Management of high risk chronic lymphocytic leukaemia (CLL) patients in Australia

Abstract

Background: Chronic lymphocytic leukaemia (CLL) frequently responds to chemoimmunotherapy combining cytotoxic chemotherapy and monoclonal antibodies. However, CLL is associated with significant genetic heterogeneity, and some high-risk forms are known to be chemo-resistant and associated with early relapse. Aims: To review the current treatment paradigm of patients with high-risk disease, in particular those with del(17p) and TP53 variants. Results: A ‘watch and wait’ approach is recommended for all patients who are asymptomatic. When symptomatic, fluorescence in situ hybridisation testing should be performed and gene sequencing considered subsequently to identify del(17p) and TP53 variants ..