Emerging therapy for chronic lymphocytic leukaemia.
The presentation, clinical course and prognosis for chronic lymphocytic leukaemia (CLL) is diverse and strategies for therapy reflect this variability. Staging of the disease has assisted in deciding treatment options and more recently the cytogenetic, molecular and surrogate markers of the immunoglobulin heavy chain mutational status, CD38 and ZAP-70, have assisted in further risk stratification. Chemotherapy has been the mainstay of interventional therapy when required and the two most important classes of agents in the treatment of CLL are nucleoside analogues and alkylating agents. Combining these two groups of agents has significantly improved prognosis in this disease. More recently a number of novel agents have been applied to patients with CLL to determine if they represent better therapy. However, allogeneic stem cell transplantation offers perhaps the only realistic chance of a cure in this disease. Clinical trials are still needed to determine the timing and role of this promising treatment modality in the treatment of CLL and, where possible, combined with the emerging awareness of the disease biology, related biological markers and prognostic indicators.
Auer
Rebecca L
RL
Centre for Haematology, Barts and the London School of Medicine, London, UK. r.l.auer@qmul.ac.uk
Gribben
John
J
Cotter
Finbarr E
FE
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy / Q000628:therapy*; D033581:Stem Cell Transplantation / Q000379:methods