title: Perspectives on the use of new diagnostic tools in the treatment of chronic lymphocytic leukemia.
abstract: Recently, considerable progress has been made in the identification of molecular and cellular markers that may predict the tendency for disease progression in patients with chronic lymphocytic leukemia (CLL) or detect minimal residual disease after therapy. These developments have created uncertainty for clinicians who hope to incorporate the use of these markers and new disease-assessment tools into standard clinical practice. However, clinical trials are required to determine whether poor-prognosis leukemia-cell markers, such as expression of unmutated immunoglobulin genes or the zeta-associated protein of 70 kDa (ZAP-70), can be used as the basis for determining the time or type of therapy. Pending the outcome of such trials, treatment decisions outside the context of a clinical trial still should be based on guidelines established by the most recent National Cancer Institute-sponsored Working Group.
authors.affiliation: Rebecca and John Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093-0663, USA.
authors.forename: Jacques-Louis
authors.initials: JL
authors.lastname: Binet
authors.forename: Federico
authors.initials: F
authors.lastname: Caligaris-Cappio
authors.forename: Daniel
authors.initials: D
authors.lastname: Catovsky
authors.forename: Bruce
authors.initials: B
authors.lastname: Cheson
authors.forename: Tom
authors.initials: T
authors.lastname: Davis
authors.forename: Guillaume
authors.initials: G
authors.lastname: Dighiero
authors.forename: Hartmut
authors.initials: H
authors.lastname: Döhner
authors.forename: Michael
authors.initials: M
authors.lastname: Hallek
authors.forename: Peter
authors.initials: P
authors.lastname: Hillmen
authors.forename: Michael
authors.initials: M
authors.lastname: Keating
authors.forename: Emili
authors.initials: E
authors.lastname: Montserrat
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Kipps
authors.forename: Kanti
authors.initials: K
authors.lastname: Rai
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D002986:Clinical Trials as Topic; D006801:Humans; D007136:Immunoglobulins / Q000378:metabolism*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000378:metabolism* / Q000628:therapy; D009316:National Institutes of Health (U.S.); D018365:Neoplasm, Residual; D017410:Practice Guidelines as Topic; D011379:Prognosis; D014481:United States; D051746:ZAP-70 Protein-Tyrosine Kinase / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D007136:Immunoglobulins; D051746:ZAP-70 Protein-Tyrosine Kinase