**Table 4.**

*Novel antibodies and antibody-drug conjugates directed against surface antigens [49].*


#### **Table 5.**

*Advances in Hematologic Malignancies*

**2-chlorodeoxy-adenosine)**

with refractory or relapsed to chemotherapy.

phatic leukemia.

**6.3 Ibrutinib (Imbruvica)**

**6.4 Idelalisib (Zydelig)**

**6.5 Venetoclax (Venclexta)**

(**Tables 4** and **5**) [52].

regular follow up without treatment. 70% of CLL patients respond to chlorambucil monotherapy which may be given orally for stabilization of leukocytosis and symptoms. Thrombocytopenia in stage IV stabilized with addition of prednisone.

Are unique drugs that are effective in low grade lymphomas and chronic lym-

Fludarabine is active and useful in patients resist to chlorambucil and in newly diagnosed CLL. The alternative use of CVP (Cyclophosphamide, Vincristine and Prednisone). In addition fludarabine and cladribine in treatment of CLL, the combination of rituximab against CD20 and alemtuzumab against CD52, has an acceptable safety profile, and has clinical activity with a short course in patients

Is a small molecule targeted drug that acts as an irreversible burton tyrosine kinase

inhibitor (BTK) and can be used to treat chronic lymphocytic leukemia (CLL). In 2013 FDA approved ibrutinib for treatment patients with mantle cell lymphoma and in 2013 also approved for CLL and small lymphocytic lymphoma with 17p [48, 49].

Is another targeted drug approved for patients with CLL with CD20 positive in combination with rituximab or ofatumumab. It blocks a kinase protein called PI3K. FDA in July 28, 2014, has approved idelalisib 150 mg tablets for the treatment of B-CLL. Idelalisib has been appeared to assist treat CLL after other medications have been attempted and is indicated in combination with rituximab for patients with relapsed chronic lymphocytic leukemia (CLL) and significantly reported excellent response rate, overall survival and progressed progression-free survival (**Tables 4** and **5**) [50, 51].

Is a selective drug that targets BCL-2, a protein in CLL cells had a manageable response for patients with small lymphocytic lymphoma (SLL) poor prognostic and chronic lymphocytic leukemia whose relapsed or refractory to other drugs

**Mechanism Drug Target**

Ofatumumab Obinutuzumab Epratuzumab Lucatumumab

Polatuzumab vedotin Inotuzumab ozogamicin SAR3419

CD19 CD20 CD20 CD22 CD40

CD30 CD79B CD22 CD19

Monoclonal antibodies MEDI-551

Antibody drug conjugates Brentuximab vedotin

*Novel antibodies and antibody-drug conjugates directed against surface antigens [49].*

**6.2 Purine nucleoside analogous: (fludarabin, deoxycoformycin,** 

**126**

**Table 4.**

*Novel antibodies directed against immune checkpoint proteins and novel small molecule inhibitors [49].*
