PMID- 15008611
OWN - NLM
STAT- MEDLINE
DCOM- 20040413
LR  - 20131213
IS  - 0025-6196 (Print)
IS  - 0025-6196 (Linking)
VI  - 79
IP  - 3
DP  - 2004 Mar
TI  - Current approach to diagnosis and management of chronic lymphocytic leukemia.
PG  - 388-98
AB  - The care of patients with chronic lymphocytic leukemia (CLL) has changed 
      dramatically during the past decade. This review summarizes the work-up of 
      lymphocytosis and the current diagnostic criteria and management of CLL. Although 
      clinical staging (Rai and Binet) remains the foundation for determining 
      prognosis, 50% of patients with early-stage disease at diagnosis will experience 
      an aggressive course of disease with early progression and premature death due to 
      CLL. New laboratory techniques (CD38, fluorescence in situ hybridization [FISH]) 
      can identify some patients with early-stage CLL at high risk of rapid disease 
      progression. The array of treatment options has expanded in recent years and now 
      includes monoclonal antibodies used alone or in combination with purine 
      nucleoside analogues and alkylating agents, which have culminated in dramatically 
      improved response rates. Supportive care guidelines now include vaccination 
      strategies, surveillance for secondary malignancies, and aggressive management of 
      infectious complications. An early hematology consultation is recommended for all 
      patients at diagnosis to identify and counsel high-risk patients with early-stage 
      disease who may benefit from more frequent follow-up or early treatment as part 
      of a clinical trial.
FAU - Shanafelt, Tait D
AU  - Shanafelt TD
AD  - Division of Hematology and Internal Medicine, Mayo Clinic College of Medicine, 
      Rochester, Minn 55905, USA. shanafelt.tait@mayo.edu
FAU - Call, Timothy G
AU  - Call TG
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Mayo Clin Proc
JT  - Mayo Clinic proceedings
JID - 0405543
SB  - IM
MH  - Humans
MH  - Leukemia, Lymphocytic, Chronic, 
      B-Cell/complications/*diagnosis/pathology/*therapy
MH  - Neoplasm Staging
MH  - Prognosis
RF  - 79
EDAT- 2004/03/11 05:00
MHDA- 2004/04/14 05:00
CRDT- 2004/03/11 05:00
PHST- 2004/03/11 05:00 [pubmed]
PHST- 2004/04/14 05:00 [medline]
PHST- 2004/03/11 05:00 [entrez]
AID - S0025-6196(11)62871-1 [pii]
AID - 10.4065/79.3.388 [doi]
PST - ppublish
SO  - Mayo Clin Proc. 2004 Mar;79(3):388-98. doi: 10.4065/79.3.388.