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High-risk chronic l...
High-risk chronic lymphocytic leukemia in the era of pathway inhibitors: integrating molecular and cellular therapies
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Dreger, P (author)
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Ghia, P (author)
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Schetelig, J (author)
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van Gelder, M (author)
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- Kimby, E (author)
- Karolinska Institutet
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Michallet, M (author)
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Moreno, C (author)
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Robak, T (author)
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Stilgenbauer, S (author)
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Montserrat, E (author)
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(creator_code:org_t)
- American Society of Hematology, 2018
- 2018
- English.
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In: Blood. - : American Society of Hematology. - 1528-0020 .- 0006-4971. ; 132:9, s. 892-902
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https://doi.org/10.1...
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Abstract
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- 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.
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- art (subject category)
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Blood
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- By the author/editor
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Dreger, P
-
Ghia, P
-
Schetelig, J
-
van Gelder, M
-
Kimby, E
-
Michallet, M
-
show more...
-
Moreno, C
-
Robak, T
-
Stilgenbauer, S
-
Montserrat, E
-
show less...
- Articles in the publication
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Blood
- By the university
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Karolinska Institutet