新药时代慢性淋巴细胞白血病的治疗选择

doi:10.6040/j.issn.1671-7554.0.2019.477

摘要/Abstract

摘要： 慢性淋巴细胞白血病(CLL)是欧美国家最常见的成人白血病。我国CLL发病率虽偏低,但呈上涨趋势。既往CLL治疗以免疫化学治疗为主。近年来,布鲁顿氏酪氨酸激酶(BTK)抑制剂伊布替尼和acalabrutinib、3-磷脂酰肌醇激酶(PI3K)抑制剂idelalisib和duvelisib、B淋巴细胞瘤-2(BCL2)抑制剂venetoclax的上市使得CLL治疗获得了突破性进展,同时包括嵌合性抗原受体T淋巴细胞(CART)在内的细胞免疫治疗也初显成效。在众多治疗选择中,如何为临床特征迥异的CLL患者选择合适的个体化治疗方案,是临床医生面临的挑战。

关键词: 慢性淋巴细胞白血病, 治疗, 伊布替尼, idelalisib, venetoclax

Abstract: Chronic lymphocytic leukemia(CLL)is the most common type of adult leukemia in Caucasian population. Although CLL is less common in Chinese, an increasing incidence of new cases is observed. Before 2010s, the standard 山东大学学报 (医学版)57卷7期 -李建勇,等.新药时代慢性淋巴细胞白血病的治疗选择 \=-therapy for CLL was chemoimmunotherapy. In recent years, Brutons tyrosine kinase(BTK)inhibitors ibrutinib and acalabrutinib, phosphatidylinositol 3-kinase(PI3K)inhibitors idelalisib and duvelisib, and BCL2 antagonist venetoclax have led to remarkable improvement in the survival of CLL patients. Novel cellular immunotherapy, including chimeric antigen receptor-engineered T(CART), has also shown promising efficacy in the treatment of CLL. How to choose individualized therapeutic regimen from the various approaches is now posing challenges upon clinicians.

Key words: Chronic lymphocytic leukemia, Treatment, Ibrutinib, Idelalisib, Venetoclax

中图分类号:

R733.7

李建勇,夏奕, 徐卫. 新药时代慢性淋巴细胞白血病的治疗选择[J]. 山东大学学报 (医学版), 2019, 57(7): 21-30.

LI Jianyong, XIA Yi, XU Wei. Selecting therapy for chronic lymphocytic leukemia in the era of novel agents[J]. Journal of Shandong University (Health Sciences), 2019, 57(7): 21-30.

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