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Despite the advances in the treatment, chronic lymphocytic leukemia (CLL) remains an incurable disease. Patient-reported outcomes like quality of life (QoL) analyses are increasingly incorporated into clinical trials. This is important where therapies that do not affect overall survival but differ by an anticipated gain in QoL are compared. 1 Besides, this also strengthens the physician-patient relationship. 2 Formal QoL analyses in CLL outside of clinical trials have been few. The most extensive international study done in 2007 was using the older QoL assessment questionnaires British Fatigue Inventory (BFI) and Functional Assessment of Cancer Therapy-General (FACT-G) Questionnaires. 3 Other studies using the more universally validated European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaires were limited to regional analyses. 4-6 These studies have shown contradictory findings from compromised to better QoL in CLL patients than the

PURPOSE Chronic lymphocytic leukemia (CLL) is uncommon in India. There are limited studies on CLL from the Indian subcontinent. METHODS This was a prospective study (2011-2017) of consecutively diagnosed patients with CLL at a single center. The diagnosis, prognosis, treatment indication, response criteria, and adverse events were recorded as per International Workshop on Chronic Lymphocytic Leukemia guidelines. Biosimilar rituximab dosing (375 mg/m2) was fixed for all cycles. Time to next treatment (TTNT) was defined as the time from front-line treatment initiation to next treatment or death from any cause. Overall survival (OS) was defined as the time from treatment initiation until death from any cause. RESULTS A total of 409 patients with CLL were enrolled over the study period. The median follow-up was 32 months (range, 2-135 months). The median age was 61 years, and 31.8% of patients with CLL were ≤ 55 years of age; 43.3% of patients had a cumulative illness rating scale score ≥ 3. Prognostic fluorescence in situ hybridization data were available in 53.3% of patients. Chlorambucil (94/180; 52.2%) and bendamustine + rituximab (BR; 57/180; 31.6%) were the most common regimens used up front. The overall response rates after front-line therapy were 74.4% and 91.2%, respectively. The TTNT was 33 months and not reached, respectively ( P = .001). Grade 3/4 neutropenia and infections were seen in 52.6% and 38.5% of patients receiving BR. The median OS was not reached in both regimens ( P = .25). CONCLUSION Indian patients with CLL are younger in chronological age but have higher morbidity burden. Treatment outcomes with biosimilar fixed-dose BR are comparable to those reported in the literature. Chlorambucil is still a valid option, given the economic burden of the disease and treatment.

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Abstract:Patients with leukemia are predisposed to various coagulation abnormalities. Thrombosis and bleeding continue to be a major cause of morbidity and mortality in leukemias. The pathophysiology of these disorders is unique, and not only the disease but also the treatment and other factors play a role. There has been an increase in the understanding of these disorders in leukemias. However, it is still difficult to predict when and which patients will have these complications. The evidence for the management of coagulation abnormalities in leukemias is still evolving and not as established as in solid malignancies. The management of these disorders is complex, and making clinical decisions is often challenging. In the era of specialization, where there are different hematologists looking after benign-and malignant-hematology patients, opinions of thrombosis experts are often sought by leukemia specialists. This review aims to bridge the gap in the knowledge of these disorders between these specialists.

y chimpanzee adenovirus vector encoding the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Spike (S) glycoprotein, produced in genetically modified human embryonic kidney (HEK) 293 cells. It is manufactured in India by the Serum Institute and is available as COV-ISHIELD™. It was rolled out in India for people > 45 years of age and comorbidities from March 2021 and for > 18 years from May 2021. Despite no data on the safety or efficacy of a replication-deficient viral vector vaccine in immunocompromised patients, the vaccine was approved in this population wherever it was the only option considering the possible benefits over the risks of COVID-19. Most countries in the developed world resorted to mRNA vaccines Deepesh P. Lad