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Review
. 2015 Jul 23;126(4):463-70.
doi: 10.1182/blood-2015-04-585067. Epub 2015 Jun 11.

Initial treatment of CLL: integrating biology and functional status

Nitin Jain  1 , Susan O'Brien  2
Affiliations
Review

Initial treatment of CLL: integrating biology and functional status

Nitin Jain et al. Blood. .

Abstract

A better understanding of the biology of chronic lymphocytic leukemia (CLL) has led to significant advances in therapeutic strategies for patients with CLL. Chemoimmunotherapy (CIT) has been the standard first-line therapy for CLL. Age and comorbidities can help decide which patients may benefit from a CIT approach. FCR (fludarabine, cyclophosphamide, and rituximab) is the current standard treatment option for younger patients with CLL. For older patients and for patients with renal dysfunction, bendamustine and rituximab may be a better option. For older patients with comorbidities who may not be able to tolerate intensive CIT, the combination treatment of chlorambucil and obinutuzumab or ofatumumab is an option. For patients with del(17p), ibrutinib is the treatment of choice. Several ongoing phase 3 clinical trials with novel therapies will further refine the frontline therapy of CLL.

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Figures

Figure 1
Figure 1
Treatment algorithm for first-line therapy of CLL. FISH, fluorescence in situ hybridization.
See this image and copyright information in PMC

References

    1. Gribben JG, O’Brien S. Update on therapy of chronic lymphocytic leukemia. J Clin Oncol. 2011;29(5):544–550. - PMC - PubMed
    1. Byrd JC, Furman RR, Coutre SE, et al. Targeting BTK with ibrutinib in relapsed chronic lymphocytic leukemia. N Engl J Med. 2013;369(1):32–42. - PMC - PubMed
    1. Byrd JC, Brown JR, O’Brien S, et al. RESONATE Investigators. Ibrutinib versus ofatumumab in previously treated chronic lymphoid leukemia. N Engl J Med. 2014;371(3):213–223. - PMC - PubMed
    1. Byrd JC, Furman RR, Coutre SE, et al. Three-year follow-up of treatment-naïve and previously treated patients with CLL and SLL receiving single-agent ibrutinib. Blood. 2015;125(16):2497–2506. - PMC - PubMed
    1. Furman RR, Sharman JP, Coutre SE, et al. Idelalisib and rituximab in relapsed chronic lymphocytic leukemia. N Engl J Med. 2014;370(11):997–1007. - PMC - PubMed

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