Onkológia 5/2014

Initial treatment of chronic lymphocytic leukaemia

Chronic lymphocytic leukaemia (CLL) is a disease with very variable clinical course. Improvement of the ability to predict the prognosis for patients with this form of leukaemia using clinical, biological and genetic parameters allows to characterize patients with very mild course of disease, intermediate prognosis and aggressive disease. This classification helps to choose treatment strategies for each group. Patients with active and symptomatic disease, or in advanced stages of the disease according to Rai or Binet classification systems are indicated for the treatment, and this therapy should be personalized – „tailored“, taking into account the patient‘s age, comorbidities and the aim of treatment. In patients in good clinical condition, so-called „fit patients“ currently immunochemotherapy with fludarabine, cyclophosphamide and rituximab represents the standard initial treatment and for patients with poor performance status, so-called „unfit patients“ initial treatment with anti-CD 20 antibody in combination with chlorambucil is indicated.

Keywords: chronic lymphocytic leukaemia, fludarabine, anti-CD 20 antibody, immunochemotherapy.