Universität zu Köln

von Tresckow, Julia, Eichhorst, Barbara, Bahlo, Jasmin and Hallek, Michael (2019). The Treatment of Chronic Lymphatic Leukemia. Dtsch. Arztebl. Int., 116 (4). S. 41 - 47. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: Chronic lymphocytic leukemia (CLL) mainly affects older persons and is the commonest form of leukemia, with an incidence of 6 cases per 100 000 persons per year. In Germany, approximately 1000 men and 850 women die of CLL each year. Methods: This review is based on pertinent publications retrieved by a selective literature search in PubMed and on the authors' scientific and clinical experience. Results: The diagnosis of CLL requires the detection of at least 5000 B-lymphocytes per microliter in the peripheral blood. Courses of CLL may be indolent and require no treatment, but may also be aggressive and progress rapidly. Treatment should be initiated when there is marked evidence of bone-marrow suppression or disease-related symptoms such as B symptoms or fatigue. In the past ten years, a number of targeted drugs have been introduced that can achieve a very good, long-lasting response, particularly when used in combination. The combination of chemotherapy with anti-CD20 antibodies (chemoimmunotherapy) is the standard first-line treatment. In younger patients without any relevant accompanying illnesses, the combination of fludarabine, cyclophosphamide, and rituximab prolongs survival. Patients with comorbidities should be treated with a combination of chlorambucil and obinutuzumab. In the last few years, ibrutinib, idelalsib, and venetoclax have been approved for clinical use. These substances inhibit cellular signal transduction pathways and are being increasingly used. Conclusion: Recent progress in the development of novel treatment options gives hope that CLL may soon be a controllable disease. Even at present, chemoimmunotherapy can achieve a progression-free survival of more than eight years in certain genetically defined subgroups of CLL patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code von Tresckow, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichhorst, Barbara UNSPECIFIED UNSPECIFIED UNSPECIFIED Bahlo, Jasmin UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-158883
DOI:	10.3238/arztebl.2019.0041
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	116
Number:	4
Page Range:	S. 41 - 47
Date:	2019
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC LYMPHOCYTIC-LEUKEMIA; TYROSINE KINASE INHIBITOR; OPEN-LABEL; INITIAL THERAPY; 17P DELETION; RISK-FACTORS; FOLLOW-UP; CLL; CYCLOPHOSPHAMIDE; FLUDARABINE Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15888