukaemia worldwide, with 4.9 new cases per 100 000 per year in the UK (Milne et al, 2020). CLL is a lymphoproliferative disorder characterised by clonal proliferation and progressive accumulation of morphologically mature, monomorphic B lymphocytes in blood, bone marrow and lymphatic tissues (Burger 2020). In CLL, CD5+ B cells undergo malignant transformation and become continuously activated by the acquisition of mutations that lead to monoclonal B-cell lymphocytosis (MBL). Further accumulation of genetic abnormalities and subsequent oncogenic transformation of monoclonal B cells leads to CLL (Burger, 2020). CLL is considered identical to the indolent non-Hodgins lymphoma, small lymphocytic lymphoma (SLL). They both involve lymphocytes and are managed similarly. However, in CLL the disease is primarily found in blood and with SLL, it is primarily found in lymph nodes.
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