B-cell chronic lymphocytic leukemia: Recent progress in biology, diagnosis, and therapy

Montserrat, Emilio; Bosch, Francesc; Rozmán, C

doi:10.1093/annonc/8.suppl_1.s93

Cited by 19 publications

(8 citation statements)

References 91 publications

(57 reference statements)

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“…For example, gastrointestinal, bladder and gynaecological tumours eventually cause acute or chronic bleeding. Patients with lymphoid leukaemia or lymphomas can present with autoimmune haemolysis [28], and metastatic tumours can infiltrate bone marrow and impair normal haematopoiesis. Bone marrow replacement by metastases or solid tumours, as can be found in breast and prostate cancer patients, destroys progenitor cells, damages the bone-marrow microenvironment and produces cytokines.…”

Section: Causes Of Anaemiamentioning

confidence: 99%

Anaemia of cancer: an overview of mechanisms involved in its pathogenesis

Grotto

2007

Med Oncol

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Anaemia is a common complication in cancer patients. The decrease in haemoglobin is associated with an impaired quality of life, poorer response to therapy and worse prognosis. Numerous factors are involved in the physiopathology of cancer-related anaemia. Some factors such as bleeding, bone marrow infiltration, the effects of chemoradiotherapy and associated nutritional deficiencies are related to the disease itself. In addition, the interaction of the immune system with iron metabolism and erythropoiesis has been shown to be an important factor in the development of anaemia in cancer patients and can be seen in the action of several cytokines on different iron-homeostasis and erythrocyte-cell-production pathways. Some inhibitory cytokines, such as tumour necrosis factor-alpha and interleukin-1, act on the suppression of erythroid precursor cells and erythropoietic production and response; others, such as interleukins 1 and 6 and hepcidin, impair iron metabolism, causing iron to be diverted from erythropoiesis and retained within the reticuloendothelial system. The main mechanisms involved in the development of cancer-related anaemia are discussed in this review.

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Section: Causes Of Anaemiamentioning

confidence: 99%

Anaemia of cancer: an overview of mechanisms involved in its pathogenesis

Grotto

2007

Med Oncol

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“…1,2 The disease is the most common adult hematological malignancy in the Western world and, based on recent estimates, has an incidence of 3.5/ 100 000 in the United States. 3 CLL arises from a malignant clone of B cells with a characteristic phenotype.…”

Section: Overview Of Chronic Lymphocytic Leukemiamentioning

confidence: 99%

Treatment options in chronic lymphocytic leukemia

Montserrat¹

2004

Hematol J

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Chronic lymphocytic leukemia (CLL) is the most common adult hematological malignancy in the Western world and predominantly affects the elderly. The disease encompasses a wide spectrum of clinical symptoms, which translate into variable prognosis and survival. The stratification of patients based on their clinical risk profile has been aided by the recognition of novel prognostic markers, for example, VH mutations and ZAP-70 expression, and this process is fundamental to assigning the most appropriate treatment strategy on an individual basis. Although CLL remains incurable with standard treatments, important progress in treatment has been made. The discovery of purine analogs such as fludarabine has led to significant improvements in remission rates and freedom from progression but, unfortunately, no significant prolongation in survival. With the success of newer therapeutic approaches, such as the monoclonal antibodies and stem cell transplantation, the focus of current therapy is on using these approaches in combination with fludarabine to produce high rates of molecular complete response, to eradicate minimal residual disease, and to lengthen survival. This paper provides an overview of CLL and discusses how recent therapeutic developments have changed the management of this form of leukemia.

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“…treat CLL have been reviewed in detail elsewhere [10,15]. Radiotherapy can be useful to treat bulky lymphadenopathy causing compressive problems.…”

Section: Ancillary Measures Complementary Measures Tomentioning

confidence: 99%

Treatment of B‐cell chronic lymphocytic leukaemia: current status and future perspectives

Montserrat

Bosch

Rozmán

1997

Journal of Internal Medicine

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In the last two decades, important advances have been made in the biology, natural history, and prognosis of B‐cell chronic lymphocytic leukaemia (CLL). In addition, treatment possibilities for patients with CLL have changed as a result of the identification of prognostic factors for survival and the availability of new drugs and treatment strategies. Patients in the early clinical stages (Binet A, Rai O) with stable disease have a probability of long survival and should not be treated unless the disease progresses. In contrast, most patients with poor prognostic features, such as an advanced clinical stage (Binet B, C; Rai III, IV), diffuse bone‐marrow infiltration or rapidly increasing blood lymphocyte levels, have a median survival probability of <5 years and require therapy. Purine analogues are highly effective. Among these, fludarabine has become the treatment of choice for patients failing standard therapies. The role of purine analogues either alone or in combination with other drugs as front‐line therapy is being investigated. Certain situations (e.g. autoimmune cytopenias, hypersplenism) require special treatment approaches (e.g. corticosteroids, splenectomy). Transplants of progenitor haemopoeitic cells are also increasingly performed and deserve further investigation in younger patients with poor prognostic features. As a result of these advances, symptoms palliation is no longer the only possible goal in CLL therapy; sustained remissions and even cures are likely to be obtained in the near future.

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B-cell chronic lymphocytic leukemia: Recent progress in biology, diagnosis, and therapy

Cited by 19 publications

References 91 publications

Anaemia of cancer: an overview of mechanisms involved in its pathogenesis

Anaemia of cancer: an overview of mechanisms involved in its pathogenesis

Treatment options in chronic lymphocytic leukemia

Treatment of B‐cell chronic lymphocytic leukaemia: current status and future perspectives

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