Department of Clinical Haematology, The Royal Melbourne Hospital and The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Division of Blood Cells and Blood Cancer, The Walter and Eliza Hall Institute, Melbourne, Victoria, Australia.
Intern Med J. 2023 Sep;53(9):1678-1691. doi: 10.1111/imj.16207.
Chronic lymphocytic leukaemia (CLL) is the most common haematological malignancy in Australia and New Zealand (ANZ). Considerable changes to diagnostic and management algorithms have occurred within the last decade. The availability of next-generation sequencing and measurable residual disease assessment by flow cytometry allow for advanced prognostication and response assessments. Novel therapies, including inhibitors of Bruton's tyrosine kinase (BTKi) and B-cell lymphoma 2 (BCL2) inhibitors, have transformed the treatment landscape for both treatment-naïve and relapsed/refractory disease, particularly for patients with high-risk genetic aberrations. Recommendations regarding appropriate supportive management continue to evolve, and special considerations are required for patients with CLL with respect to the global SARS-CoV-2 pandemic. The unique funding and treatment environments in Australasia highlight the need for specific local guidance with respect to the investigation and management of CLL. This consensus practice statement was developed by a broadly representative group of ANZ experts in CLL with endorsement by peak haematology bodies, with a view to providing this standardised guidance.
慢性淋巴细胞白血病（CLL）是澳大利亚和新西兰（ANZ）最常见的血液系统恶性肿瘤。在过去十年中，诊断和治疗方案发生了重大变化。下一代测序和流式细胞术检测可测量残留疾病的可用性，可实现更先进的预后和反应评估。新型疗法，包括布鲁顿酪氨酸激酶（BTKi）抑制剂和 B 细胞淋巴瘤 2（BCL2）抑制剂，改变了初治和复发/难治性疾病的治疗格局，特别是对具有高危遗传异常的患者。关于适当支持性治疗的建议不断发展，对于患有 CLL 的患者，特别是在全球 SARS-CoV-2 大流行的背景下，需要特别考虑。澳大拉西亚独特的资金和治疗环境突出了需要针对 CLL 的调查和管理制定具体的本地指南。该共识实践声明由广泛代表的 ANZ CLL 专家小组制定，并得到了顶级血液学机构的认可，旨在提供这种标准化指导。
