Publication: Últimos avances terapéuticos en la leucemia linfocítica crónica
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2017-02
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Abstract
La leucemia linfocítica crónica (LLC) es el tipo de leucemia con mayor incidencia en nuestra sociedad. Existen variedades de LLC marcadas por el componente genético, la principal es la delección en el cromosoma 17 o la mutación en el gen TP53, lo cual supone un reto a nivel terapéutico, ya que están asociados con un mal pronóstico y mala respuesta a los tratamientos. La gama de tratamientos para LLC se basan principalmente en quimioterapia citotóxica y anticuerpos monoclonales, eficaces ante algunas variedades de LLC. El problema reside en la aparición de efectos adversos en la mayoría de los pacientes con LLC, lo cual indica que necesitaran líneas de tratamiento posteriores; esto conlleva interrupciones de la terapia, recaídas y resistencia al tratamiento. La terapia citotóxica y los anticuerpos monoclonales son insuficientes en LLC del17p o mutación en TP53, actualmente se usa Ibrutinib o Idelalisib, cuyos mecanismos de acción son vías moleculares de señalización. Sin embargo, los resultados obtenidos en pacientes aún son insuficientes en el grupo con LLC del17p o mutación en TP53. La autorización comercial de Venetoclax por la EMA y FDA, abre la opción a una nueva terapia de primera línea para estos pacientes, más eficaz que los anteriores debido a los resultados de los ensayos clínicos obtenidos.
Chronic lymphocytic leukaemia (CLL) is the type of leukaemia that is most prevalent in our society. There are varieties of LLC marked by the genetic component, the main is the deletion on chromosome 17p or the mutation in the TP53 gene, which is a challenge at the therapeutic level, because they are associated with poor prognosis and Este trabajo tiene una finalidad docente. La Facultad de Farmacia no se hace responsable de la información contenida en el mismo. poor response to treatments. The range of treatments for CLL are based primarily on cytotoxic chemotherapy and monoclonal antibodies, effective with some varieties of CLL. The problem lies in the appearance of adverse effects in the majority of patients with CLL, which indicates that they need further treatment lines; this leads to interruptions of therapy, relapse and resistance to treatment. Cytotoxic therapy and monoclonal antibodies are insufficient in LLC 17p or mutation in TP53, currently using Ibrutinib or Idelalisib, whose mechanisms of action are molecular signalling pathways. However, the results obtained in patients are still insufficient in the LLC group of 17p or mutation in TP53. The conditional marketing authorization of Venetoclax by EMA and FDA, opens the option to a new therapy of first line for these patients, more effective than the previous ones due to the results of the obtained clinical trials.
Chronic lymphocytic leukaemia (CLL) is the type of leukaemia that is most prevalent in our society. There are varieties of LLC marked by the genetic component, the main is the deletion on chromosome 17p or the mutation in the TP53 gene, which is a challenge at the therapeutic level, because they are associated with poor prognosis and Este trabajo tiene una finalidad docente. La Facultad de Farmacia no se hace responsable de la información contenida en el mismo. poor response to treatments. The range of treatments for CLL are based primarily on cytotoxic chemotherapy and monoclonal antibodies, effective with some varieties of CLL. The problem lies in the appearance of adverse effects in the majority of patients with CLL, which indicates that they need further treatment lines; this leads to interruptions of therapy, relapse and resistance to treatment. Cytotoxic therapy and monoclonal antibodies are insufficient in LLC 17p or mutation in TP53, currently using Ibrutinib or Idelalisib, whose mechanisms of action are molecular signalling pathways. However, the results obtained in patients are still insufficient in the LLC group of 17p or mutation in TP53. The conditional marketing authorization of Venetoclax by EMA and FDA, opens the option to a new therapy of first line for these patients, more effective than the previous ones due to the results of the obtained clinical trials.