2018, Number 2
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Rev Hematol Mex 2018; 19 (2)
The modern treatment of chronic lymphocytic leukemia: An approach of the personalized therapy
Best-Aguilera C, Guzmán-Hernández AE
Language: Spanish
References: 19
Page: 77-82
PDF size: 294.30 Kb.
ABSTRACT
In recent years, we have gone from a limited comprehension of the pathogenic
mechanisms of chronic lymphocytic leukemia to a broader picture that includes
a myriad of signaling pathways for survival and proliferation, which has provided
with a significant number of novel drugs whose clinical use should be tailored to
the clinical characteristics of the patient and to his/her particular leukemia. Under
the same pattern, we have gone from a palliative treatment to an ambitious one, that
ideally should aim towards the negative minimum residual disease status. Here we
review the above concepts with emphasis on the answers to key questions that deals
with: when to treat, how to treat and the role of the minimum residual disease as an
independent prognostic factor.
REFERENCES
Kanti RR, Sawitsky A, Cronkite EP, et al. Clinical staging of chronic lymphocytic leukemia. Blood 1975;46(2):219-234.
Binet JL, Auquier A, Dighiero G, et al. A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survivial analysis. Am Cancer Society 1981;48:198-206.
Rai KR, Jain P. Chronic lymphocytic leukemia (CLL)—Then and now. Am J Hematol 2016;91:330-340.
International CLLIPI Working Group. An international prognostic index for patients with chronic lymphocytic leukaemia (CLL-IPI): a meta-analysis of individual patient data. Lancet Oncol 2016;17:779-790.
Shustik C, Mick R, Silver R, et al. Treatment of early chronic lymphocytic leukemia: intermittent chlorambucil versus observation. Hematol Oncol 1988;6:7-12.
Cheson BD, et al. National Cancer Institute-sponsored working group guidelines for chronic lymphocytic leukemia: Revised guidelines for diagnosis and treatment. Blood 1996;87:4990-4997.
Extermann M, Overcash J, Lyman GH, Parr J, Balducci L. Comorbidity and functional status are independent in older cancer patients. J Clin Oncol 1998 Apr;16(4):1582-7.
Hallek M, Fischer K, Fingerle-Rowson G, et al. Addition of rituximab to fludarabine and cyclophosphamide in patients with chronic lymphocytic leukemia: a randomised, openlabel, phase III trial. Lancet 2010;376:1164-1174.
Eichhorst B, Fink AM, Busch R, et al. Frontline chemoimmunotherapy with fludarabine (F), cyclophosphamide (C), and rituximab (R) (FCR) shows superior efficacy in comparison to bendamustine (B) and rituximab (BR) in previously untreated and physically fit patients (pts) with advanced chronic lymphocytic leukemia (CLL): final analysis of an international, randomized study of the German CLL Study Group (GCLLSG) (CLL10 Study). Blood 2014;124: Abstract 19.
Hillmen P, Robak T, Janssens A, et al. Ofatumumab + chlorambucil versus chlorambucil alone in patients with untreated chronic lymphocytic leukemia (CLL): results of the phase III study complement 1 (OMB110911). Blood 2013;122: Abstract 528.
Goede V, Fischer K, Busch R, et al. Obinutuzumab plus chlorambucil in patients with CLL and coexisting conditions. N Engl J Med 2014;370:1101-1110.
Gribben JG. How I treat CLL up front. Blood 2010;115:187-197.
Eichhorst B, Robak T, Montserrat E, et al. Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015;26 (suppl 5):v78-v84.
Byrd JC, Furman RR, Coutre SE, et al. Targeting BTK with ibrutinib in relapsed chronic lymphocytic leukemia. N Engl J Med 2013;369:32-42.
Roberts AW, Davids MS, Pagel JM, et al. Targeting BCL2 with venetoclax in relapsed chronic lymphocytic leukemia. N Engl J Med 2016;374:311-322.
Jaglowski SMT. Transplant for CLL: still an option? Blood 2014;124(26):3835-3836.
Dreger P, Schetelig J, Andersen N, et al Managing high-risk CLL during transition to a new treatment era: stem cell transplantation or novel agents? Blood 2014;124:3841-3849.
García Vela JA, García Marco JA. Enfermedad mínima residual en la leucemia linfocítica crónica. Med Clin (Barc) 2017. http://dx.doi.org/10.1016/j.medcli.2017.06.067
Kovacs G, Robrecht S, Fink AM, et al. Minimal residual disease assessment improves prediction of outcome in patients with chronic lymphocytic leukemia (CLL) who achieve partial response: comprehensive analysis of two phase III studies of the German CLL study group. J Clin Oncol 2016.