GREEK CONSENSUS ON CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) TREATMENT
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Keywords
Chronic Lymphocytic Leukaemia, Treatment, Consensus
Abstract
New targeted therapies have revolutionized the treatment landscape in CLL. Biological features, patient characteristics and preferences and the safety profile of each treatment option should be taken into consideration for making the optimal treatment choice.This consensus practice statement on CLL treatment was developed by a group of Greek experts in CLL based on the available evidence for both the first line treatment and for the relapsed/refractory setting.
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References
References
1. The Surveillance E, and End Results (SEER) Program of the National Cancer Institute. Cancer Stat Facts: Leukemia—Chronic Lymphocytic Leukemia (CLL). https://seer.cancer.gov/statfacts/html/clyl.html; 2021
2. Hallek M. Chronic lymphocytic leukemia: 2015 update on diagnosis, risk stratification, and treatment. Am J Hematol. 2015;90:446–60. doi: 10.1002/ajh.23979 PMID: 25908509
3. Hallek M, Al-Sawaf O. Chronic lymphocytic leukemia: 2022 update on diagnostic and therapeutic procedures. Am J Hematol. 2021; 96: 1679-1705. doi: 10.1002/ajh.26367 PMID: 34625994
4. Awan FT, al-Sawaf O, Fischer K, Woyach JA. Current perspectives on therapy for chronic lymphocytic leukemia. Am Soc Clin Oncol Educ Book. 2020; 40: 320-329. DOI: 10.1200/EDBK_279099 PMID: 32239979
5. Zenz T, Eichhorst B, Busch R, Denzel T, Häbe S, Winkler D, Bühler A, Edelmann J, Bergmann M, Hopfinger G, Hensel M, Hallek M, Döhner H, Stilgenbauer S. TP53 mutation and survival in chronic lymphocytic leukemia. J Clin Oncol. 2010;28:4473–4479. doi: 10.1200/JCO.2009.27.8762 PMID: 20697090
6. Campo E, Cymbalista F, Ghia P, Jäger U, Pospisilova S, Rosenquist R, Schuh A, Stilgenbauer S. TP53 aberrations in chronic lymphocytic leukemia: an overview of the clinical implications of improved diagnostics. Haematologica 2018; 103: 1956–1968. DOI: 10.3324/haematol.2018.187583 PMID: 30442727
7. Stilgenbauer S, Schnaiter A, Paschka P, Zenz T, Rossi M, Dohner K, Bühler A , Böttcher S , Ritgen M , Kneba M, Winkler D , Tausch E , Hoth P , Edelmann J , Mertens D , Bullinger L, Bergmann M , Kless S , Mack S, Jäger U , Patten N , Wu L , Wenger MK , Fingerle-Rowson G , Lichter P, Cazzola M , Wendtner CM , Fink AM , Fischer K , Busch R , Hallek M, Döhner H. Gene mutations and treatment outcome in chronic lymphocytic leukemia: results from the CLL8 trial. Blood. 2014;123:3247–3254. doi: 10.1182/blood-2014-01-546150 PMID: 24652989
8. Malcikova J, Tausch E, Rossi D, Sutton LA, Soussi T, Zenz T, Kater A P, Niemann CU, Gonzalez D, Davi F, Gonzalez Diaz M, Moreno C, Gaidano G, Stamatopoulos K, Rosenquist R, Stilgenbauer S, Ghia P, Pospisilova S. European Research Initiative on Chronic Lymphocytic Leukemia (ERIC) — TP53 network. ERIC recommendations for TP53 mutation analysis in chronic lymphocytic leukemia—update on methodological approaches and results interpretation Leukemia. 2018; 32: 1070–1080. DOI: 10.1038/s41375-017-0007-7 PMID: 29467486
9. Cramer P, Hallek M. Prognostic factors in chronic lymphocytic leukemia—what do we need to know? Nat Rev Clin Oncol. 2011;8:38–47. doi: 10.1038/nrclinonc.2010.167. PMID: 20956983
10. Crombie J, Davids MS. IGHV mutational status testing in chronic lymphocytic leukemia. Am J Hematol 2017; 92: 1393–1397 DOI: 10.1002/ajh.24808 PMID: 28589701
11. Baliakas P, Jeromin S, Iskas M, Puiggros A, Plevova K, Nguyen-Khac F, Davis Z , Rigolin GM , Visentin A , Xochelli A, Delgado J, Baran-Marszak F, Stalika E, Abrisqueta P, Durechova K, Papaioannou G, Eclache V, Dimou M, Iliakis T, Collado R, Doubek M, Calasanz MJ, Ruiz-Xiville N, Moreno C, Jarosova M, Leeksma AC, Panayiotidis P, Podgornik H, Cymbalista F, Anagnostopoulos A, Livio Trentin, Stavroyianni N, Davi F, Ghia P, Kater AP, Cuneo A, Pospisilova S, Espinet B, Athanasiadou A, Oscier D, Haferlach C, Stamatopoulos K. Cytogenetic complexity in chronic lymphocytic leukemia: definitions, associations, and clinical impact. Blood. 2019; 133: 1205–1216. DOI: 10.1182/blood-2018-09-873083. PMID: 30602617
12. Döhner H, Stilgenbauer S, Benner A, Leupolt E, Kröber A, Bullinger L, Döhner K, Bentz M, Lichter P. Genomic aberrations and survival in chronic lymphocytic leukemia. N Engl J Med. 2000;343:1910–1916 DOI: 10.1056/NEJM200012283432602. PMID: 11136261
13. Allan JN, Shanafelt T, Wiestner A, Moreno C, O'Brien SM, Braggio E, Jianling Li, Krigsfeld G , Dean JP, Ahn IE . Long-term efficacy of first-line Ibrutinib treatment for chronic lymphocytic leukemia (CLL) with 4 years of follow-up in patients with TP53 aberrations (del(17p) or TP53 mutation): a pooled analysis from 4 clinical trials. Br J Haematol. 2022 196:947-953. doi: 10.1111/bjh.17984. PMID: 34865212
14. Ahn IE, Tian X, Wiestner A. Ibrutinib for chronic lymphocytic leukemia with TP53 alterations. N Engl J Med. 2020; 383: 498–500 doi: 10.1056/NEJMc2005943 PMID: 32726539
15. Woyach JA, Ruppert AS, Heerema NA, Zhao W, Booth AM, Ding W Bartlett NL , Brander DM, Barr PM, Rogers KA, Parikh SA, Coutre S, Hurria A, Brown JR, Lozanski G, Blachly JS, Ozer HG, Major-Elechi B, Fruth B, Nattam S, Larson RA, Erba H, Litzow M, Owen C, Kuzma C, Abramson JS, Little RF, Smith SE, Stone RM, Mandrekar SJ, Byrd JC. Ibrutinib regimens versus chemoimmunotherapy in older patients with untreated CLL. N Engl J Med. 2018; 379: 2517–2528 doi: 10.1056/NEJMoa1812836 PMID: 30501481
16. Moreno C, Greil R, Demirkan F, Tedeschi A, Anz B, Larratt L, Simkovic M, Samoilova O, Novak J, Ben-Yehuda D, Strugov V, Gill D, Gribben JG, Hsu E, Lih CJ, Zhou C, Clow F, James DF, Styles L, Flinn IW . Ibrutinib plus obinutuzumab versus chlorambucil plus obinutuzumab in first-line treatment of chronic lymphocytic leukaemia (iLLUMINATE): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol 2019; 20: 43–56. DOI: 10.1016/S1470-2045(18)30788-5PMID: 30522969
17. Sharman JP, Egyed M, Jurczak W, Skarbnik A, Patel K, Flinn IW, Kamdar M, Munir T, Walewska R, Hughes M, Fogliatto LM, Herishanu Y, Banerji V, Follows G, Patricia A. Walker, Karlsson K, Ghia P, Janssens A, Cymbalista F, Byrd JC, Ferrant E, Ferrajoli A, Wierda WG, Munugalavadla V, Wachira CW, Wun CC, Woyach JA. Acalabrutinib ± Obinutuzumab Vs Obinutuzumab + Chlorambucil in Treatment-Naive Chronic Lymphocytic Leukemia: 6-Year Follow-up of Elevate-TN Blood (2023) 142 (Supplement 1): 636 https://doi.org/10.1182/blood-2023-174750
18. Al-Sawaf O, Zhang C, Lu T, Michael Z Liao, Panchal A, Robrecht S, Ching T, Tandon M, Anna-Maria Fink, Tausch E, Schneider C, Ritgen M, Böttcher S, Karl-Anton Kreuzer, Chyla B, Miles D, Clemens-Martin Wendtner, Eichhorst B, Stilgenbauer S, Jiang Y, Hallek M, Fischer K. Minimal residual disease dynamics after venetoclax-obinutuzumab treatment: extended off-treatment follow-up from the randomized CLL14 study. J Clin Oncol. 2021; 39: 4049-4060 DOI: 10.1200/JCO.21.01181 PMID: 34709929
19. Moreno C, Munir T, Owen C, Follows G, Hernandez Rivas JA, Benjamini O, Janssens A, Levin MD, Robak T, Simkovic M, Voloshin S, Vorobyev VI, Yagci M, Ysebaert L, Qi Q, Smith E, Srinivasan S, Schuier N, Baeten K, Caces DB, Niemann CU, Kater AP. First-Line Fixed-Duration Ibrutinib Plus Venetoclax (Ibr+Ven) Versus Chlorambucil Plus Obinutuzumab (Clb+O): 55-Month Follow-up from the Glow Study. Blood. 2023; 142 (Supplement 1): 634.https://doi.org/10.1182/blood-2023-177713
20. Tam CS, Allan JN, Siddiqi T, Kipps TJ, Jacobs R, Opat S, Barr PM, Tedeschi A, Trentin L, Bannerji R, Jackson S, Kuss BJ, Moreno C, Szafer-Glusman E, Russell K, Zhou C, Ninomoto J, James P Dean, Wierda WG, Ghia P. Fixed-duration ibrutinib plus venetoclax for first-line treatment of CLL: primary analysis of the CAPTIVATE FD cohort. Blood. 2022; 139: 3278–3289 DOI: 10.1182/blood.2021014488 PMID: 35196370
21. Barr PM, Allan JN, Siddiqi T, Wierda WG, Lu Tam CS, Moreno CD, Tedeschi A, Szafer-Glusman E, Zhou C, Abbazio C, Dean JP, Szoke A, Ghia P. Fixed-duration ibrutinib + venetoclax for first-line treatment of chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL): 4-y follow-up from the FD cohort of the phase 2 CAPTIVATE study. J Clin Oncol.Volume 41 Number 16, Suppl 7535 https://doi.org/10.1200/JCO.2023.41.16_suppl.7535
22. Fischer K, Bahlo J, Fink AM, Goede V, Herling CD, Cramer P, Langerbeins P, von Tresckow J, Engelke A, Maurer C, Kovacs G, Herling M, Tausch E, Kreuzer KA, Eichhorst B, Böttcher S, John F Seymour JF, Ghia P, Marlton P, Kneba M, Wendtner CM, Döhner H, Stilgenbauer S, Hallek M. Long-term remissions after FCR chemoimmunotherapy in previously untreated patients with CLL: updated results of the CLL8 trial. Blood. 2016; 127: 208–215 DOI: 10.1182/blood-2015-06-651125 PMID: 26486789
23. Thompson PA, Tam CS, O'Brien SM, Wierda WG, Stingo F, Plunkett W, Smith SC, Kantarjian HM, Freireich EJ, Keating MJ. Fludarabine, cyclophosphamide, and rituximab treatment achieves long-term disease-free survival in IGHV-mutated chronic lymphocytic leukemia. Blood. 2016; 127: 303–309. DOI: 10.1182/blood-2015-09-667675PMID: 26492934
24. Thompson PA, Tam CS, O'Brien SM, Wierda WG, Stingo F, Plunkett W, Smith SC, Kantarjian HM, Freireich EJ, Keating MJ Fludarabine, cyclophosphamide,and rituximab treatment achieves long-term disease-free survival in IGHV-mutated chronic lymphocytic leukemia.Blood.2016;127:303-309 DOI: 10.1182/blood-2015-09-667675 PMID: 26492934
25. Barr PM, Owen C, Robak T, Tedeschi A, Bairey O, Burger JA, Hillmen P, Coutre SE, Dearden C, Grosicki S, McCarthy H, Li JY, Offner F, Moreno C, Zhou C, Hsu E, Szoke A, Kipps TJ, Ghia P. Up to 8-year follow-up from RESONATE-2: first-line ibrutinib treatment for patients with chronic lymphocytic leukemia. Blood Adv. 2022;6:3440-3450 DOI: 10.1182/bloodadvances.2021006434PMID: 35377947
26. Tam CS, Brown JR, Kahl BS, Ghia P, Giannopoulos K, Jurczak W, Šimkovič M, Shadman M, Österborg A, Laurenti L, Walker P, Opat S, Chan H, Ciepluch H, Greil R, Tani M, Trněný M, Danielle M Brander, Flinn IW, Grosicki S, Verner E, Tedeschi A, Li J, Tian T, Zhou L, Marimpietri C, Paik JC, Cohen A, Huang J, Robak T, Hillmen P. Zanubrutinib versus bendamustine and rituximab in untreated chronic lymphocytic leukaemia and small lymphocytic lymphoma (SEQUOIA): a randomised, controlled, phase 3 trial. Lancet Oncol. 2022; 23: 1031–1043. DOI: 10.1016/S1470-2045(22)00293-5PMID: 35810754
27. Shanafelt TD, Wang XV, Hanson CA, Paietta EM, O'Brien S, Barrientos J. Jelinek DF, Braggio E, Leis JF, Zhang CC, Coutre SE, Barr PM, Cashen AF, Mato AR, Singh AK, Mullane MP, Little RF, Erba H, Stone RM, Litzow M, Tallman M, Neil E Kay. Long-term outcomes for ibrutinib–rituximab and chemoimmunotherapy in CLL: updated results of the E1912 trial. Blood. 2022; 140: 112–120 DOI: 10.1182/blood.2021014960 PMID: 35427411
28. Eichhorst B, Niemann CU, Kater AP, Fürstenau M, von Tresckow J, Zhang C, Robrecht S, Gregor M, Juliusson G, Thornton P, Staber PB, Tadmor T, Lindström V, da Cunha-Bang C, Schneider C, Poulsen CB, Illmer T, Schöttker B, Nösslinger T, Janssens A, Christiansen I, Baumann M, Frederiksen H, van der Klift M, Jäger U, Leys MBL, Hoogendoorn M, Lotfi K, Hebart H, Gaska T, Koene H, Enggaard L, Goede J, Regelink JC, Widmer A, Simon F, De Silva N, Fink AM, Bahlo J, Fischer K, Wendtner CM, Kreuzer KA, Ritgen M, Brüggemann M, Tausch E, Levin MD, van Oers M, Geisler C, Stilgenbauer S, Hallek M; GCLLSG, the HOVON and Nordic CLL Study Groups, the SAKK, the Israeli CLL Association, and Cancer Trials Ireland.First Line Venetoclax Combinations in Chronic Lymphocytic Leukemia.N Engl J Med. 2023;388:1739-1754. doi:10.1056/NEJMoa2213093. PMID: 3716362
29. Benjamini O, Jain P, Trinh L, Qiao W, Strom SS, Lerner S, Wang X, Burger J, Ferrajoli A, Kantarjian H, O'Brien S, Wierda W, Estrov Z, Keating M. Second cancers in patients with chronic lymphocytic leukemia who received frontline fludarabine, cyclophosphamide and rituximab therapy: distribution and clinical outcomes. Leuk Lymphoma. 2015; 56: 1643-1650 DOI: 10.3109/10428194.2014.957203 PMID: 25308294
30. Kutsch N, Bahlo J, Robrecht S, Franklin J, Zhang C, Maurer C, De Silva N, Lange L, Weide R, Kiehl MG, Sökler M, Schlag R, Vehling-Kaiser U, Köchling G, Plöger C, Gregor M, Plesner T, Herling M, Fischer K, Döhner H, Kneba M, Wendtner CM, Klapper W, Kreuzer KA, Böttcher S, Stilgenbauer S, Fink AM, Hallek M, Eichhorst B. Long term follow-up data and health-related quality of life in frontline therapy of fit patients treated with FCR versus BR (CLL10 trial of the GCLLSG). HemaSphere. 2020; 4:e336. DOI: 10.1097/HS9.0000000000000336 PMID: 32072150
31. Gerousi M, Laidou S, Gemenetzi K, Stamatopoulos K, Chatzidimitriou A. Distinctive Signaling Profiles With Distinct Biological and Clinical Implications in Aggressive CLL Subsets With Stereotyped B-Cell Receptor Immunoglobulin Front Oncol. 2021;11: 771454DOI: 10.3389/fonc.2021.771454PMID: 34804974
32. Awan FT , Addison D, Alfraih F , Baratta SJ , Campos RN , Cugliari MS, Goh YT , Ionin VA , Mundnich S, Sverdlov AL , Tam C, Ysebaert L. International consensus statement on the management of cardiovascular risk of Bruton's tyrosine kinase inhibitors in CLL Blood Adv. 2022 27:6:5516-5525DOI: 10.1182/bloodadvances.2022007938 PMID: 35790105
33. Koehler AB, Leung N, Call TG, Rabe KG, Achenbach SJ, Ding W, Kenderian SS, Leis JF, Wang Y, Muchtar E, Hayman SR, Hampel PJ, Finnes HD, Schwager SM, Slager SL, Kay NE, Parikh SA. Incidence and risk of tumor lysis syndrome in patients with relapsed chronic lymphocytic leukemia (CLL) treated with venetoclax in routine clinical practice. Leuk Lymphoma. 2020; 61: 2383-2388 doi: 10.1080/10428194.2020 PMID: 32449401
34. Langerbeins P, Hallek M. COVID-19 in patients with hematologic malignancy.Blood. 2022;140:236-252. DOI: 10.1182/blood.2021012251 PMID: 35544585
35. Munir T, Brown JR, O'Brien S, Barrientos JC, Barr PM, Reddy NM, Coutre S, Tam CS, Mulligan SP, Jaeger U, Kipps TJ, Moreno C, Montillo M, Burger JA, Byrd JC, Hillmen P, Dai S, Szoke A, Dean JP, Woyach JA. Final analysis from RESONATE: up to six years of follow-up on ibrutinib in patients with previously treated chronic lymphocytic leukemia or small lymphocytic lymphoma. Am J Hematol. 2019; 94: 1353–1363. doi: 10.1002/ajh.25638. PMID: 31512258
36. Jurczak W, Pluta A, Wach M, Lysak D, Kozak T, Šimkovič M, Kaplan P, Kraychok I, Illes A, de la Serna j, Dolan S, Campbell P, Musuraca G, Jacob A, Avery E, Lee JH, Liang W, Patel P, Quah C, Jurczak W. Three-year follow-up of the ascend trial: acalabrutinib vs rituximab plus idelalisib or bendamustine in relapsed/refractory chronic lymphocytic leukemia. Blood. 2021; 138:393. DOI: 10.1200/JCO.19.03355PMID: 32459600
37. Ghia P, Pluta A, Wach M, Lysak D, Kozak T, Simkovic M, Kaplan P, Kraychok I, Illes A, de la Serna J, Dolan S, Campbell P, Musuraca G, Jacob A, Avery E, Lee JH, Liang W, Patel P, Quah C, Jurczak W W. ASCEND: phase III, randomized trial of acalabrutinib versus idelalisib plus rituximab or bendamustine plus rituximab in relapsed or refractory chronic lymphocytic leukemia. J Clin Oncol. 2020; 38: 2849–2861. DOI: 10.1200/JCO.19.03355PMID: 32459600
38. Hillmen P, Eichhorst B, Brown JR, Lamanna N, O'Brien SM, Tam CS, Qiu L, Kazmierczak M, Zhou K, Šimkovič M, Mayer J, Gillespie-Twardy A, Shadman M, Ferrajoli A, Ganly PS, Weinkove R, Grosicki S, Mital A, Robak T, Österborg A, Yimer HA, Salmi T, Ji M, Yecies J, Idoine A, Wu K, Huang J, Jurczak W. Zanubrutinib versus ibrutinib in relapsed/refractory chronic lymphocytic leukemia and small lymphocytic lymphoma: interim analysis of a randomized phase III. J Clin Oncol 2023; 41: 1035–1045. DOI: 10.1200/JCO.22.00510 PMID: 36395435
39. Seymour JF, Kipps TJ, Eichhorst B, Hillmen P, D'Rozario J, Assouline S, Owen C, Gerecitano J, Robak T, De la Serna J, Jaeger U, Cartron G, Montillo M, Humerickhouse R, Punnoose EA, Li Y, Boyer M, Humphrey K, Mobasher M, Kater AP N Engl J Med. 2018;378:1107–20. DOI: 10.1056/NEJMoa1713976 PMID: 29562156
40. Stilgenbauer S, Eichhorst B, Schetelig J, Hillmen P, Seymour JF, Coutre S, Jurczak W , Mulligan SP, Schuh A, Assouline S, Wendtner CM, Roberts AW, Davids MS, Bloehdorn J, Munir T, Böttcher S, Zhou L, Salem AH, Desai M, Chyla B, Arzt J , Kim SY, Verdugo M, Gordon G, Hallek M , Wierda WG . Venetoclax for patients with chronic lymphocytic leukemia with 17p deletion: results from the full population of a phase II pivotal trial. J Clin Oncol. 2018; 36: 1973–1980. DOI: 10.1200/JCO.2017.76.6840PMID: 29715056
41. Stilgenbauer S, Tausch E, Roberts AW, Davids MS, Eichhorst B, Hallek M, Hillmen P , Schneider C , Schetelig J , Böttcher S , Kater AP , Jiang Y , Boyer M , Popovic R, Ghanim MT , Moran M , Sinai WJ , Wang X , Mukherjee N , Chyla B , Wierda WG , Seymour JF . Six-year follow-up and subgroup analyses of a phase 2 trial of venetoclax for del(17p) chronic lymphocytic leukemia Blood Adv.2024;8:1992-2004 doi: 10.1182/bloodadvances.2023011741. PMID: 38290108
42. Hampel PJ, Parikh SA. Chronic lymphocytic leukemia treatment algorithm Blood Cancer J. 2022.; 12:161. DOI: 10.1038/s41408-022-00756-9 PMID: 36446777
43. Byrd JC, Hillmen P, Ghia P, Kater AP , Chanan-Khan A , Furman RR , O'Brien S , Yenerel MN , Illés A , Garcia-Marco NK , Mato A, Pinilla-Ibarz J, Seymour JF , Lepretre S , Stilgenbauer S , Robak T , Rothbaum W , Izumi R , Hamdy A , Patel P, Higgins K, Sohoni S, Jurczak W . Acalabrutinib versus ibrutinib in previously treated chronic lymphocytic leukemia: results of the first randomized phase III trial. J Clin Oncol. 2021; 39: 3441-3452. DOI: 10.1200/JCO.21.01210 PMID: 34310172
44. Eichhorst B , Ghia P , Niemann CU , Kater AP , M Gregor M , Hallek M, Jerkeman M, C Buske C. ESMO Clinical Practice Guideline interim update on new targeted therapies in the first line and at relapse of chronic lymphocytic leukaemiaAnn Oncol.2024;35:762-768. doi: 10.1016/j.annonc.2024.06.016. PMID: 38969011
45. Mato AR, Shah NN, Jurczak W, Cheah CY, Pagel JM, Woyach JA, Fakhri B, Eyre TA, Lamanna N, Patel MR, Alencar A, Lech-Maranda E, Wierda WG, Coombs CC, Gerson JN, Ghia P, Le Gouill S, Lewis DJ, Sundaram S, Cohen JB, Flinn IW, Tam CS, Barve MA, Kuss B, Taylor J, Abdel-Wahab O, Schuster SJ, Palomba ML, Lewis KL, Roeker LE, Davids MS, Tan XN, Fenske TS, Wallin J, Tsai DE, Ku NC, Zhu E, Chen J, Yin M, Nair B, Ebata K, Marella N, Brown JR, Wang M. Pirtobrutinib in relapsed or refractory B-cell malignancies (BRUIN): a phase 1/2 study. Lancet. 2021;397:892-901. DOI: 10.1016/S0140-6736(21)00224-5 PMID: 33676628
46. Furman RR, Sharman JP , Coutre SE , Cheson BD, Pagel JM, Hillmen P , Barrientos JC , Zelenetz AD , Kipps TJ , Flinn I , Ghia P , Eradat H , Ervin T , Lamanna N , Coiffier B , Pettitt AR, Ma S , Stilgenbauer S , Cramer P , Aiello M , Johnson DM , Miller LL , Li D , Jahn TM , Dansey RD , Hallek M , O'Brien SM. Idelalisib and rituximab in relapsed chronic lymphocytic leukemia. N Engl J Med. 2014 13;370:997-1007 DOI: 10.1056/NEJMoa1315226 PMID: 24450857
1. The Surveillance E, and End Results (SEER) Program of the National Cancer Institute. Cancer Stat Facts: Leukemia—Chronic Lymphocytic Leukemia (CLL). https://seer.cancer.gov/statfacts/html/clyl.html; 2021
2. Hallek M. Chronic lymphocytic leukemia: 2015 update on diagnosis, risk stratification, and treatment. Am J Hematol. 2015;90:446–60. doi: 10.1002/ajh.23979 PMID: 25908509
3. Hallek M, Al-Sawaf O. Chronic lymphocytic leukemia: 2022 update on diagnostic and therapeutic procedures. Am J Hematol. 2021; 96: 1679-1705. doi: 10.1002/ajh.26367 PMID: 34625994
4. Awan FT, al-Sawaf O, Fischer K, Woyach JA. Current perspectives on therapy for chronic lymphocytic leukemia. Am Soc Clin Oncol Educ Book. 2020; 40: 320-329. DOI: 10.1200/EDBK_279099 PMID: 32239979
5. Zenz T, Eichhorst B, Busch R, Denzel T, Häbe S, Winkler D, Bühler A, Edelmann J, Bergmann M, Hopfinger G, Hensel M, Hallek M, Döhner H, Stilgenbauer S. TP53 mutation and survival in chronic lymphocytic leukemia. J Clin Oncol. 2010;28:4473–4479. doi: 10.1200/JCO.2009.27.8762 PMID: 20697090
6. Campo E, Cymbalista F, Ghia P, Jäger U, Pospisilova S, Rosenquist R, Schuh A, Stilgenbauer S. TP53 aberrations in chronic lymphocytic leukemia: an overview of the clinical implications of improved diagnostics. Haematologica 2018; 103: 1956–1968. DOI: 10.3324/haematol.2018.187583 PMID: 30442727
7. Stilgenbauer S, Schnaiter A, Paschka P, Zenz T, Rossi M, Dohner K, Bühler A , Böttcher S , Ritgen M , Kneba M, Winkler D , Tausch E , Hoth P , Edelmann J , Mertens D , Bullinger L, Bergmann M , Kless S , Mack S, Jäger U , Patten N , Wu L , Wenger MK , Fingerle-Rowson G , Lichter P, Cazzola M , Wendtner CM , Fink AM , Fischer K , Busch R , Hallek M, Döhner H. Gene mutations and treatment outcome in chronic lymphocytic leukemia: results from the CLL8 trial. Blood. 2014;123:3247–3254. doi: 10.1182/blood-2014-01-546150 PMID: 24652989
8. Malcikova J, Tausch E, Rossi D, Sutton LA, Soussi T, Zenz T, Kater A P, Niemann CU, Gonzalez D, Davi F, Gonzalez Diaz M, Moreno C, Gaidano G, Stamatopoulos K, Rosenquist R, Stilgenbauer S, Ghia P, Pospisilova S. European Research Initiative on Chronic Lymphocytic Leukemia (ERIC) — TP53 network. ERIC recommendations for TP53 mutation analysis in chronic lymphocytic leukemia—update on methodological approaches and results interpretation Leukemia. 2018; 32: 1070–1080. DOI: 10.1038/s41375-017-0007-7 PMID: 29467486
9. Cramer P, Hallek M. Prognostic factors in chronic lymphocytic leukemia—what do we need to know? Nat Rev Clin Oncol. 2011;8:38–47. doi: 10.1038/nrclinonc.2010.167. PMID: 20956983
10. Crombie J, Davids MS. IGHV mutational status testing in chronic lymphocytic leukemia. Am J Hematol 2017; 92: 1393–1397 DOI: 10.1002/ajh.24808 PMID: 28589701
11. Baliakas P, Jeromin S, Iskas M, Puiggros A, Plevova K, Nguyen-Khac F, Davis Z , Rigolin GM , Visentin A , Xochelli A, Delgado J, Baran-Marszak F, Stalika E, Abrisqueta P, Durechova K, Papaioannou G, Eclache V, Dimou M, Iliakis T, Collado R, Doubek M, Calasanz MJ, Ruiz-Xiville N, Moreno C, Jarosova M, Leeksma AC, Panayiotidis P, Podgornik H, Cymbalista F, Anagnostopoulos A, Livio Trentin, Stavroyianni N, Davi F, Ghia P, Kater AP, Cuneo A, Pospisilova S, Espinet B, Athanasiadou A, Oscier D, Haferlach C, Stamatopoulos K. Cytogenetic complexity in chronic lymphocytic leukemia: definitions, associations, and clinical impact. Blood. 2019; 133: 1205–1216. DOI: 10.1182/blood-2018-09-873083. PMID: 30602617
12. Döhner H, Stilgenbauer S, Benner A, Leupolt E, Kröber A, Bullinger L, Döhner K, Bentz M, Lichter P. Genomic aberrations and survival in chronic lymphocytic leukemia. N Engl J Med. 2000;343:1910–1916 DOI: 10.1056/NEJM200012283432602. PMID: 11136261
13. Allan JN, Shanafelt T, Wiestner A, Moreno C, O'Brien SM, Braggio E, Jianling Li, Krigsfeld G , Dean JP, Ahn IE . Long-term efficacy of first-line Ibrutinib treatment for chronic lymphocytic leukemia (CLL) with 4 years of follow-up in patients with TP53 aberrations (del(17p) or TP53 mutation): a pooled analysis from 4 clinical trials. Br J Haematol. 2022 196:947-953. doi: 10.1111/bjh.17984. PMID: 34865212
14. Ahn IE, Tian X, Wiestner A. Ibrutinib for chronic lymphocytic leukemia with TP53 alterations. N Engl J Med. 2020; 383: 498–500 doi: 10.1056/NEJMc2005943 PMID: 32726539
15. Woyach JA, Ruppert AS, Heerema NA, Zhao W, Booth AM, Ding W Bartlett NL , Brander DM, Barr PM, Rogers KA, Parikh SA, Coutre S, Hurria A, Brown JR, Lozanski G, Blachly JS, Ozer HG, Major-Elechi B, Fruth B, Nattam S, Larson RA, Erba H, Litzow M, Owen C, Kuzma C, Abramson JS, Little RF, Smith SE, Stone RM, Mandrekar SJ, Byrd JC. Ibrutinib regimens versus chemoimmunotherapy in older patients with untreated CLL. N Engl J Med. 2018; 379: 2517–2528 doi: 10.1056/NEJMoa1812836 PMID: 30501481
16. Moreno C, Greil R, Demirkan F, Tedeschi A, Anz B, Larratt L, Simkovic M, Samoilova O, Novak J, Ben-Yehuda D, Strugov V, Gill D, Gribben JG, Hsu E, Lih CJ, Zhou C, Clow F, James DF, Styles L, Flinn IW . Ibrutinib plus obinutuzumab versus chlorambucil plus obinutuzumab in first-line treatment of chronic lymphocytic leukaemia (iLLUMINATE): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol 2019; 20: 43–56. DOI: 10.1016/S1470-2045(18)30788-5PMID: 30522969
17. Sharman JP, Egyed M, Jurczak W, Skarbnik A, Patel K, Flinn IW, Kamdar M, Munir T, Walewska R, Hughes M, Fogliatto LM, Herishanu Y, Banerji V, Follows G, Patricia A. Walker, Karlsson K, Ghia P, Janssens A, Cymbalista F, Byrd JC, Ferrant E, Ferrajoli A, Wierda WG, Munugalavadla V, Wachira CW, Wun CC, Woyach JA. Acalabrutinib ± Obinutuzumab Vs Obinutuzumab + Chlorambucil in Treatment-Naive Chronic Lymphocytic Leukemia: 6-Year Follow-up of Elevate-TN Blood (2023) 142 (Supplement 1): 636 https://doi.org/10.1182/blood-2023-174750
18. Al-Sawaf O, Zhang C, Lu T, Michael Z Liao, Panchal A, Robrecht S, Ching T, Tandon M, Anna-Maria Fink, Tausch E, Schneider C, Ritgen M, Böttcher S, Karl-Anton Kreuzer, Chyla B, Miles D, Clemens-Martin Wendtner, Eichhorst B, Stilgenbauer S, Jiang Y, Hallek M, Fischer K. Minimal residual disease dynamics after venetoclax-obinutuzumab treatment: extended off-treatment follow-up from the randomized CLL14 study. J Clin Oncol. 2021; 39: 4049-4060 DOI: 10.1200/JCO.21.01181 PMID: 34709929
19. Moreno C, Munir T, Owen C, Follows G, Hernandez Rivas JA, Benjamini O, Janssens A, Levin MD, Robak T, Simkovic M, Voloshin S, Vorobyev VI, Yagci M, Ysebaert L, Qi Q, Smith E, Srinivasan S, Schuier N, Baeten K, Caces DB, Niemann CU, Kater AP. First-Line Fixed-Duration Ibrutinib Plus Venetoclax (Ibr+Ven) Versus Chlorambucil Plus Obinutuzumab (Clb+O): 55-Month Follow-up from the Glow Study. Blood. 2023; 142 (Supplement 1): 634.https://doi.org/10.1182/blood-2023-177713
20. Tam CS, Allan JN, Siddiqi T, Kipps TJ, Jacobs R, Opat S, Barr PM, Tedeschi A, Trentin L, Bannerji R, Jackson S, Kuss BJ, Moreno C, Szafer-Glusman E, Russell K, Zhou C, Ninomoto J, James P Dean, Wierda WG, Ghia P. Fixed-duration ibrutinib plus venetoclax for first-line treatment of CLL: primary analysis of the CAPTIVATE FD cohort. Blood. 2022; 139: 3278–3289 DOI: 10.1182/blood.2021014488 PMID: 35196370
21. Barr PM, Allan JN, Siddiqi T, Wierda WG, Lu Tam CS, Moreno CD, Tedeschi A, Szafer-Glusman E, Zhou C, Abbazio C, Dean JP, Szoke A, Ghia P. Fixed-duration ibrutinib + venetoclax for first-line treatment of chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL): 4-y follow-up from the FD cohort of the phase 2 CAPTIVATE study. J Clin Oncol.Volume 41 Number 16, Suppl 7535 https://doi.org/10.1200/JCO.2023.41.16_suppl.7535
22. Fischer K, Bahlo J, Fink AM, Goede V, Herling CD, Cramer P, Langerbeins P, von Tresckow J, Engelke A, Maurer C, Kovacs G, Herling M, Tausch E, Kreuzer KA, Eichhorst B, Böttcher S, John F Seymour JF, Ghia P, Marlton P, Kneba M, Wendtner CM, Döhner H, Stilgenbauer S, Hallek M. Long-term remissions after FCR chemoimmunotherapy in previously untreated patients with CLL: updated results of the CLL8 trial. Blood. 2016; 127: 208–215 DOI: 10.1182/blood-2015-06-651125 PMID: 26486789
23. Thompson PA, Tam CS, O'Brien SM, Wierda WG, Stingo F, Plunkett W, Smith SC, Kantarjian HM, Freireich EJ, Keating MJ. Fludarabine, cyclophosphamide, and rituximab treatment achieves long-term disease-free survival in IGHV-mutated chronic lymphocytic leukemia. Blood. 2016; 127: 303–309. DOI: 10.1182/blood-2015-09-667675PMID: 26492934
24. Thompson PA, Tam CS, O'Brien SM, Wierda WG, Stingo F, Plunkett W, Smith SC, Kantarjian HM, Freireich EJ, Keating MJ Fludarabine, cyclophosphamide,and rituximab treatment achieves long-term disease-free survival in IGHV-mutated chronic lymphocytic leukemia.Blood.2016;127:303-309 DOI: 10.1182/blood-2015-09-667675 PMID: 26492934
25. Barr PM, Owen C, Robak T, Tedeschi A, Bairey O, Burger JA, Hillmen P, Coutre SE, Dearden C, Grosicki S, McCarthy H, Li JY, Offner F, Moreno C, Zhou C, Hsu E, Szoke A, Kipps TJ, Ghia P. Up to 8-year follow-up from RESONATE-2: first-line ibrutinib treatment for patients with chronic lymphocytic leukemia. Blood Adv. 2022;6:3440-3450 DOI: 10.1182/bloodadvances.2021006434PMID: 35377947
26. Tam CS, Brown JR, Kahl BS, Ghia P, Giannopoulos K, Jurczak W, Šimkovič M, Shadman M, Österborg A, Laurenti L, Walker P, Opat S, Chan H, Ciepluch H, Greil R, Tani M, Trněný M, Danielle M Brander, Flinn IW, Grosicki S, Verner E, Tedeschi A, Li J, Tian T, Zhou L, Marimpietri C, Paik JC, Cohen A, Huang J, Robak T, Hillmen P. Zanubrutinib versus bendamustine and rituximab in untreated chronic lymphocytic leukaemia and small lymphocytic lymphoma (SEQUOIA): a randomised, controlled, phase 3 trial. Lancet Oncol. 2022; 23: 1031–1043. DOI: 10.1016/S1470-2045(22)00293-5PMID: 35810754
27. Shanafelt TD, Wang XV, Hanson CA, Paietta EM, O'Brien S, Barrientos J. Jelinek DF, Braggio E, Leis JF, Zhang CC, Coutre SE, Barr PM, Cashen AF, Mato AR, Singh AK, Mullane MP, Little RF, Erba H, Stone RM, Litzow M, Tallman M, Neil E Kay. Long-term outcomes for ibrutinib–rituximab and chemoimmunotherapy in CLL: updated results of the E1912 trial. Blood. 2022; 140: 112–120 DOI: 10.1182/blood.2021014960 PMID: 35427411
28. Eichhorst B, Niemann CU, Kater AP, Fürstenau M, von Tresckow J, Zhang C, Robrecht S, Gregor M, Juliusson G, Thornton P, Staber PB, Tadmor T, Lindström V, da Cunha-Bang C, Schneider C, Poulsen CB, Illmer T, Schöttker B, Nösslinger T, Janssens A, Christiansen I, Baumann M, Frederiksen H, van der Klift M, Jäger U, Leys MBL, Hoogendoorn M, Lotfi K, Hebart H, Gaska T, Koene H, Enggaard L, Goede J, Regelink JC, Widmer A, Simon F, De Silva N, Fink AM, Bahlo J, Fischer K, Wendtner CM, Kreuzer KA, Ritgen M, Brüggemann M, Tausch E, Levin MD, van Oers M, Geisler C, Stilgenbauer S, Hallek M; GCLLSG, the HOVON and Nordic CLL Study Groups, the SAKK, the Israeli CLL Association, and Cancer Trials Ireland.First Line Venetoclax Combinations in Chronic Lymphocytic Leukemia.N Engl J Med. 2023;388:1739-1754. doi:10.1056/NEJMoa2213093. PMID: 3716362
29. Benjamini O, Jain P, Trinh L, Qiao W, Strom SS, Lerner S, Wang X, Burger J, Ferrajoli A, Kantarjian H, O'Brien S, Wierda W, Estrov Z, Keating M. Second cancers in patients with chronic lymphocytic leukemia who received frontline fludarabine, cyclophosphamide and rituximab therapy: distribution and clinical outcomes. Leuk Lymphoma. 2015; 56: 1643-1650 DOI: 10.3109/10428194.2014.957203 PMID: 25308294
30. Kutsch N, Bahlo J, Robrecht S, Franklin J, Zhang C, Maurer C, De Silva N, Lange L, Weide R, Kiehl MG, Sökler M, Schlag R, Vehling-Kaiser U, Köchling G, Plöger C, Gregor M, Plesner T, Herling M, Fischer K, Döhner H, Kneba M, Wendtner CM, Klapper W, Kreuzer KA, Böttcher S, Stilgenbauer S, Fink AM, Hallek M, Eichhorst B. Long term follow-up data and health-related quality of life in frontline therapy of fit patients treated with FCR versus BR (CLL10 trial of the GCLLSG). HemaSphere. 2020; 4:e336. DOI: 10.1097/HS9.0000000000000336 PMID: 32072150
31. Gerousi M, Laidou S, Gemenetzi K, Stamatopoulos K, Chatzidimitriou A. Distinctive Signaling Profiles With Distinct Biological and Clinical Implications in Aggressive CLL Subsets With Stereotyped B-Cell Receptor Immunoglobulin Front Oncol. 2021;11: 771454DOI: 10.3389/fonc.2021.771454PMID: 34804974
32. Awan FT , Addison D, Alfraih F , Baratta SJ , Campos RN , Cugliari MS, Goh YT , Ionin VA , Mundnich S, Sverdlov AL , Tam C, Ysebaert L. International consensus statement on the management of cardiovascular risk of Bruton's tyrosine kinase inhibitors in CLL Blood Adv. 2022 27:6:5516-5525DOI: 10.1182/bloodadvances.2022007938 PMID: 35790105
33. Koehler AB, Leung N, Call TG, Rabe KG, Achenbach SJ, Ding W, Kenderian SS, Leis JF, Wang Y, Muchtar E, Hayman SR, Hampel PJ, Finnes HD, Schwager SM, Slager SL, Kay NE, Parikh SA. Incidence and risk of tumor lysis syndrome in patients with relapsed chronic lymphocytic leukemia (CLL) treated with venetoclax in routine clinical practice. Leuk Lymphoma. 2020; 61: 2383-2388 doi: 10.1080/10428194.2020 PMID: 32449401
34. Langerbeins P, Hallek M. COVID-19 in patients with hematologic malignancy.Blood. 2022;140:236-252. DOI: 10.1182/blood.2021012251 PMID: 35544585
35. Munir T, Brown JR, O'Brien S, Barrientos JC, Barr PM, Reddy NM, Coutre S, Tam CS, Mulligan SP, Jaeger U, Kipps TJ, Moreno C, Montillo M, Burger JA, Byrd JC, Hillmen P, Dai S, Szoke A, Dean JP, Woyach JA. Final analysis from RESONATE: up to six years of follow-up on ibrutinib in patients with previously treated chronic lymphocytic leukemia or small lymphocytic lymphoma. Am J Hematol. 2019; 94: 1353–1363. doi: 10.1002/ajh.25638. PMID: 31512258
36. Jurczak W, Pluta A, Wach M, Lysak D, Kozak T, Šimkovič M, Kaplan P, Kraychok I, Illes A, de la Serna j, Dolan S, Campbell P, Musuraca G, Jacob A, Avery E, Lee JH, Liang W, Patel P, Quah C, Jurczak W. Three-year follow-up of the ascend trial: acalabrutinib vs rituximab plus idelalisib or bendamustine in relapsed/refractory chronic lymphocytic leukemia. Blood. 2021; 138:393. DOI: 10.1200/JCO.19.03355PMID: 32459600
37. Ghia P, Pluta A, Wach M, Lysak D, Kozak T, Simkovic M, Kaplan P, Kraychok I, Illes A, de la Serna J, Dolan S, Campbell P, Musuraca G, Jacob A, Avery E, Lee JH, Liang W, Patel P, Quah C, Jurczak W W. ASCEND: phase III, randomized trial of acalabrutinib versus idelalisib plus rituximab or bendamustine plus rituximab in relapsed or refractory chronic lymphocytic leukemia. J Clin Oncol. 2020; 38: 2849–2861. DOI: 10.1200/JCO.19.03355PMID: 32459600
38. Hillmen P, Eichhorst B, Brown JR, Lamanna N, O'Brien SM, Tam CS, Qiu L, Kazmierczak M, Zhou K, Šimkovič M, Mayer J, Gillespie-Twardy A, Shadman M, Ferrajoli A, Ganly PS, Weinkove R, Grosicki S, Mital A, Robak T, Österborg A, Yimer HA, Salmi T, Ji M, Yecies J, Idoine A, Wu K, Huang J, Jurczak W. Zanubrutinib versus ibrutinib in relapsed/refractory chronic lymphocytic leukemia and small lymphocytic lymphoma: interim analysis of a randomized phase III. J Clin Oncol 2023; 41: 1035–1045. DOI: 10.1200/JCO.22.00510 PMID: 36395435
39. Seymour JF, Kipps TJ, Eichhorst B, Hillmen P, D'Rozario J, Assouline S, Owen C, Gerecitano J, Robak T, De la Serna J, Jaeger U, Cartron G, Montillo M, Humerickhouse R, Punnoose EA, Li Y, Boyer M, Humphrey K, Mobasher M, Kater AP N Engl J Med. 2018;378:1107–20. DOI: 10.1056/NEJMoa1713976 PMID: 29562156
40. Stilgenbauer S, Eichhorst B, Schetelig J, Hillmen P, Seymour JF, Coutre S, Jurczak W , Mulligan SP, Schuh A, Assouline S, Wendtner CM, Roberts AW, Davids MS, Bloehdorn J, Munir T, Böttcher S, Zhou L, Salem AH, Desai M, Chyla B, Arzt J , Kim SY, Verdugo M, Gordon G, Hallek M , Wierda WG . Venetoclax for patients with chronic lymphocytic leukemia with 17p deletion: results from the full population of a phase II pivotal trial. J Clin Oncol. 2018; 36: 1973–1980. DOI: 10.1200/JCO.2017.76.6840PMID: 29715056
41. Stilgenbauer S, Tausch E, Roberts AW, Davids MS, Eichhorst B, Hallek M, Hillmen P , Schneider C , Schetelig J , Böttcher S , Kater AP , Jiang Y , Boyer M , Popovic R, Ghanim MT , Moran M , Sinai WJ , Wang X , Mukherjee N , Chyla B , Wierda WG , Seymour JF . Six-year follow-up and subgroup analyses of a phase 2 trial of venetoclax for del(17p) chronic lymphocytic leukemia Blood Adv.2024;8:1992-2004 doi: 10.1182/bloodadvances.2023011741. PMID: 38290108
42. Hampel PJ, Parikh SA. Chronic lymphocytic leukemia treatment algorithm Blood Cancer J. 2022.; 12:161. DOI: 10.1038/s41408-022-00756-9 PMID: 36446777
43. Byrd JC, Hillmen P, Ghia P, Kater AP , Chanan-Khan A , Furman RR , O'Brien S , Yenerel MN , Illés A , Garcia-Marco NK , Mato A, Pinilla-Ibarz J, Seymour JF , Lepretre S , Stilgenbauer S , Robak T , Rothbaum W , Izumi R , Hamdy A , Patel P, Higgins K, Sohoni S, Jurczak W . Acalabrutinib versus ibrutinib in previously treated chronic lymphocytic leukemia: results of the first randomized phase III trial. J Clin Oncol. 2021; 39: 3441-3452. DOI: 10.1200/JCO.21.01210 PMID: 34310172
44. Eichhorst B , Ghia P , Niemann CU , Kater AP , M Gregor M , Hallek M, Jerkeman M, C Buske C. ESMO Clinical Practice Guideline interim update on new targeted therapies in the first line and at relapse of chronic lymphocytic leukaemiaAnn Oncol.2024;35:762-768. doi: 10.1016/j.annonc.2024.06.016. PMID: 38969011
45. Mato AR, Shah NN, Jurczak W, Cheah CY, Pagel JM, Woyach JA, Fakhri B, Eyre TA, Lamanna N, Patel MR, Alencar A, Lech-Maranda E, Wierda WG, Coombs CC, Gerson JN, Ghia P, Le Gouill S, Lewis DJ, Sundaram S, Cohen JB, Flinn IW, Tam CS, Barve MA, Kuss B, Taylor J, Abdel-Wahab O, Schuster SJ, Palomba ML, Lewis KL, Roeker LE, Davids MS, Tan XN, Fenske TS, Wallin J, Tsai DE, Ku NC, Zhu E, Chen J, Yin M, Nair B, Ebata K, Marella N, Brown JR, Wang M. Pirtobrutinib in relapsed or refractory B-cell malignancies (BRUIN): a phase 1/2 study. Lancet. 2021;397:892-901. DOI: 10.1016/S0140-6736(21)00224-5 PMID: 33676628
46. Furman RR, Sharman JP , Coutre SE , Cheson BD, Pagel JM, Hillmen P , Barrientos JC , Zelenetz AD , Kipps TJ , Flinn I , Ghia P , Eradat H , Ervin T , Lamanna N , Coiffier B , Pettitt AR, Ma S , Stilgenbauer S , Cramer P , Aiello M , Johnson DM , Miller LL , Li D , Jahn TM , Dansey RD , Hallek M , O'Brien SM. Idelalisib and rituximab in relapsed chronic lymphocytic leukemia. N Engl J Med. 2014 13;370:997-1007 DOI: 10.1056/NEJMoa1315226 PMID: 24450857
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Feb 27, 2025
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Sachanas, S. (2025) “GREEK CONSENSUS ON CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) TREATMENT”, Mediterranean Journal of Hematology and Infectious Diseases, 17(1), p. e2025014. doi: 10.4084/MJHID.2025.014.
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