Chlorambucil for Chronic Lymphocytic Leukaemia
Chronic lymphocytic leukaemia (CLL) is a malignancy of mature B lymphocytes which occurs in older adults. A 'wait and watch' approach is taken with patients with early-stage CLL. Treatment of later-stage CLL is generally palliative. For many years oral chlorambucil has been a standard first-line chemotherapeutic agent in patients with CLL. The position of chlorambucil in this indication is less secure now because fludarabine has been shown to be more effective than chlorambucil. However, chlorambucil may still be preferred over fludarabine as a first-line agent for CLL because of superior tolerability and lower cost.