In spite of the great advances made in understanding its biology, chronic lymphocytic leukemia (CLL-B) is still incurable. Historically, the objective of the treatment of CLL-B has been to alleviate the disease-related symptoms and to prolong the survival. Chemotherapy for all patients in the initial stages of the disease does not obtain an increase in the survival, but rather, only causes an unnecessary toxicity. The decision to treat the patient is oriented by the clinical conditions, by the presence of symptoms and by the signs of activity of the disease. With the conventional treatments currently available, there is only evidence of an advantage in immediate treatment, directly following the diagnosis, for patients in an advanced stage (Raí III and IV or Binet B and C). Patients in initial stages (Rai 0-II or Binet A) generally should not receive immediate treatment, but only be periodically observed. In the initial stages, treatment is only indicated if disease-related symptoms (such as: B symptoms, reduction in the performance status, or organomegaly symptoms or complications) or signs of highly active CLL-B (such as: lymphocyte duplication time of less than six months or a rapid growth in lymph nodes) are present.
Chronic lymphocytic leukemia; treatment