Abstract:
:Recently, the use of novel targeted drugs has changed the treatment paradigms in chronic lymphocytic leukemia (CLL). Among the several drugs used for the management of relapsed/refractory (R/R) CLL, Bruton tyrosine kinase inhibitors (ibrutinib and acalabrutinib), phosphatidylinositol 3-kinase inhibitors (idelalisib and duvelisib), B-cell lymphoma 2 inhibitor (venetoclax), and novel CD20 monoclonal antibodies have demonstrated the greatest improvements in survival among R/R CLL patients. However, patients with relapsed but asymptomatic CLL do not need immediate alternative treatment and should be observed until evident sign of progression. Among available approved treatments, venetoclax + rituximab for 24 months or ibrutinib as continuous therapy is recommended. Another, less recommended, option is idelalisib in combination with rituximab. The correct treatment selection depends on the type of prior therapy, response to previous treatment and side effects, presence of comorbidities, and the risk of drug toxicity. Allogeneic hematopoietic stem cell transplantation and investigational therapies such as chimeric antigen receptor-T-cell therapy are promising treatment options for high-risk patients, including those progressing after 1 or more targeted therapies. The present review discusses current treatment strategies for patients with R/R CLL.
journal_name
Acta Haematoljournal_title
Acta haematologicaauthors
Smolewski P,Robak Tdoi
10.1159/000510768subject
Has Abstractpub_date
2020-11-25 00:00:00pages
1-15eissn
0001-5792issn
1421-9662pii
000510768pub_type
杂志文章,评审abstract::A patient with common acute lymphoblastic leukaemia (ALL), hypereosinophilic syndrome and t(5;14) (q31.1;q32.3) translocation is described. Even with intensive treatment only short periods of complete remission were achieved. Recurrence of the leukaemia was always accompanied by the appearance of eosinophilic granuloc...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000205289
更新日期:1989-01-01 00:00:00
abstract::The 8p11 myeloproliferative syndrome (EMS) is an aggressive neoplasm associated with chromosomal translocations involving the fibroblast growth factor receptor 1 (FGFR1) tyrosine kinase gene on chromosome 8p11-12. A new case of a 9-year-old boy with leukocytosis, eosinophilia, and general lymphadenopathy is reported i...
journal_title:Acta haematologica
pub_type: 杂志文章,评审
doi:10.1159/000481392
更新日期:2018-01-01 00:00:00
abstract::To test whether anti-idiotypic immunoregulation of factor VIII(FVIII)-inhibiting antibodies could be feasible in hemophiliacs, we assayed the minimal number and range of immunogenic, functional FVIII epitopes to which a series of murine anti-FVIII monoclonal antibodies (MAb) were directed. Rabbit anti-idiotypic sera t...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000205171
更新日期:1990-01-01 00:00:00
abstract::We describe a patient with hemophagocytic syndrome resembling malignant histiocytosis which was complicating myelodysplastic disease of 3 years duration. Detailed morphological and ultrastructural studies indicate that the histiocytic component did not demonstrate features of malignancy. A review of other known malign...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000206198
更新日期:1985-01-01 00:00:00
abstract::A hemophilia B patient, seropositive for HIV antibodies since 1984, came to us in March 1989 with a severe necrotizing lesion of the nose. It was an erythematous lesion and looked like rhinophyma. Microbiological examination of the skin biopsy showed the presence of Cryptococcus neoformans. At the time of the study, t...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000205038
更新日期:1990-01-01 00:00:00
abstract::Platelet-derived growth factor (PDGF) is thought to take part in the genesis of bone marrow fibrosis that can be found in patients with myeloproliferative diseases. We evaluated platelet mitogenic activity as the difference between serum and plasma activity in 8 patients with myeloproliferative disease. We observed a ...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000205544
更新日期:1989-01-01 00:00:00
abstract::Fetal hemoglobin (HbF) concentrations were measured by a radial immunodiffusion assay in 233 patients with various malignancies. In 96 of these, alpha-fetoprotein (AFP) was also measured by radioimmunoassay. The concentration of HbF exceeded 2 SDs above the normal mean in 39 of 233 patients, most notably in patients w...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000207839
更新日期:1977-01-01 00:00:00
abstract::A study was carried out of 332 babies suffering from severe neonatal jaundice who were admitted to the General Hospital, Kuala Lumpar, Malaysia. Of the 332 neonates, 51 were premature and 281 were full-term babies, 178 (110 Chinese, 58 Malay, 9 Indian and 1 European-Pakistani) had bilirubin levels of 20 mg% or higher,...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000207822
更新日期:1977-01-01 00:00:00
abstract::The effect of methylprednisolone on fresh cells from patients with chronic lymphocytic leukaemia (CLL) has been studied using the differential staining cytotoxicity (DiSC) assay resulting in LC90s of < or = 0.2 to 2,000 micrograms/ml. Cells from previously treated patients were, on average, significantly more sensitiv...
journal_title:Acta haematologica
pub_type: 临床试验,杂志文章
doi:10.1159/000204115
更新日期:1995-01-01 00:00:00
abstract::Peripheral blood stem cells (PBSC) are widely used in the setting of dose-intensive chemotherapies in patients with multiple myeloma (MM). Although the granulocyte colony-stimulating factor (G-CSF), following chemotherapy or not, is considered the standard growth factor for mobilizing PBSC, the optimal chemotherapeuti...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000070967
更新日期:2003-01-01 00:00:00
abstract::A 64-year-old man with multiple sclerosis developed a circulating anticoagulant. Three immunoglobulin fractions (I = IgG; II =IgG+IgA; III = IgM) were separated from patient serum by 33-percent ammonium sulfate precipitation and DEAE-52 cellulose column chromatography. Fractions I (IgG) and II (IgG+IgA) had factor VII...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000207993
更新日期:1976-01-01 00:00:00
abstract::Premature neonates require blood transfusions, and biological parents may wish to be directed donors. Biological mothers pose a potential danger because their plasma may contain antibodies that will react with blood cell antigens inherited by the infant from the father. We studied 25 healthy, pregnant women at the tim...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000204889
更新日期:1991-01-01 00:00:00
abstract::In a 42-year-old Caucasian female, acute myelocytic leukemia (M2) presented as occlusion of the distal aorta and right iliac artery. She died after 10 days of respiratory failure. At postmortem examination the aortic wall contained multiple thrombi composed of fibrin and leukemic cells. There was no evidence of diffus...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000206100
更新日期:1986-01-01 00:00:00
abstract::This report describes a case of hairy cell leukemia (HCL) occurring with autoimmune chronic active hepatitis (CAH). A 74-year-old woman presented with typical clinical and histologic features of HCL for which splenectomy was performed. 2 years later she developed abnormal liver function tests due to auto-immune CAH. T...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000206291
更新日期:1985-01-01 00:00:00
abstract::A case of steroid-resistant acquired pure red-cell aplasia associated with a relative and absolute increase of TG cells is described. Removal of T cells enhanced erythroid colony and burst formation in vitro, and it is suggested that TG cells may be implicated in the pathogenesis of this case of acquired pure red-cell...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000207191
更新日期:1981-01-01 00:00:00
abstract::RAS mutations are found in about 25% of acute myeloid leukemia (AML) cases. The importance of these changes is unknown. If RAS mutations confer growth advantage to leukemia subclones in which they emerge, substantially more nonconservative than conservative mutations should be found. The incidence of conservative muta...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000204200
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Danaparoid sodium and synthetic protease inhibitors (SPIs) have been approved for the treatment of disseminated intravascular coagulation (DIC) in Japan. OBJECTIVES:To compare the clinical results of the treatment of DIC with danaparoid or SPIs. METHODS:We retrospectively examined 188 patients with hematol...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000501818
更新日期:2020-01-01 00:00:00
abstract::Two family members (daughter and mother) with a bleeding disorder showed prolonged bleeding time and activated partial thromboplastin time associated with decreased plasma levels of factor VIII procoagulant activity, factor VIII-related antigen, and factor VIII-ristocetin cofactor activity. The ristocetin-induced plat...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000206579
更新日期:1984-01-01 00:00:00
abstract::Primary lymphoma of the female genital tract is very rare. We report the case of a 36-year-old woman who was referred to our hospital because of an indeterminate Pap smear test. The colposcopy showed a thickening of the posterior vaginal wall and various irregular ulcerated nodular lesions. Histological examination, i...
journal_title:Acta haematologica
pub_type: 杂志文章,评审
doi:10.1159/000337336
更新日期:2012-01-01 00:00:00
abstract::The detection and enumeration of sideroblasts depend critically on the method used for iron staining of bone marrow smears. Several methods proposed for semiquantitative evaluation of bone marrow hemosiderin (iron stores) were compared with respect to their suitability for detection of normal and abnormal sideroblasts...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000207856
更新日期:1977-01-01 00:00:00
abstract::We report a patient with lung cancer who developed CD56-positive acute lymphoblastic leukemia. He was referred to our hospital for thrombocytopenia. Atypical cells were found in the blood and the bone marrow. These cells were immunophenotypically positive for CD3epsilon, CD56, and terminal deoxynucleotidyl transferase...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000087891
更新日期:2005-01-01 00:00:00
abstract::Systematic reviews and meta-analyses have made a major contribution to the evidence-based management of infections in cancer patients. We review the contribution of systematic reviews with regard to antibiotic, antifungal, antiviral and Pneumocystis pneumonia prophylaxis; antibiotic and antifungal treatment of febrile...
journal_title:Acta haematologica
pub_type: 杂志文章,评审
doi:10.1159/000318900
更新日期:2011-01-01 00:00:00
abstract::To clarify the role of thrombopoietin (c-Mpl ligand, TPO) in 'hypersplenic' thrombocytopenia, we used an enzyme-linked immunosorbent assay to examine changes in serum TPO levels accompanied with splenectomy in 6 patients with liver cirrhosis, 4 patients with gastric cancer, and 2 patients with lymphoid malignancies. W...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000040888
更新日期:1998-12-01 00:00:00
abstract:BACKGROUND:Not all patients with diffuse large B-cell lymphoma (DLBCL) are candidates for aggressive regimens. (90)Y ibritumomab tiuxetan ((90)Y-IT), an anti-CD20 radionuclide-conjugated antibody, has demonstrated clinical efficacy in DLBCL with a favorable toxicity profile. METHODS:This phase II trial investigated th...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000368291
更新日期:2015-01-01 00:00:00
abstract::An increased bone marrow (BM) apoptosis is one of the mechanisms responsible for the ineffective hematopoiesis of myelodysplastic syndromes (MDS). It is controversial whether the excessive apoptosis in myelodysplasia predominantly involves the subset of progenitor cells or of maturing cells. We investigated the degree...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000067275
更新日期:2003-01-01 00:00:00
abstract::2 fatal cases of graft-versus-host disease (GvHD) occurred following blood product transfusions given to patients receiving standard chemotherapy for Hodgkin's disease. GvHD was established by HLA typing, clinical course, and compatible skin biopsy. 23 cases of GvHD following transfusion of blood products from normal ...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000206599
更新日期:1984-01-01 00:00:00
abstract::The course and management of avascular necrosis of the femoral head (AVNFH) in six hips of 5 sickle cell syndrome patients (3 with Hb SS, 1 with Hb SC and 1 with Hb S/beta+-thalassaemia) are described. Two patients (aged 13 and 17 years) presented with Perthes- and osteochondritis dessicans-type lesions. These hips pr...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000205873
更新日期:1987-01-01 00:00:00
abstract::Pyruvate kinase (PK) from four patients with moderate to severe congenital non-spherocytic haemolytic anaemia was characterized by methods recommended by the ICSH. The possibility that two of the patients are true homozygotes cannot be ruled out, while the other two apparently represent double heterozygotes. All but o...
journal_title:Acta haematologica
pub_type: 杂志文章,评审
doi:10.1159/000204184
更新日期:1994-01-01 00:00:00
abstract::A 74-year-old woman was treated by lithium carbonate 3 x 300 mg per day for drug-induced aplastic anemia. After 8 days, she suddenly developed severe impairment of consciousness with myoclonias and hypertonia which persisted during 10 days despite lithium withdrawal and sodium chloride infusion. Slight disorders of wa...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000207314
更新日期:1980-01-01 00:00:00
abstract::In a group of 56 patients with acute leukaemia, the relation between leukaemic cell motility and peripheral leukaemic cell count, degree of organomegaly, maturation and FAB classification was investigated. Cell motility was studied by means of directly observed motility and scoring of handmirror cells and anti-HLA-cap...
journal_title:Acta haematologica
pub_type: 杂志文章
doi:10.1159/000205595
更新日期:1988-01-01 00:00:00