Department of Internal Medicine I, Center for Integrated Oncology Köln-Bonn, University of Cologne, Germany.
Nat Rev Clin Oncol. 2011 Jan;8(1):38-47. doi: 10.1038/nrclinonc.2010.167. Epub 2010 Oct 19.
Of all leukemias, chronic lymphocytic leukemia (CLL) shows the highest variability in its clinical presentation and course. CLL can present as an aggressive and life threatening leukemia or as an indolent form that will not require treatment over decades. The currently available clinical staging systems for CLL are simple and inexpensive but lack accuracy to predict disease progression and survival on an individual basis. The increased understanding of the key events of molecular pathogenesis has provided a plethora of novel molecular and biological factors that correlate with the outcome of CLL. This Review provides a concise discussion of the most important discoveries and gives guidance on how to implement novel prognostic tools in the clinical management of CLL by applying the criteria of evidence, relevance, and simplicity to the selection of prognostic markers.
在所有白血病中，慢性淋巴细胞白血病 (CLL) 的临床表现和病程变化最大。CLL 可以表现为侵袭性和危及生命的白血病，也可以表现为惰性形式，在数十年内不需要治疗。目前用于 CLL 的临床分期系统简单且廉价，但缺乏准确性，无法预测个体疾病进展和生存情况。对分子发病机制关键事件的深入了解提供了大量与 CLL 结局相关的新的分子和生物学因素。这篇综述简要讨论了最重要的发现，并就如何通过应用证据、相关性和简单性标准来选择预后标志物，在 CLL 的临床管理中实施新的预后工具提供了指导。
