双重耐火性慢性淋巴细胞白血病:临床情景和治疗策略
Pablo Mozas1, David Quintela2, Ángel Serna3
1Servicio de Hematología, Hospital Clínic de Barcelona e Institut d'Investigacions August Pi i Sunyer, Barcelona, España.
概括
慢性淋巴细胞白血病 (CLL) 可能会对BTK和BCL2抑制剂等常见治疗方法产生抗性. 本综述探讨了CLL的双重暴露和折射性,为这个具有挑战性的患者群体提供了管理策略.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性淋巴细胞白血病 (CLL) 通常是惰的,但可以变得耐标准治疗.
- 性BTK抑制剂和BCL2抑制剂是CLL治疗的主要支柱.
- 治疗耐药性需要了解复杂的药物相互作用和患者的结果.
研究的目的:
- 审查在CLL中中止BTK和BCL2抑制剂的原因.
- 在CLL中定义双重暴露 (DE) 和双重折射率 (DR).
- 为DE/DR CLL患者概述治疗序列,预后和治疗替代方案.
主要方法:
- 在CLL中停止药物治疗,抗药机制和治疗结果的文献综述.
- 双重曝光和双重折射性的定义和概念化.
- 对临床细节进行分析,以获得实际管理见解.
主要成果:
- 确定了CLL中药物类别停药的潜在原因.
- 定义了DE和DR,概述了导致DR的治疗序列.
- 总结了与DE/DR CLL相关的不良预后.
- 描述了对DE/DR CLL的已批准,正在研究和替代疗法.
结论:
- 在CLL中,双重折射性是一个重大的临床挑战,治疗选择有限.
- 了解DE/DR对于治疗复发性或耐火性CLL患者至关重要.
- 临床细节为管理复杂的DE/DR CLL病例提供了实际指导.
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