Perspectives on the use of new diagnostic tools in the treatment of chronic lymphocytic leukemia.
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.
Binet
Jacques-Louis
JL
Rebecca and John Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093-0663, USA.
Caligaris-Cappio
Federico
F
Catovsky
Daniel
D
Cheson
Bruce
B
Davis
Tom
T
Dighiero
Guillaume
G
Döhner
Hartmut
H
Hallek
Michael
M
Hillmen
Peter
P
Keating
Michael
M
Montserrat
Emili
E
Kipps
Thomas J
TJ
Rai
Kanti
K
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*
D014408:Biomarkers, Tumor; D007136:Immunoglobulins; D051746:ZAP-70 Protein-Tyrosine Kinase