Predicting clinical outcome in B-chronic lymphocytic leukemia.

B-Chronic lymphocytic leukemia (CLL) is a relatively common B-cell malignancy that has a very heterogeneous clinical course, despite carrying the designation of "chronic," which is a gross oversimplification. Being able to give some estimate of the rates of disease progression and overall survival (OS) at first diagnosis is, therefore, important in CLL. The ability to accurately predict response to therapy, as well as subsequent duration of response to therapy, is required given the variability of current therapies to induce and sustain treatment responses. The holy grail of prognostics would be to state with accuracy which therapy or types of therapy are best for a given patient. Although there is no complete answer to prognostic counseling, there is a continued development of markers specific to the CLL B cell and/or to its environment, as well as of testing of prognostic models. These models use both traditional and novel prognostic markers that can aid in the dissection of outcome for early-stage CLL in terms of progression risk and time to therapy. This has resulted in significant enhancement of our ability to guide and predict outcome for our patients with CLL.