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Relapsed/Refractory Chronic Lymphocytic Leukemia (CLL).

Oluwatobi Odetola1, Shuo Ma2

  • 1Robert H. Lurie Comprehensive Cancer Center, Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 805, Chicago, IL, 60611, USA. Oluwatobi.odetola@northwestern.edu.

Current Hematologic Malignancy Reports
|June 6, 2023
PubMed
Summary
This summary is machine-generated.

Advances in targeted therapies offer new hope for relapsed chronic lymphocytic leukemia (CLL). While a cure remains elusive, novel treatments like BTK inhibitors and CAR T-cell therapy improve disease control and delay progression.

Keywords:
BTK inhibitorMonoclonal antibodyRelapsed CLLTargeted therapyVenetoclax

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Area of Science:

  • Hematology
  • Oncology
  • Pharmacology

Background:

  • Chronic lymphocytic leukemia (CLL) treatment aims for disease control, not cure, especially in older patients.
  • Relapsed CLL presents unique challenges in treatment selection.
  • Understanding relapse factors is crucial for effective management.

Purpose of the Study:

  • Review the concept and predisposing factors of relapsed CLL.
  • Summarize current and investigational therapeutic options for relapsed CLL.
  • Provide a framework for selecting therapies in relapsed CLL.

Main Methods:

  • Review of recent clinical findings and therapeutic advances in relapsed/refractory CLL.
  • Analysis of targeted therapies including BTK inhibitors and venetoclax-based regimens.
  • Evaluation of novel agents like non-covalent BTK inhibitors and CAR T-cell therapy.

Main Results:

  • Targeted therapies (BTKi, venetoclax) surpass chemoimmunotherapy in relapsed CLL.
  • Second-generation BTK inhibitors offer improved safety; novel non-covalent BTK inhibitors show promise for resistant cases.
  • CAR T-cell therapy demonstrates significant activity in relapsed/refractory CLL.

Conclusions:

  • Relapsed CLL patients have expanding therapeutic options, including novel targeted agents.
  • Individualized treatment selection is paramount due to a lack of direct comparative data.
  • Further research is needed to determine optimal sequencing of therapies and the role of MRD negativity.