ABSTRACT
The last decade has seen rapid progress in the management of chronic lymphocytic
leukemia (CLL). Fludarabine and a monoclonal antibody, alemtuzumab, have been
approved by the European and American regulatory agencies for treatment of CLL.
Additional monoclonal antibodies (anti-CD20, anti-CD23, anti-MHC II, anti-CD40) as
well as other drugs (flavopiridol, bendamustine, lenalidomide) are currently being tested
in clinical trials. In addition, the increased experience with allogeneic progenitor cell
transplantation provides an intensified treatment option to physically fit patients at very
high risk of relapse. Similarly, rapid progress has been achieved with regard to new
diagnostic tests to identify prognostic subgroups in CLL and to assess their response to
therapy. However, the optimal use of these different therapeutic and diagnostic modalities
remains to be determined. This chapter attempts to summarize the current state of the art
in the initial management of CLL.
