Advances in the treatment of relapsed/refractory chronic lymphocytic leukemia

被引：21

作者：

Shustik, C. ^{[1
]}

Bence-Bruckler, I. ^{[2
]}

Delage, R. ^{[3
]}

Owen, C. J. ^{[4
]}

Toze, C. L. ^{[5
,6
]}

Coutre, S. ^{[7
]}

机构：

[1] McGill Univ, Ctr Hlth, Montreal, PQ, Canada

[2] Ottawa Hosp, Dept Hematol, Ottawa, ON, Canada

[3] CHU Quebec Univ Laval, Dept Hematol, Quebec City, PQ, Canada

[4] Univ Calgary, Div Hematol & Hematol Malignancies, Calgary, AB, Canada

[5] BC Canc Agcy, Vancouver Gen Hosp, Div Hematol, Leukemia BMT Program BC, Vancouver, BC, Canada

[6] Univ British Columbia, Vancouver, BC, Canada

[7] Stanford Univ, Sch Med, Div Hematol, Stanford, CA 94305 USA

来源：

ANNALS OF HEMATOLOGY | 2017年 / 96卷 / 07期

关键词：

CLL; HSCT; Ibrutinib; Idelalisib; Venetoclax; STEM-CELL TRANSPLANTATION; PREVIOUSLY UNTREATED PATIENTS; TERM-FOLLOW-UP; OPEN-LABEL; INITIAL THERAPY; TREATMENT-NAIVE; ADVERSE EVENTS; FREE SURVIVAL; IBRUTINIB; RITUXIMAB;

D O I：

10.1007/s00277-017-2982-1

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Treatment of chronic lymphocytic leukemia (CLL) has advanced with the introduction of chemoimmunotherapy (CIT) agents that have improved the outcomes of frontline therapy. However, most treated patients will relapse and require subsequent therapy. This review focuses on recent advances in the treatment of relapsed or refractory CLL. Until recently, treatment options for relapsed CLL were of limited efficacy. Retreatment with fludarabine, cyclophosphamide, and rituximab (FCR) was recommended for patients with a durable response to first-line FCR, although acquired genetic aberrations, impaired marrow reserve, and comorbidities often made this suboptimal therapy for many patients. New options include two agents targeting B cell receptor (BCR) signaling pathways (ibrutinib and idelalisib) and a B cell lymphoma-2 (BCL-2) inhibitor (venetoclax). Allogeneic hematopoietic stem cell transplantation (HSCT) remains a potentially curative option for younger patients with a suitable donor.

引用

页码：1185 / 1196

页数：12