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CLL, SLL And MBL Are Clinically Overlapping
- CLL and SLL are managed interchangeably and often considered the same disease in trials and practice.
- MBL is diagnosed when clonal B lymphocytes <5,000/µL without lymphadenopathy and usually requires watchful waiting.
Do Baseline Molecular Testing Before Treatment
- Order diagnostic prognostic testing (FISH, TP53, IGHV) at least once before treatment to guide choices.
- Reserve bone marrow and CT imaging for patients who are starting therapy or have cytopenias or symptoms.
Treat For Cytopenias Or Clear Disease Progression
- Treat CLL for cytopenias, symptomatic or progressive bulky disease, not for lymphocyte doubling time alone.
- Investigate alternative causes of symptoms before attributing them to CLL.