Therapie und Diagnostik der chronischen lymphatischen Leukämie

Die chronische lymphatische Leukämie (CLL) steht exemplarisch für Fortschritte in der personalisierten Medizin. Moderne Diagnostik, genetische Marker und individuell zugeschnittene Therapien ermöglichen eine immer präzisere Behandlung, wodurch Patienten bessere Perspektiven und eine optimierte Versorgung erhalten.

Schlüsselwörter

Chronische lymphatische Leukämie - CLL - Leitlinie - Therapie - Diagnostik

Publikationsverlauf

Artikel online veröffentlicht:
15. Oktober 2025

• Literatur

• 1 Hallek M, Cheson BD, Catovsky D. et al. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood 2018; 131: 2745-2760
• 2 Alaggio R, Amador C, Anagnostopoulos I. et al. The 5^th edition of the World Health Organization Classification of Haematolymphoid Tumours: Lymphoid Neoplasms. Leukemia 2022; 36: 1720-1748
• 3 Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF): S3-Leitlinie Diagnostik, Therapie und Nachsorge für Patient*innen mit einer chronischen lymphatischen Leukämie (CLL), Langversion 2.0, 2024, AWMF-Registernummer: 018–032OL. Zugriff am 24. Juni 2025 unter: https://www.leitlinienprogramm-onkologie.de/leitlinien/chronische-lymphatische-leukaemie-cll/
• 4 Hamblin TJ, Davis Z, Gardiner A. et al. Unmutated Ig V(H) genes are associated with a more aggressive form of chronic lymphocytic leukemia. Blood 1999; 94: 1848-1854
• 5 Baliakas P, Jeromin S, Iskas M. et al. Cytogenetic complexity in chronic lymphocytic leukemia: definitions, associations, and clinical impact. Blood 2019; 133: 1205-1216
• 6 Döhner H, Stilgenbauer S, Benner A. et al. Genomic Aberrations and Survival in Chronic Lymphocytic Leukemia. New England Journal of Medicine 2000; 343: 1910-1916
• 7 Stilgenbauer S, Schnaiter A, Paschka P. et al. Gene mutations and treatment outcome in chronic lymphocytic leukemia: results from the CLL8 trial. Blood 2014; 123: 3247-3254
• 8 International CLL-IPI working group. An international prognostic index for patients with chronic lymphocytic leukaemia (CLL-IPI): a meta-analysis of individual patient data. Lancet Oncol 2016; 17: 779-790
• 9 Eichhorst B, Ghia P, Niemann CU. et al. ESMO Clinical Practice Guideline interim update on new targeted therapies in the first line and at relapse of chronic lymphocytic leukaemia. Annals of Oncology 2024; 35: 762-768
• 10 Al-Sawaf O, Robrecht S, Zhang C. et al. Venetoclax-obinutuzumab for previously untreated chronic lymphocytic leukemia: 6-year results of the randomized phase 3 CLL14 study. Blood 2024; 144: 1924-1935
• 11 Brown JR, Seymour JF, Jurczak W. et al. Fixed-Duration Acalabrutinib Combinations in Untreated Chronic Lymphocytic Leukemia. New England Journal of Medicine 2025; 392: 748-762
• 12 Fürstenau M, Kater AP, Robrecht S. et al. First-line venetoclax combinations versus chemoimmunotherapy in fit patients with chronic lymphocytic leukaemia (GAIA/CLL13): 4-year follow-up from a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 2024; 25: 744-759
• 13 Niemann CU, Munir T, Moreno C. et al. Fixed-duration ibrutinib–venetoclax versus chlorambucil–obinutuzumab in previously untreated chronic lymphocytic leukaemia (GLOW): 4-year follow-up from a multicentre, open-label, randomised, phase 3 trial. The Lancet Oncology 2023; 24: 1423-1433
• 14 Shanafelt TD, Wang XV, Hanson CA. et al. Long-term outcomes for ibrutinib–rituximab and chemoimmunotherapy in CLL: updated results of the E1912 trial. Blood 2022; 140: 112-120
• 15 Sharman JP, Egyed M, Jurczak W. et al. Efficacy and safety in a 4-year follow-up of the ELEVATE-TN study comparing acalabrutinib with or without obinutuzumab versus obinutuzumab plus chlorambucil in treatment-naïve chronic lymphocytic leukemia. Leukemia 2022; 36: 1171-1175
• 16 Tam CS, Brown JR, Kahl BS. et al. Zanubrutinib versus bendamustine and rituximab in untreated chronic lymphocytic leukaemia and small lymphocytic lymphoma (SEQUOIA): a randomised, controlled, phase 3 trial. The Lancet Oncology 2022; 23: 1031-1043
• 17 Brown JR, Eichhorst B, Lamanna N. et al. Sustained benefit of zanubrutinib vs ibrutinib in patients with R/R CLL/SLL: final comparative analysis of ALPINE. Blood 2024; 144: 2706-2717
• 18 Seymour JF, Byrd JC, Ghia P. et al. Detailed safety profile of acalabrutinib vs ibrutinib in previously treated chronic lymphocytic leukemia in the ELEVATE-RR trial. Blood 2023; 142: 687-699
• 19 Mato AR, Woyach JA, Brown JR. et al. Pirtobrutinib after a Covalent BTK Inhibitor in Chronic Lymphocytic Leukemia. N Engl J Med 2023; 389: 33-44