期刊
LEUKEMIA
卷 21, 期 9, 页码 1885-1891出版社
NATURE PUBLISHING GROUP
DOI: 10.1038/sj.leu.2404802
关键词
chronic lymphocytic leukemia; cytogenetics; genomic abnormalities; immunotherapy; prognostic factors; purine analogs
The management of chronic lymphocytic leukemia ( CLL) has historically relied on ` watchful waiting' and palliative approaches to therapy. However, the course of disease is highly variable and a substantial proportion of patients with earlystage CLL develop rapidly progressive disease requiring therapy. In recent decades, numerous clinical and biological prognostic markers that are predictive of decreased survival outcomes, disease progression and/ or resistance to therapy, and that may play a role in defining the subgroups of patients with ` high- risk' CLL have been identified. At the same time, highly effective treatment modalities have become available with the advent of chemoimmunotherapy combinations and allogeneic stem cell transplantation. Thus, we are approaching an era when patients with CLL may potentially benefit from individualized risk assessments based on prognostic markers and when specific therapies may be offered to the subgroup of patients with high- risk disease. This review provides a brief overview of newer biological prognostic markers, discusses the challenges associated with identifying the subgroup of patients with high- risk CLL and further aims to provide recommendations on how prognostic markers may be used to assess highrisk subgroups in different clinical situations in CLL.
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