Current and developing chemotherapy for CLL

After several decades in which the standard treatment for chronic lymphocytic leukemia (CLL) was palliative, there is a shift toward intervention in patients with progressive disease. The introduction of the purine analogs has already seen great improvements in response rates, particularly when fludarabine is used in previously untreated patients. Combination chemotherapies, many of them based on fludarabine with alkylating agents or monoclonal antibodies, are continuing to improve the frequency, quality, and duration of responses.