High-risk chronic lymphocytic leukemia in the era of pathway inhibitors: integrating molecular and cellular therapies
Visual Abstract - <img class="highwire-fragment fragment-image" alt="Figure1" src="http://www.bloodjournal.org/content/bloodjournal/132/9/892/F1.medium.gif" width="411" height="440"/>Download figureOpen in new tabDownload powerpoint - - High-r...
Saved in:
| Main Author: | |
|---|---|
| Format: | Article (Journal) |
| Language: | English |
| Published: |
30 August 2018
|
| In: |
Blood
Year: 2018, Volume: 132, Issue: 9, Pages: 892-902 |
| ISSN: | 1528-0020 |
| DOI: | 10.1182/blood-2018-01-826008 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1182/blood-2018-01-826008 Verlag, Volltext: http://www.bloodjournal.org/content/132/9/892 
|
| Author Notes: | Peter Dreger, Paolo Ghia, Johannes Schetelig, Michel van Gelder, Eva Kimby, Mauricette Michallet, Carol Moreno, Tadeusz Robak, Stephan Stilgenbauer and Emili Montserrat |
| Summary: | Visual Abstract - <img class="highwire-fragment fragment-image" alt="Figure1" src="http://www.bloodjournal.org/content/bloodjournal/132/9/892/F1.medium.gif" width="411" height="440"/>Download figureOpen in new tabDownload powerpoint - - High-risk chronic lymphocytic leukemia (CLL) has been defined by clinical and/or genetic resistance (TP53 abnormalities) to treatment with chemoimmunotherapy (CIT). With the availability of pathway inhibitors (PIs), such as kinase inhibitors and BCL2 antagonists, the outlook of CIT-resistant patients has dramatically improved. Here, we propose a revision of the concept of high-risk CLL, driven by TP53 abnormalities and response to treatment with PI. CLL high-risk-I, CIT-resistant is defined by clinically CIT-resistant disease with TP53 aberrations, but fully responsive to PI. This category is largely the domain of PI-based therapy, and cellular therapy (ie, allogeneic hematopoietic cell transplantation) remains an option only in selected patients with low individual procedure-related risk. In CLL high-risk-II, CIT- and PI-resistant, characterized by increasing exhaustion of pharmacological treatment possibilities, cellular therapies (including chimeric antigen receptor-engineered T cells) should be considered in patients eligible for these procedures. Moreover, molecular and cellular therapies are not mutually exclusive and could be used synergistically to exploit their full potential. |
|---|---|
| Item Description: | Gesehen am 14.06.2019 |
| Physical Description: | Online Resource |
| ISSN: | 1528-0020 |
| DOI: | 10.1182/blood-2018-01-826008 |