VJHemOnc Podcast Updates to the ESMO CLL clinical practice guidelines: implications for frontline treatment
Apr 25, 2025
Lydia Scarfò, an expert in chronic lymphocytic leukemia from Milan, and Anna Schuh, a professor from the University of Oxford, share insights on the latest ESMO guidelines for CLL. They delve into diagnostic advancements, highlighting critical biomarkers and clinical practice variations between the US and Europe. The duo discusses evolving treatment strategies focusing on personalized medicine, patient preferences, and the significance of measurable residual disease. They also explore the debate over time-limited versus continuous regimens in enhancing patient outcomes.
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Diagnosing CLL by Blood Test
- Diagnose CLL based on blood test immunophenotype without bone marrow or lymph node biopsy.
- Perform flow cytometry and assess lymphocyte count and organ involvement including spleen and deep lymph nodes.
TP53 Testing Timing and Treatment
- Do TP53 mutation testing only when treatment is imminent, not at diagnosis.
- Do not start early treatment solely based on high-risk markers without clinical progression.
Focus on Comorbidities Over Age
- Assess patient comorbidities and concomitant medications over age or fitness scores.
- Consider supportive care availability and treatment logistics when choosing therapy.