Diagnostic and therapeutic recommendations of the Polish Society of Haematologists and Transfusiologists and Polish Adult Leukemia Group-CLL for chronic lymphocytic leukemia in 2021
Acta Haematologica Polonica
; 52(5):455-482, 2021.
Article
in English
| EMBASE | ID: covidwho-1744723
ABSTRACT
Chronic lymphocytic leukemia (CLL) is a disease of the elderly, with a median age at diagnosis of approximately 70 years. The natural course of the disease varies greatly, and patients with non-progressive and asymptomatic leukemia do not require treatment. The results of CLL treatment have improved significantly in recent years, mainly due to the introduction of new, more effective drugs, including BCR inhibitors and BCL2 inhibitors. The new drugs are used continuously, while venetoclax in combination with anti-CD20 antibodies is used for 24 (rituximab) or 12 (obinutuzumab) months, depending on the type of antibody and line of therapy. The choice of treatment protocol should largely depend on the assessment of 17p deletion/TP53 mutation and immunoglobulin variable heavy chain (IGVH) mutation status, which correlate with a worse response to immunochemotherapy. The role of immunochemotherapy, which until recently was the mainstay of CLL treatment, has now significantly decreased. In the first-line, it is recommended only in patients without 17p deletion/TP53 mutation, with mutated IGVH. Other patients should receive novel targeted therapies. However, at the time of the preparation of these recommendations, these therapies are not available in the firs-line of treatment in Poland. Novel targeted therapies play a major role in the treatment of refractory/relapsed CLL, and immunochemotherapy is recommended primarily in patients with a long-term response to first-line therapy. In this article, we present an update of the guidelines for the diagnosis and treatment of CLL, including the treatment of autoimmune complications, as well as the prophylaxis and treatment of infections, developed by the Polish Society of Haematologists and Transfusiologists and PALG-CLL Working Group.
alkylating agent; antineoplastic agent; bcl2 antagonist; bendamustine; Bruton tyrosine kinase inhibitor; CD20 antibody; chlorambucil; cladribine; cyclophosphamide; fludarabine; immunoglobulin; protein inhibitor; protein p53; purine derivative; rituximab; SARS-CoV-2 vaccine; unclassified drug; allogeneic hematopoietic stem cell transplantation; autoimmune disease; B cell lymphoma; cancer chemotherapy; cancer combination chemotherapy; cancer diagnosis; cancer prognosis; cancer resistance; chimeric antigen receptor immunotherapy; chromosome 17p; chromosome deletion; chronic lymphatic leukemia; clinical evaluation; comorbidity; coronavirus disease 2019; diagnostic approach route; drug choice; eligibility criteria; gene mutation; good general condition; human; immunoglobulin variable region; infection control; infection prevention; leukemia relapse; medical decision making; medical society; nonhuman; patient assessment; poor general condition; practice guideline; prophylaxis; review; Richter transformation; treatment indication; treatment planning; vaccination
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Language:
English
Journal:
Acta Haematologica Polonica
Year:
2021
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS