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Recent advances in therapy of chronic lymphocytic leukaemia
Author(s) -
Routledge David J. M.,
Bloor Adrian J. C.
Publication year - 2016
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.14184
Subject(s) - fludarabine , medicine , chronic lymphocytic leukemia , chemotherapy , immunology , refractory (planetary science) , disease , oncology , hematology , breakpoint cluster region , leukemia , receptor , cyclophosphamide , biology , astrobiology
Summary 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.