Audience Response:
Risk-adapted Therapy for CLL: Is it ready for “Prime Time”?
Discussant: Susan O’Brien, MD

A 52-year-old male university professor is referred for evaluation of leukocytosis and fatigue. His primary care physician found WBC of 42,000 with an absolute lymphocytosis. The patient complained of moderate fatigue requiring extra periods of rest, but no fever, weight loss, or malaise.  

    PHYSICAL EXAM:
  • Shotty bilateral cervical and axillary lymphadenopathy with largest nodes 1.5 – 2.0 cm in diameter.
  • Splenomegaly: Tip palpable 4 cm below left costal margin
    EVALUATION:
  • WBC: 43,500 with 83% typical mature appearing lymphocytes
  • Hgb: 12.2 g/dl
  • Platelets: 140,000
  • Β2 microglobulin: 4.2 mg/L – (upper normal = 3.5 mg/L)
  • Cytogenetics: del (17p)

Participate:

Part I: Which of the following additional prognostic factors do you feel would be useful in your management of this patient?

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Part II: Which of the following would you recommend for this patient’s initial therapy?

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Part III: Assuming a good response (MRD bone marrow), would you recommend screening for an allotransplant?

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Part IV: Assuming disease progression within 6 months of completing initial therapy, which of the following would you recommend?

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Chronic Lymphocytic Leukemia

CME Posttest

This activity is supported by Allos Therapeutics, Inc; Cephalon, Inc; Genentech BioOncology; and Millennium, the Takeda Oncology Company.