SUMMARY
We refer to the recent Belgian Haematological Society (BHS) guidelines for the management of small lymphocytic lymphoma (SLL) and chronic lymphocytic leukaemia (CLL) made by the BHS lymphoproliferative disease committee. The 2020 publication is already the third update after the initial paper published in 2012. For diagnosing CLL, we recommend using the immunophenotype panel according the European research initiative on CLL and European society for clinical cell analysis (ERIC/ESCCA) harmonization project. Concerning diagnostic and pre-treatment work-up, we advise testing of the IGVH mutational status only in young ‘and’ older patients without a 17p del/TP53 mutation if chemo-immunotherapy (CIT) could be a therapeutic option. We are waiting for reimbursement of the IGVH testing in this small number of elderly patients. The recently updated international workshop on CLL (iwCLL) guidelines added as indication for initiating treatment ‘symptomatic functional extranodal disease’. Although criteria for initiating first-line or second-line treatment follow in general similar rules, the same iwCLL guidelines stress that subsequent therapy can be acceptable, sometimes in overlap with the previous one, in patients when substantial disease persists or disease progresses under novel agents, even if the patient stays asymptomatic, to avoid Richter-like acceleration.1 At EHA 2020, an update on treatment advances in previously untreated and relapsed/refractory CLL was given. This overview will provide an update on the most important study results and how these results might change the current guidelines in the treatment of CLL.
(BELG J HEMATOL 2020;11(5):209-15)
