ONKOLOGIE / Onkologie. 2023;17(3):192-196 / www.onkologiecs.cz 196 PŘEHLEDOVÉ ČLÁNKY Inhibitory Brutonovy tyrosinkinázy a jejich současné postavení v léčbě chronické lymfocytární leukemie Závěr Inhibitory Brutonovy tyrosinkinázy zaujímají v současné době ústřední postavení v léčbě chronické lymfocytární leukemie. Nejlepších výsledků dosahují při použití v primoterapii a zásadní přínos mají pro pacienty s aberací TP53. Velký potenciál v léčbě CLL má i kombinace BTKi s BCL-2 inhibitorem. Z nežádoucích účinků u BTKi je nezbytné myslet na riziko krvácivých komplikací, fibrilace síní, a vzhledem k nezanedbatelnému vlivu BTKi na imunitní systém i na zvýšenou náchylnost k infekcím a sníženou odpověď na vakcinaci. Možnou terapeutickou strategií pro pacienty po selhání kovalentního BTKi bude do budoucna použití nekovalentních BTKi (např. pirtobrutinibu). Uplatnění v léčbě Richterovy transformace by výhledově mohla nalézt především kombinace BTKi s chemoimunoterapií či jinou cílenou léčbou. 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