Advances in the biology and treatment of B-cell chronic lymphocytic leukemia.
Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in the western hemisphere. Diagnosis and staging of CLL are usually straightforward, but predicting an individual patient's prognosis is still a challenge. Cytogenetic abnormalities provide important prognostic information in CLL and may show its molecular heterogeneity. A search for oncogene abnormalities continues, although no consistent defects have been identified. New agents such as fludarabine produce high complete remission rates and have generated interest in earlier treatment as a first step in a potential cure. Fludarabine also makes autologous bone marrow transplant feasible as a consolidation therapy. Immunologic abnormalities and minimal residual disease persist in most patients in remission. Combining fludarabine with other active agents and devising effective postremission strategies may change the natural history of CLL.
O'Brien
S
S
Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
del Giglio
A
A
Keating
M
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000209:etiology; D016026:Bone Marrow Transplantation; D002699:Chlorambucil / Q000008:administration & dosage; D002869:Chromosome Aberrations; D017338:Cladribine / Q000008:administration & dosage; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007167:Immunotherapy; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008213:Lymphocyte Activation; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use
D007155:Immunologic Factors; D002699:Chlorambucil; D017338:Cladribine; D014740:Vidarabine; C024352:fludarabine