Salvage therapy for CLL and the role of stem cell transplantation.
Chronic lymphocytic leukaemia (CLL) remains an incurable disease and, notwithstanding the excellent remission rates now achieved with purine analogs and monoclonal antibodies, the vast majority of patients with CLL are destined to relapse after primary treatment. The management of relapsed CLL patients is then dependent upon a number of factors, most importantly age, performance status, previous therapy administered, the response and duration of response to such therapy, and time from last therapy. Although prior therapy and response to such therapy are important factors in determining next therapy, it is often difficult to determine their importance from published studies. Furthermore, the goal of therapy, whether palliative or aggressive, must also be weighed into the decision when deciding on the next line of treatment. With many potential treatments available, the sequence of treatments and the timing of procedures such as stem cell transplantation remain controversial and are the focus of ongoing clinical trials.
Gribben
John G
JG
Barts and The London School of Medicine, St. Bartholomew's Hospital, 45Little Britain, London, England EC1A 7BE, United Kingdom. john.gribben@cancer.org.uk
D000911:Antibodies, Monoclonal / Q000235:genetics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005818:Genetic Engineering; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000601:surgery*; D010166:Palliative Care; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods*; D033581:Stem Cell Transplantation / Q000379:methods*; D014184:Transplantation, Homologous
D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents