Abstract
Chronic lymphocytic leukemia is regarding prognosis a heterogeneous disease. Majority of newly diagnosed patients is in an early stage of the disease.
The challenge of search for new prognostic markers in CLL is to define the subgroup of patients that might potentially benefit from early treatment. The standard approach otherwise is to institute the therapy in late stage or rapidly progressing and active disease.
Except of clinical stage the lymphocyte doubling time (LDT) belongs to so called classical prognostic factors. In past decade the new biological, prognostic factors for CLL were discovered.
They are not routinely used for timing of the therapy but they may be helpful in choice of the appropriate therapy including allogeneic hematopoietic stem cell transplantation, however. The strongest marker is cytogenetics (FISH), 17p- being very poor prognostic factor as well as TP53 mutation.
Significant negative impact on survival has presence of either unmutated IgVH or mutation VH3.21. Independent prognostic factors are also the high expression of CD38 and ZAP70, elevated level of β2mikroglobulin, thymidinkinase and some angiogenesis markers.
One of the important clinical risk factor is also the response to the therapy.