[New perspectives in the evolution of prognosis and treatment of chronic lymphocytic leukaemia]

Abstract

Chronic lymphocytic leukaemia is a disease with a variable clinical course and prognosis. New prognostic factors like immunoglobulin gene mutational status, cytogenetic abnormalities, CD38 and ZAP70 expression of malignant cells have been described recently. Conventional and biological prognostic factors allow to identify patients with unfavorable prognosis at early stage. Purin analogues, fludarabine and fludarabine based combinations can achieve complete hematological remission in approximately one third of patients with chronic lymphocytic leukaemia. Chemoimmunotherapy (most experience is obtained by combination of fludarabine + cyclophosphamide + rituximab) can increase not only complete remission rate, but also induce molecular remission in some cases. Stem cell transplantation as well as early and effective chemotherapy are curative choices of treatment in patients with chronic lymphocytic leukaemia.