Therapeutic management of chronic lymphocytic leukaemia State of the art and future perspectives

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Blank Therapeutic management of chronic lymphocytic leukaemia State of the art

and future perspectives.

I -Escobar, J Sepulveda, D Castellano, and H Cortes-Funes

Crit Rev Oncol Hematol, December 9, 2010; .

Lymphoma and Leukaemia Unit, Medical Oncology Division, University Hospital " 12

de Octubre " , Avda de C?rdoba s/n, 28041 Madrid, Spain.

Chronic lymphocytic leukaemia (CLL) is a common, often incurable low-grade-B

lymphoproliferative disorder. For many years, chlorambucil alone or with

steroids has been the drug of choice in treatment-naive patients. Purine

nucleoside analogues (PNAs) and, more recently, monoclonal antibodies (i.e.

rituximab, alemtuzumab), have increased the potential for obtaining complete or

even molecular remissions. Despite these advances, recurrent and/or relapsing

disease remains a major concern. In this respect, new clinical and biological

agents have recently been identified, which may allow a better selection for

high-risk patients, who could be offered more aggressive therapies including

haematopoietic stem cell transplantation (HSCT). Although autologous transplant

does not appear to provide additional benefit in advanced refractory disease,

allogeneic transplant may offer a chance for cure. Non-myeloablative allogeneic

transplant probably has curative potential with a better toxicity profile, and

it is actively being investigated. We will review the role of the current

therapeutic approach to CLL, focusing on the most recent advances in

chemoimmunotherapy and haematopoietic stem cell transplantation.

PMID: 21146422