The survival of patients with chronic lymphocytic leukemia (CLL) has significantly improved in the last 30 years. The introduction of purine analogs in the treatment armamentarium followed by the combination of these compounds with alkylating agents first improved response rates and progression-free survival (PFS) when compared with alkylating agent-based therapy only.
However, the great advance arrived with the development of a chemoimmunotherapeutic approach comparing this with chemotherapy alone demonstrating an improvement not only in terms of response rate and PFS but also, for the first time, in the rate of overall survival (OS). The last decade brought significant achievements in the understanding of CLL pathogenesis leading to the development of new agents targeting cell surface, intracellular pathways, and tumor microenvironment. As traditional chemotherapy is asso- ciated with acute and long-term toxicity, interest in these non-chemotherapeutic treatments has been constantly growing.
The challenge will be to develop a rationale for non-chemotherapeutic approaches using these new agents as monotherapy, or in combination, with the aim of obtaining an individualized strategy based on disease characteristics and even patient basis. Hopefully, an increasing participation of ultra high-risk CLL patients in clinical trials evaluating the efficacy of these new treatments may lead to reasonable success, if not cure, in this unfavorable setting.
This post contains a redirected link to the full paper using Tiny URL. Security wise, I strongly advise against the use of URL shorteners like Tiny URL, primarily because people can't see where on the Internet they are going and the original poster has given a third party (and any hackers that may get into the redirection service) control over that link forever - or until the service goes out of business - which is another reason I don't like them. However, sometimes links in their original format are problematic and services like Tiny URL do provide a solution.
Tiny URL does provide a means by which you can check where a Tiny URL link is directing you,. I couldn't get it working, but others may find it reassuring if they are able to use it (though of course you are still reliant on Tiny URL's service):
While members have minimal risk in using Tiny URL links posted by long standing community members such as Cllcanada, I would strongly advise against anyone following such a link that has been posted by someone unknown to them, particularly if it comes in an email.
Here's a post that provides some email related security tips:
I did try to open the above mention site. once I got it to down load the article, but it did not work. is it possible to give me a good working web site. I tried Libertas Academica but could not find the article. It s a wonderfull overview.
I'm going to have a second opinion by a famous dutch hematoloque special in cll..Professor on the amsterdam university. there is still no change in my condition, but my internist wanted to start chemo just because off my leukemia cell count. 196.000 in figures off europe. I said no and ask for th e second opinion.
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. Thanks for finding these interesting papers.
