The treatment of CLL is evolving as investigators test new treatments and new combinations. The optimal approach has yet to be defined. In Figure 1, the approach taken by the group at the Cleveland Clinic Taussig Cancer Center is outlined. Treatment is delayed until the onset of symptomatic progression, at which time the most effective therapy, FCR, is administered in the hope that a higher CR rate will translate into longer remission and improved overall survival. Post-remission treatment is investigational. Treatment with FCR is continued until the patient becomes FLU refractory. If no clinical trial is available, alemtuzumab is given.

The approach outlined in Figure 26.1 largely assumes that all patients have the same disease. As discussed in Chapter 25, this assumption is false. Unfortunately, we are currently unable to offer patients with adverse risk factors, such as ZAP-70 expression, treatment options that are known to improve their prognosis. Risk-adapted approaches to CLL are as desperately needed as are new drugs and methods, which advocate for accrual to innovative clinical trials.

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Chapter 27

10 Ways To Fight Off Cancer

10 Ways To Fight Off Cancer

Learning About 10 Ways Fight Off Cancer Can Have Amazing Benefits For Your Life The Best Tips On How To Keep This Killer At Bay Discovering that you or a loved one has cancer can be utterly terrifying. All the same, once you comprehend the causes of cancer and learn how to reverse those causes, you or your loved one may have more than a fighting chance of beating out cancer.

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