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慢性淋巴细胞白血病/小淋巴细胞淋巴瘤:Mayo Clinic 淋巴系统恶性肿瘤系统管理与风险适应性治疗(lySMART)共识指南 2026

英文原题:Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma: Mayo Clinic Systematic Management and Risk-Adapted Therapy for Lymphoid Malignancies (lySMART) Consensus Guidelines 2026.

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Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma: Mayo Clinic Systematic Management and Risk-Adapted Therapy for Lymphoid Malignancies (lySMART) Consensus Guidelines 2026.

PubMed 2026/06/05(内容时间) Mayo Clin Proc Q1 · IF 6.5(JCR 2025)

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中文摘要

慢性淋巴细胞白血病(CLL)是美国成人中最常见的白血病,预计2026年将有约24,000例新发病例,目前有超过220,000人带病生存。在过去20年中,生物学认识的进步和治疗选择的增加显著改善了CLL患者的结局。治疗范式已决定性地从化学免疫治疗转向靶向药物。Bruton酪氨酸激酶抑制剂、B细胞淋巴瘤2抑制剂和抗CD20单克隆抗体现在构成了前线治疗的骨干,并根据遗传风险、合并症和患者偏好进行个体化治疗。对于复发/难治性疾病,共价和非共价Bruton酪氨酸激酶抑制剂、B细胞淋巴瘤2抑制剂以及细胞疗法(包括CAR-T 细胞疗法)的序贯应用扩大了选择,并改善了高危情况下的结局。CLL的Richter转化是一个未满足需求的领域,因为大多数当代系列报告生存期不足24个月。这些指南总结了Mayo Clinic对CLL患者(包括CLL的Richter转化患者)的诊断、风险分层和管理方法。

展开英文摘要原文

Chronic lymphocytic leukemia (CLL) is the most frequent leukemia in adults in the United States, with roughly 24,000 new cases expected in 2026 and more than 220,000 people currently living with the disease. During the past 2 decades, advancements in biologic insights and treatment options have significantly enhanced the outcomes for patients with CLL. Treatment paradigms have shifted decisively from chemoimmunotherapy to targeted agents. Bruton tyrosine kinase inhibitors, B-cell lymphoma 2 inhibitors, and anti-CD20 monoclonal antibodies now form the backbone of frontline care, with therapy tailored by genetic risk, comorbidities, and patient preferences.

For relapsed or refractory disease, sequencing of covalent and noncovalent Bruton tyrosine kinase inhibitors, B-cell lymphoma 2 inhibitors, and cellular therapies, including chimeric antigen receptor T-cell therapy, has expanded options and improved outcomes in high-risk settings.

Richter transformation of CLL represents an area of unmet need as most contemporary series report survival of less than 24 months. These guidelines summarize the Mayo Clinic approach to the diagnosis, risk stratification, and management of patients with CLL, including those with Richter transformation of CLL.

论文信息

作者
Parikh SA、Hampel PJ、Roeker LE、Wang Y、Tsang M、Parrondo R、Bailen R、Koehler A
单位
Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN. Electronic address: parikh.sameer@mayo.edu.United States
文献类型
临床实践指南
期刊
Mayo Clinic proceedings2026 Jul
原文标识
PubMed 42246910 · DOI 10.1016/j.mayocp.2026.03.001