Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in developed countries. CLL is diagnosed with absolute B lymphocyte count (B-ALC) >5000/micrL sustained for at least 3 months, morphologically mature-appearing small lymphocytes, and flow cytometry showing the typical immunophenotype of CLL cells. Different prognostic parameters are used to differentiate between low-and high-risk patients, which would affect treatment decisions. Rai and Binet staging systems are the two most commonly used in practice. There has been a significant change in how we manage patients in CLL over the last 5 years. We have shifted away from chemoimmunotherapy toward novel agents such as BTK, PIK3, and BCL-2 inhibitors, which are not only more efficacious but are also safer and better tolerated. New prognostic models are being developed, and it appears that minima residual disease (MRD) directed therapy will become the norm in the future. Many clinical trials are looking at various combinations of novel therapies, with a defined period of treatment based on MRD analysis, to enable patients to have a period of treatment-free remission instead of continuous therapy. In this chapter, we summarize the latest updates in CLL management.
Part of the book: Advances in Hematologic Malignancies