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Vol. 147. Issue 10.
Pages 447-454 (November 2016)
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Vol. 147. Issue 10.
Pages 447-454 (November 2016)
Review
DOI: 10.1016/j.medcle.2016.12.005
Advances in the treatment of chronic lymphocytic leukaemia
Avances en el tratamiento de la leucemia linfocítica crónica
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Pablo Mozas, Julio Delgado
Corresponding author
jdelgado@clinic.ub.es

Corresponding author.
Servicio de Hematología, Instituto Clínico de Enfermedades Hemato-Oncológicas, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Table 1. Recently published phase iii clinical trials.
Table 2. Drugs recently approved by the Spanish Agency of Medicines and Medical Devices for the treatment of chronic lymphocytic leukaemia.
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Abstract

Chronic lymphocytic leukaemia (CLL), a proliferation of mature B cells, is one of the most prevalent haematological malignancies. Progress has been made in its treatment during the last few decades, and chemoimmunotherapy based on fludarabine, cyclophosphamide and rituximab is considered the treatment of choice for patients with standard-risk CLL and good performance status. However, due to the characterization of high-risk biological subgroups and its presentation in elderly patients and/or with comorbidities, targeted therapies, such as B-cell receptor inhibitors, have been developed and approved during the last few years. The current review examines traditional therapeutic strategies and focuses on new small molecules that already represent promising elements of the CLL treatment landscape.

Keywords:
Chronic lymphocytic leukaemia
B-cell receptor
Chemoimmunotherapy
Ibrutinib
Idelalisib
Resumen

La leucemia linfocítica crónica (LLC) es una proliferación de linfocitos B maduros que constituye una de las neoplasias hematológicas más prevalentes. Su tratamiento ha evolucionado en las últimas décadas hasta considerarse la inmunoquimioterapia a base de fludarabina, ciclofosfamida y rituximab el tratamiento de elección en pacientes de riesgo estándar y con buena situación funcional. Sin embargo, la caracterización de subgrupos biológicos de alto riesgo y la presentación de esta enfermedad en pacientes de edad avanzada y/o con comorbilidad ha llevado en los últimos años al desarrollo y aprobación de tratamientos dirigidos, especialmente los inhibidores del receptor del linfocito B. La presente revisión repasa las estrategias terapéuticas convencionales y se centra en las nuevas moléculas que ya constituyen elementos prometedores del actual panorama terapéutico de la LLC.

Palabras clave:
Leucemia linfocítica crónica
Receptor del linfocito B
Inmunoquimioterapia
Ibrutinib
Idelalisib

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