Genetic lesions in chronic lymphocytic leukemia: what's ready for prime time use?

C hronic lymphocytic leukemia (CLL) is a frequent CD5 + B-cell neoplasia that involves peripheral blood, bone marrow, lymph nodes and other lym-phoid tissues. The median age of patients at diagnosis of CLL is around 70 years old and the prognosis is extremely variable. In spite of some advances in its therapy, CLL continues to be incurable. Due to this fact, and to the prognos-tic heterogeneity of the disease, individual, risk-adapted therapies are needed. A number of clinical parameters identified in the 1980s and 1990s, particularly clinical stages, enable a prediction of the clinical outcome of patients with CLL. These parameters do not, however, indicate which patients will have rapidly evolving disease and which will have stable patients. X, et al. Outcome of treatment in adults with Philadelphia chromosome positive acute lymphoblastic leukemia-results of the prospective multicenter LALA-94 trial. Long-term remission of Philadelphia chromosome-positive acute lymphoblastic leukemia after allogeneic hematopoietic cell transplan-tation from matched sibling donors: a 20-year experience with the fractionated total body irradiation-etoposide regimen. Prospective outcome data on 267 unselected adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia confirms superiority of allogeneic transplantation over chemotherapy in the pre-imatinib era: results from the International ALL Trial MRC UKALLXII/ECOG2993. V, et al. Philadelphia chromosome-positive (Ph+) childhood acute lymphoblastic leukemia: good initial steroid response allows early prediction of a favorable treatment outcome. A, et al. Outcome of treatment in children with Philadelphia chromosome positive acute lymphoblastic leukemia. et al. Allogeneic hematopoietic stem cell trans-plantation with reduced-intensity conditioning in acute lymphoblas-tic leukemia: a feasibility study. Fauser AA, et al. Nonmyeloablative stem cell transplantation in adults with high-risk ALL may be effective in early but not in advanced disease. A, et al. Reduced intensity conditioning allogeneic stem cell trans-plantation for adult patients with acute lymphoblastic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation. Fielding AK, et al. In adults with standard-risk acute lymphoblastic leukemia, the greatest benefit is achieved from a matched sibling allo-geneic transplantation in first complete remission, and an autologous transplantation is less effective than conventional consolidation/maintenance chemotherapy in all patients: final results of the International ALL Trial (MRC UKALL XII/ECOG E2993). et al. Alternating versus concurrent schedules of imatinib and chemotherapy as front-line therapy for Philadelphia-positive acute lymphoblastic leukemia (Ph+ ALL). al. Combination of intensive chemotherapy and imatinib can rapidly induce high-quality complete remission for a majority of patients with newly diagnosed BCR-ABL-positive acute lymphoblastic …