Once the diagnosis of chronic lymphocytic leukemia (CLL) is made (Chapter 23) and there is an indication to begin therapy (Chapter 24), treatment should then begin without delay. The initial treatment has traditionally been palliative, as no treatment to date has demonstra-bly prolonged overall survival. However, new paradigms are emerging that promise to increase complete remission (CR) rates and eliminate minimal residual disease (MRD). These innovative strategies (Table 26.1) may yet prove to prolong survival and are the subject of intense investigation.

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