Individualization of frontline chronic lymphocytic leukaemia treatment – a comprehensive view on risk stratification in the era of targeted therapy
Authors:
A. Panovská
Authors‘ workplace:
Interní hematologická a onkologická klinika LF MU a FN Brno
Published in:
Transfuze Hematol. dnes,32, 2026, No. 2, p. 98-104.
Category:
Review/Educational Papers
doi:
https://doi.org/10.48095/cctahd202610
Overview
Over the past decade, the treatment of chronic lymphocytic leukaemia (CLL) has undergone a fundamental transformation, driven by a deeper understanding of disease biology – particularly at the level of molecular genetic alterations and key signalling pathways. Targeted agents acting on the B-cell receptor (notably Bruton tyrosine kinase inhibitors) and on apoptotic regulation (BCL-2 protein inhibitors) have progressively replaced chemoimmunotherapy as the standard first-line approach. The article by E. Tausch and colleagues, published in the Hematology 2024 education issue (from the Annual Meeting of the American Society of Hematology), offers a comprehensive overview of current strategies for risk stratification and the selection of targeted first-line therapy for patients with CLL. The authors summarize diagnostic recommendations, the role of molecular genetic markers (particularly IGHV mutational status, 17p deletion, and TP53 mutation), and compare results from major phase III randomized trials. Emphasis is placed on the individualization of therapy based on genetic risk, comorbidities, and other patient-specific factors. These postulates should be implemented into the standard of care for patients with CLL in Czechia.
Keywords:
chronic lymphocytic leukaemia – BTK inhibitors – frontline therapy – BCL-2 inhibitors – individualization of treatment
Sources
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