Sandbox:haytham1

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