Treatment of Chronic Lymphocytic Leukemia: Achieving Minimal Residual Disease–Negative Status As a Goal

For many years, primum non nocere (“First, do no harm”) dictated the treatment of patients with chronic lymphocytic leukemia (CLL). This approach came from the idea that, in most cases, CLL had an indolent course (a frequently unfortunate misconception) and that there were no effective therapies for this disease (regrettably, true). However, in the 1970s, the development of staging systems and other prognostic factors allowed the identification of subsets of patients with different outcomes ranging from a normal life span to a short survival. This advance, coupled with the appearance of more effective therapies, renewed