Sandbox:haytham1: Difference between revisions
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{{familytree/start |summary= | {{familytree/start |summary=Therapy Algorithm.}} | ||
{{familytree | | | | | | A02 | | | | | |A02=<div style="width: 10em; padding:0.2em;">'''Initial patients evaluation'''</div>}} | {{familytree | | | | | | A02 | | | | | |A02=<div style="width: 10em; padding:0.2em;">'''Initial patients evaluation'''</div>}} | ||
{{familytree|boxstyle= border-top: 0px;| | | | | | A01 | | | | | | |A01=<div style="width: 15em; padding:1em;">History<br>Physical examination<br>Complete blood count</div>}} | {{familytree|boxstyle= border-top: 0px;| | | | | | A01 | | | | | | |A01=<div style="width: 15em; padding:1em;">History<br>Physical examination<br>Complete blood count</div>}} | ||
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{{familytree | | | | | |!| | | | | | | | | | | | | | | | | }} | {{familytree | | | | | |!| | | | | | | | | | | | | | | | | }} | ||
{{familytree | |,|-|-|-|+|-|-|-|.| | | | | | | | | | | | | }} | {{familytree | |,|-|-|-|+|-|-|-|.| | | | | | | | | | | | | }} | ||
{{familytree | G01 | | G02 | | G03 | | | | | | | | | | | | |G01=<div style="width: 15em; padding:1em;">'''Immunochemotherapeutic regimens for management of patients | {{familytree | G01 | | G02 | | G03 | | | | | | | | | | | | |G01=<div style="width: 15em; padding:1em;">'''Immunochemotherapeutic regimens for management of patients without chromosome 17p deletion or chromosome 11q deletion can be found [[#Immunochemotherapeutic regimens for the management of patients without chromosome 17p deletion or chromosome 11q deletion|'''here''']]'''</div>|G02=<div style="width: 15em; padding:1em;">'''Immunochemotherapeutic regimens for management of patients with chromosome 17p deletion can be found [[#Immunochemotherapeutic regimens for the management of patients with chromosome 17p deletion|'''here''']]'''</div>|G03=<div style="width: 15em; padding:1em;">'''Immunochemotherapeutic regimens for management of patients with chromosome 17p deletion can be found [[#Immunochemotherapeutic regimens for management of patients with chromosome 11q deletion|'''here''']]'''</div>}} | ||
{{familytree/end}} | {{familytree/end}} | ||
===Immunochemotherapeutic regimens for the management of patients without chromosome 17p deletion or chromosome 11q deletion=== | |||
===Immunochemotherapeutic regimens for management of patients without chromosome 17p deletion or chromosome 11q deletion=== | ====First line therapy==== | ||
*'''Patients older than 70 years of age with poor performance status:''' | |||
:* Obinutuzumab {{and}} chlorambucil | |||
:* Rituximab {{and}} chlorambucil | |||
:* Bendamustine {{and}} rituximab | |||
:* Cyclophosphamide {{and}} predinisone {{withorwithout}} retixumab | |||
:* Retixumab | |||
:* Fludarabinec {{withorwithout}} retixumab | |||
:* Cladrabine | |||
:* Chlorambucil | |||
:* Fludarabine {{and}} cyclophosphamide {{and}} rituximab | |||
:* Fludarabine {{and}} rituximab | |||
:* Bendamustine {{withorwithout}} rituximab | |||
:* Obinutuzumab {{and}} chlorambucil | |||
*'''Patients younger than 70 years of age with good status performance status:''' | |||
:* Fludarabine {{and}} cyclophosphamide {{and}} rituximab | |||
:* Fludarabine, rituximab | |||
:* pentostatin, cyclophosphamide, rituximab | |||
:* Bendamustine ± rituximab | |||
:* Obinutuzumab + chlorambucil | |||
====Refactory/recurrent therapy==== | |||
Bendamustine + Rituximab | Bendamustine + Rituximab | ||
Chlorambucil | Chlorambucil | ||
Chlorambucil + PredniSONE | Chlorambucil + PredniSONE | ||
Cladribine | Cladribine | ||
Cyclophosphamide/PredniSONE | Cyclophosphamide/PredniSONE | ||
Cyclophosphamide/PredniSONE + Rituximab | Cyclophosphamide/PredniSONE + Rituximab | ||
FCR (Fludarabine/Cyclophosphamide + Rituximab) | FCR (Fludarabine/Cyclophosphamide + Rituximab) | ||
Fludarabine | Fludarabine | ||
FR (Fludarabine + Rituximab) | FR (Fludarabine + Rituximab) | ||
MethylPREDNISolone (Pulse) | MethylPREDNISolone (Pulse) | ||
PCR (Pentostatin/Cyclophosphamide + Rituximab) | PCR (Pentostatin/Cyclophosphamide + Rituximab) | ||
Rituximab | Rituximab | ||
===Immunochemotherapeutic regimens for management of patients with chromosome 17p deletion=== | ===Immunochemotherapeutic regimens for the management of patients with chromosome 17p deletion=== | ||
Alemtuzumab + Rituximab | Alemtuzumab + Rituximab | ||
Bendamustine + Rituximab | Bendamustine + Rituximab | ||
FCR (Fludarabine/Cyclophosphamide + Rituximab) | FCR (Fludarabine/Cyclophosphamide + Rituximab) | ||
FR (Fludarabine + Rituximab) | FR (Fludarabine + Rituximab) | ||
HDMP (High-Dose Methylprednisolone) + Rituximab | HDMP (High-Dose Methylprednisolone) + Rituximab | ||
===Immunochemotherapeutic regimens for management of patients with chromosome 11q deletion=== | ===Immunochemotherapeutic regimens for management of patients with chromosome 11q deletion=== | ||
Bendamustine + Rituximab | Bendamustine + Rituximab | ||
Chlorambucil | Chlorambucil | ||
Chlorambucil + PredniSONE | Chlorambucil + PredniSONE | ||
Cyclophosphamide/PredniSONE | Cyclophosphamide/PredniSONE | ||
Cyclophosphamide/PredniSONE + Rituximab | Cyclophosphamide/PredniSONE + Rituximab | ||
FCR (Fludarabine/Cyclophosphamide + Rituximab) | FCR (Fludarabine/Cyclophosphamide + Rituximab) | ||
PCR (Pentostatin/Cyclophosphamide + Rituximab) | PCR (Pentostatin/Cyclophosphamide + Rituximab) | ||
Reduced-dose FCR (Fludarabine/Cyclophosphamide + Rituximab) | Reduced-dose FCR (Fludarabine/Cyclophosphamide + Rituximab) | ||
Rituximab | Rituximab | ||
Latest revision as of 17:16, 16 October 2015
Initial patients evaluation | |||||||||||||||||||||||||||||||||||||||||||||
History Physical examination Complete blood count | |||||||||||||||||||||||||||||||||||||||||||||
Staging | |||||||||||||||||||||||||||||||||||||||||||||
Rai Staging System Binet Staging System | |||||||||||||||||||||||||||||||||||||||||||||
Rai stage 3-4 Binet stage B-C | Rai stage 0-2 Binet stage A | ||||||||||||||||||||||||||||||||||||||||||||
Evaluate patients by cumulative index illness rating scale | Patients managed by observation and close follow-up | ||||||||||||||||||||||||||||||||||||||||||||
Frail patients (CIRS ≥6) | Fit patients (CIRS <6) | ||||||||||||||||||||||||||||||||||||||||||||
Retixumab/obinutuzumab AND chlorambucil | FISH chromosomal analysis | ||||||||||||||||||||||||||||||||||||||||||||
Immunochemotherapeutic regimens for management of patients without chromosome 17p deletion or chromosome 11q deletion can be found here | Immunochemotherapeutic regimens for management of patients with chromosome 17p deletion can be found here | Immunochemotherapeutic regimens for management of patients with chromosome 17p deletion can be found here | |||||||||||||||||||||||||||||||||||||||||||
Immunochemotherapeutic regimens for the management of patients without chromosome 17p deletion or chromosome 11q deletion
First line therapy
- Patients older than 70 years of age with poor performance status:
- Obinutuzumab AND chlorambucil
- Rituximab AND chlorambucil
- Bendamustine AND rituximab
- Cyclophosphamide AND predinisone ± retixumab
- Retixumab
- Fludarabinec ± retixumab
- Cladrabine
- Chlorambucil
- Fludarabine AND cyclophosphamide AND rituximab
- Fludarabine AND rituximab
- Bendamustine ± rituximab
- Obinutuzumab AND chlorambucil
- Patients younger than 70 years of age with good status performance status:
- Fludarabine AND cyclophosphamide AND rituximab
- Fludarabine, rituximab
- pentostatin, cyclophosphamide, rituximab
- Bendamustine ± rituximab
- Obinutuzumab + chlorambucil
Refactory/recurrent therapy
Bendamustine + Rituximab
Chlorambucil
Chlorambucil + PredniSONE
Cladribine
Cyclophosphamide/PredniSONE
Cyclophosphamide/PredniSONE + Rituximab
FCR (Fludarabine/Cyclophosphamide + Rituximab)
Fludarabine
FR (Fludarabine + Rituximab)
MethylPREDNISolone (Pulse)
PCR (Pentostatin/Cyclophosphamide + Rituximab)
Rituximab
Immunochemotherapeutic regimens for the management of patients with chromosome 17p deletion
Alemtuzumab + Rituximab
Bendamustine + Rituximab
FCR (Fludarabine/Cyclophosphamide + Rituximab)
FR (Fludarabine + Rituximab)
HDMP (High-Dose Methylprednisolone) + Rituximab
Immunochemotherapeutic regimens for management of patients with chromosome 11q deletion
Bendamustine + Rituximab
Chlorambucil
Chlorambucil + PredniSONE
Cyclophosphamide/PredniSONE
Cyclophosphamide/PredniSONE + Rituximab
FCR (Fludarabine/Cyclophosphamide + Rituximab)
PCR (Pentostatin/Cyclophosphamide + Rituximab)
Reduced-dose FCR (Fludarabine/Cyclophosphamide + Rituximab)
Rituximab