Table 7. Treatment strategies for newly-diagnosed chronic lymphocytic leukemia.

Stratification 1	Stratification 2	Category I recommendations	Category II recommendations
del(17p), deletion of chromosome 17p; FCR, fludarabine, cyclophosphamide and rituximab.
Without del(17p)/ TP53 mutation	Frail patients with significant comorbidities (not able to tolerate purine analogs)	Ibrutinib Venetoclax + obinutuzumab (Level 1 evidence)	Chlorambucil + obinutuzumab (Level 2A evidence) Zanubrutinib (Level 2B evidence) Ibrutinib + obinutuzumab (Level 2B evidence) Obintuzumab (Level 2B evidence) High-dose methylprednisolone + rituximab (Level 2B evidence)
	≥65 years or <65 years with significant comorbidities	Ibrutinib (Level 1 evidence) Venetoclax + obinutuzumab (Level 1 evidence) Bendamustine (70 mg/m2 cycle1, escalate to 90 mg/m2 if tolerated) + anti-CD20 monoclonal antibody	Chlorambucil + obinutuzumab (Level 2A evidence) Zanubrutinib (Level 2B evidence) Ibrutinib + obinutuzumab (Level 2B evidence) Obintuzumab (Level 2B evidence) High dose methylprednisolone + rituximab (Level 2B evidence)
	<65 years without significant comorbidities	FCR (preferred for patients with mutated IGHV) (Level 1 evidence) Ibrutinib (Level 1 evidence)	Bendamustine ± anti-CD20 monoclonal antibody (Level 2A evidence) Fludarabine + rituximab (Level 2A evidence) Zanubrutinib (Level 2B evidence) Venetoclax + obinutuzumab, (Level 2B evidence) High-dose methylprednisolone + rituximab (category 2B)
With del(17p)/ TP53 mutation		Ibrutinib (Level 2A evidence) Zanbrutinib (Level 2B evidence) Clinical trial	Venetoclax + obinutuzumab (Level 2A evidence) High dose methylprednisolone + rituximab (Level 2B evidence) Obintuzumab (Level 2B evidence)