慢性淋巴细胞白血病(CLL)预后标记的研究进展

Advance on study in prognostic markers of chronic lymphocytic leukemia(CLL)

近数十年来的有关CLL总生存期、疾病进展和治疗反应的不同预后标记的预示价值已有许多相关报道。该类预后标记包括临床分期系统、增殖标记、细胞遗传学标记和IgVH突变状态及其替代标记等。本文从临床和技术观点出发对不同预后标记的优缺点作了点评,多数尚未包括在国际治疗指南之中,值得前瞻性临床试验评估有助于改善CLL患者的临床处理。

During the last decades many efforts have been made to identify prognostic markers in CLL, resulting in a plethora of reports describing the predictive value of different parameters with regard to overall survival, disease progression and response to therapy. In this review, the most important prognostic markers in CLL are discussed, from clinical staging systems and serum markers over proliferation markers and cytogenetics to more recent markers like the IgVn mutation status and its possible surrogate markers, and both from a clinical and from a technical point - of - view. Although the great majority of prognostic markers is not included in current international treatment guidelines, several of these markers deserve to be evaluated in prospective clinical trials and may eventually contribute to an improved clinical management of CLL patients.