Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma Survey

Question Title

* 1. Please fill out the following contact information in the case that you match a medical study

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 2. Are you at least 18 years old?

Yes

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* 3. Have you been diagnosed with Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Lymphoma (SLL)?

Yes

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* 4. Have you experienced a relapse after completing at least one line of therapy?

Yes

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* 5. Have you experienced disease progression after cycle 15 of treatment?

Yes

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* 6. Is your platelet count great or equal to 20,000/mcl?

Yes

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* 7. Is your bilirubin level less then or equal to 2 times the normal rage (unless you have Gilbert’s disease or a non-hepatic origin)?

Yes

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* 8. Do you have normal LFT’s (liver function tests) - less then 4 times the normal range that is considered acceptable?

Yes

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* 9. Is your serum creatinine less than or equal to 1.5 times the normal range?

Yes

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* 10. If you are childbearing age, are you currently NOT pregnant and on adequate contraception?

Yes

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* 11. If you are currently or have been treated with oral corticosteroids, has the current dose been stable for the past 7 days and 20mg daily or LESS?

Yes

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* 12. Are you free or allogeneic hematologist stem cell transplant?

Yes

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* 13. Are you free of CNS (Central Nervous System) involvement?

Yes

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* 14. Are you currently free of other malignancies (except carcinoma in situ without disease progression and low-risk prostate cancer under surveillance)?

Yes

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* 15. If you have been vaccinated with a live attenuated vaccine, has it been at least more than 4 weeks?

Yes

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* 16. Are you free of bleeding disorders or hemophilia?

Yes

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* 17. If you have a history of stroke, intracranial hemorrhage, or major bleed, has it been at least 6 months or longer?

Yes

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* 18. Are you free of HIV, active hepatitis C and hepatitis B?

Yes

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* 19. Are you free of any mental and or social disorders or situations that would affect compliance with study requirements?

Yes

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* 20. Are you free of any malabsorption disorders (ex: stomach or small bowel resection, ulcerative colitis, inflammatory bowel disease, partial or complete bowel obstruction)?

Yes

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* 21. Are you free of autoimmune anemia and/or autoimmune thrombocytopenia?

Yes

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* 22. If you have a history of myocardial infarction, unstable angina or acute coronary syndrome, have you been stable and has it occurred more than 6 months ago?

Yes

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* 23. Are you free of an uncontrolled cardiac arrhythmia?

Yes

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* 24. If you have CHF (congestive heart failure), are you currently NOT classified as class 3 or 4 As defined by the New York Heart Association Functional Classification?

Yes

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* 25. Have you been free of treatment with a covalent BTK or BCL-2 inhibitor?
Cohort A

Yes

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* 26. Have you had prior treatment with a BTK inhibitor or a BCL-2 inhibitor (not both) and did not show disease progression?
Cohort B

Yes

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* 27. Have you been treated for CLL/SLL with a covalent BTK inhibitor (not zanubruitnib) and the disease progressed?
Cohort C

Yes

Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

Question Title

* 1. Please fill out the following contact information in the case that you match a medical study

Question Title

* 2. Are you at least 18 years old?

Question Title

* 3. Have you been diagnosed with Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Lymphoma (SLL)?

Question Title

* 4. Have you experienced a relapse after completing at least one line of therapy?

Question Title

* 5. Have you experienced disease progression after cycle 15 of treatment?

Question Title

* 6. Is your platelet count great or equal to 20,000/mcl?

Question Title

* 7. Is your bilirubin level less then or equal to 2 times the normal rage (unless you have Gilbert’s disease or a non-hepatic origin)?

Question Title

* 8. Do you have normal LFT’s (liver function tests) - less then 4 times the normal range that is considered acceptable?

Question Title

* 9. Is your serum creatinine less than or equal to 1.5 times the normal range?

Question Title

* 10. If you are childbearing age, are you currently NOT pregnant and on adequate contraception?

Question Title

* 11. If you are currently or have been treated with oral corticosteroids, has the current dose been stable for the past 7 days and 20mg daily or LESS?

Question Title

* 12. Are you free or allogeneic hematologist stem cell transplant?

Question Title

* 13. Are you free of CNS (Central Nervous System) involvement?

Question Title

* 14. Are you currently free of other malignancies (except carcinoma in situ without disease progression and low-risk prostate cancer under surveillance)?

Question Title

* 15. If you have been vaccinated with a live attenuated vaccine, has it been at least more than 4 weeks?

Question Title

* 16. Are you free of bleeding disorders or hemophilia?

Question Title

* 17. If you have a history of stroke, intracranial hemorrhage, or major bleed, has it been at least 6 months or longer?

Question Title

* 18. Are you free of HIV, active hepatitis C and hepatitis B?

Question Title

* 19. Are you free of any mental and or social disorders or situations that would affect compliance with study requirements?

Question Title

* 20. Are you free of any malabsorption disorders (ex: stomach or small bowel resection, ulcerative colitis, inflammatory bowel disease, partial or complete bowel obstruction)?

Question Title

* 21. Are you free of autoimmune anemia and/or autoimmune thrombocytopenia?

Question Title

* 22. If you have a history of myocardial infarction, unstable angina or acute coronary syndrome, have you been stable and has it occurred more than 6 months ago?

Question Title

* 23. Are you free of an uncontrolled cardiac arrhythmia?

Question Title

* 24. If you have CHF (congestive heart failure), are you currently NOT classified as class 3 or 4 As defined by the New York Heart Association Functional Classification?

Question Title

* 25. Have you been free of treatment with a covalent BTK or BCL-2 inhibitor?*Cohort A*

Question Title

* 26. Have you had prior treatment with a BTK inhibitor or a BCL-2 inhibitor (not both) and did not show disease progression?*Cohort B*

Question Title

* 27. Have you been treated for CLL/SLL with a covalent BTK inhibitor (not zanubruitnib) and the disease progressed?*Cohort C*

* 25. Have you been free of treatment with a covalent BTK or BCL-2 inhibitor?
Cohort A

* 26. Have you had prior treatment with a BTK inhibitor or a BCL-2 inhibitor (not both) and did not show disease progression?
Cohort B

* 27. Have you been treated for CLL/SLL with a covalent BTK inhibitor (not zanubruitnib) and the disease progressed?
Cohort C