PMID- 11722982
OWN - NLM
STAT- MEDLINE
DCOM- 20020717
LR  - 20191105
IS  - 1520-4391 (Print)
IS  - 1520-4383 (Linking)
DP  - 2001
TI  - Chronic lymphocytic leukemia: case-based session.
PG  - 140-56
AB  - Drs. Hartmut Dohner, Michael J. Keating, Kanti R. Rai and Emili Montserrat form 
      the panel to review chronic lymphocytic leukemia (CLL) while focusing on the 
      clinical features of a particular patient. The pace of progress in CLL has 
      accelerated in the past decade. The pathophysiological nature of this disease, as 
      had been known in the past, was based largely on the intuitive and empiric 
      notions of two leaders in hematology, William Dameshek and David Galton. Now the 
      works of a new generation of leaders are providing us with the scientific 
      explanations of why CLL is a heterogeneous disease, perhaps consisting of at 
      least two separate entities. In one form of CLL, the leukemic lymphocytes have a 
      surface immunoglobulin (Ig) variable region gene that has undergone somatic 
      mutations, with tell-tale markers suggesting that these cells had previously 
      traversed the germinal centers. Such patients have a distinctly superior 
      prognosis than their counterparts whose leukemic lymphocytes IgV genes have no 
      mutations (these are indeed immunologically naive cells), who have a worse 
      prognosis. The introduction of fluorescence in situ hybridization (FISH) 
      technique has provided us with new insights into the diverse chromosomal 
      abnormalities that can occur in CLL, and which have significant impact on the 
      clinical behavior and prognosis of patients with this disease. Major advances in 
      therapeutics of CLL also have occurred during the past decade. Two monoclonal 
      antibodies, Campath-1H (anti-CD52) and rituximab (anti-CD20), and one nucleoside 
      analogue, fludarabine, have emerged as three agents of most promise in the 
      front-line treatment of this disease. Studies currently in progress reflect our 
      attempts to find the most effective manner of combining these agents to improve 
      the overall survival statistics for CLL patients. As in many other hematological 
      malignancies, high dose chemotherapy followed by autologous or HLA-compatible 
      allogeneic stem cells rescue strategies are under study as a salvage treatment 
      for a relatively younger age group of CLL patients with poor prognosis 
      characteristics.
FAU - Rai, K R
AU  - Rai KR
AD  - Division of Hematology-Oncilogy, Long Island Jewish Medical Center, New Hyde 
      Park, NY 11040, USA.
FAU - Dohner, H
AU  - Dohner H
FAU - Keating, M J
AU  - Keating MJ
FAU - Montserrat, E
AU  - Montserrat E
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Hematology Am Soc Hematol Educ Program
JT  - Hematology. American Society of Hematology. Education Program
JID - 100890099
RN  - 0 (Immunoglobulin Variable Region)
SB  - IM
MH  - Cytogenetic Analysis
MH  - Disease Progression
MH  - Humans
MH  - Immunoglobulin Variable Region/genetics
MH  - *Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis/genetics/therapy
MH  - Mutation
MH  - Prognosis
RF  - 81
EDAT- 2001/11/28 10:00
MHDA- 2002/07/18 10:01
CRDT- 2001/11/28 10:00
PHST- 2001/11/28 10:00 [pubmed]
PHST- 2002/07/18 10:01 [medline]
PHST- 2001/11/28 10:00 [entrez]
AID - 10.1182/asheducation-2001.1.140 [doi]
PST - ppublish
SO  - Hematology Am Soc Hematol Educ Program. 2001:140-56. doi: 
      10.1182/asheducation-2001.1.140.