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