What`s new in chronic lymphocytic leukemia research and treatment?
Many studies of chronic lymphocytic leukemia (CLL) are being done in labs and in clinical trials around the world.
Genetics of chronic lymphocytic leukemia
Scientists are making great progress in understanding how changes in a person's DNA can cause normal bone marrow cells to develop into leukemia cells. Learning about changes in the genes (regions of the DNA) that often occur in CLL is providing insight into why these cells grow too quickly, live too long, and fail to develop into normal blood cells. Doctors are also learning how to use these changes to help them determine a person's outlook and whether they will need treatment.
New treatment combinations
Many different drugs are now used to treat CLL. Doctors are looking into which combinations of these drugs are most effective, offering the best chance for long-term survival with the fewest side effects.
The role of stem cell transplants in CLL is still not well-defined. Doctors aren't sure which type of transplant (autologous, allogeneic, or mini-transplant) might be most effective, or which drugs should be used along with the transplant. Studies are now being done to try to answer these questions.
New drugs for chronic lymphocytic leukemia
Dozens of new drugs are being tested for use against CLL. Many of these drugs are targeted at specific parts of cancer cells, while others are more like standard chemotherapy drugs.
Ibrutinib is a new targeted drug. It blocks the activity of a protein called a kinase that tells the leukemia cells to divide and helps them survive. It showed promise in a study of patients with CLL that is hard to treat, such as cases with chromosome 17 deletions and cases that have grown back after other treatments.
Oblimersen (Genasense®) is a drug that has been studied for use in CLL. In studies, giving this drug along with chemo was more likely than chemo alone to cause the CLL to go into remission and stay there.
A number of new monoclonal antibodies (man-made versions of immune system proteins) are now being studied for use in CLL treatment. Some of these antibodies, such as lumiliximab and ofatumumab, are used to try to prompt the immune system to attack leukemia cells. They are being tested either alone or in combination with chemotherapy.
Other antibodies are attached to substances that can poison cancer cells, and are known as immunotoxins. They act as homing devices to deliver the toxins directly to the cancer cells. An immunotoxin known as BL22 has shown a great deal of promise in treating hairy cell leukemia (HCL) in clinical trials. A newer version of this drug, known as HA22 (CAT-8015) is now being tested for use against CLL.
Last Medical Review: 07/31/2013
Last Revised: 11/14/2013