Chronic lymphocytic leukemia: prognostic factors and impact on treatment

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BlankChronic lymphocytic leukemia: prognostic factors and impact on treatment.

TL and MP Strout

Discov Med, February 1, 2011; 11(57): 115-23.

Yale Cancer Center and Department of Internal Medicine Section of Hematology,

Yale University School of Medicine, New Haven, Connecticut 06520, USA.

matthew.strout@... .

Chronic lymphocytic leukemia (CLL) is a clonal malignancy of mature B cells that

displays immense clinical heterogeneity as reflected by the observation that

many patients have an indolent disease that will not require intervention for

many years while others will present with an aggressive and symptomatic leukemia

requiring immediate treatment. Although there is no cure for CLL, the disease is

treatable and current standard chemotherapy regimens have been shown to prolong

survival. There is no obvious survival advantage to early treatment versus

observation but the timing as to when a patient will require treatment is highly

unpredictable. Thus, there has been great interest in identifying prognostic

markers that can be used to distinguish those patients who may have an

aggressive form of CLL and might benefit from early intervention. While clinical

staging systems have been used to stratify patients into risk categories, they

lack the ability to predict disease progression or response to therapy. Recent

advances in our understanding of the biology of CLL have led to the

identification of numerous cellular and molecular markers with potential

prognostic and therapeutic significance. This review provides a concise overview

of prognostic markers in CLL and a discussion of how those markers have impacted

the clinical management of the disease.

PMID: 21356166