State-of-the-art treatment of chronic lymphocytic leukemia.
The last decade has produced rapid progress in the management of chronic lymphocytic leukemia (CLL). Fludarabine, bendamustine and two monoclonal antibodies, alemtuzumab and rituximab, have been approved by the European and/or American regulatory agencies. Several, novel monoclonal antibodies targeting CD20, CD23 or CD40, as well as drugs designed to interfere with proteins regulating the cell cycle, apoptotic machinery, or leukemic microenvironment (eg, flavopiridol, oblimersen, or lenalidomide), are currently being tested in clinical trials. Furthermore, the increased experience with reduced-intensity allogeneic progenitor cell transplantation allows offering this option to physically fit patients. In addition, new prognostic markers that may influence therapeutic decisions have been identified. This review attempts to summarize the current use of these different modalities in CLL therapy.
Hallek
Michael
M
University of Cologne, Cologne, Germany. michael.hallek@uni-koeln.de
D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D000912:Antibodies, Neoplasm / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000069461:Bendamustine Hydrochloride; D002453:Cell Cycle / Q000187:drug effects; D003131:Combined Modality Therapy; D054697:Cytostatic Agents / Q000008:administration & dosage; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007167:Immunotherapy; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D018365:Neoplasm, Residual; D009588:Nitrogen Mustard Compounds / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D000069283:Rituximab; D016879:Salvage Therapy; D013873:Thionucleotides / Q000008:administration & dosage; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D000912:Antibodies, Neoplasm; D054697:Cytostatic Agents; D009588:Nitrogen Mustard Compounds; D013873:Thionucleotides; D000074323:Alemtuzumab; D000069283:Rituximab; C408162:oblimersen; C509683:lumiliximab; D000069461:Bendamustine Hydrochloride; D014740:Vidarabine; C024352:fludarabine