Current Hematologic Malignancy Reports

, Volume 5, Issue 1, pp 45–51 | Cite as

Challenges in the Frontline Treatment of Patients With Chronic Lymphocytic Leukemia

Article

Abstract

Therapy for chronic lymphocytic leukemia has improved dramatically over the past 20 years. Traditional therapy with oral chlorambucil led to complete responses in less than 5% of treated patients, in marked contrast to modern regimens, which can reliably produce complete responses in over 50% of patients. This remarkable improvement is attributable to the use of purine analogue-based treatment as well as monoclonal antibodies. Novel combinations of these agents have emerged as effective new therapies for previously untreated patients. Clinical studies indicate that such combinations can induce higher response rates (including complete responses) than single-agent therapy. Those patients who achieve a complete response have superior progression-free survival compared with those who achieve only a partial response. Though not yet demonstrated in a prospective randomized trial, treatment approaches aimed at achieving high-quality responses may one day improve survival for patients with chronic lymphocytic leukemia. However, many challenges remain, such as finding less toxic and equally efficacious regimens for older patients, who remain the majority of the population with this disease.

Keywords

Chronic lymphocytic leukemia Frontline treatment 

Notes

Disclosure

Dr. Lamanna has been a consultant for Celgene and has received research support from Hospira, Celgene, and Biogen-Idec.

References

Papers of particular interest, published recently, have been highlighted as: • Of Importance •• Of Major Importance

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Leukemia Service, Department of Medicine Memorial Sloan-Kettering Cancer CenterNew YorkUSA

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