Chronic Lymphocytic Leukaemia Still an Incurable Disease
Chronic lymphocytic leukaemia (CLL) is the most common form of leukaemia in adults in Western countries. Despite advances in the treatment of chronic leukaemias, CLL continues to be an incurable disease with median survival varying from 18 months to 12 years depending on severity. Two staging systems are in current use (see table 1) and the stage of the disease assists in the decision to initiate treatment (see patient care guidelines). Fludarabine has now been shown to be the most effective agent in the treatment of the disease, more effective than the previous standard therapy with chlorambucil. However, the toxicity of fludarabine has lead to controversy over whether the drug should be used as first-line treatment or only after chlorambucil has proved unsuccessful. Newer treatment modalities, including gene therapy, have not yet produced the breakthrough which is hoped for in the treatment of CLL. The goal for clinical research is to pursue these techniques, integrating them with current therapies, in order to provide a cure for this disease.


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