The Treatment of Relapsed Refractory Chronic Lymphocytic Leukemia
The Treatment of Relapsed Refractory Chronic Lymphocytic Leukemia
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DOI：
10.1182/asheducation-2011.1.110
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发表时间：
2011-12-01
影响因子：
3
通讯作者：
Brown, Jennifer R.
中科院分区：
文献类型：
--
作者：
Brown, Jennifer R.
尽管广泛使用高效的化学免疫疗法（CIT），氟达拉滨难治性慢性淋巴细胞白血病（CLL）仍然是一个具有挑战性的临床问题，与总生存率（OS）差。传统的定义包括那些在氟达拉滨治疗6个月内没有反应或复发的患者，随着人们认识到即使是在CIT后长达几年的较长缓解期的患者，后续的治疗反应和生存率也很差，传统的定义正在不断发展。这些患者的批准治疗选择仍然有限，并且身体健康患者的治疗目标通常是实现足够的细胞减少以进行同种异体干细胞移植（alloSCT）。幸运的是，临床试验中的几种新型靶向治疗方法有望为这一患者群体带来显著益处。本综述讨论了现有的和新的治疗方法在氟达拉滨难治性或氟达拉滨耐药CLL以及最近更新的数据在CLL alloSCT的活动。
Despite the widespread use of highly effective chemoimmunotherapy (CIT), fludarabine-refractory chronic lymphocytic leukemia (CLL) remains a challenging clinical problem associated with poor overall survival (OS). The traditional definition, which includes those patients with no response or relapse within 6 months of fludarabine, is evolving with the recognition that even patients with longer remissions of up to several years after CIT have poor subsequent treatment response and survival. Approved therapeutic options for these patients remain limited, and the goal of therapy for physically fit patients is often to achieve adequate cytoreduction to proceed to allogeneic stem cell transplantation (alloSCT). Fortunately, several novel targeted therapeutics in clinical trials hold promise of significant benefit for this patient population. This review discusses the activity of available and novel therapeutics in fludarabine-refractory or fludarabine-resistant CLL as well as recently updated data on alloSCT in CLL.