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Chronic Lymphocytic Leukemia Treatment (PDQ®)

Health Professional Version
Last Modified: 04/16/2014

Changes to This Summary (04/16/2014)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information About Chronic Lymphocytic Leukemia (CLL)

Updated statistics with estimated new cases and deaths for 2014 (cited American Cancer Society as reference 1).

Added text to state that a characteristic genetic finding in almost 50% of the patients with T-cell large granular lymphocyte leukemia involves mutations in the signal transducer and activator of the transcription 3 gene (STAT 3) (cited Koskela et al. as reference 41).

Stage I, II, III, and IV CLL

Revised text to state that lenalidomide is an oral immunomodulatory agent with response rates over 50%, with or without rituximab, for patients with previously treated and untreated disease (cited Wendtner et al. and Badoux et al. as references 38 and 39, respectively).

Added Pettitt et al. as reference 59.

Added Gritti et al. as reference 63.

Revised text to state that in a combination regimen, subcutaneous alemtuzumab plus fludarabine (with or without cyclophosphamide) or intravenous alemtuzumab plus alkylating agents have resulted in excess infectious toxicities and death, with no compensatory improvement in efficacy in phase II trials (cited Lepretre et al. as reference 66).

Added text to state that antibiotic prophylaxis includes trimethoprim and sulfamethoxazole, itraconazole, and acyclovir for asymptomatic cytomegalovirus viremia.

Added Dreger et al. as reference 76.

Added Toze et al. as reference 79.

Added text to state that ibrutinib is a selective irreversible inhibitor of Bruton tyrosine kinase, a signaling molecule located upstream in the B-cell receptor signaling cascade; other trials of relapsed and refractory CLL have shown durable responses to the oral agent in phase I and II studies (cited Advani et al. as reference 86 and level of evidence 3iiiDiii). A phase Ib–II trial (NCT01105247) of 85 patients with relapsed or refractory CLL showed a 26-month progression-free survival rate of 76%, including patients with 17p- or unmutated IgVH fluorescence in situ hybridization testing (cited Byrd et al. as reference 87 and level of evidence 3iiiDiii).

This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.