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CME: Updates in chronic lymphocytic leukemia (CLL) treatment paradigms

Activity Description / Statement of Need:

In this online, self-learning activity:

Chronic lymphocytic leukemia (CLL) is a diverse group of hematologic cancers in which B-cells accumulate in the blood, bone marrow, and lymphatic tissue, constituting as absolute lymphocytosis of mature-appearing lymphocytes with an appropriate immunophenotype. Elderly patients comprise the vast majority of those diagnosed with CLL with a median patient age of 71 years. Men have close to twice the risk of women of developing CLL, and there are over 21,000 cases per year, with an annual mortality rate in excess of 4,300. CLL is an indolent disease and often goes undetected for some time. The goals of therapy in treating patients with CLL are achievement and maintenance of prolonged remission while minimizing treatment-related toxicity.

This learning activity has been designed to update healthcare professionals’ knowledge of therapeutic options available for CLL and improve their competence and performance in treating the disease.

Target Audience:

The following HCPs: Medical oncologists and hematologists; physician assistants, nurse practitioners, and pharmacists who practice in oncology; and other healthcare professionals who commonly encounter patients with CLL.

Commercial Support Disclosure: This program is supported by an educational grant from Genmab.

This activity is free of charge.

Release Date: July 21, 2021 -- Expiration Date: July 21, 2022

Faculty: Matthew Davids, MD, MMSc


Introduction, disclosures

Introduction content

  • Statistics
  • Clinical features: types, onset, risk factors, clinical presentation
  • Pathophysiology, cytogenetics (del [17p], TP53)
  • Diagnosis, staging, prognostic factors, and comorbidities relevant to treatment decision-making [Learning Objective #1]

Updates in treatment in patients with CLL [Learning Objectives #2 & 3]

  • Factors impacting treatment decision-making
  • Goals of therapy
  • Initial management in patients with active disease

·       Risk stratification

·       Very high risk: del(17p) or TP53 mutations

·       High risk: no del(17p) / TP53 mutation, unmutated immunoglobulin heavy chain variable (IGHV)

·       Standard risk: no del(17p) / TP53 mutation, mutated IGHV

·       Targeted therapy

·       Bruton tyrosine kinase (BTK) inhibition (ibrutinib)

·       BCL2 inhibition (venetoclax)

·       CD-20 targeting (obinutuzumab, ofatumumab)

·       Chemoimmunotherapy

  • Assessment of patient response
  • A change of pace: Intolerance to initial therapy or disease progression
  • Relapsed/refractory: Therapies and treatment principles governing their selection

·       Prior treatment regimen(s)

·       Potential therapies

·       BTK inhibition (ibrutinib, acalabrutinib)

·       BCL2 inhibition (venetoclax)

·       PI3K inhibition (idelalisib, duvelisib)

·       Chemoimmunotherapy

  • Treatment advances: Emerging therapies and regimens

·       Ibrutinib + venetoclax

·       Chimeric antigen receptor T cells

  • The importance of personalizing treatment regimens: Cytogenetics, comorbidities, and treatment complications
  • Management of treatment complications and palliation of symptoms
  • Patient case(s)

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • List the characteristics that play a role in determining the staging, prognosis, and diagnosis of CLL
  • Describe the first-line therapy for the treatment of CLL, and apply it to a patient case
  • Recall treatments for the management of relapsed/refractory CLL, and formulate an individualized treatment regimen


This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.


ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

PhysiciansFor maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: Not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in this section, then it does NOT provide MOC credit.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-21-028-H01-P.  ACPE Accreditation effective 7/21/2021, expires 7/21/2022. This is an Application (A)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review by ScientiaCME.

Faculty Disclosure: Matthew S. Davids, MD, MMSc, Associate Professor of Medicine, Harvard Medical School, has received financial compensation for grant/research support from: Genentech, Pharmacyclics, TG Therapeutics, Verastem, BMS, MEI Pharma, Surface Oncology, Astra-Zeneca, Ascentage Pharma, Novartis; and honoraria from:  AbbVie, Genentech, Janssen, TG Therapeutics, Celgene, Astra-Zeneca, Verastem, Eli Lilly, Adaptive Biosciences, BeiGene, Novartis, Ascentage Pharma, Research to Practice, Takeda.

Off label use and/or investigational use in presentation: venetoclax, duvelisib, acalabrutinib, ibrutinib, obinutuzumab

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Genmab.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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