Table 2.

Updated 2018 International Workshop on CLL (IWCLL) guidelines to initiate CLL therapy⁵

Any one of the following criteria should be met to initiate CLL therapy:

• Progressive marrow failure, hemoglobin <10 gm/dL or platelet count of <100 × 109/L

• Massive (≥6 cm below the left costal margin) or progressive or symptomatic splenomegaly

• Massive (≥10 cm in longest diameter) or progressive or symptomatic lymphadenopathy

• Progressive lymphocytosis with an increase of ≥50% over a 2-month period or lymphocyte doubling time of <6 months

• Autoimmune complications of CLL, that are poorly responsive to corticosteroids

• Symptomatic extranodal involvement (e.g., skin, kidney, lung, spine)

• Disease-related symptoms, including:

◦ Unintentional weight loss of ≥10% within the previous 6 months

◦ Significant fatigue

◦ Fever ≥38 °C for 2 or more weeks without evidence of infection

◦ Night sweats for ≥1 month without evidence of infection