Diagnosis, treatment and supportive management of chronic lymphocytic leukemia: recommendations of the Dutch HOVON CLL working group

Abstract

Management of patients with chronic lymphocytic leukemia (CLL) is changing due to considerable advances in the therapeutic armamentarium, and new therapies will possibly continue to emerge in the near future. Therefore, the CLL working group of the Dutch-Belgium Haemato-Oncology Cooperative Group for Adults in the Netherlands (HOVON) necessitated revising the Dutch CLL guidelines. The current guideline is based on the expert opinion of the HOVON CLL working group members and focusses on well-designed clinical trials taking into account efficacy with special emphasis on toxicity, treatment duration and treatment intensity. This article provides recommendations on diagnosis, treatment strategies in front-line and relapsed setting and provides supportive care measurements during novel-based therapies as well as for infectious CLL-related complications. The recommendations presented here are intended to provide guidance for the management of CLL patients in the Netherlands, and take into account the availability of treatment strategies at the time of this publication.

Keywords:

• Chronic lymphocytic leukemia
• small lymphocytic lymphoma
• diagnostics
• treatment
• guideline

Aknowledgements

The authors thank all the members of the HOVON CLL working group that participated in the discussions and the realization of the current guideline.

Author contributions

The HOVON CLL working group designed the guideline; LvdS wrote the manuscript under supervision of GR with contributions from all authors, who also interpreted the data, and read, commented on, and approved the final version of the manuscript.

Disclosure statement

GR declared consulting fees from Abbvie. MvG declared consulting fee from Janssen, Roche, Gilead, Celgene, Abbvie, Mundipharma, and travel grants from Janssen, Roche, Gilead, Celgene and research funding from Celgene and Roche. SK declared travel grants from Celgene and research funding from Roche, Abbvie and Janssen. MDL declared consulting fee from Roche, Amgen, Janssen, Abbvie and travel grants from Janssen, Roche and Abbvie. RM declared consulting fees from Janssen, Celgene, Gilead, BMC and research grants from Janssen and Gilead. EvdS declared educational fees from Amgen. MB declared educational fee from Janssen. JD declared travel grants from Celgene and Roche. APK declared consulting fee from Janssen, Roche, Abbvie, BMS, Astra Zeneca, LAVA and travel grants from Janssen, Roche, Abbvie, Astra Zeneca and research funding from Roche, Abbvie, Janssen, Astra Zeneca and BMS. The remaining authors declare no conflict of interest for this research work.