Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma: Mayo Clinic Systematic Management and Risk-Adapted Therapy...

Area of Science:

• Hematology
• Oncology

Background:

• Chronic lymphocytic leukemia (CLL) is the most common adult leukemia in the US.
• Significant progress in understanding CLL biology and treatment has been made over the last 20 years.

Purpose of the Study:

• To outline the Mayo Clinic's strategy for diagnosing, stratifying risk, and managing CLL.
• To address the specific challenges of Richter transformation in CLL.

Main Methods:

• Review of current treatment paradigms for CLL.
• Integration of genetic risk, comorbidities, and patient preferences in therapy selection.
• Consideration of novel agents and cellular therapies for relapsed/refractory disease.

Main Results:

• Treatment has shifted from chemoimmunotherapy to targeted agents, including Bruton tyrosine kinase inhibitors, B-cell lymphoma 2 inhibitors, and anti-CD20 monoclonal antibodies.
• Sequencing of targeted agents and cellular therapies offers improved outcomes for relapsed/refractory CLL.
• Richter transformation of CLL continues to have poor survival rates, representing an unmet need.

Conclusions:

• Current CLL management emphasizes personalized treatment with targeted agents.
• Advances have improved outcomes, but Richter transformation requires further research and novel therapeutic approaches.