Diagnosis and treatment of chronic lymphocytic leukemia: 2025 recommendations of the Brazilian Group of Chronic Lymphocytic Leukemia of the Brazilian Association of Hematology and Hemotherapy (ABHH)
Chronic lymphocytic leukemia, characterized by an accumulation of monoclonal B lymphocytes, is the most common adult leukemia. The disease predominantly affects older adults, with a significant proportion being asymptomatic at diagnosis. This manuscript provides a comprehensive review of chronic lymphocytic leukemia, including its epidemiology, clinical presentation, diagnostic criteria, and treatment strategies. Prognostic factors, particularly IGHV mutation status and chromosomal abnormalities, are discussed as critical determinants of disease behavior and treatment response. Recent advances in targeted therapies, such as Bruton's tyrosine kinase inhibitors (BTKi) and B-cell lymphoma 2 inhibitors (BCL-2i), have changed the treatment landscape by demonstrating superior efficacy to chemoimmunotherapy. However, disparities in access to care, particularly in low- and middle-income countries such as Brazil, highlight the need for equitable treatment approaches. The discussion of measurable residual disease (MRD) assessment for prognostication and treatment planning is also highlighted. This review highlights the need for continued research and integration of novel therapies to optimize patient outcomes in chronic lymphocytic leukemia.
Authors
- Dani Laks
- Carlos Chiattone (ORCID: https://orcid.org/0000-0002-4639-2578)
- Talita Silveira (ORCID: https://orcid.org/0000-0002-6367-7516)
- Danielle Leão Cordeiro de Farias (ORCID: https://orcid.org/0000-0002-3140-2235)
- Valéria Buccheri (ORCID: https://orcid.org/0000-0002-6999-4109)
- Vera Figueiredo (ORCID: https://orcid.org/0000-0002-9471-1369)
- Rony Schaffel (ORCID: https://orcid.org/0000-0002-0886-4474)
- Glaciano Ribeiro (ORCID: https://orcid.org/0000-0002-0933-0562)
- Celso Arrais‐Rodrigues (ORCID: https://orcid.org/0000-0002-6395-6849)
- Sérgio Costa Fortier (ORCID: https://orcid.org/0000-0002-4539-6825)
- Maura Rosane Valério Ikoma (ORCID: https://orcid.org/0000-0002-1473-9696)
- Rafael Dezen Gaiolla (ORCID: https://orcid.org/0000-0002-9480-4995)
- Samir Kanaan Nabhan (ORCID: https://orcid.org/0000-0001-8617-384X)
- Nelson Hamerschlak (ORCID: https://orcid.org/0000-0002-5140-5310)
- Pedro Amoedo Fernandes
- Marcelo Pitombeira de Lacerda (ORCID: https://orcid.org/0000-0001-5554-7167)
- Mihoko Yamamoto (ORCID: https://orcid.org/0000-0001-7881-1856)
- Fernanda de Morais Marques (ORCID: https://orcid.org/0009-0004-4742-0800)
- Matheus Vescovi Gonçalves
- Adriana Scheliga
- Wolney Barreto
- Abel Costa
Institutions
- Universidade Federal de Minas Gerais (BR)
- Universidade Federal do Rio de Janeiro (BR)
- Brazilian Medical Association (BR)
- Hospital Israelita Albert Einstein (BR)
- Centro Universitário Católico Salesiano Auxilium (BR)
- Hospital do Servidor Público Municipal (BR)
- Hospital Samaritano de São Paulo (BR)
- Universidade da Região de Joinville (BR)
- D’Or Institute for Research and Education (BR)
- Hospital Amaral Carvalho (BR)
- Beneficência Portuguesa de São Paulo (BR)
- Medecell (Brazil) (BR)
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (BR)
- Fleury S.A. (Brazil) (BR)
- Fundação Faculdade de Medicina (BR)
- Hospital São Paulo (BR)
- Instituto de Hematología e Inmunología (CU)
- Universidade Federal do Paraná (BR)
- Universidade Federal de São Paulo (BR)
Publication Details
- Journal
- Hematology Transfusion and Cell Therapy
- Published
- 2025-04-01
- DOI
- https://doi.org/10.1016/j.htct.2025.103822
- Citations
- 5
- Primary Topic
- Chronic Lymphocytic Leukemia Research
- Type
- article
- Field-Weighted Citation Impact
- 8.13