Vol 11, No 4 (2020)
Case report
Published online: 2021-03-30

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Young CLL patient with 17p deletion and relapse after immunochemotherapy treated with venetoclax — case report and literature review

Anna Dąbrowska-Iwanicka1, Katarzyna Błachnio1, Renata Woroniecka1, Grzegorz Rymkiewicz1, Jan Walewski1
Hematologia 2020;11(4):240-252.

Abstract

Chronic lymphocytic leukaemia (CLL) is the commonest B-cell malignancy and leukaemia in western countries. It mainly affects the elderly population with a median age of 72. Overall survival varies from 2 to 15 years and depends on clinical and pathological risk factors like age, clinical stage and the presence of genetic mutations with TP53 aberrations conferring the worst prognosis. Indications for therapy include active and symptomatic disease and advanced clinical stage assessed in the Rai or Binet staging system. CLL therapy has been revolutionized in the last years due to the introduction of novel agents — small molecule inhibitors interfering with signalling pathways. These agents proved to be of greater efficacy than immunochemotherapy in both untreated and relapsed patients and led to the significant improvement in survival of CLL patients. These novel agents have been incorporated into new recommendations for CLL treatment. They have also improved the survival of high-risk CLL patients with TP53 aberrations and complex karyotype although their prognosis is still inferior as compared to other patients’ subgroups. Questions concerning optimal sequencing novel agents and the timing of allogeneic bone marrow transplantation remain still open for high-risk group CLL patients.

 

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Hematology in Clinical Practice