[Chronic lymphocytic leukemia]

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[Chronic lymphocytic leukemia]

M Leporrier

Rev Prat, November 15, 2008; 58(17): 1861-7.

Service d'hématologie clinique, CHU Caen, 14033 Caen Cedex, France.

leporrier-m@...

Chronic lymphocytic leukemia results from a proliferation/accumulation of

monoclonal B lymphocytes. The diagnosis is easily made on blood cytology and

immunophenotype. The complexity of mechanisms which govern the clonal evolution

translate in a large pronostic diversity on long-term outcome, with a life

expectancy ranging from a few years to more than 25 years in the most indolent

forms. Prognostic appraisal is currently based on clinical and hematological

presentation, whereas cytogenetics, immunoglobulin gene status, expression of

proteins involved in cell proliferation such as ZAP70 or CD38 provide more

precise but non routine indications. Although there is a lot of effective drugs

against the clonal process, any of them are curative, and long term benefit of

treatment tailored on individual prognostic features still deserves further

studies. Therefore, current treatment recommendations aim at sustaining quality

of life in elderly patients, whereas response quality and length are the main

targets in younger ones.

PMID: 19157199

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