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Zanubrutinib, a New Bullet Against Chronic Lymphocytic Leukemia Even When Localized in Central Nervous System
Maria D'Amato1, Claudia Baratè2, Giulia Cervetti1
1Department of Clinical and Experimental Medicine, Section of Hematology, University of Pisa, Via Roma, 67, Pisa, Italy, unipi.it.
Introduction:
Central nervous system (CNS) and extralymphatic involvement in chronic lymphocytic leukemia (CLL) is rare and associated with poor prognosis.
Case Description:
We report the case of a 45-year-old woman with refractory CLL who developed CNS and extralymphatic lesions after three prior lines of therapy, including rituximab-bendamustine, rituximab-idelalisib, and rituximab-venetoclax. Third-line treatment with rituximab-venetoclax led to partial remission (PR), followed by a 2-month treatment-free interval before the emergence of a new lesion. Treatment with zanubrutinib, a second-generation Bruton's tyrosine kinase inhibitor (BTKi), was initiated, resulting in significant clinical improvement and near-complete resolution of lesions.
Discussion:
Zanubrutinib's enhanced blood-brain barrier (BBB) penetration and favorable safety profile make it a promising option for CNS-CLL and also for other extralymphatic lesions.
Conclusion:
This case underscores the potential of zanubrutinib in addressing challenging CLL presentations.
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