Risk categories and refractory CLL in the era of chemoimmunotherapy
Standardized criteria for diagnosis and response evaluation in CLL are essential to achieve comparability of results and improvement of clinical care. With the increasing range and efficacy of therapeutic options, the specific treatment context is particularly important when defining refractory CLL....
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| 1. Verfasser: | |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
March 6, 2012
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| In: |
Blood
Year: 2012, Jahrgang: 119, Heft: 18, Pages: 4101-4107 |
| ISSN: | 1528-0020 |
| DOI: | 10.1182/blood-2011-11-312421 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: http://dx.doi.org/10.1182/blood-2011-11-312421 Verlag, kostenfrei, Volltext: http://www.bloodjournal.org/content/early/2012/03/06/blood-2011-11-312421 
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| Verfasserangaben: | Thorsten Zenz, John G. Gribben, Michael Hallek, Hartmut Döhner, Michael J. Keating, and Stephan Stilgenbauer |
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| 520 | |a Standardized criteria for diagnosis and response evaluation in CLL are essential to achieve comparability of results and improvement of clinical care. With the increasing range and efficacy of therapeutic options, the specific treatment context is particularly important when defining refractory CLL. Refractory CLL has been defined as no response or response lasting ≤6 months from last therapy. This subgroup has a very poor outcome and many trials of investigational agents use this group as an entry point for early drug development. With the intensification of first line regimens, the proportion of patients with refractory CLL using these criteria decreases. This has immediate consequences for recruitment of patients into trials as well as salvage strategies. Conversely, patients who are not refractory according to the traditional definition but who have suboptimal or short response to intense therapy also have a very poor outcome. In this perspective we will discuss recent results that may lead to a reassessment of risk categories in CLL focussing on fit patients who are eligible for all treatment options. We will cover aspects of the history and biological basis for refractory CLL and will focus on how emerging data on treatment failure from large trials using chemoimmunotherapy may help to define risk groups in CLL. | ||
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