What is the Best Frontline Therapy for Patients with CLL and 17p Deletion?

• Published in: Current hematologic malignancy reports 2011-03, Vol.6 (1), p.36-46
• Main Authors: Badoux, Xavier C., Keating, Michael J., Wierda, William G.
• Format: Article
• Language: English
• Subjects: Chromosome Deletion; Chromosomes, Human, Pair 17; Combined Modality Therapy; Geriatrics/Gerontology; Hematology; Humans; Leukemia, Lymphocytic, Chronic, B-Cell - diagnosis; Leukemia, Lymphocytic, Chronic, B-Cell - genetics; Leukemia, Lymphocytic, Chronic, B-Cell - therapy; Medicine; Medicine & Public Health; Oncology; Prognosis; Treatment Outcome; Tumor Suppressor Protein p53 - genetics; Tumor Suppressor Protein p53 - metabolism
• ISSN: 1558-8211; 1558-822X; 1558-822X
• DOI: 10.1007/s11899-010-0069-3

Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disease with significant variation in disease progression, response to therapy, and survival outcome. Deletions of 17p or mutations of TP53 have been identified as one of the poorest prognostic factors, being predictive of short time for disease progression, lack of response to therapy, short response duration, and short overall survival. The treatment of patients with CLL has improved significantly with the development of chemoimmunotherapy, but this benefit was not pronounced in patients with 17p deletion. We compare various treatment strategies used in these patients, including FCR-like chemoimmunotherapy, alemtuzumab, other antibody combinations, or novel targeted therapies with promising results. Allogeneic stem cell transplantation offers the possibility for long-term disease control in these patients and should be considered early in younger, transplant-eligible patients. The current state of therapy is far from optimal and resources should be applied to studying therapeutic options for patients who have CLL with loss of p53 function.