Intensive therapy of chronic lymphocytic leukaemia

In contrast to advances in understanding the biology and natural history of CLL, progress in treatment has been slow. Considerable data indicate that response to therapy is associated with increased survival. Also, more intensive therapy is associated with increased responses. However, few data suggest that this translates into increased survival or cure, even in patients seemingly free of CLL cells using sensitive detection techniques. Preliminary results with allogeneic and autologous bone marrow transplants are promising but controlled or randomized trials are needed to determine survival and/or cure. Several considerations suggest that intensive therapy should be reserved for young persons with adverse prognostic features failing conventional treatment.