Management of patients with chronic lymphocytic leukemia with a high risk of adverse outcome: The Mayo Clinic approach

Clive S. Zent, Neil E. Kay

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations

Abstract

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) is usually an incidental diagnosis in patients with earlyintermediate stage disease. However, most patients with a diagnosis of CLL will subsequently have significant morbidity and die from their disease and its complications. For these patients, CLL is not the ?good leukemia? with a predictably ?benign? outcome. Indeed, we can now identify a cohort of patients with high-risk CLL at diagnosis who will have rapid disease progression, poor response to treatment, and poor survival based on prognostic methods developed from an improved understanding of the biology of CLL. The concomitant development of improved treatments has led to risk-adjusted management approaches that could improve outcomes. We discuss the clinical and laboratory components of comprehensive risk evaluation of patients with CLL and our approach to the management of patients with a high to very high risk of disease progression and poor outcome. In addition, we review the challenges and prospects for improving prognostic precision and the development of new drugs to improve the treatment of patients with CLL with a high risk of adverse outcome.

Original languageEnglish (US)
Pages (from-to)1425-1434
Number of pages10
JournalLeukemia and Lymphoma
Volume52
Issue number8
DOIs
StatePublished - Aug 2011

Keywords

  • CLL
  • Chronic lymphocytic leukemia
  • SLL
  • high risk
  • risk stratified management
  • therapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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