Saturday, April 26, 2014

The Hematologic malignancy review has been completed in Las Vegas II....CLL

In CLL

*?review role of Thyrosine Kinase in CLL
*Prognosi factor remains the same (17p deletion, 11q dletion, ZAP70, etc.)
*CLL remains an uncurable disease
*FCR better than FC
*FCR better than Bendamustin -Rituxan despite more infection which does not impact mortality ultimately, and particularly in the young? (And who thought FCR lost its luster before Bendamustine-R ? watch for 17p deletion though and pick carefully!)
*17p deletion better treated in clinical trials
*Omecetaxine, an alternative approach to treatment
*Therapeutic choices
1.FCR
2.Benda-Rituxan
3.New anti CD20
4.Ibrutinib
5.Idelalisib
6.BCL-2 antibody
Obinutuzumab always used with Chlorambucil :"The monoclonal anti-CD20 antibody rituximab, combined with chemotherapeutic agents, has been shown to prolong overall survival in physically fit patients with previously untreated chronic lymphocytic leukemia (CLL) but not in those with coexisting conditions. We investigated the benefit of the type 2, glycoengineered antibody obinutuzumab (also known as GA101) as compared with that of rituximab, each combined with chlorambucil, in patients with previously untreated CLL and coexisting conditions." NEJM.
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