Recent advances in therapy of chronic lymphocytic leukaemia.
The last 5 to 10 years have been marked by considerable advances in both our understanding of the biology and treatment of chronic lymphocytic leukaemia (CLL). Fludarabine-based immuno-chemotherapy is the current standard of care for first line therapy in younger fit patients and although this can be highly effective its use in older co-morbid patients is limited by toxicity, and the prognosis for patients with high risk or fludarabine-refractory disease is poor. The introduction of new antibodies has however, facilitated the use of immuno-chemotherapy in co-morbid patients. Beyond this, the recognition that CLL cells are critically dependent on B-cell receptor (BCR) signalling and interactions with the cellular micro-environment for proliferation and survival has led to the investigation of BCR inhibitors in CLL treatment. These have been shown to be highly effective although a number of questions remain about how they should be optimally used in clinical practice.
Department of Haematology, The Christie NHS Foundation Trust, Manchester, UK.
David J M
DJ
Routledge
Department of Haematology, The Christie NHS Foundation Trust, Manchester, UK.|University of Manchester, Manchester, UK.|Manchester Academic Health Science Centre, Manchester, UK.
Adrian J C
AJ
Bloor
D000367:Age Factors; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology; D006801:Humans; D007167:Immunotherapy / Q000379:methods / Q000639:trends*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000628:therapy*; D011379:Prognosis; D011947:Receptors, Antigen, B-Cell / Q000037:antagonists & inhibitors
D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D011947:Receptors, Antigen, B-Cell
B-cell receptor; chronic lymphocytic leukaemia; ibrutinib; idelalisib; immuno-chemotherapy