Jamil Abdur, Aslam Shehroz, Riaz Rida, Qureshi Zaheer, Akram Hamzah, Kichloo Asim, Selene Insija Ilyas
Department of Internal Medicine, Core Faculty, Samaritan Medical Centre, Watertown, NY, USA.
Department of Internal Medicine, Samaritan Medical Centre, Watertown, NY, USA.
Ann Hematol. 2025 Mar;104(3):1387-1397. doi: 10.1007/s00277-025-06280-7. Epub 2025 Mar 29.
Chronic lymphocytic leukemia and small lymphocytic lymphoma (CLL/SLL) are common lymphoproliferative diseases in the elderly, accounting for 33% of all leukemias. The use of targeted therapies has significantly changed the management landscape of CLL/SLL. However, the efficacy of specific targeted therapies, such as venetoclax-based therapies, is limited. This review, therefore, aims to summarize the current evidence on the effectiveness and safety of venetoclax-based treatments in the management of CLL/SLL. We conducted a comprehensive search of three electronic databases, PubMed, Science Direct and Google Scholar, for all relevant articles. The reported outcomes were then analyzed using the statistical software Review Manager (RevMan 5.4.1). Our electronic search yielded 347 articles, of which only five were included in the review. We pooled the outcomes from 2195 patients. Our analysis found that venetoclax-based therapies significantly increased progression-free survival (PFS) (HR 0.30; 95% CI [0.21, 0.43] p < 0.00001), overall survival (OS) (HR 0.60; 95% CI [0.45, 0.80] p = 0.0004), and time to the next treatment (TTNT) (HR 0.29; 95% [0.18, 0.46] p < 0.00001). Additionally, we found the comparative safety of venetoclax-based therapies to other combination therapies. Our study found that venetoclax-based therapies are superior to other combination therapies in prolonging survival. Furthermore, they are comparable in safety to standard chemotherapy regimens and cost-effective. The findings of this review provide preliminary evidence on the efficacy of venetoclax-based regimens in CLL/SLL. However, further research is required to determine the best comparative regimen and the feasibility of venetoclax monotherapy in patients with CLL/SLL.
慢性淋巴细胞白血病和小淋巴细胞淋巴瘤（CLL/SLL）是老年人常见的淋巴增殖性疾病，占所有白血病的33%。靶向治疗的应用显著改变了CLL/SLL的治疗格局。然而，特定靶向治疗的疗效，如基于维奈克拉的治疗，是有限的。因此，本综述旨在总结目前关于基于维奈克拉的治疗在CLL/SLL管理中的有效性和安全性的证据。我们对三个电子数据库PubMed、Science Direct和Google Scholar进行了全面搜索，以查找所有相关文章。然后使用统计软件Review Manager（RevMan 5.4.1）对报告的结果进行分析。我们的电子搜索产生了347篇文章，其中只有5篇被纳入综述。我们汇总了2195名患者的结果。我们的分析发现，基于维奈克拉的治疗显著提高了无进展生存期（PFS）（风险比0.30；95%置信区间[0.21, 0.43]，p < 0.00001）、总生存期（OS）（风险比0.60；95%置信区间[0.45, 0.80]，p = 0.0004）以及至下次治疗时间（TTNT）（风险比0.29；95%[0.18, 0.46]，p < 0.00001）。此外，我们发现了基于维奈克拉的治疗与其他联合治疗相比的安全性。我们的研究发现，基于维奈克拉的治疗在延长生存期方面优于其他联合治疗。此外，它们在安全性上与标准化疗方案相当且具有成本效益。本综述的结果为基于维奈克拉的方案在CLL/SLL中的疗效提供了初步证据。然而，需要进一步研究以确定最佳的对比方案以及维奈克拉单药治疗在CLL/SLL患者中的可行性。
