Chronic lymphocytic leukaemia: new biological markers for assessing prognosis.

Well-established clinical staging systems continue to form a basis for deciding when to initiate treatment and assigning prognosis in chronic lymphocytic leukaemia. However, these staging systems do not identify those patients with early-stage disease who will progress to require treatment. Recent developments have provided a variety of prognostic markers, which can determine those patients with poor prognosis disease. For example, serum markers (soluble CD23), cell surface (CD38) and cytoplasmic (ZAP70) proteins, cytogenetics and immunoglobulin gene mutational status have all been utilised for this purpose. In order for patients to benefit fully from these discoveries they need to be translated into rapid, standardised and cost-effective clinical laboratory tests. The current range of prognostic markers, and techniques for measuring them are discussed.