Sandbox:therapy
- Asymptomatic patients with chronic lymphocytic leukemia are managed with observation, whereas symptomatic patients with chronic lymphocytic leukemia are treated with a combination of immunochemotherapy.
- Indications to initiate immunochemotherapy among patients with chronic lymphocytic leukemia include:
- Symptomatic chronic lymphocytic leukemia patients presenting with:
- Fever of unknown origin (>38.1°C for more than two weeks)
- Night sweats for more than one month
- Unintentional significant weight loss over a period of six months
- Patients presenting with thrombocytopenia or anemia due to bone marrow failure
- Patients presenting with refractory autoimmune anemia or refractory autoimmune thrombocytopenia
- Evidence of symptomatic splenomegaly, with the spleen being palpated more than 6cm below the costal margin
- Evidence of symptomatic progressive lymph nodes swelling, with a size greater than 10 cm in diameter
- Evidence of progressive and rapid lymphocytosis, which may be indicated by:
- An increase of greater than 50% over a 2-month period
- A lymphocyte doubling period shorter than six months
- The optimal therapy for chronic lymphocytic leukemia depends on a number of factors which include:
- The clinical presentation of the patients
- The stage of the tumor
- The presence of specific genetic mutations
- The performance status of the patients
- First line therapy vs. second line therapy
- The mainstay of therapy for asymptomatic chronic lymphocytic leukemia patients is immunochemotherapy.
- Pharmacologic medical therapies for [disease name] include (either) [therapy 1], [therapy 2], and/or [therapy 3].