Department of Hematology, Institute of Hematology and Transfusion Medicine, 02-776 Warsaw, Poland.
Department of Hematology, Medical University of Lodz, 93-510 Lodz, Poland.
Int J Mol Sci. 2024 Jan 27;25(3):1589. doi: 10.3390/ijms25031589.
Recent years have seen significant improvement in chronic lymphocytic leukemia (CLL) management. Targeting B-cell lymphoma (BCL-2) and Bruton's kinase (BTK) have become the main strategies to restrain CLL activity. These agents are generally well tolerated, but the discontinuation of these therapies happens due to resistance, adverse effects, and Richter's transformation. A growing population of patients who have previously used both BTK inhibitors and BCL2 suffer from the constriction of the following regimens. This review explores the resistance mechanisms for both ibrutinib and venetoclax. Moreover, we present innovative approaches evaluated for treating double-refractory CLL.
近年来,慢性淋巴细胞白血病(CLL)的治疗取得了显著进展。针对 B 细胞淋巴瘤(BCL-2)和布鲁顿酪氨酸激酶(BTK)已成为抑制 CLL 活性的主要策略。这些药物通常具有良好的耐受性,但由于耐药性、不良反应和里希特大细胞转化,这些治疗会被中断。越来越多的患者先前同时使用过 BTK 抑制剂和 BCL2 抑制剂,他们面临着治疗方案选择受限的困境。本综述探讨了伊布替尼和维奈托克的耐药机制。此外,我们还介绍了评估用于治疗双重难治性 CLL 的创新方法。