Consensus guidelines for the management of treatment-naïve chronic lymphocytic leukaemia in Singapore (2024).

IF 2.5 Q1 MEDICINE, GENERAL & INTERNAL
Yeow Tee Goh, Yvonne Loh, Esther Chan, Yuh Shan Lee, Venkata Sreekanth Sampath, Daryl Tan, Shin Yeu Ong, Chandramouli Nagarajan
{"title":"Consensus guidelines for the management of treatment-naïve chronic lymphocytic leukaemia in Singapore (2024).","authors":"Yeow Tee Goh, Yvonne Loh, Esther Chan, Yuh Shan Lee, Venkata Sreekanth Sampath, Daryl Tan, Shin Yeu Ong, Chandramouli Nagarajan","doi":"10.47102/annals-acadmedsg.2024174","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Chronic lymphocytic leukaemia (CLL) has a heterogeneous disease course and a variable preva-lence across populations. Appropriate management for achieving optimal outcomes requires consideration of multiple factors, including disease-related factors like genomic alterations, patient characteristics and fitness, availability and access to treatments, and logistics/cost. This review aims to provide comprehen-sive and pragmatic recommendations for the management of treatment-naïve (TN) CLL that are relevant to Singapore's clinical context.</p><p><strong>Method: </strong>Clinical consensus statements were developed by an expert panel of haematologists from Singapore through a 2-round modified Delphi process. Statements were drafted using recent evidence-based guidelines and published literature. Panel members reviewed draft statements, provided anonymised feedback and proposed modifications where relevant. A physical meeting was held to facilitate discussion, voting and endorsement of the final consensus statements.</p><p><strong>Results: </strong>The final consensus included 15 statements covering major TN CLL patient subsets. The recommendations highlight the importance of molecular testing for key biomarkers, where available/accessible, to guide initial therapy. Due to the superior efficacy of targeted agents (Bruton's tyrosine kinase inhibitors [BTKis] and B-cell lymphoma 2 inhibitors [BCL2is]) these are favoured over standard chemotherapy or chemotherapy-immunotherapy, especially for patients with del(17p) or TP53 mutation, and less fit patients.</p><p><strong>Conclusion: </strong>These consensus statements provide practical recommendations for the current manage-ment of TN CLL patients in Singapore and similar healthcare systems based on up-to-date evidence. Regular updates to treatment guidelines are important to ensure responsiveness to emerging evidence and evolving clinical practices and to improve patient outcomes and quality of life.</p>","PeriodicalId":502093,"journal":{"name":"Annals of the Academy of Medicine, Singapore","volume":"54 1","pages":"36-52"},"PeriodicalIF":2.5000,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of the Academy of Medicine, Singapore","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.47102/annals-acadmedsg.2024174","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Chronic lymphocytic leukaemia (CLL) has a heterogeneous disease course and a variable preva-lence across populations. Appropriate management for achieving optimal outcomes requires consideration of multiple factors, including disease-related factors like genomic alterations, patient characteristics and fitness, availability and access to treatments, and logistics/cost. This review aims to provide comprehen-sive and pragmatic recommendations for the management of treatment-naïve (TN) CLL that are relevant to Singapore's clinical context.

Method: Clinical consensus statements were developed by an expert panel of haematologists from Singapore through a 2-round modified Delphi process. Statements were drafted using recent evidence-based guidelines and published literature. Panel members reviewed draft statements, provided anonymised feedback and proposed modifications where relevant. A physical meeting was held to facilitate discussion, voting and endorsement of the final consensus statements.

Results: The final consensus included 15 statements covering major TN CLL patient subsets. The recommendations highlight the importance of molecular testing for key biomarkers, where available/accessible, to guide initial therapy. Due to the superior efficacy of targeted agents (Bruton's tyrosine kinase inhibitors [BTKis] and B-cell lymphoma 2 inhibitors [BCL2is]) these are favoured over standard chemotherapy or chemotherapy-immunotherapy, especially for patients with del(17p) or TP53 mutation, and less fit patients.

Conclusion: These consensus statements provide practical recommendations for the current manage-ment of TN CLL patients in Singapore and similar healthcare systems based on up-to-date evidence. Regular updates to treatment guidelines are important to ensure responsiveness to emerging evidence and evolving clinical practices and to improve patient outcomes and quality of life.

导言:慢性淋巴细胞白血病(CLL)的病程各不相同,不同人群的发病率也各不相同。为获得最佳疗效而进行适当的管理需要考虑多种因素,包括基因组改变等疾病相关因素、患者特征和体质、治疗方法的可用性和可及性以及物流/成本。本综述旨在为治疗无效(TN)CLL 的管理提供符合新加坡临床情况的全面、务实的建议:方法:由新加坡血液学专家组成的专家小组通过两轮改良德尔菲程序制定了临床共识声明。声明的起草采用了最新的循证指南和已发表的文献。专家组成员审查了声明草案,提供了匿名反馈,并提出了相关修改建议。召开了一次实体会议,以便对最终共识声明进行讨论、投票和批准:最终共识包括 15 项声明,涵盖了主要的 TN CLL 患者亚群。这些建议强调了对关键生物标志物进行分子检测的重要性(如有/可获得),以指导初始治疗。由于靶向药物(布鲁顿酪氨酸激酶抑制剂[BTKis]和B细胞淋巴瘤2抑制剂[BCL2is])的疗效优于标准化疗或化疗-免疫疗法,因此这些药物更受青睐,尤其是对于有del(17p)或TP53突变的患者以及体质较差的患者:这些共识声明基于最新证据,为新加坡及类似医疗体系中TN CLL患者的当前治疗提供了实用建议。定期更新治疗指南非常重要,可确保对新出现的证据和不断变化的临床实践做出反应,并改善患者的治疗效果和生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信