Universität zu Köln

Fischer, Kirsten and Hallek, Michael (2017). Optimizing frontline therapy of CLL based on clinical and biological factors. Hematol.-Am. Soc. Hematol. Educ. Program. S. 338 - 346. WASHINGTON: AMER SOC HEMATOLOGY. ISSN 1520-4383

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Abstract

The heterogeneity of the clinical course of chronic lymphocytic leukemia (CLL) ranges from an indolent course, where patients do not require therapy for many years, to a very aggressive disease, where treatment is required soon after diagnosis and relapses may occur early. The improved tools for prognostication allow predicting the outcome of patients with increasing reliability. Some markers also allow selecting more specific therapies with improved activity in the presence of certain genetic or clinical features of CLL. Of these markers, TP53 dysfunction, age, the presence of comorbidities and the immunoglobulin heavy-chain variable region gene mutational status, or serum markers such as beta(2)-microglobulinl have shown independent prognostic value in multiple prospective trials. During the last 10 years, multiple novel agents have become available. The advent of oral kinase inhibitors or BcI-2 antagonists has provided highly effective options with acceptable toxicity. This manuscript summarizes the current evidence of the available treatment options and proposes an integrated algorithm for the frontline therapy of CLL.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Fischer, Kirsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-208248
DOI:	10.1182/asheducation-2017.1.338
Journal or Publication Title:	Hematol.-Am. Soc. Hematol. Educ. Program
Page Range:	S. 338 - 346
Date:	2017
Publisher:	AMER SOC HEMATOLOGY
Place of Publication:	WASHINGTON
ISSN:	1520-4383
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHRONIC LYMPHOCYTIC-LEUKEMIA; PREVIOUSLY UNTREATED PATIENTS; MINIMAL RESIDUAL DISEASE; OPEN-LABEL; PROGNOSTIC INDEX; INDEPENDENT PREDICTOR; INITIAL THERAPY; TREATMENT-NAIVE; PLUS RITUXIMAB; OLDER PATIENTS Multiple languages Education, Scientific Disciplines; Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20824