慢性淋巴细胞白血病的最新治疗方法。

State-of-the-art treatment of chronic lymphocytic leukemia.

机构信息

University of Cologne, Cologne, Germany.

出版信息

Hematology Am Soc Hematol Educ Program. 2009:440-9. doi: 10.1182/asheducation-2009.1.440.

DOI:10.1182/asheducation-2009.1.440

PMID:20008230

Abstract

The last decade has produced rapid progress in the management of chronic lymphocytic leukemia (CLL). Fludarabine, bendamustine and two monoclonal antibodies, alemtuzumab and rituximab, have been approved by the European and/or American regulatory agencies. Several, novel monoclonal antibodies targeting CD20, CD23 or CD40, as well as drugs designed to interfere with proteins regulating the cell cycle, apoptotic machinery, or leukemic microenvironment (eg, flavopiridol, oblimersen, or lenalidomide), are currently being tested in clinical trials. Furthermore, the increased experience with reduced-intensity allogeneic progenitor cell transplantation allows offering this option to physically fit patients. In addition, new prognostic markers that may influence therapeutic decisions have been identified. This review attempts to summarize the current use of these different modalities in CLL therapy.

摘要

过去十年中，慢性淋巴细胞白血病（CLL）的治疗取得了快速进展。氟达拉滨、苯达莫司汀和两种单克隆抗体，阿仑单抗和利妥昔单抗，已获得欧洲和/或美国监管机构的批准。目前，几种针对 CD20、CD23 或 CD40 的新型单克隆抗体，以及旨在干扰调节细胞周期、细胞凋亡机制或白血病微环境的蛋白质的药物（如 flavopiridol、oblimersen 或 lenalidomide），正在临床试验中进行测试。此外，随着减强度异基因祖细胞移植经验的增加，允许为身体状况良好的患者提供这种选择。此外，已经确定了可能影响治疗决策的新预后标志物。本文试图总结这些不同方法在 CLL 治疗中的当前应用。