PMID- 37606492
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230824
IS  - 2038-8322 (Print)
IS  - 2038-8330 (Electronic)
IS  - 2038-8322 (Linking)
VI  - 15
IP  - 3
DP  - 2023 Aug 1
TI  - How I Manage Chronic Lymphocytic Leukemia.
PG  - 454-464
LID - 10.3390/hematolrep15030047 [doi]
AB  - Chronic lymphocytic leukemia (CLL), is a hematologic malignancy characterized by 
      the uncontrolled proliferation of mature B lymphocytes. CLL is the most prevalent 
      leukemia in Western countries. Its presentation can range from asymptomatic with 
      the incidental finding of absolute lymphocytosis on a routine blood test, to 
      symptomatic disease requiring immediate intervention. Prognosis of the disease is 
      defined by the presence or absence of specific mutations such as TP53, 
      chromosomal abnormalities such as del(17p), a type of IGHV mutational status, and 
      elevation of B2M and LDH. Treatment of CLL in the United States and Europe has 
      evolved over the recent years thanks to the development of targeted therapies. 
      The standard of care has shifted from traditional chemoimmunotherapy approaches 
      to targeted therapies including Bruton tyrosine kinase inhibitors (BTKis) and 
      BCL2 inhibitors, administered either as monotherapy or in combination with CD20 
      monoclonal antibodies. Several clinical trials have also recently evaluated 
      combinations of BTKi and venetoclax and showed the combination to be well 
      tolerated and able to induce deep remissions. Targeted therapies have a good 
      safety profile overall; however, they also have unique toxicities that are 
      important to recognize. Diarrhea, fatigue, arthralgia, infections, cytopenias, 
      bleeding, and cardiovascular toxicities (including atrial fibrillation, 
      ventricular arrhythmias, and hypertension) are the adverse events (AEs) commonly 
      associated with BTKis. Initiation of therapy with venetoclax requires close 
      monitoring because of the risk for tumor lysis syndrome associated with this 
      agent, particularly in patients with a high disease burden. Development of newer 
      target therapies is ongoing and the therapeutic landscape in CLL is expanding 
      rapidly.
FAU - Nasnas, Patrice
AU  - Nasnas P
AUID- ORCID: 0009-0008-5149-8618
AD  - Department of Leukemia, The University of Texas MD Anderson Cancer Center, 
      Houston, TX 77030, USA.
FAU - Cerchione, Claudio
AU  - Cerchione C
AUID- ORCID: 0000-0002-9104-5436
AD  - Department of Leukemia, The University of Texas MD Anderson Cancer Center, 
      Houston, TX 77030, USA.
FAU - Musuraca, Gerardo
AU  - Musuraca G
AUID- ORCID: 0000-0003-1947-1032
AD  - Department of Leukemia, The University of Texas MD Anderson Cancer Center, 
      Houston, TX 77030, USA.
FAU - Martinelli, Giovanni
AU  - Martinelli G
AUID- ORCID: 0000-0002-1025-4210
AD  - Department of Leukemia, The University of Texas MD Anderson Cancer Center, 
      Houston, TX 77030, USA.
FAU - Ferrajoli, Alessandra
AU  - Ferrajoli A
AD  - Department of Leukemia, The University of Texas MD Anderson Cancer Center, 
      Houston, TX 77030, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230801
PL  - Switzerland
TA  - Hematol Rep
JT  - Hematology reports
JID - 101556723
PMC - PMC10443285
OTO - NOTNLM
OT  - BCL2 inhibitor
OT  - Bruton tyrosine kinase inhibitors
OT  - CLL
OT  - targeted therapies
COIS- The authors declare no conflict of interest.
EDAT- 2023/08/22 13:42
MHDA- 2023/08/22 13:43
PMCR- 2023/08/01
CRDT- 2023/08/22 09:17
PHST- 2023/04/04 00:00 [received]
PHST- 2023/06/09 00:00 [revised]
PHST- 2023/07/24 00:00 [accepted]
PHST- 2023/08/22 13:43 [medline]
PHST- 2023/08/22 13:42 [pubmed]
PHST- 2023/08/22 09:17 [entrez]
PHST- 2023/08/01 00:00 [pmc-release]
AID - hematolrep15030047 [pii]
AID - hematolrep-15-00047 [pii]
AID - 10.3390/hematolrep15030047 [doi]
PST - epublish
SO  - Hematol Rep. 2023 Aug 1;15(3):454-464. doi: 10.3390/hematolrep15030047.