NCCN Guidelines for Patients® | Chronic Lymphocytic Leukemia

52 NCCN Guidelines for Patients ® : Chronic Lymphocytic Leukemia, 2018 4 Treatment guide Review Review † † Treatment options start with a first-line treatment. First-line treatment is the first treatment offered to treat the cancer. † † Treatment options for CLL that isn’t missing parts of chromosome 17 or has TP53 mutations are partly based on age and health status. Obinutuzumab with chlorambucil, ibrutinib, and ofatumumab with chlorambucil are the preferred options. † † Treatment options for CLL that is missing parts of chromosome 17 or has TP53 mutations are based on your health status and may include purine analogs. A clinical trial is preferred followed by ibrutinib. † † Your doctor will re-test to assess FISH, karyotype, and TP53 mutation status after you have treatment and the CLL responds but returns (relapsed) or doesn’t respond well (refractory). † † A small number of people with CLL can develop Richter’s transformation. CLL can also progress. † † People with CLL often need care for health conditions related to the cancer or cancer treatment. Treatment for conditions other than cancer is part of supportive care. “ Approach your “recovery” in whatever way you deem best for your situation. Allow yourself to heal. Be positive and stay proactive. - Ted