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===Immunochemotherapeutic regimens for the management of patients without chromosome 17p deletion or chromosome 11q deletion===
===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 {{withorwithout}} retixumab
:* Retixumab
:* Fludarabinec {{withorwithout}} retixumab
:* Cladrabine
:* Chlorambucil
:* Fludarabine {{and}} cyclophosphamide {{and}} rituximab
:* Fludarabine {{and}} rituximab
:* Bendamustine {{withorwithout}} 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
Bendamustine + Rituximab



Latest revision as of 17:16, 16 October 2015

 
 
 
 
 
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