Значение минимальной остаточной болезни при хроническом лимфолейкозе в эру таргетных лекарственных препаратов

Полная ремиссия (ПР) и длительная беспрогрессивная выживаемость (БПВ) могут быть достигнуты уже после первой линии химиоиммунотерапии у большинства больных хроническим лимфолейкозом (ХЛЛ). Тем не менее в костном мозге значительного числа больных с ПР заболевания иммунологическими и генетическими методами выявляют некоторое количество опухолевых клеток (более 1 на 10 000 нормальных клеток), которые определяют суть минимальной остаточной болезни (МОБ). МОБ- негативный статус больного ассоциируется с длительной БПВ и общей выживаемостью и является единственным благоприятным прогностическим фактором, определяемым после терапии. Появление таргетных препаратов терапии ХЛЛ (ибрутиниб, иделалисиб, венетоклакс), имеющих высокую эффективность и низкий профиль токсичности, позволяет надеяться на увеличение числа МОБ-негативных ремиссий, а изменение тактики лечения - на решение проблемы контроля за остаточным опухолевым клоном.

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