Lenalidomide in the Treatment of Chronic Lymphocytic Leukemia

The application of nucleoside analogue-based chemotherapy and immunotherapy with rituximab or alemtuzumab has increased both response rate and survival in patients with Chronic Lymphocytic Leukemia (CLL). However, because none of these therapies is curative, sequential therapeutic regimens are requi...

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Main Authors: Agostino Cortelezzi, Mariarita Sciumè, Gianluigi Reda
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Advances in Hematology
Online Access:http://dx.doi.org/10.1155/2012/393864
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author Agostino Cortelezzi
Mariarita Sciumè
Gianluigi Reda
author_facet Agostino Cortelezzi
Mariarita Sciumè
Gianluigi Reda
author_sort Agostino Cortelezzi
collection DOAJ
description The application of nucleoside analogue-based chemotherapy and immunotherapy with rituximab or alemtuzumab has increased both response rate and survival in patients with Chronic Lymphocytic Leukemia (CLL). However, because none of these therapies is curative, sequential therapeutic regimens are required. The majority of patients with relapsed or refractory CLL carry poor prognostic factors and show shorter overall survival and resistance to standard treatment. Numerous drugs have recently been approved for CLL therapy and many novel agents are under clinical investigation. The role of the tumor microenvironment and of immune dysfunction in CLL have allowed to enlarge the therapeutic armamentarium for CLL patients. This article will provide a comprehensive summary regarding mechanism of action, efficacy and safety of lenalidomide in CLL patients. Relevant clinical trials using lenalidomide alone or in combinations are discussed. Lenalidomide shows good activity also in relapsed/refractory or treatment-naive CLL patients. Definitive data from ongoing studies are needed to validate overall and progression-free survival. The toxicity profile might limit lenalidomide use because it can result in serious side effects, but largely controlled by gradual dose escalation. Further understanding of the exact mechanism of action in CLL will allow more efficacious use of lenalidomide alone or in combination regimens.
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spelling doaj-art-a34e60229e934aac998908d0fd28b0262025-08-20T02:20:32ZengWileyAdvances in Hematology1687-91041687-91122012-01-01201210.1155/2012/393864393864Lenalidomide in the Treatment of Chronic Lymphocytic LeukemiaAgostino Cortelezzi0Mariarita Sciumè1Gianluigi Reda2Hematology and Transplantation Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico and Università degli Studi Di Milano, 20122 Milan, ItalyHematology and Transplantation Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico and Università degli Studi Di Milano, 20122 Milan, ItalyHematology and Transplantation Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico and Università degli Studi Di Milano, 20122 Milan, ItalyThe application of nucleoside analogue-based chemotherapy and immunotherapy with rituximab or alemtuzumab has increased both response rate and survival in patients with Chronic Lymphocytic Leukemia (CLL). However, because none of these therapies is curative, sequential therapeutic regimens are required. The majority of patients with relapsed or refractory CLL carry poor prognostic factors and show shorter overall survival and resistance to standard treatment. Numerous drugs have recently been approved for CLL therapy and many novel agents are under clinical investigation. The role of the tumor microenvironment and of immune dysfunction in CLL have allowed to enlarge the therapeutic armamentarium for CLL patients. This article will provide a comprehensive summary regarding mechanism of action, efficacy and safety of lenalidomide in CLL patients. Relevant clinical trials using lenalidomide alone or in combinations are discussed. Lenalidomide shows good activity also in relapsed/refractory or treatment-naive CLL patients. Definitive data from ongoing studies are needed to validate overall and progression-free survival. The toxicity profile might limit lenalidomide use because it can result in serious side effects, but largely controlled by gradual dose escalation. Further understanding of the exact mechanism of action in CLL will allow more efficacious use of lenalidomide alone or in combination regimens.http://dx.doi.org/10.1155/2012/393864
spellingShingle Agostino Cortelezzi
Mariarita Sciumè
Gianluigi Reda
Lenalidomide in the Treatment of Chronic Lymphocytic Leukemia
Advances in Hematology
title Lenalidomide in the Treatment of Chronic Lymphocytic Leukemia
title_full Lenalidomide in the Treatment of Chronic Lymphocytic Leukemia
title_fullStr Lenalidomide in the Treatment of Chronic Lymphocytic Leukemia
title_full_unstemmed Lenalidomide in the Treatment of Chronic Lymphocytic Leukemia
title_short Lenalidomide in the Treatment of Chronic Lymphocytic Leukemia
title_sort lenalidomide in the treatment of chronic lymphocytic leukemia
url http://dx.doi.org/10.1155/2012/393864
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AT mariaritasciume lenalidomideinthetreatmentofchroniclymphocyticleukemia
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