Chronic lymphocytic leukaemia

Lancet. 2018 Apr 14;391(10129):1524-1537. doi: 10.1016/S0140-6736(18)30422-7. Epub 2018 Feb 21.

Abstract

Important advances in understanding the pathogenesis of chronic lymphocytic leukaemia in the past two decades have led to the development of new prognostic tools and novel targeted therapies that have improved clinical outcome. Chronic lymphocytic leukaemia is the most common type of leukaemia in developed countries, and the median age at diagnosis is 72 years. The criteria for initiating treatment rely on the Rai and Binet staging systems and on the presence of disease-related symptoms. For many patients with chronic lymphocytic leukaemia, treatment with chemotherapy and anti-CD20 monoclonal antibodies is the standard of care. The impressive efficacy of kinase inhibitors ibrutinib and idelalisib and the BCL-2 antagonist venetoclax have changed the standard of care in specific subsets of patients. In this Seminar, we review the recent progress in the management of chronic lymphocytic leukaemia and highlight new questions surrounding the optimal disease management.

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bridged Bicyclo Compounds, Heterocyclic / therapeutic use
  • Diagnosis, Differential
  • Genetic Predisposition to Disease
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis*
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Leukemia, Lymphocytic, Chronic, B-Cell / etiology
  • Leukemia, Lymphocytic, Chronic, B-Cell / genetics
  • Mutation
  • Prognosis
  • Purines / therapeutic use
  • Pyrazoles / therapeutic use
  • Pyrimidines / therapeutic use
  • Quinazolinones / therapeutic use
  • Recurrence
  • Risk Factors
  • Sulfonamides / therapeutic use
  • Survival Analysis
  • Treatment Outcome

Substances

  • Bridged Bicyclo Compounds, Heterocyclic
  • Purines
  • Pyrazoles
  • Pyrimidines
  • Quinazolinones
  • Sulfonamides
  • ibrutinib
  • venetoclax
  • idelalisib