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复发性和/或耐药性慢性淋巴细胞白血病的管理

Allison Kagerer¹, Meghan C Thompson²

¹Department of Medicine, New York Presbyterian/Weill Cornell Medical College, 530 E 74th Street, New York, NY 10021, USA.

Hematology/oncology clinics of North America

|July 17, 2025

概括

治疗复发性或耐药性慢性淋巴细胞白血病 (CLL) 后,共价布鲁顿的氨酸激酶抑制剂 (cBTKi) 和venetoclax治疗提出了新的挑战. 本综述涵盖了对"双重暴露"的CLL患者的当前和新兴疗法.

科学领域:

血液学血液学血液学
在瘤学瘤学.
药理学药理学是指药理学的学科.

背景情况:

协同布鲁顿的氨酸激酶抑制剂 (cBTKis) 和BCL2抑制剂,如venetoclax,是慢性淋巴细胞白血病 (CLL) 的标准疗法.
患有复发性和/或耐药性 (R/R) CLL 的患者可能先前接触过化疗免疫疗法,cBTKis 和基于venetoclax的疗法.
在连续暴露于cBTKis和venetoclax后,管理R/R CLL是一个新兴的临床挑战.

研究的目的:

对R/RCLL患者的现有和新兴治疗策略进行审查,这些患者以前曾经接受过cBTKis和venetoclax的治疗.
讨论对"双重暴露"的CLL患者的管理选择.

主要方法:

对R/R CLL治疗选择的文献综述.
分析目前的治疗策略,包括重新治疗venetoclax,pirtobrutinib和CAR T细胞疗法.
在临床试验中探索新兴药物的探索.

主要成果:

对R/RCLL的已知疗法包括化疗免疫疗法,cBTKis和venetoclax.
"双重暴露"CLL的治疗选择包括重新治疗venetoclax,皮尔托布鲁替尼和CAR T细胞疗法 (lisocabtagene maraleucel).
新兴的选择包括BTK降解剂和临床试验中的双特异性抗体.

结论:

顺序cBTKi和venetoclax治疗后R/RCLL的有效管理需要仔细考虑现有和新的治疗选择.
皮尔托布鲁丁尼和CAR T细胞疗法是"双重暴露"患者的关键选择.
目前对BTK降解剂和双特异性抗体的研究对未来的R/R CLL治疗有希望.

关键词:

亚卡拉布鲁丁尼布是一种慢性淋巴细胞白血病 (CLL) 是一种利索-细胞是一种.皮尔托布鲁丁尼布的使用情况复发性CLLL是什么意思威尼托克拉克斯 (Venetoclax) 是一个属于威尼托克拉克斯的地区.赞努布鲁丁尼布 (Zanubrutinib) 是一种可以

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