文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

我如何治疗慢性淋巴细胞白血病。

How I Manage Chronic Lymphocytic Leukemia.

作者信息

Nasnas Patrice, Cerchione Claudio, Musuraca Gerardo, Martinelli Giovanni, Ferrajoli Alessandra

机构信息

Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

出版信息

Hematol Rep. 2023 Aug 1;15(3):454-464. doi: 10.3390/hematolrep15030047.


DOI:10.3390/hematolrep15030047
PMID:37606492
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10443285/
Abstract

Chronic lymphocytic leukemia (CLL), is a hematologic malignancy characterized by the uncontrolled proliferation of mature B lymphocytes. CLL is the most prevalent leukemia in Western countries. Its presentation can range from asymptomatic with the incidental finding of absolute lymphocytosis on a routine blood test, to symptomatic disease requiring immediate intervention. Prognosis of the disease is defined by the presence or absence of specific mutations such as TP53, chromosomal abnormalities such as del(17p), a type of IGHV mutational status, and elevation of B2M and LDH. Treatment of CLL in the United States and Europe has evolved over the recent years thanks to the development of targeted therapies. The standard of care has shifted from traditional chemoimmunotherapy approaches to targeted therapies including Bruton tyrosine kinase inhibitors (BTKis) and BCL2 inhibitors, administered either as monotherapy or in combination with CD20 monoclonal antibodies. Several clinical trials have also recently evaluated combinations of BTKi and venetoclax and showed the combination to be well tolerated and able to induce deep remissions. Targeted therapies have a good safety profile overall; however, they also have unique toxicities that are important to recognize. Diarrhea, fatigue, arthralgia, infections, cytopenias, bleeding, and cardiovascular toxicities (including atrial fibrillation, ventricular arrhythmias, and hypertension) are the adverse events (AEs) commonly associated with BTKis. Initiation of therapy with venetoclax requires close monitoring because of the risk for tumor lysis syndrome associated with this agent, particularly in patients with a high disease burden. Development of newer target therapies is ongoing and the therapeutic landscape in CLL is expanding rapidly.

摘要

慢性淋巴细胞白血病(CLL)是一种血液系统恶性肿瘤,其特征为成熟B淋巴细胞的不受控制的增殖。CLL是西方国家最常见的白血病。其表现范围从常规血液检查时偶然发现绝对淋巴细胞增多的无症状状态,到需要立即干预的有症状疾病。该疾病的预后由特定突变(如TP53)的存在与否、染色体异常(如del(17p))、一种IGHV突变状态以及B2M和LDH的升高来定义。近年来,由于靶向治疗的发展,美国和欧洲对CLL的治疗有了进展。治疗标准已从传统的化学免疫疗法转向靶向治疗,包括布鲁顿酪氨酸激酶抑制剂(BTKis)和BCL2抑制剂,可作为单一疗法或与CD20单克隆抗体联合使用。最近的几项临床试验也评估了BTKi与维奈托克的联合使用情况,结果显示该联合用药耐受性良好且能够诱导深度缓解。总体而言,靶向治疗具有良好的安全性;然而,它们也有一些需要认识到的独特毒性。腹泻、疲劳、关节痛、感染、血细胞减少、出血和心血管毒性(包括心房颤动、室性心律失常和高血压)是与BTKis通常相关的不良事件(AE)。由于与该药物相关的肿瘤溶解综合征风险,尤其是在疾病负担高的患者中,使用维奈托克开始治疗需要密切监测。更新的靶向治疗正在研发中,CLL的治疗前景正在迅速扩展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eab/10443285/f0414c3e1eaf/hematolrep-15-00047-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eab/10443285/4fee795733a5/hematolrep-15-00047-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eab/10443285/f0414c3e1eaf/hematolrep-15-00047-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eab/10443285/4fee795733a5/hematolrep-15-00047-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eab/10443285/f0414c3e1eaf/hematolrep-15-00047-g002.jpg

相似文献

[1]
How I Manage Chronic Lymphocytic Leukemia.

Hematol Rep. 2023-8-1

[2]
BCL-2 Inhibition as Treatment for Chronic Lymphocytic Leukemia.

Curr Treat Options Oncol. 2021-6-10

[3]
Chronic lymphocytic leukemia: 2020 update on diagnosis, risk stratification and treatment.

Am J Hematol. 2019-10-4

[4]
[Current diagnosis and treatment of chronic lymphocytic leukaemia].

Dtsch Med Wochenschr. 2020-8

[5]
Approved and emerging Bruton's tyrosine kinase inhibitors for the treatment of chronic lymphocytic leukemia.

Expert Opin Pharmacother. 2022-9

[6]
Ibrutinib Plus Venetoclax for First-line Treatment of Chronic Lymphocytic Leukemia: A Nonrandomized Phase 2 Trial.

JAMA Oncol. 2021-8-1

[7]
Efficacy and safety of new-generation Bruton tyrosine kinase inhibitors in chronic lymphocytic leukemia/small lymphocytic lymphoma: a systematic review and meta-analysis.

Ann Hematol. 2024-7

[8]
Chronic lymphocytic leukemia: 2022 update on diagnostic and therapeutic procedures.

Am J Hematol. 2021-12-1

[9]
The Next Generation of Targeted Molecules for the Treatment of Chronic Lymphocytic Leukemia.

Oncology (Williston Park). 2016-11-15

[10]
Targeted multigene deep sequencing of Bruton tyrosine kinase inhibitor-resistant chronic lymphocytic leukemia with disease progression and Richter transformation.

Cancer. 2018-12-3

引用本文的文献

[1]
iVAC-XS15-CLL01: personalized multi-peptide vaccination in combination with the TLR1/2 ligand XS15 in CLL patients undergoing BTK-inhibitor-based regimens.

Front Oncol. 2024-8-26

[2]
Targeting BTK in B Cell Malignancies: From Mode of Action to Resistance Mechanisms.

Int J Mol Sci. 2024-3-12

[3]
Disrupting pro-survival and inflammatory pathways with dimethyl fumarate sensitizes chronic lymphocytic leukemia to cell death.

Cell Death Dis. 2024-3-18

[4]
Engagement of Mesenchymal Stromal Cells in the Remodeling of the Bone Marrow Microenvironment in Hematological Cancers.

Biomolecules. 2023-11-24

本文引用的文献

[1]
Fixed-Duration Ibrutinib-Venetoclax in Patients with Chronic Lymphocytic Leukemia and Comorbidities.

NEJM Evid. 2022-7

[2]
Zanubrutinib or Ibrutinib in Relapsed or Refractory Chronic Lymphocytic Leukemia.

N Engl J Med. 2023-1-26

[3]
Practical Management of the Venetoclax-Treated Patient in Chronic Lymphocytic Leukemia and Acute Myeloid Leukemia.

J Adv Pract Oncol. 2022-5

[4]
BTK inhibitor selection for chronic lymphocytic leukemia: which drug for which patient?

Expert Rev Hematol. 2022-5

[5]
Up to 8-year follow-up from RESONATE-2: first-line ibrutinib treatment for patients with chronic lymphocytic leukemia.

Blood Adv. 2022-6-14

[6]
PI3K Inhibitors for the Treatment of Chronic Lymphocytic Leukemia: Current Status and Future Perspectives.

Cancers (Basel). 2022-3-18

[7]
Mechanisms of Resistance to Noncovalent Bruton's Tyrosine Kinase Inhibitors.

N Engl J Med. 2022-2-24

[8]
Fixed-duration ibrutinib plus venetoclax for first-line treatment of CLL: primary analysis of the CAPTIVATE FD cohort.

Blood. 2022-6-2

[9]
CLL update 2022: A continuing evolution in care.

Blood Rev. 2022-7

[10]
Chronic lymphocytic leukemia: 2022 update on diagnostic and therapeutic procedures.

Am J Hematol. 2021-12-1

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索