Sandbox:therapy

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  • 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].