Hospital Clinic Barcelona, Insitut de Investigacions Biomediques August Pi i Sunyer, Spain.
Institut investigacion Biomedica August Pi i Sunyer (IDIBAPS) of Barcelona, Spain.
Haematologica. 2020 Sep 1;105(9):2205-2217. doi: 10.3324/haematol.2019.236000.
Chronic lymphocytic leukemia is a well-defined lymphoid neoplasm with very heterogeneous biological and clinical behavior. The last decade has been remarkably fruitful in novel findings elucidating multiple aspects of the pathogenesis of the disease including mechanisms of genetic susceptibility, insights into the relevance of immunogenetic factors driving the disease, profiling of genomic alterations, epigenetic subtypes, global epigenomic tumor cell reprogramming, modulation of tumor cell and microenvironment interactions, and dynamics of clonal evolution from early steps in monoclonal B cell lymphocytosis to progression and transformation into diffuse large B-cell lymphoma. All this knowledge has offered new perspectives that are being exploited therapeutically with novel target agents and management strategies. In this review we provide an overview of these novel advances and highlight questions and perspectives that need further progress to translate into the clinics the biological knowledge and improve the outcome of the patients.
慢性淋巴细胞白血病是一种明确的淋巴肿瘤，具有非常异质的生物学和临床行为。在过去的十年中，在阐明疾病发病机制的多个方面取得了显著的成果，包括遗传易感性机制、免疫遗传因素在疾病中的相关性、基因组改变谱、表观遗传亚型、肿瘤细胞整体表观遗传重编程、肿瘤细胞与微环境相互作用的调节以及从单克隆 B 细胞淋巴细胞增多症的早期阶段到弥漫性大 B 细胞淋巴瘤的进展和转化的克隆进化动态。所有这些知识都提供了新的视角，正在利用新型靶向药物和管理策略进行治疗。在这篇综述中，我们概述了这些新的进展，并强调了需要进一步进展的问题和观点，以将生物学知识转化为临床实践并改善患者的预后。
