Second-line or later treatments for B-chronic lymphocytic leukemia

The clinical course of B-chronic lymphocytic leukemia (CLL) after the failure of the first line of treatment is characterized by increasingly frequent episodes of disease progression and the need for new therapies. Treatment options include pathway inhibitors (PIs) such as Bruton's tyrosine kinase inhibitors (BTKi), BCL2 inhibitors, as a monotherapy as well as combined with antiCD20 monoclonal antibodies, while a minority of patients is referred to allogeneic stem cell transplantation or CAR-T cell therapy where available. When choosing a treatment method for the relapsed/refractory B-CLL, the characteristics of the patient and the disease should be kept in mind in order to choose the right drug in case of unfavorable prognostic markers, which could possibly overcome the expected worse outcomes.

Key words:
BCL2i inhibitors; Bruton's tyrosine kinase inhibitors; cell therapy; monoclonal anti-CD20 antibodies; relapsed/refractory B-CLL