Universität zu Köln

Cramer, Paula, Langerbeins, Petra, Eichhorst, Barbara and Hallek, Michael (2016). Advances in first-line treatment of chronic lymphocytic leukemia: current recommendations on management and first-line treatment by the German CLL Study Group (GCLLSG). Eur. J. Haematol., 96 (1). S. 9 - 19. HOBOKEN: WILEY. ISSN 1600-0609

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Abstract

The management of patients with CLL is undergoing significant changes; during the last decade, the outcome of first-line therapies has been markedly improved with the addition of anti-CD20 antibodies to chemotherapy. Today, chemoimmunotherapy for physically fit patients <= 65 years should consist of fludarabine, cyclophosphamide, and rituximab (FCR). The combination of bendamustine and rituximab (BR) should be considered in physically fit patients >65 years and in patients with a higher risk of infections. Patients with reduced fitness and/or relevant comorbidity should receive chlorambucil with a CD20 antibody, preferably obinutuzumab. Regardless of their fitness, patients with CLL carrying genetic aberrations such as del(17p) and/or TP53 mutation poorly respond to chemoimmunotherapy and therefore require different therapeutic approaches. An increasing understanding of the disease biology has led to the development of targeted drugs for the treatment of CLL, such as the BTK inhibitor ibrutinib and PI3K inhibitor idelalisib. These agents have shown efficacy in high-risk and relapsed/refractory patients and are currently being evaluated in clinical trials for first-line therapy. It is anticipated that these compounds and further other novel agents will profoundly change the therapy of CLL.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Cramer, Paula UNSPECIFIED UNSPECIFIED UNSPECIFIED Langerbeins, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichhorst, Barbara UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-291746
DOI:	10.1111/ejh.12678
Journal or Publication Title:	Eur. J. Haematol.
Volume:	96
Number:	1
Page Range:	S. 9 - 19
Date:	2016
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1600-0609
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PREVIOUSLY UNTREATED PATIENTS; FLUDARABINE PLUS CYCLOPHOSPHAMIDE; STEM-CELL TRANSPLANTATION; PROGRESSION-FREE SURVIVAL; LOW-DOSE FLUDARABINE; PHASE-II TRIAL; GENOMIC ABERRATIONS; FRONTLINE TREATMENT; INITIAL THERAPY; RITUXIMAB Multiple languages Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/29174