Abstract
Chemotherapy of chronic lymphocytic leukemia (CLL) underwent significant development in last two decades involving new agents, allogeneic stem cell transplantation; finally also monoclonal antibodies were added to the CLL management. Chlorambucil had been gold standard in the treatment of CLL for long time.
Fludarabine and other purine analogs entered the therapy including 1 st line in mid 90. Since beginning of the 21st century the combination fludarabine and cyclophosphamide (FC) came as the salvage treatment as the effective therapy of CLL then was successfully tested in the 1 st line.
This regimen has been eventually enriched for rituximab and the regimen FCR became widely used for the treatment of CLL in 1st line. Other purine analog cladribine was tested in combination with cyclophosphamide and mitoxantrone.
Promising is rediscovered agent bendamustine, especially for combination therapy with monoclonal antibodies. Pentostatine in combination with cyclophosphamide and rituximab was found effective in the treatment of refractory CLL.
Radiotherapy and splenectomy is effective approach in the therapy of CLL in certain situations.