Summary of National Comprehensive Cancer Network Clinical Practice Guidelines (accessed on 28 Nov 2019).
| Category 2A if not indicated | First-line | Relapse or refractory | ||
|---|---|---|---|---|
| Preferred | Other | Preferred | Other | |
| Without del(17p) or |
||||
| Fit and young (≤65 yr) | Ibrutinib (C1) | Bendamustine+anti-CD20 | Acalabrutinib (C1) | Alemtuzumab±rituximab |
| Venetoclax+obinutuzumab | FCR for IGHV mutated | Ibrutinib (C1) | BR | |
| FR | Venetoclax+rituximab (C1) | FC+ofatumumab | ||
| HDMP+rituximab (C2B) | Duvelisib | FCR | ||
| Ibrutinib+rituximab (C2B) | Idelalisib+rituximab | HDMP+rituximab | ||
| PCR (C3) | Idelalisib | |||
| Lenalidomide±rituximab | ||||
| Obinutuzumab | ||||
| Ofatumumab | ||||
| PCR | ||||
| Venetoclax | ||||
| BR+ibrutinib (C2B) | ||||
| BR+idelalisib (C2B) | ||||
| Frail or old | Ibrutinib (C1) | Bendamustine+anti-CD20 (not for frail) | Acalabrutinib (C1) | Alemtuzumab±rituximab |
| Venetoclax+obinutuzumab | Ibrutinib (C1) | Chlorambucil+rituximab | ||
| Chlorambucil+obinutuzumab | Venetoclax+rituximab (C1) | Reduced FCR | ||
| HDMP+rituximab (C2B) | Duvelisib | HDMP+rituximab | ||
| Ibrutinib+obinutuzumab (C2B) | Idelalisib+rituximab | Idelalisib | ||
| Obinutuzumab (C2B) | Lenalidomide±rituximab | |||
| Chlorambucil (C3) | Obinutuzumab | |||
| Rituximab (C3) | Ofatumumab | |||
| Reduced PCR | ||||
| Venetoclax | ||||
| Dose dense rituximab (C2B) | ||||
| BR±ibrutinib or idelalisib | ||||
| (C2B for BR/BR+ibrutinib) | ||||
| (C3 for BR+idelalisib | ||||
| With del(17p) or |
||||
| Ibrutinib | Alemtuzumab±rituximab | Acalabrutinib (C1) | Alemtuzumab±rituximab | |
| Venetoclax+obinutuzumab | HDMP+rituximab | Ibrutinib (C1) | HDMP+rituximab | |
| Obinutuzumab | Venetoclax+rituximab (C1) | Idelalisib | ||
| Duvelisib | Lenalidomide±rituximab | |||
| Idelalisib+rituximab | ofatumumab | |||
| Venetoclax | ||||
Abbreviations: BR, bendamustine, rituximab; C1, category 1; C2B, category 2B; C3, category 3; FC, fludarabine, cyclophosphamide; FCR, fludarabine, cyclophosphamide, rituximab; FR, fludarabine, rituximab; HDMP, high-dose methyl-prednisolone; PCR, pentostatin, cyclophosphamide, rituximab.
Blood Res 2020;55:S72~S82 https://doi.org/10.5045/br.2020.S012
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