B-cell chronic lymphocytic leukemia/prolymphocytic leukemia/small lymphocytic lymphoma refractory
Introduction to B-Cell Chronic Lymphocytic Leukemia/Prolymphocytic Leukemia/Small Lymphocytic Lymphoma Refractory
Slightly more than 10-15% of patients with chronic lymphocytic leukemia and small lymphocytic lymphoma (SLL) are considered to have disease that is “refractory” or difficult to treat.
Refractory (resistant) disease is a term used to describe cancer that is resistant to standard treatments, such as chemotherapy, immunotherapy, or other targeted therapies. Treatment resistance or refractoriness to therapy for chronic lymphocytic leukemia may occur due to the emergence of point mutations, modified expression of target proteins, and/or epigenetic changes in the cancer cells.
Risk Factors Associated With Refractory Chronic Lymphocytic Leukemia/Prolymphocytic Leukemia/Small Lymphocytic Lymphoma
Risk factors associated with refractory CLL/SLL (Chronic Lymphocytic Leukemia/Prolymphocytic Leukemia/Small Lymphocytic Lymphoma) include:
- Advanced age
- High white blood cell count at diagnosis
- Presence of poor prognostic gene mutations, such as p53/ATM and SF3B1
- Prior treatment with a chemotherapy agent
Treatment of Refractory Chronic Lymphocytic Leukemia/Prolymphocytic Leukemia/Small Lymphocytic Lymphoma
Treatment of refractory Chronic Lymphocytic Leukemia/Prolymphocytic Leukemia/Small Lymphocytic Lymphoma will depend on a patient’s individual circumstances. Treatment will depend on the specific features of each person’s disease, educational background, and the availability of approved medical treatments at the time of consultation.
Treatment options may include chemotherapy such as bendamustine, chidamide and ibrutinib; monoclonal antibodies such as rituximab and obinutuzumab; immuno-chemotherapy with alemtuzumab; and hematopoietic stem cell transplantation.
It is important to note that treatment should be individualized for each person. A person’s medical team should help them determine which treatments might be most beneficial for them, based on the specific features of their disease and overall health.
