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Leukemia/Lymphoma Program, University of Colorado Health Science Center, Aurora, Colorado, USA
Key Words. CCL • Chronic lymphocytic leukemia • Rituximab • ZAP70
Correspondence: Brian L. Abbott, M.D., Leukemia/Lymphoma Program, University of Colorado Health Science Center, 1665 N. Ursula Street, Room CP-2254, (P.O. Box 6510 Mail Stop F-704), Aurora, Colorado 80010, USA. Telephone: 720-848-0300; Fax: 720-848-0360; e-mail: Brian.Abbott{at}uchsc.edu
Chronic lymphocytic leukemia (CLL) is a low-grade B-lineage lymphoid malignancy but may have more heterogeneity than previously thought. Many cases require no treatment at all because of an indolent course, while other patients become symptomatic or develop signs of rapid progression. Treatment is usually noncurative and is directed at reducing the symptoms. Some molecular risk features may help delineate, at initial diagnosis, which patients will have a more aggressive course. Newer CLL treatment regimens incorporating purine nucleoside analogues and monoclonal antibodies have increased the rate of molecular complete remissions, which may lead to better survival times. Reduced intensity allogeneic transplant conditioning regimens have made the potentially curative modality more widely available. All these treatments have significant risks for infectious complications, which must be carefully weighed against the risks posed by the underlying disease. A proposed risk-based treatment algorithm is discussed.
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