Department of Internal Medicine, Center of Integrated Oncology Köln Bonn, University Hospital of Cologne, Cologne, Germany.
Stanford University School of Medicine, Stanford, CA, USA.
Lancet. 2018 Apr 14;391(10129):1524-1537. doi: 10.1016/S0140-6736(18)30422-7. Epub 2018 Feb 21.
Important advances in understanding the pathogenesis of chronic lymphocytic leukaemia in the past two decades have led to the development of new prognostic tools and novel targeted therapies that have improved clinical outcome. Chronic lymphocytic leukaemia is the most common type of leukaemia in developed countries, and the median age at diagnosis is 72 years. The criteria for initiating treatment rely on the Rai and Binet staging systems and on the presence of disease-related symptoms. For many patients with chronic lymphocytic leukaemia, treatment with chemotherapy and anti-CD20 monoclonal antibodies is the standard of care. The impressive efficacy of kinase inhibitors ibrutinib and idelalisib and the BCL-2 antagonist venetoclax have changed the standard of care in specific subsets of patients. In this Seminar, we review the recent progress in the management of chronic lymphocytic leukaemia and highlight new questions surrounding the optimal disease management.
在过去的二十年中，人们对慢性淋巴细胞白血病发病机制的认识取得了重要进展，这导致了新的预后工具和新型靶向治疗方法的发展，从而改善了临床结果。慢性淋巴细胞白血病是发达国家最常见的白血病类型，诊断时的中位年龄为 72 岁。开始治疗的标准依赖于 Rai 和 Binet 分期系统以及疾病相关症状的存在。对于许多慢性淋巴细胞白血病患者，化疗和抗 CD20 单克隆抗体治疗是标准的治疗方法。激酶抑制剂伊布替尼和idelalisib 以及 BCL-2 拮抗剂 venetoclax 的显著疗效改变了特定患者亚群的治疗标准。在本次研讨会上，我们回顾了慢性淋巴细胞白血病管理方面的最新进展，并强调了围绕最佳疾病管理的新问题。
