A whole range of new therapeutic agents is in development, some of which are already in the clinic. Lenalidomide  might act by interfering with the tumour/stroma interaction. Ofatumumab is a fully humanised CD20 monoclonal antibody with reputed advantages over rituximab because of a slower off-rate. Lumiliximab—a primatised anti-CD23—is entering clinical trials in patients with chronic lymphocytic leukaemia. Chronic lymphocytic leukaemia cells with deletions at 11q23 seem to be especially sensitive to the orally available poly (ADP-ribose) polymerase inhibitor 4-amino-1,8-naphthalamide. ATM-deletion-mediated drug resistance might also be overcome with Nutlin 3a. Finally, acadesine seems to be a new chemotherapeutic agent capable of killing chronic lymphocytic leukaemia cells yet leaving T cells unharmed.
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