The Difficult-to-Treat del 17 p Patient-A Case Report in Chronic Lymphocytic Leukemia.
Ana-Maria MoldovianuAna Manuela CrisanZsofia VaradyDaniel CoriuPublished in: Medicina (Kaunas, Lithuania) (2021)
Chronic lymphocytic leukemia (CLL) treatment strategies have evolved to include mechanism-driven drugs but now raise new questions regarding their optimum timing and sequencing. In high-risk patients, switching from pathway inhibitors to allogeneic stem cell transplantation (allo-HCT) is still a matter of intense debate. We report the case of a CLL patient with 17 p deletion treated with ibrutinib as a bridge to allo-HCT. Early relapse after allo-HCT urged the initiation of salvage therapy, including donor lymphocytes infusions, ibrutinib, and venetoclax. We aim to outline and discuss the potential benefits of novel therapies, the current role of allo-HCT in CLL, drug timing and sequencing, and the unmet need to improve the long-term outcome of high-risk CLL patients.
Keyphrases
- chronic lymphocytic leukemia
- stem cell transplantation
- end stage renal disease
- newly diagnosed
- chronic kidney disease
- high dose
- case report
- peritoneal dialysis
- patient reported outcomes
- cell death
- peripheral blood
- cell proliferation
- cell cycle arrest
- emergency department
- mesenchymal stem cells
- low dose
- signaling pathway
- drug induced
- human health
- adverse drug