Past, present and future role of chlorambucil in the treatment of chronic lymphocytic leukemia

被引:19
作者
Goede, Valentin [1 ,2 ]
Eichhorst, Barbara [1 ]
Fischer, Kirsten [1 ]
Wendtner, Clemens-Martin [1 ,3 ]
Hallek, Michael [1 ,4 ]
机构
[1] Univ Hosp Cologne, Ctr Integrated Oncol Cologne Bonn, Dept Internal Med 1, German CLL Study Grp, D-50924 Cologne, Germany
[2] Univ Cologne, Fac Med, Dept Geriatr, D-50931 Cologne, Germany
[3] Univ Klinikum Schleswig Holstein, Dept Hematol Oncol Immunol Palliat Care Infect Di, Munich, Germany
[4] Univ Cologne, Cologne Excellence Cluster Cellular Stress Respon, D-50931 Cologne, Germany
关键词
Chronic lymphocytic leukemia; chemotherapy; immunotherapy; PREVIOUSLY UNTREATED PATIENTS; COOPERATIVE-ONCOLOGY-GROUP; HIGH-DOSE CHLORAMBUCIL; INITIAL THERAPY; INTERMITTENT CHLORAMBUCIL; PREDNISONE THERAPY; 1ST-LINE TREATMENT; PLUS CHLORAMBUCIL; OPEN-LABEL; CYCLOPHOSPHAMIDE;
D O I
10.3109/10428194.2014.963077
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
For many decades, chlorambucil was the standard of care for chronic lymphocytic leukemia (CLL), but meanwhile has been replaced by purine analog-based chemoimmunotherapy. Monotherapy with the alkylator only retained significance in the treatment of older patients unfit for standard treatment. After successful phase II studies, recent phase Ill trials established combinations of chlorambucil with anti-CD20 antibodies such as rituximab, ofatumumab and obinutuzumab as a valuable treatment option for these patients. Today, chlorambucil therefore should be used as a chemotherapy backbone for antibody-based chemoimmunotherapy in this patient population rather than as monotherapy. Starting from the past role of chlorambucil in CLL treatment, we here review the most recent efforts to elaborate chlorambucil-based chemoimmunotherapy in CLL and discuss clinically relevant questions that arise from this approach.
引用
收藏
页码:1585 / 1592
页数:8
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