MODERN APPROACHES TO TREATMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA

Abstract

Purpose of the study: to systematize published data on the effectiveness of drugs used to treat patientswith chronic lymphocytic leukemia.Material and Methods. A literature search was conducted using Medline, Pubmed databases. 93 publications were selected to write this review.Results. General information about chronic lymphocytic leukemia (biological features, criteria for establishing diagnosis, staging, criteria for evaluating antitumor therapy response) was presented. The focus was made on antitumor drugs used as monotherapy and in combination with other anti-cancer agents. The use of drugs belonging to the classes of cytostatics, monoclonal antibodies, as well as drugs that affect the signaling pathways of the B-cell receptor, BCL -2 inhibitors, immunomodulators was discussed. The gold standard for first-line therapy remains the RFC scheme. With a positive Coombs test, bendamustine is an equivalent alternative to the FC regimen. The use of chlorambucil is limited in situations in which the goal of therapy is the palliative treatment of older people with serious comorbidity. In subsequent lines of therapy, molecular action drugs are beginning to take an increasingly important place.Conclusion. During the past twenty years, significant advances have been made in understanding biological features of chronic lymphocytic leukemia, the synthesis of several dozen new therapeutic drugs of targeted action, some of which are already undergoing clinical testing. These drugs may lead to serious complications. The review is devoted to new drugs, the efficacy and safety of which has already been tested in a clinical setting.

Keywords

• chronic lymphocytic leukemia
• ofatumumab
• obinutuzumab
• ibrutinib
• idelalysib
• venetoclax
• lenalidomide
• pembrolizumab