NCCN Guidelines for Patients® | Chronic Lymphocytic Leukemia

25 NCCN Guidelines for Patients ® : Chronic Lymphocytic Leukemia, 2019 3  Treatment guide Review Guide 3. Next-in-line treatment del(17p) or TP53 mutation is present What are the preferred options? • Ibrutinib • Venetoclax + rituximab • Duvelisib • Idelalisib + rituximab • Venetoclax What are the other options? • Acalabrutinib • Alemtuzumab ± rituximab • High-dose methylprednisolone + rituximab • Idelalisib • Lenalidomide ± rituximab • Ofatumumab del(17p) and TP53 mutation are absent What are the preferred options? • Ibrutinib • Venetoclax + rituximab • Duvelisib • Idelalisib + rituximab What are the other options? • Acalabrutinib • Alemtuzumab ± rituximab • Bendamustine + rituximab (younger and healthy) • Chlorambucil + rituximab (older or sick) • Dose-dense rituximab (older or sick) • FC + ofatumumab (younger and fairly healthy) • FCR (reduced dose if older or sick) • PCR (reduced dose if older or sick) • High-dose methylprednisolone + rituximab • Idelalisib • Lenalidomide ± rituximab • Obinutuzumab • Ofatumumab • Venetoclax • Bendamustine, rituximab ± ibrutinib • Bendamustine, rituximab ± idelalisib FCR = fludarabine, cyclophosphamide, rituximab; FR = fludarabine, rituximab; PCR = pentostatin, cyclophosphamide, rituximab Approach your ‘recovery’ in whatever way you deem best for your situation. Allow yourself to heal. Be positive and stay proactive.” – Ted Leukemia survivor “

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