一线慢性淋巴细胞白血病的治疗管理。
Management of front line chronic lymphocytic leukemia.
机构信息
Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne, Duesseldorf and German CLL Study Group, University of Cologne, Cologne, Germany.
出版信息
Am J Hematol. 2022 Nov;97 Suppl 2:S3-S10. doi: 10.1002/ajh.26677.
Treatment options with targeted agents have changed the treatment landscape of CLL profoundly. Besides chemoimmunotherapy, treatment regimen approved for frontline therapy include continuous treatment with BTK inhibitors like ibrutinib and acalabrutinib or fixed-duration regimen like venetoclax-obinutuzumab with the approval of venetoclax-ibrutinib to be awaited. Although these agents have usually manageable side effects, toxicities might limit choices for the individual patient. We here discuss latest trial data and propose a treatment algorithm for frontline treatment of CLL according to fitness and relevant genetic risk factors like IGHV mutational status and TP53 aberrations.
靶向药物治疗方案的出现极大地改变了 CLL 的治疗格局。除了化疗免疫疗法外，批准用于一线治疗的治疗方案还包括连续使用 BTK 抑制剂（如伊布替尼和阿卡替尼）或固定疗程方案（如维奈托克-奥滨尤妥珠单抗），维奈托克-伊布替尼的批准正在等待中。尽管这些药物通常具有可管理的副作用，但毒性可能会限制个体患者的选择。我们在此讨论最新的临床试验数据，并根据患者的健康状况和相关遗传风险因素（如 IGHV 突变状态和 TP53 异常），为 CLL 的一线治疗提出治疗算法。
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