Refractory chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder characterized by the progressive accumulation of monoclonal peripheral B cells in bone marrow, peripheral blood and lymphoid tissues. Median survival is about 10 years but it ranges from less than 3 years to a normal life expectancy. Previously, treatment of patients with CLL was based on the use of alkylating agents such as chlorambucil, with resulted in a complete response rate minor than 10%, with a palliation of symptoms and no impact on survival. The introduction of purine analogs and rituximab in first line have improved the complete remission rate, the overall response rate and OS.