D'Rozario James, Bennett Samuel K
Canberra Hospital and Health Service, Garran, Canberra, Australian Capital Territory 2605, Australia.
Canberra Hospital, Canberra, Australian Capital Territory, Australia.
Ther Adv Hematol. 2019 May 10;10:2040620719844697. doi: 10.1177/2040620719844697. eCollection 2019.
For the treatment of mature B cell malignancies including chronic lymphocytic leukemia (CLL), the last 5 years has brought major advances in the application of targeted therapies. Whilst monoclonal anti-CD20 agents such as rituximab have a central role in combination with traditional cytotoxic therapy, their combination with novel agents that target the B cell receptor signaling pathway and other intracellular mechanisms of B cell proliferation is a new approach to treatment. Venetoclax is a highly specific novel agent inhibiting the bcl-2 anti-apoptotic pathway and has potent activity in CLL. Its combination with rituximab results in deeper and more durable responses and this regimen is a valuable option in the treatment of relapsed or refractory CLL including adverse prognostic variants such as cases that are fludarabine refractory or harbor the 17p chromosomal deletion. This review centers on the use of venetoclax and rituximab in relapsed or refractory CLL.
在治疗包括慢性淋巴细胞白血病（CLL）在内的成熟B细胞恶性肿瘤方面，过去5年靶向治疗的应用取得了重大进展。虽然诸如利妥昔单抗等单克隆抗CD20药物在与传统细胞毒性疗法联合使用中发挥着核心作用，但将它们与靶向B细胞受体信号通路及B细胞增殖的其他细胞内机制的新型药物联合使用是一种新的治疗方法。维奈克拉是一种高度特异性的新型药物，可抑制bcl-2抗凋亡途径，在CLL中具有强大活性。它与利妥昔单抗联合使用可产生更深度、更持久的反应，并且该方案是治疗复发或难治性CLL（包括不良预后变异型，如氟达拉滨难治或存在17p染色体缺失的病例）的宝贵选择。本综述聚焦于维奈克拉和利妥昔单抗在复发或难治性CLL中的应用。
