International Workshop on Chronic Lymphocytic Leukemia 2018 indications for therapy
| Progressive marrow failure, as evidenced by development or worsening anemia < 10 g/dL or thrombocytopenia (<100 000 platelets per liter) |
| Massive or progressive symptomatic splenomegaly |
| Massive lymph nodes (>10 cm) or progressive symptomatic lymphadenopathy |
| Rapidly increasing lymphocytosis defined as an increase of 50% over a 2-mo period or a lymphocyte doubling time < 6 mo* |
| Autoimmune complications (anemia, thrombocytopenia) poorly responsive to corticosteroids |
| Symptomatic extranodal involvement |
| Constitutional symptoms |
| Unintentional weight loss > 10% within 6 months |
| Progressive fatigue |
| Temperature > 100.5°F for >2 weeks without another cause |
| Night sweats for >1 month without alternative etiology |
| ECOG PS > 2 if progressive/worsening |
| Progressive marrow failure, as evidenced by development or worsening anemia < 10 g/dL or thrombocytopenia (<100 000 platelets per liter) |
| Massive or progressive symptomatic splenomegaly |
| Massive lymph nodes (>10 cm) or progressive symptomatic lymphadenopathy |
| Rapidly increasing lymphocytosis defined as an increase of 50% over a 2-mo period or a lymphocyte doubling time < 6 mo* |
| Autoimmune complications (anemia, thrombocytopenia) poorly responsive to corticosteroids |
| Symptomatic extranodal involvement |
| Constitutional symptoms |
| Unintentional weight loss > 10% within 6 months |
| Progressive fatigue |
| Temperature > 100.5°F for >2 weeks without another cause |
| Night sweats for >1 month without alternative etiology |
| ECOG PS > 2 if progressive/worsening |
ECOG PS, Eastern Cooperative Oncology Group Performance Status.
Absolute lymphocytosis alone is not an indication for treatment but can be used to determine disease pace; leukostasis rarely occurs in patients with CLL.