Introduction: Chronic lymphocytic leukemia in perspective

Although during the past two decades there has been considerable progress in our understanding of the pathophysiology of chronic lymphocytic leukemia (CLL) and in our ability to treat this disease, actual integration of the newly identified pathophysiological mechanisms has not occurred. This perspective essay identifies some of the questions which deserve to be addressed by clinicians and scientists involved in the study of CLL. The most important unresolved remaining issue, however, is the need for standardization of tests performed by commercial labs to assure the reliability and reproducibility of results of ZAP-70, CD38, IgVH gene mutation status and fluorescence in-situ hybridization (FISH) cytogenetics.