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Current Hematologic Malignancy Reports

, Volume 6, Issue 1, pp 36–46 | Cite as

What is the Best Frontline Therapy for Patients with CLL and 17p Deletion?

  • Xavier C. BadouxEmail author
  • Michael J. Keating
  • William G. Wierda
Article

Abstract

Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disease with significant variation in disease progression, response to therapy, and survival outcome. Deletions of 17p or mutations of TP53 have been identified as one of the poorest prognostic factors, being predictive of short time for disease progression, lack of response to therapy, short response duration, and short overall survival. The treatment of patients with CLL has improved significantly with the development of chemoimmunotherapy, but this benefit was not pronounced in patients with 17p deletion. We compare various treatment strategies used in these patients, including FCR-like chemoimmunotherapy, alemtuzumab, other antibody combinations, or novel targeted therapies with promising results. Allogeneic stem cell transplantation offers the possibility for long-term disease control in these patients and should be considered early in younger, transplant-eligible patients. The current state of therapy is far from optimal and resources should be applied to studying therapeutic options for patients who have CLL with loss of p53 function.

Keywords

Chronic lymphocytic leukemia p53 TP53 Frontline treatment del(17p) Prognosis Alemtuzumab Combination therapies Allogeneic stem cell transplantation AlloSCT 

Notes

Disclosure

Conflicts of interest: X.C. Badoux: None. M.J. Keating: Consultant for Roche, Celgene, GlaxoSmithKline, Genzyme. W.G. Wierda: Consultant, speaker, DSMB member for Genentech; speaker for Roche; speaker and consultant for Genzyme, Celgene, and Cephalon; speaker, research funding from GlaxoSmithKline.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Xavier C. Badoux
    • 1
    Email author
  • Michael J. Keating
    • 1
  • William G. Wierda
    • 1
  1. 1.Department of LeukemiaUniversity of Texas MD Anderson Cancer CenterHoustonUSA

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