American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended treatment for chronic lymphocytic leukemia?

1. Chemotherapy

2. Radiation therapy

3. Ibrutinib

4. Stem cell transplant

The correct answer is: Ibrutinib

The recommended treatment for chronic lymphocytic leukemia (CLL) in many cases is ibrutinib, which is a targeted therapy that inhibits Bruton's tyrosine kinase (BTK). This medication has shown efficacy in treating CLL by disrupting the signaling pathways crucial for the survival and proliferation of malignant B cells. Ibrutinib has transformed the management of CLL, especially for patients with specific genetic abnormalities such as del(17p) or those who have relapsed after other therapies. As a targeted therapy, ibrutinib is typically favored over traditional chemotherapy due to its more favorable side effect profile and the convenience of oral administration, making it a preferred option in many treatment scenarios, including for older patients or those who may not tolerate aggressive treatments well. Other treatment modalities, such as chemotherapy, can be effective but are generally not the first-line approach in the presence of suitable targeted therapies like ibrutinib. Radiation therapy is not commonly used as a primary treatment for CLL and is typically reserved for treating specific complications or localized disease involvement. Stem cell transplant is usually considered for younger patients with more advanced disease or those who have failed prior therapies, but it is not the first-line approach for most patients with CLL. Given