Binet Jacques-Louis, Caligaris-Cappio Federico, Catovsky Daniel, Cheson Bruce, Davis Tom, Dighiero Guillaume, Döhner Hartmut, Hallek Michael, Hillmen Peter, Keating Michael, Montserrat Emili, Kipps Thomas J, Rai Kanti
Rebecca and John Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093-0663, USA.
Blood. 2006 Feb 1;107(3):859-61. doi: 10.1182/blood-2005-04-1677. Epub 2005 Oct 13.
Recently, considerable progress has been made in the identification of molecular and cellular markers that may predict the tendency for disease progression in patients with chronic lymphocytic leukemia (CLL) or detect minimal residual disease after therapy. These developments have created uncertainty for clinicians who hope to incorporate the use of these markers and new disease-assessment tools into standard clinical practice. However, clinical trials are required to determine whether poor-prognosis leukemia-cell markers, such as expression of unmutated immunoglobulin genes or the zeta-associated protein of 70 kDa (ZAP-70), can be used as the basis for determining the time or type of therapy. Pending the outcome of such trials, treatment decisions outside the context of a clinical trial still should be based on guidelines established by the most recent National Cancer Institute-sponsored Working Group.
最近，在识别分子和细胞标志物方面取得了相当大的进展，这些标志物可以预测慢性淋巴细胞白血病（CLL）患者的疾病进展趋势，或在治疗后检测微小残留病。这些进展给希望将这些标志物和新的疾病评估工具纳入标准临床实践的临床医生带来了不确定性。然而，需要进行临床试验来确定预后不良的白血病细胞标志物，如未突变免疫球蛋白基因的表达或70 kDa的ζ相关蛋白（ZAP-70），是否可作为确定治疗时间或治疗类型的依据。在此类试验结果出来之前，临床试验背景之外的治疗决策仍应基于最近由美国国立癌症研究所赞助的工作组制定的指南。
