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.
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