E.A. Nikitin, A.B. Sudarikov
FSBI «Haematological Research Center» Russian Ministry of Health, Moscow, Russian Federation
ABSTRACT
High-risk chronic lymphocytic leukemia is an emerging concept that was first established in fludarabine era. While fludarabine and fludarabine-containing regimens are highly effective in the majority of patients, a small subgroup of patients show poor response to standard regimens. The prognosis of these patients is dismal with a median overal survival of 2 – 3 years. The article present historical review and modern definition of high risk CLL, describes known molecular mechanisms of refractoriness to fludarabine and focuses on different treatment approaches.
Keywords: chronic lymphocytic leukemia, TP53, 17p deletion, fludarabine
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