The role of Bruton's kinase inhibitors (BTKi) in accelerated Chronic Lymphocytic Leukemia (a-CLL): a case of successful response to acalabrutinib.

Q3 Pharmacology, Toxicology and Pharmaceutics

Journal of Basic and Clinical Physiology and Pharmacology Pub Date : 2023-05-01 DOI:10.1515/jbcpp-2023-0051

Gioacchino Catania, Rita Tavarozzi, Giacomo Maria Pini, Tiziana Borra, Carolina Gandolfo, Giulia Zacchi, Daniela Pietrasanta, Federico Monaco, Manuela Zanni, Maddalena Lettieri, Paolo Rivela, Francesco Zallio, Marco Ladetto

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引用次数: 1

Abstract

Objectives: The use of Bruton's tyrosine kinase (BTK) inhibitors has changed the clinical history of patients with chronic lymphocytic leukemia (CLL) in both naïve and relapsed/refractory settings. "Accelerated" chronic lymphocytic leukemia (a-CLL) is a relatively rare form of CLL representing less than 1 % of all CLL cases. a-CLL patients usually have a more aggressive course and a reduced overall survival was reported with conventional chemo-immunotherapy approaches.

Methods: The role of Bruton Tyrosine Kinase-inhibitor, ibrutinib, in a-CLL is well established with encouraging preliminary results.

Results: We report a case of a-CLL-treated first-line with second-generation BTKi, acalabrutinib with a prompt clinical response. As known, it is the first literature report on acalabrutinib in a-CLL highlighting the role of second-generation BTKi also in this high-risk setting.

Conclusions: Target therapies (Bruton Kinase inhibitors and Bcl2 inhibitors) have improved the therapeutic landscape of CLL. The availability of therapeutic targets requires greater diagnostic accuracy to choose the most appropriate therapy for each patient.

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布鲁顿激酶抑制剂(BTKi)在加速慢性淋巴细胞白血病(a- cll)中的作用:阿卡拉布替尼成功应答的一例

目的:布鲁顿酪氨酸激酶(BTK)抑制剂的使用改变了naïve和复发/难治性慢性淋巴细胞白血病(CLL)患者的临床病史。“加速型”慢性淋巴细胞白血病(a-CLL)是一种相对罕见的慢性淋巴细胞白血病，占所有慢性淋巴细胞白血病病例的比例不到1%。据报道，a- cll患者通常具有更积极的病程，采用传统的化学免疫治疗方法总生存率降低。方法:布鲁顿酪氨酸激酶抑制剂依鲁替尼在a-CLL中的作用得到了很好的确立，并取得了令人鼓舞的初步结果。结果:我们报告了一例使用第二代BTKi阿卡拉布替尼一线治疗的a- cll患者，临床反应迅速。众所周知，这是第一篇关于阿卡拉布替尼治疗a-CLL的文献报道，强调了第二代BTKi在这种高风险环境中的作用。结论:靶向治疗(布鲁顿激酶抑制剂和Bcl2抑制剂)改善了CLL的治疗前景。治疗靶点的可用性要求更高的诊断准确性，以便为每位患者选择最合适的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Basic and Clinical Physiology and Pharmacology Pharmacology, Toxicology and Pharmaceutics-Pharmacology

CiteScore

3.90

自引率

0.00%

发文量

期刊介绍： The Journal of Basic and Clinical Physiology and Pharmacology (JBCPP) is a peer-reviewed bi-monthly published journal in experimental medicine. JBCPP publishes novel research in the physiological and pharmacological sciences, including brain research; cardiovascular-pulmonary interactions; exercise; thermal control; haematology; immune response; inflammation; metabolism; oxidative stress; and phytotherapy. As the borders between physiology, pharmacology and biochemistry become increasingly blurred, we also welcome papers using cutting-edge techniques in cellular and/or molecular biology to link descriptive or behavioral studies with cellular and molecular mechanisms underlying the integrative processes. Topics: Behavior and Neuroprotection, Reproduction, Genotoxicity and Cytotoxicity, Vascular Conditions, Cardiovascular Function, Cardiovascular-Pulmonary Interactions, Oxidative Stress, Metabolism, Immune Response, Hematological Profile, Inflammation, Infection, Phytotherapy.