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Updated: Aug 9, 2026
09:02
Immunoglobulin Gene Sequence Analysis In Chronic Lymphocytic Leukemia: From Patient Material To Sequence Interpretation
Published on: November 26, 2018
Contemporary Management of Relapsed or Refractory Chronic Lymphocytic Leukemia
Mathias Castonguay1, John F Seymour1
1Department of Clinical Haematology, Peter MacCallum Cancer Centre, Royal Melbourne Hospital, and University of Melbourne, Melbourne, Australia.
Summary
Treatment for relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is complex. New targeted therapies and cellular treatments offer options, requiring individualized sequencing based on patient and disease factors for optimal outcomes.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Relapsed or refractory (RR) chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) presents significant therapeutic challenges, particularly after frontline targeted agent use.
- Previous treatments like covalent Bruton tyrosine kinase inhibitors (cBTKis) and venetoclax have improved remission depth but eventual relapse necessitates further management strategies.
Purpose of the Study:
- To review current and emerging therapeutic options for RR CLL/SLL.
- To discuss the complexities of sequencing treatments based on patient-specific factors and disease characteristics.
Main Methods:
- Literature review of clinical trials and therapeutic guidelines for RR CLL/SLL.
- Analysis of efficacy, safety, and sequencing considerations for various treatment modalities.
Main Results:
- Second-generation cBTKis and venetoclax-based regimens offer durable disease control and high response rates.
- Noncovalent BTKis, cellular therapies like lisocabtagene maraleucel, and allogeneic stem cell transplantation are viable options for specific patient populations.
- Emerging therapies including BTK degraders and novel BCL2 inhibitors show promise for future treatment paradigms.
Conclusions:
- Optimal management of RR CLL/SLL requires integrating clinical status, prior therapies, genomic profiling, and patient preferences.
- Individualized treatment planning and clinical trial participation are crucial for improving outcomes in patients with RR CLL/SLL.
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