Anti-Cancer Zvinodhaka Acalabrutinib: Kurapa kweCLL / SLL / MCL - AASraw
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Anti-Kenza Zvinodhaka Acalabrutinib

 

  1. Acalabrutinib Kudzokera shure
  2. Acalabrutinib Ongororo
  3. Acalabrutinib Kurapa (Inoshandiswa)
  4. Acalabrutinib Maitiro Ekuita
  5. Ndezvipi zvingangoitika mhedzisiro yeAcalabrutinib?
  6. Acalabrutinib VS Ibrutinib
  7. Kutsvagisa: Acalabrutinib Pakurapa Chirwere cheLymphocytic leukemia (CLL)

 

Acalabrutinib Kudzokera shure

Parizvino, acalabrutinib yakashandiswa mumiedzo ichidzidza kurapwa kweB-All, Myelofibrosis, Ovarian Cancer, Multiple Myeloma, uye Hodgkin Lymphoma, pakati pevamwe.

Kubva munaGumiguru 31, 2017 iyo FDA yakabvumidza Astra Zeneca's inogadzirwa nemuromo Calquence (acalabrutinib). Iyi Bruton Tyrosine Kinase (BTK) inhibitor yakaratidza kurapwa kwechirwere chisingaperi chine lymphocytic leukemia, diki lymphocytic lymphoma, uye nevarwere vakuru vane Mantle Cell Lymphoma (MCL) vakatowana kurapwa kamwe chete.

Uyewo anozivikanwa se ACP-196, acalabrutinib inoonekwawo sechizvarwa chechipiri BTK inhibitor nekuti yaive nehungwaru yakagadzirirwa kuve yakasimba uye kusarudza kupfuura ibrutinib, inoretically inotarisirwa kuratidza mashoma mhedzisiro nekuda kwekudzikiswa kwevanomira pane zvinangwa kunze kweBTK.

Zvakangodaro, acalabrutinib yakagamuchirwa pasi peiyo FDA's yekukurumidza nzira yekubvumidzwa, iyo yakavakirwa pane yakazara mhinduro chiyero uye inogonesa kutanga mvumo yemishonga inobata zvakakomba mamiriro kana / uye inozadza chisingaenzaniswi zvekurapa zvinodiwa zvichibva pane yekupedzisira nzvimbo. Kuenderera mberi kubvumidzwa kwechiratidzo cheacalabrutinib chinogamuchirwa parizvino chingangoenderana nekuenderera mberi kwekusimbiswa uye tsananguro yekiriniki yekubatsirwa mumiedzo yekuvhiringidza.

Zvakare, iyo FDA yakapa uyu mushonga Kukoshesa Kuongorora uye Kubudirira Therapy kudomwa. Yakagamuchira zvakare Orphan Drug kudomwa, iyo inopa zvinokurudzira kubatsira uye kukurudzira kuvandudzwa kwemishonga yezvirwere zvisingawanzo. Panguva ino, anopfuura makumi matatu nemashanu emakiriniki ekuedzwa munyika makumi mana ane varwere vanopfuura 35 ari kuenderera kana apedzwa maererano nekuenderera mberi nekutsvaga mukunzwisisa kuri nani uye kuwedzera kushandiswa kwekurapa kweacalabrutinib 40.

 

Acalabrutinib Reviews

Acalabrutinib (CAS:1420477-60-6), iyo inotengeswa pasi pezita rekutengesa reCalquence® muUS neCanada, iri yechipiri-chizvarwa chidiki mamorekuru inhibitor yeBruton's tyrosine kinase (BTK). Pamusoro pekutungamira kwemuromo, acalabrutinib inosunga uye isingadzokere shure chiitiko cheBTK iyo inodzivirira zvese B-cell activation uye B-cell-inopindirana chiratidzo. Ichi chiito chinotungamira mukuvharirwa kwekukura kwemaseru B maseru ayo anowedzeraxpress BTK. BTK inodikanwa kune B-cell siginecha, inoita basa rakakosha muB-cell kusimba, uye yakanyanyisa kutsanangurwa muhuwandu hweB-cell malignancies, kusanganisira CLL / SLL. Kutaura kweBTK mumaseru maseru kwakabatana nekuwedzera kuwanda uye kurarama. Sechizvarwa chechipiri BTK inhibitor, acalabrutinib yakagadzirirwa kuwedzera mhedzisiro paBTK uye kudzikisira kunze-kwekuvavarira zviitiko paTEC (Tec Protein Tyrosine Kinase), EGFR (epidermal kukura factor receptor), uye ITK (interleukin-2-inducible T- sero kinase). Chizvarwa chekutanga BTK inhibitor, ibrutinib (Imbruvica), inoshaya izvi zvakasarudzika zvinoguma nezviitiko zvakakwirira zvemhedzisiro. Mukuwedzera kune CLL / SLL, acalabrutinib inogamuchirwa yeMantle Cell Lymphoma (MCL). Iyo National Cancer Center Network (NCCN) Nongedzo inonyora acalabrutinib ine kana isina obinituzumab seyokutanga mutsara kurapa kweCLL / SLL pamwe nekukodzera kuti ishandiswe mukudzokazve kana kuramba (R / R) CLL.

 

Acalabrutinib Kurapa (Kunoshandiswa)

Acalabrutinib inoshandiswa kurapa vanhu vane mantle cell lymphoma (MCL; kenza inokura nekukurumidza iyo inotanga mumasero ezvirwere zvemuviri) avo vakatorapwa nechero imwe chemotherapy mishonga.

Acalabrutinib inoshandiswa yoga kana ine obinutuzumab (Gazyva) kurapa chisingaperi lymphocytic leukemia (CLL; mhando yekenza inotanga mumasero machena eropa) uye diki lymphocytic lymphoma (SLL: rudzi rwe kenza iyo inotanga mumasero machena eropa).

Acalabrutinib iri mukirasi yemishonga inonzi kinase inhibitors. Inoshanda nekudzivirira chiito cheprotein isina kujairika iyo inoratidza masero ekenza kuti iwande. Izvi zvinobatsira kumisa kupararira kwekenza masero.

 

Acalabrutinib Mechanism Of Action

Mantle Cell Lymphoma (MCL) iri mhando isingawanzo asi ine hukasha yeB-cell isiri-Hodgkin lymphoma (NHL) ine fungidziro yakaipa. Shure kwaizvozvo, kudzokazve kwakajairika mune varwere veMCL uye pakupedzisira kunomiririra kufambira mberi kwechirwere.

Lymphoma inoitika kana immune system lymphocyte ichikura uye ichiwedzera isingadzoreki. MaLymphocyte ane gomarara akadaro anogona kufamba achienda kunzvimbo zhinji dzemuviri, kusanganisira ma "lymph node", "spleen", "marora" "" "" "" "uye" nedzimwe "nhengo '' dzavanogona kuwanda voita masero anonzi mabundu. Imwe yemhando huru dzeema lymphocyte dzinogona kukura kuita cancer lymphomas ndiwo maB-lymphocyte emuviri (B-maseru).

Bruton Tyrosine Kinase (BTK) inoratidzira mamorekuru eB-cell antigen receptor uye cytokine receptor nzira. Kuratidzira kwakadai kweBTK kunokonzera kumisikidzwa kwenzira dzinodiwa pakuwedzera kweB-cell, kutengesa, chemotaxis, uye kunamatira.

Acalabrutinib idiki mamorekuru inhibitor yeBTK. Ose acalabrutinib uye ayo anoshanda metabolite, ACP-5862, inoita kugadzira covalent bond necysteine ​​residue (Cys481) mune BTK inoshanda saiti, zvichitungamira mukudziviswa kweBTK enzymatic chiitiko. kusaina mapuroteni CD86 neCD69, ayo anozopedzisira avhiringidza kuwanda kweB-cell kupararira uye kurarama.

Ipo ibrutinib inowanzozivikanwa seyekutanga-mu-kirasi BTK inhibitor, acalabrutinib inoonekwa sechizvarwa chechipiri BTK inhibitor kunyanya nekuti inoratidza kusarudzika uye kuvharidzira kweakanangwa zviitiko zveBTK nepo iine IC50 yakakura kana neimwe nzira pasina kuvharirwa kinase zviitiko zveITK, EGFR, ERBB2, ERBB4, JAK3, BLK, FGR, FYN, HCK, LCK, LYN, SRC, uye YES1.

Mukudaro, acalabrutinib yaive yakagadziriswa kuti ive yakasimba uye inosarudzika kupfuura ibrutinib, nguva yese iyi ichiratidza mashoma mhedzisiro - murondedzero - nekuda kwechinoderedzwa chakaderedzwa kubva pane zvinangwa.

AASraw ndiyo nyanzvi inogadzira Acalabrutinib.

Ndokumbirawo ubaye pano kuti uwane ruzivo Cont Cont us

 

Ndezvipi zvingangoitika mhedzisiro yeAcalabrutinib?

Acalabrutinib inogona kukonzera zvakakomba mhedzisiro, kusanganisira:

Zvirwere zvakakomba zvinogona kuitika panguva yekurapwa neAcalabrutinib uye zvinogona kutungamira kurufu. Mubatsiri wako wehutano anogona kupa mimwe mishonga kana iwe uine njodzi yakawanda yekuwana hutachiona. Udza mupi wako wezvehutano ipapo kana iwe uine chero zviratidzo kana zviratidzo zvehutachiona, kusanganisira fivhiri, kutonhora, kana zviratidzo zvakaita sefuru.

Zvinetso zvekubuda ropa (kubuda ropa) zvinogona kuitika panguva yekurapwa neAcalabrutinib uye inogona kuve yakakomba uye inogona kutungamira kurufu. Ngozi yako yekubuda ropa inogona kuwedzera kana iwe uri kutorawo ropa rakaonda mushonga. Udza mupi wako wezvehutano kana iwe uine chero zviratidzo kana zviratidzo zvekubuda ropa, kusanganisira ropa muzvituru zvako kana zvituru zvitema (zvinoita kunge tara), pink kana weti weti, kubuda ropa kusingatarisirwe kana kubuda ropa kwakanyanya kana iwe usingakwanise kudzora, kurutsa ropa kana kurutsa izvo zvinoita kunge kofi nzvimbo, kukosora ropa kana kugwamba kweropa, dzungu, kushaya simba, kuvhiringidzika, shanduko mukutaura kwako, kutemwa nemusoro kunogara kwenguva refu, kana kupwanya kana kutsvuka kana kwepuru mamakisi

Kuderera mumasero eropa kuverenga. Kuderedza kuwanda kweropa (machena masero eropa, maplatelet, uye masero matsvuku eropa) zvakajairika neAcalabrutinib, asi inogona zvakare kuve yakaoma. Mubatsiri wako wehutano anofanira kuongorora ropa kuti aongorore kuwanda kweropa rako nguva nenguva panguva yekurapwa neAcalabrutinib.

Yechipiri yekutanga cancer. Makenza matsva akaitika muvanhu panguva yekurapwa neAcalabrutinib, kusanganisira kanzira yeganda kana dzimwe nhengo. Anopa hutano hwako anozokutarisa kenza dzeganda panguva yekurapwa neAcalabrutinib. Shandisa kudzivirira kwezuva kana uri kunze muchiedza chezuva.

Matambudziko emwoyo rhythm (atrial fibrillation uye atrial flutter) zvakaitika kune vanhu vanorapwa neAcalabrutinib. Udza mupi wako wezvehutano kana iwe uine chero anotevera zviratidzo kana zviratidzo: nekukurumidza kana zvisina kujairika kurova kwemoyo, dzungu, kunzwa kupera simba, kusagadzikana pachipfuva, kana kufema kwekufema

Mhedzisiro inowanzoitika yeAcalabrutinib inosanganisira kutemwa nemusoro, manyoka, mhasuru uye marwadzo akabatana, epamusoro hutachiona hwehutachiona, uye kupwanya.

Izvi hazvisi zvese zvinokanganisa mhedzisiro yeAcalabrutinib. Dana chiremba wako kuti akupe mazano ekurapa nezvemigumisiro. Unogona kuzivisa mhedzisiro kuDAA pa1-800-FDA-1088.

 

Acalabrutinib

 

 

Acalabrutinib VS Ibrutinib

BTK inoita basa rakakosha muB-cell receptor yekusainira nzira; acalabrutinib inosunga isingachinjiki kune BTK uye kuchititadzisa chiitiko chayo. Mushonga uyu wakagadzirwa senge inogona kusarudzika BTK inhibitor, mukuyedza kudzikisira dzimwe dzekurapa-kudzikisira huturu hunowanzoonekwa ne ibrutinib. Sekureva kwaDr. Brown, "Acalabrutinib ndiyo BTK inhibitor yesarudzo kune vanhu vane comorbidities, kunyanya nyaya dzemwoyo."

Iyo inoshanda data inotaridzika yakafanana pakati peacalabrutinib uye ibrutinib, kunyangwe kutevedzera kuri kureba neibrutinib, Dr. Brown akaenderera mberi. Naizvozvo, musiyano wakakosha pakati pemishonga iri mune yavo yepashure-mhedzisiro profiles. Ibrutinib inowanzo kuve isinganyanyo kushivirirwa kune vakura varwere uye inosanganiswa neakakwira mwero weatrial fibrillation uye hypertension. "Acalabrutinib iri nani-inoshivirirwa [kupfuura ibrutinib], saka ndinoishandisa zvakanyanya, kunyanya kuvarwere vangu vakuru," akadaro.

Mvumo yemushonga muCLL, yakapihwa munaNovember 2019, yaive yakanangana nedziviriro uye nehunyanzvi dhata kubva kuongororo yepakati yeEVIVU-TN kutongwa kwevarwere vaimbove vasina kurapwa CLL uye iyo ASCEND kutongwa kwevarwere vakadzokororwa kana kupokana neCLL. Mune ese miedzo, acalabrutinib yakaratidza kukunda kwekuenderera-kwemahara kwakapfuura zvichienzaniswa neyakajairwa kurapa, uye neyakavimbika mamiriro ekuregerera. Mukuyedzwa kweEVESU-TN, kunyanya, acalabrutinib inosanganiswa neobinutuzumab uye semonotherapy yakadzora njodzi yekuwedzera kwechirwere kana kufa ne90% uye 80%, zvichiteerana.

"Kusashivirira kunoramba kuri nyaya munzvimbo yekurapa yazvino yeCLL, iyo ingangoda kurapwa kunoenderera kwemakore mazhinji," akadaro Jeff Sharman, MD, Director weResearch kuWillamette Valley kenza Institute, Medical Director weHematology Tsvagiridzo yeiyo US Oncology Network, uye anotungamira munyori weEVIVATE-TN kutongwa, mukuburitswa kwepepanhau. "MuEVIVU-TN uye ASCEND miedzo tichienzanisa [acalabrutinib] nemishonga inowanzoshandiswa yekurapa, [acalabrutinib] yakaratidza kuvandudzika kwechipatara mukufambira mberi-kwekusununguka kwevarwere munzvimbo dzakawanda, uku ichichengetedza kushushikana kwayo uye chimiro chekuchengetedza."

 

Tsvakurudzo: Acalabrutinib Pakurapa Chisingaperi lymphocytic leukemia (CLL)  

(1) Chisingaperi lymphocytic leukemia (CLL)

Chisingaperi lymphocytic leukemia (CLL), yakajairika leukemia yevakuru, ndeye clonal neoplasm inoumbwa nema monomorphic madiki maseru B maseru ayo anonwisa CD5 neCD23. Mamiriro ekurapwa kweCLL akachinja zvakanyanya mumakore achangopfuura. Zvinodhaka zvinotarisa mapuroteni muB B antigen receptor (BCR) nzira, senge ibrutinib, yaratidza kuvandudzika mukufambira mberi kwemahara uye kupona kwese, kusanganisira varwere vane chirwere chine njodzi huru. Kunyangwe iyi mishonga yashandura marapirwo ekurapa mune varwere vane CLL, kurapwa kwekurapa uye kusimba neibrutinib kunogona kudzikiswa nekuda kwechero-mhedzisiro profile uye zvine chekuita nezvekurapa. Acalabrutinib, chizvarwa chechipiri uye yakasarudzika Bruton's tyrosine kinase (BTK) inhibitor, yakagadziridzwa kuti iwedzere kushanda nepo ichideredza zviitiko zvakasangana nebrutinib zvakasangana kuti zvive zvechipiri kune ibrutinib's off-target zvinokanganisa. Kuongorora uku kuchapfupisa kuvandudza, pre-kiriniki kuongorora, uye akakosha emakiriniki miedzo yakaratidza kushanda kweacalabrutinib uye hunyanzvi muLCL.

 

(2) Preclinical Zvidzidzo zveAcalabrutinib muCLL

Tsvakurudzo dzinoverengeka dzakatarisana dzakaratidza kushanda kweacalabrutinib paBTK inhibition. Kana ichiedzwa paropa remunhu rose, acalabrutinib yaive neabototent BTK inhibition kana ichienzaniswa nebrutinib. Ibrutinib yakawanikwa ichikonzera kuwedzera apoptosis kwemaCLL maseru kana achienzaniswa neacalabrutinib, iyo inogona kutsanangurwa nezvakabviswa-zvinangwa zveibrutinib. Acalabrutinib yaive nemhedzisiro pane maseru T ane hutano angangoita nekuda kwesarudzo yayo ichienzaniswa nebrutinib.

Iyo anti-bhero mhedzisiro yeacalabrutinib yakaongororwa mumaviri murine CLL mamodheru: iyo TCL1 inogamuchira yekuchinjisa modhi uye xenografted yemunhu CLL modhi. Acalabrutinib yakaratidzirwa kuti inhibit BCR kuratidza uye kurapwa neacalabrutinib yaibatanidzwa nekuwedzera kukuru mukupona zvichienzaniswa nemakonzo asina kurapwa (median 81 mazuva vs 59 mazuva, p = 0.02). Acalabrutinib zvakare yakakonzera kudzikira kukuru mumasero ari kuwanda uye zvachose mutoro mutoro mudumbu.

Kubatana kwaAbalabrutinib nema anti-CD20 monoclonal antibodies akaongororwawo. Ibrutinib inogona kukanganisa akati wandei enzira dzekuita kwema anti-CD20 antibodies zvakanyanyisa kudzivirira hutachiona-inotenderera maseru cytotoxicity uye phagocytosis iyo inogona kudzora yavo inorwisa-bundu mhedzisiro. uye akawana kuti haina kupindira nemaitiro aya, pamwe zvichikonzerwa neakanyanya kuregedza mhedzisiro mhedzisiro yeacalabrutinib. Kunyangwe iko kusanganiswa kweacalabrutinib ine anti-CD20 monoclonal antibody haina kudzidza mune in vivo modhi, akati wandei chikamu 2 uye chikamu 3 zvidzidzo zviri kuenderera mberi kana zvakapedzwa zvinoratidza kushanda kweacalabrutinib mukubatana neanti-CD20 monoclonal antibody.

Mamwe maacalabrutinib musanganiswa akave akaverengerwa mune zvese mu vitro uye mune vivo modhi. Acalabrutinib yakabatanidzwa nePI3Kdelta inhibitor (ACP-319) mune murine CLL modhi uye yakaratidza kudzikira kukuru mukuwedzera kwechirwere, NF-KB kuratidza uye kutaura kweBCL-xL uye MCL-1 zvichienzaniswa ne monotherapy. Ropa masampuli akawanikwa kubva kuCLL varwere vasina kunyoreswa mukiriniki kuyedzwa vakabatwa neacalabrutinib uye venetoclax.Uyu mubatanidzwa wakaratidzirwa kuve wakawedzera apoptosis kana uchienzaniswa nechimwe chinodhaka chete, zvichiratidza hukama hwekubatana hwakafanana neuyo unoonekwa neibrutinib uye venetoclax. Imwe yakatevera muvivo kuyedza yakaratidza kurarama kwenguva refu mumakonzo akabatwa neese acalabrutinib uye venetoclax kana ichienzaniswa nechero mushonga wega.

 

(3) mhedziso

Mukupfupisa, izvo zvidzidzo zvinotsanangurwa zvinoratidza kuti acalabrutinib ine hunyanzvi hwekurapa kweCLL, ese ekurapa naïve uye yakadzokazve yekuratidzira. Hazvina kujeka kana kushanda kwacho kwakaenzana kana kukwirira kune ibrutinib uye zvidzidzo zviri kuenderera mberi mukuyedza kuenzanisa ava vamiririri. Kunyangwe yakasarudzika BTK-inosanganisirwa huturu senge kubuda ropa kana atrial fibrillation zviitiko zviri zviitiko zvisingawanzo, akacherenib ine yakasarudzika AE chimiro, kunyanya kurwadziwa nemusoro, uko kunoda kungwarira kuongorora uye hunyanzvi mukutungamira Dhata kubva kuongororo inoenderera ichiongorora musanganiswa neacalabrutinib ichabatsira kuwedzera kutsanangura basa rayo mukutungamira kweCLL. Chekupedzisira, nemvumo yeDAA, chaiyo-yepasirese ruzivo neacalabrutinib ichabatsira kuwedzera kutsanangudza huturu hunhu.

AASraw ndiyo nyanzvi inogadzira Acalabrutinib.

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Reference

[1] US Kudya neDrug Administration. Project Orbis: FDA inobvumira acalabrutinib yeCLL uye SLL. Inowanikwa pa https://www.fda.gov/drugs/resource-information-approved-drugs/project-orbis-fda-approves-acalabrutinib-cll-and-sll. Yakasvika Kubvumbi 29, 2020.

[2] Sharman JP, Banerji V, Fogliatto LM, et al. ELEVATE-TN: Phase 3 kudzidza kweacalabrutinib inosanganiswa neobinutuzumab kana iri yoga vs obinutuzumab pamwe neklorambucil mune varwere vane kurapwa-naive chisingaperi chisingaregerere lymphocytic leukemia. Ropa 2019; 134 (suppl 1): 31.

[3] AstraZeneca Press Kuburitswa. Calquence inogamuchirwa muUS kune vakuru varwere vane chisingaperi lymphocytic leukemia. Inowanikwa pa https://www.astrazeneca.com/media-centre/press-releases/2019/calquence-approved-in-the-us-for-adult-patients-with-chronic-lymphocytic-leukaemia-21112019.html. Yakasvika Kubvumbi 29, 2020.

[4] Goede V, Fischer K, Busch R, et al. Obinutuzumab pamwe chlorambucil mune varwere vane CLL uye mamiriro ezvinhu aripo. N Engl J Med. 2014; 370 (12): 1101–1110. doi: 10.1056 / NEJMoa1313984.

[5] Parikh SA, Muchtar E, Laplant B, et al. Chikamu chakasarudzika chechipiri kudzidza kuenzanisa acalabrutinib pamwe kana isina obinutuzumab pakurapa kwekutanga nhanho varwere vane chirwere cheLymphocytic Leukemia (CLL) kana Chidiki Lymphocytic Lymphoma (SLL). Ropa. 2; 2019 (Kuwedzera_134): 1. doi: 4306 / ropa-10.1182-2019.

[6] Covey T, Gulranjani M, Cheung J, et al. Pharmacodynamic kuongororwa kweacalabrutinib mukudzokazve / kukanganisa uye kurapa-vasina ruzivo varwere vane Chronic Lymphocytic Leukemia (CLL) muchikamu che1 / 2 ACE-CL-001 Study. Ropa. 2017; 130 (Kuwedzera1): 1741. doi: 10.1182 / ropa.V130.Suppl_1.1741.1741.

[7] Byrd JC, Brown JR, O'Brien S, et al. Ibrutinib maringe neatatumumab mune yakamborapwa isingagumi lymphoid leukemia. N Engl J Med. 2014; 371 (3): 213-223. doi: 10.1056 / NEJMoa1400376.

[8] Woyach JA, Bojnik E, Ruppert AS, et al. Bruton's tyrosine kinase (BTK) basa rakakosha mukusimudzira nekuwedzera kwechirwere cheLymphocytic leukemia (CLL). Ropa. 2014; 123 (8): 1207-1213. doi: 10.1182 / ropa-2013-07-515361.

[9] Chiorazzi N, Rai KR, Ferrarini M. Chisingaperi lymphocytic leukemia. N Engl J Med. 2005; 352 (8): 804-815. doi: 10.1056 / NEJMra041720.

[10] Barr PM, Robak T, Owen C, et al. Kubudirira kwakasimba uye kwakadzama kiriniki yekutevera-yekutanga-mutsara ibrutinib kurapwa mune vakura varwere vane chisingaperi lymphocytic leukemia: yakawedzera chikamu 3 mhedzisiro kubva ku RESONATE-2. Haematologica. 2018; 103 (9): 1502-1510. doi: 10.3324 / haematol.2018.192328.

[11] Herman SEM, Montraveta A, Niemann CU, uye al. Iyo Bruton Tyrosine Kinase (BTK) inhibitor ACP-196 inoratidza kiriniki chiitiko mune maviri mbeva mhando dzechisingaperi lymphocytic leukemia. Ropa. 2015; 126 (23): 2920. doi: 10.1182 / ropa.V126.23.2920.2920.

 

 

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