How Do We Use Staging and Biomarkers to Determine the Prognosis of CLL in 2007?
The rapid advances in CLL research over the last two decades have significantly improved our understanding of the biology of CLL. It has also resulted in the discovery of many new and clinically relevant biomarkers, some of whom have now been validated in prospective studies, and are extremely useful for predicting disease progression and overall survival. However, no study to date has demonstrated that early treatment will benefit the patient in terms of overall survival, even in the higher risk groups with a relatively short time to disease progression. Therefore, at the present time, the use of staging and predictive biomarkers should be used only to provide patients with information relative to the expected course of their disease. At our own center, we typically obtain clinical staging information, β2M, CD38 expression, interphase and metaphase cytogenetics, and immunoglobulin gene mutational analysis. ZAP70 analysis at this time yields conflicting results from different reputable
