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These individuals are thought of to T viruses applied {in possess accomplished a minimal residual disease (MRD) unfavorable status.17-20 Quite a few phase II trials have demonstrated that sufferers reaching MRD negativity possess a signif-icantly M-1 "extends the range" {of the|from the|in the|on longer survival than people that remain MRD constructive, and this can be correct for sufferers treated with traditional chemotherapy,21,22 monoclonal antibodies,23 chemoimmunotherapy,24 or stem cell transplantation.25,26 Additionally, a phase III trial performed by the German CLL Study Group (GCLLSG) recently revealed that individuals acquiring MRD negativity had significantly longer progression-free and general survivals, irrespectively in the therapy received.18 Regrettably, on the other hand, a few of these studies had been flawed by inappropriate statistical analysis, specifically the measurement of time-to-event outcomes from therapy initiation.27 In addition, there are several caveats towards the use of MRD evaluation in sufferers with CLL.28 Initially, CLL remains incurable and at the very least 30 of sufferers who attain MRD negativity following front-line therapy with fludarabine-cyclophosphamide (FC) or rituximab-FC sooner or later practical experience a disease relapse inside 5 years.18 Secondly, as opposed to the situation in acute promyelocytic leukemia or chronic myeloid leukemia,29,30 there's no formal proof of a therapeutic benefit of re-treatment upon documentation of MRD positivity soon after an initial MRD-negative response when compared with therapy in the time of clinical relapse. In truth, very handful of studies have demonstrated a clear benefit from MRD eradication or consolidation therapy in CLL,31,32 and some from the techniques tested, while effective, resulted in significant toxicity.33-35 Thirdly, it might be argued that MRD assessment is just a surrogate for evalution of other adverse prognostic markers considering that, for instance, patients using a 17p014 Ferrata Storti Foundation. That is an open-access paper. doi:10.3324/haematol.2013.099796 The on the internet version of this article includes a Supplementary Appendix. Manuscript received on October 17, 2013. Manuscript accepted on December 31, 2013. Correspondence: jdelgado@clinic.ub.eshaematologica | 2014; 99(five)R. Santacruz et al.deletion possess a larger probability of remaining MRD-positive just after therapy in comparison with sufferers without the need of this chromosome abnormality.18 For all these reasons, existing recommendations for the management of sufferers with CLL advocate MRD assessment only inside clinical trials with "curative intention".36 With all this details in mind, we retrospectively evaluated the effect of MRD on the outcome of patients with CLL getting any front-line therapy inside the context of a very detailed prognostic evaluation, like not too long ago described recurrent gene mutations.survival and all round survival were calculated applying a landmark evaluation. All calculations had been performed employing either SPSS, version 18.0, or R, version 3.0.1. Two-sided P values 0.05 were regarded statistically significant. A detailed explanation in the statistical methods is offered inside the Online Supplement.Benefits Baseline characteristicsThe median age with the complete cohort was 58 years (range, 27-93 years), plus the percentage of individuals older than 70 years was 22 . According to D ner's hierarchical model, 17/221 (8 ) and 40/221 (18 ) individuals had 17p deletion and 11q deletion, respectively.