This clinical trial simulation was performed using a virtual population based on characteristics from the CLARITY study to determine the impact of alternative treatment scenarios on absolute lymphocyte count (ALC) and relapse rate.

Our results indicate that 92% of patients will not require their treatment to be postponed, but by allowing a 6-month delay, ~  99% of patients would be eligible for their second-year course of treatment.

Implementation of ALC-based treatment guidelines would reduce the occurrence of Grade 3–4 lymphopenia at any time, without having a negative impact on the risk of relapse over 2 years.