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Is it possible to apply individual treatments in patients with chronic lymphocytic leukemia?

Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in adults. This disease can be defined as a clonal disease of unknown etiology characterized by progressive accumulation of functionally incompetent B lymphocytes in the blood, lymph nodes, spleen and bone marrow. In clinical practice, substantial variability can be noticed in the course of CLL. Some patients are asymptomatic at the time of the diagnosis and do not need to be treated for a long time. On the other hand, there are subgroups with rapid disease progression and early resistance to therapy. Identifying the optimal timing and the type of first - line treatment is a major issue in CLL. This paper discusses treatment approaches according to individual risk profiles. While it is important to have prognostic markers, it is also critical to account for the difference between prognostic and predictive markers. A prognostic factor is a situation, condition or characteristic of a patient that can be used to estimate the outcome of the disease irrespective of the treatment given. Treatment response variable is an important difference when it comes to a predictive factor. A predictive factor is a condition or finding that predicts the differential efficacy of a particular therapy based on marker status (i.e. patients with presence or absence of a specific marker will respond differently to a specific treatment). Most factors associated with giving prognosis in CLL have not been proven yet to be a predictive impact. The current therapeutic approach reflects clinical trial reality although many CLL patients present with comorbidities and advanced age. Therefore we need to mark the significance of patients' tailored therapy aimed at avoiding treatment complications.