Personalizing treatment for chronic lymphocytic leukemia

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BlankPersonalizing treatment for chronic lymphocytic leukemia.

P Abrisqueta, M Crespo, and F Bosch

Expert Rev Hematol, February 1, 2011; 4(1): 27-35.

Department of Hematology, University Hospital of Vall d'Hebron 119-129, 08035

Barcelona, Spain.

Over the past few years, more effective therapies have emerged in the treatment

of chronic lymphocytic leukemia (CLL); these are mainly combinations of

immunotherapy with fludarabine-based regimens. Despite the higher response rates

obtained with these more intensive treatments, they may not always be

applicable. Patients with several comorbidities have an increased toxicity with

these newer therapies. Effective tools to distinguish between fit and nonfit

patients and new therapeutic approaches suitable for fragile patients with CLL

are therefore necessary. Moreover, there is still a subset of patients who are

refractory to standard fludarabine-based treatments who continue to have very

poor survival. Efforts to understand the mechanisms of resistance to treatment

in order to develop new therapeutic agents for those patients are mandatory.

Finally, advances in the knowledge of the pathogenesis of CLL are promoting the

emergence of drugs directed to new biological targets of this disease.

Consequently, trials exploring the toxicity profile and efficacy of these new

therapeutic agents, alone or in combination with standard treatments, are

warranted.

PMID: 21322776