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University of Cologne, Cologne, Germany.
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Editor’s note: For patients with chronic lymphocytic leukemia (CLL), marked improvements in quality of response, remission duration, and survival have been achieved by the introduction of chemoimmunotherapy, particularly purine analogue combinations. Although the FCR (fludarabine, cyclophosphamide, and rituximab) regimen is considered to be the standard of care for first-line therapy, a substantial proportion of patients have co-morbidities that preclude this approach; even in younger patients with normal renal function, significant hematological and infectious toxicity is seen.