Rekomendacje diagnostyczne i terapeutyczne dla przewlek łej białaczki limfocytowej w 2016 r – Raport Grupy Roboczej PTHiT i PALG-CLL

Publication date: Available online 16 August 2016 Source:Acta Haematologica Polonica Author(s): Tadeusz Robak, Iwona Hus, Krzysztof Giannopoulos, Jerzy Błoński, Krzysztof Jamroziak, Jacek Roliński, Piotr Smolewski, Dariusz Wołowiec The management of patients with chronic lymphocytic leukaemia (CLL) is currently undergoing improvements, particularly because of novel therapies. Purine analogs based immuno-chemotherapy, particularly fludarabine combined with cyclophosphamide and rituximab (FCR), is still the current standard of care for first line therapy in younger, fit patients. However, its use in older, co-morbid patients is limited, particularly due to high toxicity. Recently, in these patients’ population, chlorambucil and anti CD20 monoclonal antibodies (rituximab, obinutuzumab or ofatumumab) are recommended as the first-line treatment. In addition, in 2014, two novel agents targeting the B cell receptor (BCR) signaling pathway, ibrutinib and idelalisib, were approved for patients with 17p deletion and/or p53 mutations and in the relapsed situation because of high efficacy and a favorable toxicity. Subsequently, ibrutinib has been approved to treat CLL patients regardless of their treatment history. Thus far it is recommended to treat patients with these agents until progression or unacceptable toxicity. The BCL-2 antagonist venetoclax is another oral drug with very promising preliminary data in patients refractory to immunochemotherapy as well as patients...
Source: Acta Haematologica Polonica - Category: Hematology Source Type: research