Siddon et al reported an algorithm for treating a patient with chronic lymphocytic leukemia (CLL) based on prognostic indicators. This is based on a report by Gribben. The authors are from Yale University.
Patient selection: CLL
Parameters:
(1) symptoms
(2) high risk for progression
(3) performance status
Symptoms |
Performance Status |
Risk for Progression |
Protocol |
no |
NA |
high |
1 |
no |
NA |
not high risk |
2 |
yes |
good |
yes |
3 |
yes |
good |
not high risk |
4 |
yes |
not good |
na |
5 |
Protocol |
Plan |
1 |
Evaluate for early intervention. |
2 |
Watch and wait. If symptoms develop then assess for performance status and re-evaluate risk for progression. |
3 |
Alemtuzumab, allogeneic stem cell transplant |
4 |
Consider fludarabine, cyclophosphamide and rituximab. |
5 |
Administer chlorambucil or enroll in clinical trial. |
Specialty: Hematology Oncology
ICD-10: ,