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CHRONIC LYMPHOCYTIC LEUKEMIA

Measurable residual disease in chronic lymphocytic leukemia. Where do we stand?

Leukemia volume 37, pages 2339–2342 (2023)Cite this article

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Measurable/minimal residual disease (MRD) is always more integrated is the management of different hematologic malignancies, namely acute promyelocytic leukemia, chronic myeloid leukemia and acute lymphoblastic leukemia, where a MRD- status is/should be the primary endpoint of treatment. In chronic lymphocytic leukemia (CLL), the most frequent leukemia in the Western world with increasing numbers of patients due to a broader use of routine blood tests and of the aging of the general population, the role of MRD is still debated [1]. Our Perspective on CLL complements this Collection on MRD for LEUKEMIA.

CLL has been considered an indolent disease of the elderly and many patients are not treated at diagnosis and some never require treatment. For decades the approach has been conservative (wait and watch) and treatment initiated only when clinically required with the aim of controlling the disease. The identification of biologically-based prognostic markers, particularly those associated with a more aggressive disease and an unfavorable outcome, have prompted to investigate therapeutic strategies associated with a more profound anti-leukemic activity. This was primarily obtained by adding rituximab to chemotherapy, in particular fludarabine and cyclophosphamide (FCR). This chemoimmunotherapy strategy allowed to show that a proportion of patients, particularly those with a favorable prognostic profile, could become MRD negative [2, 3]. More importantly, these patients had a very good clinical outcome, some being cured of their disease [3,4,5], demonstrating that MRD may be an important prognosticator also in CLL.

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Authors and Affiliations

  1. Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy

    Ilaria Del Giudice & Robin Foà

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  1. Ilaria Del Giudice
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IDG and RF equally contributed to the conception and the writing of the manuscript.

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Correspondence to Ilaria Del Giudice or Robin Foà.

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Del Giudice, I., Foà, R. Measurable residual disease in chronic lymphocytic leukemia. Where do we stand?. Leukemia 37, 2339–2342 (2023). https://doi.org/10.1038/s41375-023-02066-w

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