Diagnostic et prise en charge du lymphome à petits lymphocytes (LPL) en 2025 par rapport à la leucémie lymphoïde chronique (LLC)
Résumé
La leucémie lymphoïde chronique (LLC) et le lymphome à petits lymphocytes (LPL) (ou lymphome lymphocytaire) sont reconnus comme une seule entité pathologique, mais avec des manifestations phénotypiques distinctes. La LLC et le LPL diffèrent par l’emplacement des cellules cancéreuses. On observe une atteinte prédominante dans sang périphérique (SP) dans la LLC et une atteinte ganglionnaire et splénique dans le LPL1-3. Cet article examinera les approches historiquement divergentes adoptées pour traiter la LLC et le LPL, mettra en évidence les progrès récents dans la compréhension de leur biologie commune et plaidera en faveur d’une approche unifiée de la prise en charge dans le monde réel ainsi que de l’inclusion dans les essais cliniques pour les deux entités.
Références
Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, et al. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood. 2018;131(25):2745-60.
Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375-90.
Santos FP, O'Brien S. Small lymphocytic lymphoma and chronic lymphocytic leukemia: are they the same disease? Cancer J. 2012;18(5):396-403.
Moia R, Favini C, Ferri V, Forestieri G, Terzi Di Bergamo L, Schipani M, et al. Multiregional sequencing and circulating tumour DNA analysis provide complementary approaches for comprehensive disease profiling of small lymphocytic lymphoma. Br J Haematol. 2021;195(1):108-12.
Tooze JA, Hamzic E, Willis F, Pettengell R. Differences between chronic lymphocytic leukaemia and small lymphocytic lymphoma cells by proteomic profiling and SNP microarray analysis. Cancer Genet. 2017;218-219:20-38.
Martínez-Trillos A, Pinyol M, Delgado J, Aymerich M, Rozman M, Baumann T, et al. The mutational landscape of small lymphocytic lymphoma compared to non-early stage chronic lymphocytic leukemia. Leuk Lymphoma. 2018;59(10):2318-26.
Puckrin R, Owen C, Stewart D, Peters A. Real-world management of small lymphocytic lymphoma as chronic lymphocytic leukaemia versus an indolent non-Hodgkin lymphoma. Br J Haematol. 2023;202(2):445-8.
Olszewski AJ, Shafqat H, Ali S. Disparate survival outcomes after front-line chemoimmunotherapy in older patients with follicular, nodal marginal zone and small lymphocytic lymphoma. Leuk Lymphoma. 2015;56(4):942-50.
Cencini E, Calomino N, Sicuranza A, Gozzetti A, Fabbri A, Bocchia M. Are small lymphocytic lymphoma and chronic lymphocytic leukemia the same disease? The unsolved dilemma. J Chemother. 2024;36(6):501-5.
Sachanas S, Pangalis GA, Fink AM, Bahlo J, Fischer K, Levidou G, et al. Small Lymphocytic Lymphoma: Analysis of Two Cohorts Including Patients in Clinical Trials of the German Chronic Lymphocytic Leukemia Study Group (GCLLSG) or in "Real-Life" Outside of Clinical Trials. Anticancer Res. 2019;39(5):2591-8.
Tsimberidou AM, Wen S, O'Brien S, McLaughlin P, Wierda WG, Ferrajoli A, et al. Assessment of chronic lymphocytic leukemia and small lymphocytic lymphoma by absolute lymphocyte counts in 2,126 patients: 20 years of experience at the University of Texas M.D. Anderson Cancer Center. J Clin Oncol. 2007;25(29):4648-56.
Hallek M, Cheson BD, Catovsky D, Caligaris-Cappio F, Dighiero G, Döhner H, et al. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines. Blood. 2008;111(12):5446-56.
Malcikova J, Tausch E, Rossi D, Sutton LA, Soussi T, Zenz T, et al. ERIC recommendations for TP53 mutation analysis in chronic lymphocytic leukemia-update on methodological approaches and results interpretation. Leukemia. 2018;32(5):1070-80.
Tarella C, Arcaini L, Baldini L, Barosi G, Billio A, Marchetti M, et al. Italian Society of Hematology, Italian Society of Experimental Hematology, and Italian Group for Bone Marrow Transplantation guidelines for the management of indolent, nonfollicular B-cell lymphoma (marginal zone, lymphoplasmacytic, and small lymphocytic lymphoma). Clin Lymphoma Myeloma Leuk. 2015;15(2):75-85.
Owen C, Banerji V, Johnson N, Gerrie A, Aw A, Chen C, et al. Canadian evidence-based guideline for frontline treatment of chronic lymphocytic leukemia: 2022 update. Leuk Res. 2023;125:107016.
Association HCoCM, Association HOCoCA-C, Leukemia CWGfCL. [The guidelines for diagnosis and treatment of chronic lymphocytic leukemia/small lymphocytic lymphoma in China(2022)]. Zhonghua Xue Ye Xue Za Zhi. 2022;43(5):353-8.
Eichhorst B, Robak T, Montserrat E, Ghia P, Niemann CU, Kater AP, et al. Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2021;32(1):23-33.
Soumerai JD, Barrientos JC, Ahn IE, Coombs CC, Gladstone DE, Hoffmann MS, et al. Consensus Recommendations from the 2024 Lymphoma Research Foundation Workshop on Treatment Selection and Sequencing in CLL or SLL. Blood Adv. 2024.
N. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, Version 1.2025 — October 1, 2024 https://www.nccn.org/professionals/physician_gls/pdf/cll.pdf2024 [
Schuh AH, Parry-Jones N, Appleby N, Bloor A, Dearden CE, Fegan C, et al. Guideline for the treatment of chronic lymphocytic leukaemia: A British Society for Haematology Guideline. Br J Haematol. 2018;182(3):344-59.
Walewska R, Parry-Jones N, Eyre TA, Follows G, Martinez-Calle N, McCarthy H, et al. Guideline for the treatment of chronic lymphocytic leukaemia. Br J Haematol. 2022;197(5):544-57.
Anderson MA, Bennett R, Badoux X, Best G, Chia N, Cochrane T, et al. Chronic lymphocytic leukaemia Australasian consensus practice statement. Intern Med J. 2023;53(9):1678-91.
Raa DGT, van der Straten L, van Gelder M, Kersting S, Levin MD, Mous R, et al. Diagnosis, treatment and supportive management of chronic lymphocytic leukemia: recommendations of the Dutch HOVON CLL working group. Leuk Lymphoma. 2022;63(10):2276-89.
Burlile JF, Saifi O, Laughlin B, Harmsen WS, Rule WG, Peterson JL, et al. Local Control after Low-Dose Radiation for Two Rare Forms of Indolent Non-Hodgkin Lymphoma. International Journal of Radiation Oncology, Biology, Physics , . 2023;117(2):e459.
Puckrin R, Owen C, Peters A. Underrepresentation of Small Lymphocytic Lymphoma in Clinical Trials for Chronic Lymphocytic Leukemia. Eur J Haematol. 2024.
Tam CS, Brown JR, Kahl BS, Ghia P, Giannopoulos K, Jurczak W, et al. Zanubrutinib versus bendamustine and rituximab in untreated chronic lymphocytic leukaemia and small lymphocytic lymphoma (SEQUOIA): a randomised, controlled, phase 3 trial. Lancet Oncol. 2022;23(8):1031-43.
Tam CS, Robak T, Ghia P, Kahl BS, Walker P, Janowski W, et al. Zanubrutinib monotherapy for patients with treatment naïve chronic lymphocytic leukemia and 17p deletion. Haematologica. 2021;106(9):2354-63.
Chanan-Khan A, Cramer P, Demirkan F, Fraser G, Silva RS, Grosicki S, et al. Ibrutinib combined with bendamustine and rituximab compared with placebo, bendamustine, and rituximab for previously treated chronic lymphocytic leukaemia or small lymphocytic lymphoma (HELIOS): a randomised, double-blind, phase 3 study. Lancet Oncol. 2016;17(2):200-11.
Publié
Comment citer
Numéro
Rubrique
Licence
© Actualité hématologique au Canada 2025
Cette œuvre est sous licence Creative Commons Attribution - Pas d'Utilisation Commerciale - Pas de Modification 4.0 International.
