BHS Guidelines
Based on new reimbursements and robust clinical data, the existing recommendations for CLL were updated in February 2020. Download the full overview of the recently published BHS Guidelines for SLL/CLL in pdf here[1]:
Diagnostic and/or pre-treatment work-up CLL [1]
Front-Line CLL [1]
CLL: chronic lymphocytic leukemia; 17p del/p53 mut: 17p deletion/p53 mutation; unfit for FCR: Cr Cl <70 ml/min, CIRS >6, therapy-related cytopenia, history of autoimmune cytopenia; FCR: fludarabine, cyclophosphamide, rituximab; BR: bendamustine, rituximab; Ob: obinutuzumab; Chl: chlorambucil; R: rituximab ; allo-SCT: allogeneic stem cell transplantation
Relapsed/Refractory CLL [1]
R/R: relapsed/refractory; CLL: chronic lymphocytic leukemia; 17p del/p53 mut: 17p deletion/p53 mutation; CIT: chemo-immunotherapy; R: rituximab; allo-SCT: allogeneic stem cell transplantation
Front-Line MCL[2]
MCL: mantle cell lymphoma; CIT: chemo-immunotherapy; IF RT: •involved field radiotherapy; Auto-SCT: autologous stem cell transplantation; R: rituximab; R-CHOP: rituximab-cyclophosphamide-adriamycine-vincristin-corticosteroids; R-DHAP:rituximab-cisplatinum-cytarabine-dexamethasone; BR: bendamustine-rituximab; VR-CAP: bortezomib-rituximab-cyclophosphamide-adriamycine-corticosteroids; HD CT: high dose chemotherapy
Relapsed/Refractory MCL[2]
R/R MCL: relapsed/refractory mantle cell lymphoma; allo-SCT: allogeneic stem cell transplantation; CIT: chemo-immunotherapy; R: rituximab; R-DHAP:rituximab-cisplatinum-cytarabine-dexamethasone; BR: bendamustine-rituximab; HD ARA-C: high dose cytarabine
Front-Line WM[2]
WM: Waldenström macroglobulinemia; CIT: chemo-immunotherapy; Auto-SCT: autologous stem cell transplantation; AIC: auto-immune cytopenia; PNP: polyneuropathy; R: rituximab; R-CP: rituximab- cyclophosphamide -prednisolone; R-CD: rituximab- cyclophosphamide-dexamethasone; BR: bendamustine- rituximab; BRD: bortezomib- rituximab-dexamethasone; R-Chl: rituximab-chlorambucil
Relapsed/Refractory WM[2]
R/R WM: relapsed/refractory Waldenström macroglobulinemia; CIT: chemo-immunotherapy; Auto-SCT: autologous stem cell transplantation; Allo-SCT: allogeneic stem cell transplantation
Reimbursement criteria Imbruvica
Practical guide
Download the practical guide with reimbursement criteria and other practicalties on Imbruvica.
References for banner:
a. Munir T, et al. Final analysis from RESONATE: Up to six years of follow-up on ibrutinib in patients with previously treated chronic lymphocytic leukemia or small lymphocytic lymphoma. Am J Hematol. 2019 Dec;94(12):1353-1363.
b. Fraser GAM, et al. Final 5-year findings from the phase 3 HELIOS study of ibrutinib plus bendamustine and rituximab in patients with relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma. Leuk Lymphoma. 2020 Dec;61(13):3188-3197.
c. Shanafelt T.D., et al, Long-term Outcomes for Ibrutinib-Rituximab and Chemoimmunotherapy in CLL: Updated Results of the E1912 Trial ; Blood. 2022 Apr 15;blood.2021014960. doi: 10.1182/blood.2021014960. Online ahead of print.
d. Barr PM, et al., Up to 8 Years Follow-up From RESONATE-2: First-Line Ibrutinib Treatment for Patients With Chronic
Lymphocytic Leukemia. Blood Adv. 2022 Apr 4:bloodadvances.2021006434. doi: 10.1182/Bloodadvances.2021006434. Online ahead of print.
CLL: Chronic Lymphocytic Leukemia.
