Abstract:
Recent developments in the diagnosis and treatment of chronic lymphocytic leukemia (B-CLL) have led to change of approach in clinical practice. New treatments have been approved based on the results of randomized multicenter trials for first line and for salvage therapy, and the results of numerous ongoing clinical trials are permanently providing new answers and further refining of therapeutic strategies. This is paralleled by substantial increase in understanding the disease genetics due to major advances in the next generation sequencing (NGS) technology. We define current position of the Croatian Cooperative Group for Hematologic Disease on diagnosis and treatment of CLL in the transition from chemo-immunotherapy paradigm into a new one that is based on new diagnostic stratification and unprecedented therapeutic results of B-cell receptor inhibitors (BRI) and Bcl-2 antagonists. This is a rapidly evolving field as a great number of ongoing clinical trials con-stantly accumulate and provide new knowledge. We believe that novel therapy research including genomic diagnosis is likely to offer new options that will eventually lead to time limited therapies without chemotherapy and more effective clinical care for B-CLL based on individualized precision medicine.
摘要:
慢性淋巴细胞白血病(B-CLL)的诊断和治疗的最新进展导致了临床实践方法的改变。根据一线和抢救治疗的随机多中心试验的结果,新的治疗方法已被批准。许多正在进行的临床试验的结果永久提供了新的答案,并进一步完善了治疗策略。这与由于下一代测序(NGS)技术的重大进展而导致的对疾病遗传学的理解的大幅增加并行。我们定义了克罗地亚血液病合作小组在CLL的诊断和治疗方面的当前位置,该小组从化学免疫疗法范式过渡到基于B细胞受体抑制剂(BRI)的新诊断分层和前所未有的治疗结果的新范式。和Bcl-2拮抗剂。这是一个快速发展的领域,因为大量正在进行的临床试验不断积累并提供新的知识。我们认为,包括基因组诊断在内的新疗法研究可能会提供新的选择,最终将导致无化疗的时间限制疗法以及基于个体化精准医学的B-CLL更有效的临床护理。