علاج سرطان الدم الليمفاوي المزمن النشط مع حالة IGHV غير المتحورة وبدون طفرة TP53 في مريض لائق طبياً

References

• CLL with unmutated IGHV status and without TP53 mutation or del(17p) (if there was similar efficacy, panel is giving preference to time-limited therapies): Fit patients: ibrutinib [I, A] (data for other BTKis for fit patients are still pending); CIT should be avoided due to survival disadvantage, but may be used if other options are not available [I, A]. Venetoclax plus obinutuzumab might be an alternative to BTKis, but data for fit patients are still pending [III, A].
• One of the two following treatment options should be chosen [I, A]: Venetoclax plus rituximab for 24 months; Ibrutinib or acalabrutinib or other BTKis (if available) as continuous therapy.
• The PI3K inhibitor idelalisib in combination with rituximab [II, B].
• In case of long-lasting remissions (>3 years) to prior time-limited therapy, patients may be re-exposed to the same treatment regimen, though data are limited with no long-term observation [II, B].