慢性淋巴细胞白血病:临床综述
Chadi Nabhan1, Steven T Rosen2
1Section of Hematology and Oncology, Department of Medicine, The University of Chicago Medicine, Chicago, Illinois.
JAMA
|December 3, 2014
概括
化学免疫疗法是慢性淋巴细胞白血病 (CLL) 的标准一线治疗方法,这是最常见的成人白血病. 治疗是针对症状性疾病开始的,导致高生存率.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 慢性淋巴细胞白血病 (CLL) 是美国成年人中最常见的白血病.
- 诊断到CLL每年影响15,000人,有5,000人死亡.
- 最近的进展显著改善了CLL的治疗选择.
研究的目的:
- 提供基于证据的CLL诊断,分期和治疗的综述.
- 分析CLL患者目前的治疗策略和结果.
主要方法:
- 使用PubMed,Cochrane图书馆,Scopus和谷歌学者进行了全面的文献搜索.
- 在2000年至2014年间发表的24篇同行评审文章,根据预先定义的标准进行了选择.
- 治疗建议是从这些选定的研究的分析中得出的.
主要成果:
- 目前的分期系统 (Rai,Binet) 并不能完全涵盖新的CLL分类,如单克隆B细胞淋巴细胞病.
- 风险分层现在包括分子和细胞遗传分析,识别不同的CLL子集.
- 作为一线治疗的化疗免疫治疗产生的应答率为75-90%,3年生存率超过80%和5年生存率为66%.
结论:
- 化学免疫疗法是症状性慢性淋巴细胞白血病的既定标准一线治疗方法.
- 在症状出现时开始治疗会显著改善患者的生存率.
- 治疗方面的进步显著改善了被诊断患有CLL的成年人的治疗结果.
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