Guidance on the use of fludarabine for B-cell chronic lymphocytic leukaemia

Further appropriately constructed clinical trials should assess impact on quality of life directly.

Further research into fludarabine as a first line therapy, either singly or in combination with current first line drugs, would be of value. Recruitment of patients to the current CLL4 trial is recommended.

More comprehensive research, in the form of an adequately powered randomised controlled trial, to determine with greater certainty whether oral fludarabine is as clinically effective as intravenous fludarabine, is required.