Update of the Grupo Español de Leucemia Linfocítica Crónica clinical guidelines of the management of chronic lymphocytic leukemia

Abstract

Background and objective: The broad therapeutic arsenal and the biological heterogeneity of patients with chronic lymphocytic leukemia (CLL) makes it difficult to standardize treatment for CLL patients with specific clinical settings in routine clinical practice. These considerations prompted us to elaborate the present consensus document, which constitutes an update of the previous version published in 2013, mainly focusing on novel treatment strategies that have been developed over last 5 years, namely B-cell receptor inhibitors (ibrutinib and idelalisib), anti-CD20 monoclonal antibodies (ofatumumab and obinutuzumab), and Bcl-2 inhibitors (venetoclax).

Material and methods: A group of experts from the Spanish Chronic Lymphocytic Leukemia Group reviewed all published literature from January 2010 to January 2016, in order to provide recommendations based on clinical evidence. For those areas without strong scientific evidence, the panel of experts established consensus criteria based on their clinical experience.

Results: The project has resulted in several practical recommendations that will facilitate the diagnosis, treatment, and follow-up of patients with CLL.

Conclusions: There are many controversial issues in the management of CLL with no appropriate studies for making consensus recommendations.

Keywords: Actualización; Chronic lymphocytic leukemia; Diagnosis; Diagnóstico; Grupo Español de Leucemia Linfocítica Crónica; Guidelines; Guías; Leucemia linfocítica crónica; Spanish Chronic Lymphocytic Leukemia Group; Tratamiento; Treatment; Update.