Davids Matthew S, Alyea Edwin P
Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA,
Curr Hematol Malig Rep. 2015 Mar;10(1):18-27. doi: 10.1007/s11899-014-0247-9.
Chronic lymphocytic leukemia (CLL) patients with high-risk markers such as del(17p) or those who have relapsed after multiple lines of therapy have a poor prognosis and allogeneic hematopoietic cell transplantation (alloHCT) has historically been the best opportunity for achieving long-term disease control. Recently, several new highly efficacious and well-tolerated small molecules targeting the B cell receptor (BCR) pathway and Bcl-2 have been approved or are in the late stages of development. These new agents are altering therapeutic paradigms in CLL, but unlike with alloHCT, information on long-term disease control is lacking. Here, we provide an overview of the data supporting the use of HCT in CLL and the promising results with the novel agents. We discuss the evolving role of alloHCT for CLL in the novel agent era, including identifying the patients most likely to benefit from transplantation and optimal transplantation timing, as well the use of novel agents in the post-transplantation setting.
具有高危标志物如del(17p)的慢性淋巴细胞白血病（CLL）患者或那些经过多线治疗后复发的患者预后较差，而异基因造血细胞移植（alloHCT）历来是实现长期疾病控制的最佳机会。最近，几种靶向B细胞受体（BCR）通路和Bcl-2的新型高效且耐受性良好的小分子药物已获批准或正处于研发后期。这些新型药物正在改变CLL的治疗模式，但与alloHCT不同的是，缺乏关于长期疾病控制的信息。在此，我们概述支持在CLL中使用造血细胞移植（HCT）的数据以及新型药物的 promising 结果。我们讨论了在新型药物时代alloHCT在CLL中不断演变的作用，包括确定最有可能从移植中获益的患者和最佳移植时机，以及新型药物在移植后环境中的使用。
