title: Front-line therapy for chronic lymphocytic leukemia.
abstract: BACKGROUND
  Historically, alkylator-based therapy has been used to treat patients with chronic lymphocytic leukemia (CLL). More effective therapies, such as the use of monoclonal antibodies in combination with chemotherapy, have been shown to prolong both progression-free survival and overall survival. Improvements in the identification of prognostic markers for CLL, as well as novel combinations for chemoimmunotherapy regimens, have improved the outcome for patients with CLL.
  
  
  METHODS
  We examine the diagnosis of CLL, the role of prognostic factors in determining treatment goals, and current data on front-line management of CLL.
  
  
  RESULTS
  The benefits of single-agent and combination therapies are associated with prolonged progression-free and overall survival. While more aggressive management may therefore be warranted, each patient's comorbidities and performance status must be weighed against the benefits, availability, cost, treatment goals, and incidence of adverse effects associated with each therapy.
  
  
  CONCLUSIONS
  New single agents and novel treatment combinations have shown promising results in phase I/II studies. The ultimate therapeutic goals of prolonged survival and improved quality of life will be validated only by ongoing clinical and laboratory research and by continuous enrollment of patients in clinical trials.
authors.affiliation: Department of Pharmacy, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA. Sheetal.Desai@moffitt.org
authors.forename: Sheetal
authors.initials: S
authors.lastname: Desai
authors.forename: Javier
authors.initials: J
authors.lastname: Pinilla-Ibarz
mesh_terms: D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis