Key issues in the treatment of chronic lymphocytic leukaemia (CLL)

The outcome of the treatment of chronic lymphocytic leukaemia (CLL) has improved little over the past 30 years. The recent introduction of purine analogues, particularly fludarabine, may change this situation. These agents are highly effective and generally well tolerated. They raise the possibility of improved disease-free survival and allow appropriate patients to be considered for bone marrow transplantation (BMT). Randomised clinical trials are needed to establish the roles of purine analogues and other novel agents in improving the survival of CLL patients. These trials should use consistent diagnostic and assessment criteria to allow for the clinical heterogeneity of CLL.