Classification system in CLL

The clinical course of chronic lymphocytic leukemia is quite variable. Some patients suffer a progressive course with survival measured in months, while others experience a more indolent disease that may never require treatment. Thus, it is important to identify those patients with agressive disease, who may potentially benefit from early intervention and, if possible, determine the most effective form of therapy. Clinical staging using classification systems developed by Rai et al. and Binet et al. forms the foundation for assessing prognosis in patients with CLL. But approximately half the early‐stage cases will progress and require treatment. New prognosis factors, as cytogenetic abnormalities, mutational status of IgVH gene and CD38 expression, appear to correlate with clinical course and treatment response. These parameters may be of significant prognostic benefit and key when determining the need for early therapeutic intervention.