Current Treatment of Chronic Lymphocytic Leukemia: The Diminishing Role of Chemoimmunotherapy

Drugs ◽  
2021 ◽  
Author(s):  
Lindsey E. Roeker ◽  
Meghan Thompson ◽  
Anthony R. Mato
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Current Treatment ◽  
Lymphocytic Leukemia

scholarly journals The role of combined fludarabine, cyclophosphamide and rituximab chemoimmunotherapy in chronic lymphocytic leukemia: current evidence and controversies

2016 ◽  
Vol 8 (3) ◽  
pp. 99-105 ◽  
Author(s):  
Alan P. Skarbnik ◽  
Stefan Faderl
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Standard Of Care ◽  
Current Treatment ◽  
Lymphocytic Leukemia ◽  
Current Evidence ◽  
Treatment Paradigm

Chemoimmunotherapy (CIT) has become a cornerstone in the treatment of patients with chronic lymphocytic leukemia (CLL). The combination of fludarabine, cyclophosphamide and rituximab (FCR) has emerged as the standard of care for therapy of previously untreated patients with CLL who are younger than 65 years and have no significant comorbidities. In this article, we review the role of FCR in the current treatment paradigm for CLL.

Distinct gene expression patterns in chronic lymphocytic leukemia defined by usage of specific VH genes

Blood ◽  
2006 ◽  
Vol 107 (5) ◽  
pp. 2090-2093 ◽  
Author(s):  
Dirk Kienle ◽  
Axel Benner ◽  
Alexander Kröber ◽  
Dirk Winkler ◽  
Daniel Mertens ◽  
...  
Keyword(s):  
Gene Expression ◽  
Chronic Lymphocytic Leukemia ◽  
Expression Patterns ◽  
Gene Expression Pattern ◽  
Cell Receptor ◽  
Lymphocytic Leukemia ◽  
Expression Of Genes ◽  
Vh Genes ◽  
Signaling Activation

The mutation status and usage of specific VH genes such as V3-21 and V1-69 are potentially independent pathogenic and prognostic factors in chronic lymphocytic leukemia (CLL). To investigate the role of antigenic stimulation, we analyzed the expression of genes involved in B-cell receptor (BCR) signaling/activation, cell cycle, and apoptosis control in CLL using these specific VH genes compared to VH mutated (VH-MUT) and VH unmutated (VH-UM) CLL not using these VH genes. V3-21 cases showed characteristic expression differences compared to VH-MUT (up: ZAP70 [or ZAP-70]; down: CCND2, P27) and VH-UM (down: PI3K, CCND2, P27, CDK4, BAX) involving several BCR-related genes. Similarly, there was a marked difference between VH unmutated cases using the V1-69 gene and VH-UM (up: FOS; down: BLNK, SYK, CDK4, TP53). Therefore, usage of specific VH genes appears to have a strong influence on the gene expression pattern pointing to antigen recognition and ongoing BCR stimulation as a pathogenic factor in these CLL subgroups.

Pivotal Role of Poly(ADP-Ribose) Polymerase Activation in the Pathogenesis of Immunodeficiency and in the Therapy of Chronic Lymphocytic Leukemia

1989 ◽  
pp. 372-377 ◽  
Author(s):  
Carlos J. Carrera ◽  
Shiro Seto ◽  
D. Bruce Wasson ◽  
Lawrence D. Piro ◽  
Ernest Beutler ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Pivotal Role

Association of a novel regulatory polymorphism (−938C>A) in the BCL2 gene promoter with disease progression and survival in chronic lymphocytic leukemia

Blood ◽  
2006 ◽  
Vol 109 (1) ◽  
pp. 290-297 ◽  
Author(s):  
Holger Nückel ◽  
Ulrich H. Frey ◽  
Maja Bau ◽  
Ludger Sellmann ◽  
Jens Stanelle ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Cox Regression ◽  
Gene Promoter ◽  
Lymphocytic Leukemia ◽  
Disease Stage ◽  
Genotype Distribution ◽  
Single Nucleotide ◽  
Regulatory Polymorphism ◽  
Time To First Treatment

Abstract Bcl-2 plays a key role in the regulation of apoptosis. We investigated the role of a novel regulatory single-nucleotide polymorphism (−938C>A) in the inhibitory P2 BCL2 promoter in B-cell chronic lymphocytic leukemia (B-CLL). The −938C allele displayed significantly increased BCL2 promoter activity and binding of nuclear proteins compared with the A allele. Concomitantly, Bcl-2 protein expression in B cells from CLL patients carrying the −938 AA genotype was significantly increased compared with CC genotypes. Genotype distribution between 123 CLL patients (42 AA, 55 AC, 26 CC) and 120 genotyped healthy controls (36 AA, 63 AC, 21 CC) was not significantly different, suggesting that genotypes of this polymorphism do not increase the susceptibility for B-CLL. However, median time from first diagnosis to initiation of chemotherapy and median overall survival were significantly shorter in patients with −938AA genotype (38 and 199 months, respectively) compared with AC/CC genotypes (120 and 321 months, respectively; P = .008 and P = .003, respectively). Multivariable Cox regression identified the BCL2−938AA genotype as an independent prognostic factor for the time to first treatment (hazard ratio [HR] 1.9; P = .034) together with disease stage at diagnosis (HR 2.5; P = .004) and ZAP-70 status (HR 3.0; P = .001). The BCL2−938AA genotype is associated with increased Bcl-2 expression and a novel unfavorable genetic marker in patients with B-CLL.

Diagnostic value of serum miR-145 and miR-185 as targeting of the APRIL oncogene in the B-cell chronic lymphocytic leukemia

2020 ◽  
Author(s):  
Malihe Bagheri ◽  
Behzad Khansarinejad ◽  
Ghasem Mosayebi ◽  
Alireza Moradabadi ◽  
Mahdieh Mondanizadeh
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Hematologic Malignancy ◽  
Rna Extraction ◽  
Diagnostic Value ◽  
Lymphocytic Leukemia ◽  
Pcr Analysis ◽  
Healthy Individuals ◽  
Potential Biomarker ◽  
New Biomarkers

Abstract Background: Chronic lymphocytic leukemia (CLL) is one of the most common hematologic malignancy in adults worldwide. This cancer has a poor prognosis at different stages. So, the identification of new biomarkers is important for early diagnosis of B-CLL. Considering the oncogenic role of APRIL molecule in this leukemia as well as the regulatory role of microRNAs (miRNAs) in different signaling pathways, the present study evaluated the miRNAs targeting APRIL gene in B-CLL.Methods: The miRNAs were predicted and selected using bioinformatics algorithms. A total of 80 plasma samples (40 samples of healthy individuals and 40 samples of B-CLL patients) were subjected to RNA extraction and synthesis of cDNA. The expressions levels of predicted miRNAs and APRIL gene in plasma of B-CLL patients and healthy individuals were assessed by Real time PCR analysis. ROC analysis was performed to investigate the role predicted miRNAs as novel biomarkers in diagnosis of B-CLL. Results: The results of the prediction showed that miR-145-5p and miR-185-5p target the APRIL gene. The expression level of APRIL gene was strikingly higher in plasma of B-CLL patients than in the healthy individuals (102, P= 0.001). On the other hand, expression levels of miR-145-5p and miR-185-5p were strikingly lower in B-CLL patients than in the healthy individuals (0.07, P= 0.001) (0.29, P= 0.001). Also, ROC curve analyses demonstrated that miR-145-5p and miR-185-5p are specific and sensitive and may serve as new biomarkers for the early detection of B-CLL. Conclusions: These data suggest that the study miRNAs may have a role in B-CLL development and progression. Moreover, miR-145-5p and miR-185-5p can be served as a novel and potential biomarker in the diagnosis of B-CLL.

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