Introduction

The prognosis of patients with chronic lymphocytic leukaemia (CLL) is dependent on a variety of patient-, disease- and treatment-related factors (Table 1). Disease-related factors include biomarkers able to predict prognosis and response to specific treatments (Hallek, 2017; Stilgenbauer et al., 2015; Oscier et al., 2012).​

Table 1. Factors affecting prognosis of patients with CLL (Oscier et al., 2012).
Patient-related

Age
Gender
Performance status
Comorbidities

Disease-related

Disease stage
Marrow failure
Immunodeficiency/autoimmunity
Lymphomatous transformation
Biomarkers

Treatment-related

Type of treatment
Response/toxicity
Minimal residual disease status

As outlined in Table 1, factors such as male gender, increasing age, worse performance status, presence and increasing number of comorbidities, later-stage disease (as defined by Rai and Binet staging systems), lymphomatous transformation (Richter’s transformation), are unfavourable prognostic factors for patients with CLL. Biomarkers (genetic and molecular) are increasingly being identified as having prognostic significance as well as minimal residual disease status, whereby patients who have no minimal residual disease tend to have better outcomes than those with residual disease after treatment. These are discussed in the clinical staging section.