Advances in the diagnosis and treatment of chronic lymphocytic leukemia.
Chronic lymphocytic leukemia (CLL) is a low-grade B-lineage lymphoid malignancy, which is often not treated until patients become symptomatic or develop signs of rapid progression. Even in this setting, treatment is non-curative and is directed at reducing the symptoms from an increasing disease burden. Newer treatment regimens incorporating purine nucleoside analogs have increased the rate of successful remission induction in CLL patients. Recent combination chemoimmunotherapy regimens have produced frequent complete molecular remissions, and early evidence suggests this may result in an improved long-term survival. Allogeneic hematopoietic cell transplantation is the only curative therapy for CLL but is infrequently used due to the older age of most patients, although reduced intensity conditioning regimens have reduced the toxicity of allogeneic transplantation. This review will summarize recent advances in the management of CLL, including prognostic factors, combination chemotherapy including nucleoside analogs and monoclonal antibodies, and reduced intensity allogeneic transplant conditioning regimens.
Abbott
Brian L
BL
Leukemia/Lymphoma Program, University of Colorado Health Science Center, Aurora, 80010, USA. stem_cell_doc@yahoo.com
D000367:Age Factors; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007167:Immunotherapy; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy*; D009705:Nucleosides / Q000627:therapeutic use; D011379:Prognosis; D012074:Remission Induction; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous
D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D009705:Nucleosides