Targeting chronic lymphocytic leukemia cells in the tumor microenviroment: A review of the in vitro and clinical trials to date.

摘要: Chronic lymphocytic leukemia (CLL) is the most common in western world. Despite significant advances therapy over last decade CLL remains incurable. Current front-line often consists of chemoimmunotherapy-based regimens, commonly fludarabine, cyclophosphamide plus rituximab combination, but rates relapse and refractory disease are high among these patients. Several key signaling pathways now known to mediate survival proliferation cells vivo, notable which mediated by B-cell receptor (BCR) cytokine receptors. A better understanding pathogenesis disease, underlying biology CLL-cell roles tumour microenvironment has provided rationale for trials a range novel, more targeted therapeutic agents. In particular, clinical ibrutinib idelalisib, target Brutons tyrosine kinase delta isoform phosphoinositol-3 components BCR pathway respectively, have shown extremely promising results. Here we review current literature on interactions that leukemic cells. For each describe results recent vitro studies novel