Tratamiento de la leucemia linfática crónica. La historia se repite.

Abstract

Treatment in chronic lymphocytic leukemia (CLL) represents the paradigm of advances in the therapy for hematological malignancies. In the last 10 years, the increased knowledge on the mechanisms of tumor progression, crosstalk with the microenvironment, molecular biology and cytogenetic breakthroughs became the fundamental pieces of these advances.However, therapeutic strategies seem to follow the same pattern. Whereas early therapy used single drugs, they were gradually combined in duplets and triplets leading to successful results that had never been achieved and envisioning for the first time a future full of hope for this incurable disease.The development of ibrutinib has been probably the milestone that definitely highlighted the importance of signaling pathways in CLL progression and opens the investigation of novel target agents which constitute the current treatment of this disease. Today, we have a plethora of new drugs that, as in their early stages, went from being used as monotherapy to being tested in combinations with optimal results, even in high-risk patients. It shows us that history repeats itself.