Goals of treatment

• Treatment goals for patients with CLL have evolved from palliation to include complete response (CR), minimal residual disease (MRD) negativity, improved duration of response, and progression-free survival (PFS)⁹ (Table 6 and Figure 6)
• Response to therapy, or response rates in CLL, are determined using the 2008 IWCLL update of the NCI-WG response criteria defining CR, partial response (PR), stable disease (SD), and progressive disease (PD) (Table 6 for definitions of treatment goals)^9,12
• When evaluating different clinical trials that appear in the literature, it is important to note that the definition of response in CLL has evolved over time. The assessment of response can also vary depending on the quality of data collection and the rigor of data analysis. Some examples include:
  • Confirmatory CT scans or bone marrow biopsies to assess response may not be utilized in all CLL trials^41,42
  • Assessment by a blinded independent review committee is not conducted in all clinical trials⁴³
  • Read more about assessing CR in the Current issues in CLL section

Table 6. Definitions of key goals of treatment.⁹ Adapted from Hallek M et al. Blood. 2008;111:5446-5456.

Figure 6. The goals of treatment for CLL have evolved over time with the emergence of highly sensitive assays, improved prognostic indicators and risk stratification, and advanced therapeutic options.^38,44,45

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