The treatment landscape of chronic lymphocytic leukemia (CLL) has tremendously evolved in the last decades thanks to the introduction of more effective therapies. Front-line therapy for patients with CLL includes chemoimmunotherapy (CIT) and pathway inhibitors (PI) (i.e., Bruton tyrosine kinase inhibitors and BCL2 inhibitors); the latter have proved to be more effective than CIT mainly in patients with high-risk features (eg, TP53 aberrations, unmutated IGHV) with acceptable toxicity. Combinations of PIs are playing a protagonist role as front-line therapy for CLL. In this article, the management of treatment- naïve patients with CLL is discussed.

中文翻译：

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慢性淋巴细胞白血病的一线治疗。

由于更有效疗法的引入，慢性淋巴细胞白血病（CLL）的治疗前景在过去几十年中发生了巨大的发展。CLL患者的一线治疗包括化学免疫疗法（CIT）和通路抑制剂（PI）（即Bruton酪氨酸激酶抑制剂和BCL2抑制剂）；后者已被证明比 CIT 更有效，主要针对具有高风险特征（例如 TP53 畸变、未突变 IGHV）且毒性可接受的患者。PI 组合作为 CLL 的一线治疗发挥着主角作用。本文讨论了初治 CLL 患者的治疗。