Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, G71910, Seattle, WA, 98109, USA.
Department of Pathology, University of Washington, Seattle, WA, USA.
Curr Oncol Rep. 2019 Jul 20;21(8):74. doi: 10.1007/s11912-019-0819-x.
Treatment of chronic lymphocytic leukemia (CLL) has undergone a major shift since introduction of multiple targeted agents. B cell receptor inhibitors that target either bruton tyrosine kinase (ibrutinib) or phosphatidylinositol 3-kinases (idelalisib and duvelisib) and BCL-2 inhibitor venetoclax have become the mainstay of treatment.
Newer generations of monoclonal antibodies targeting CD20 (obinutuzumab and ofatumumab) are commonly used with novel drugs or chemotherapy agents and result in improved efficacy. At the same time, chemoimmunotherapy remains a reasonable option for selected patients. Therefore, with variety of reasonable options, choice of treatment in first-line or relapsed setting has become more challenging. Better understanding of the molecular and cytogenetics data for each patient is critical to improve management of patients with CLL. Herein, we review our approach to diagnosis and treatment of CLL in the era of novel therapeutic agents.
自多种靶向药物问世以来，慢性淋巴细胞白血病（CLL）的治疗发生了重大转变。靶向布鲁顿酪氨酸激酶（ibrutinib）或磷酸肌醇 3-激酶（idelalisib 和 duvelisib）的 B 细胞受体抑制剂以及 BCL-2 抑制剂 venetoclax 已成为治疗的主要手段。
新一代靶向 CD20 的单克隆抗体（obinutuzumab 和 ofatumumab）通常与新型药物或化疗药物联合使用，可提高疗效。同时，化疗免疫疗法仍然是某些患者的合理选择。因此，由于有多种合理的选择，一线或复发患者的治疗选择变得更加具有挑战性。更好地了解每位患者的分子和细胞遗传学数据对于改善 CLL 患者的管理至关重要。在此，我们回顾了在新型治疗药物时代我们对 CLL 的诊断和治疗方法。
