Progress and prognosis in chronic lymphocytic leukaemia

Chronic lymphocytic leukaemia (CLL) follows an extremely variable clinical course with survival ranging from months to decades. In recent years, although effective therapeutic approaches for CLL have been developed, some patients remain primarily refractory or develop resistance to such treatment during the course of the disease. This situation is associated with a particularly poor prognosis and short survival time. Molecular and cellular markers that may predict for refractory disease and disease progression in patients with CLL have recently been identified. Genomic aberrations, mutational profile of immunoglobulin heavy chain genes and ZAP-70 expression provide prognostic information for individual patients independently of clinical disease characteristics. These molecular markers have now entered the stage of risk stratification for individual patients in clinical trials.