背景:尽管最近在诊断方面取得了进展,预测,和治疗选择,慢性淋巴细胞白血病(CLL)仍然是一种无法治愈的疾病。诊断的新概念,分期,治疗,近年来,CLL的后续行动已被纳入。缺乏区域共识指南导致该地区CLL患者的管理实践各不相同。
目的:本手稿旨在就定义在专家血液学家之间达成共识,分类,以及CLL的相关实践。专家们利用他们的个人经验以及当前有关CLL管理的文献制定了一套声明。该共识旨在为参与CLL管理的医疗保健专业人员提供指导,并作为制定区域指南的一个步骤。
方法:八位专家回答了关于诊断的50个陈述,分期,治疗,和CLL的预后有三个潜在的回答选择,范围在同意,不同意,弃权。该共识采用了改良的德尔菲共识方法。当达成至少75%的答案时,就达成了共识。这份手稿介绍了与会人员的科学见解,小组讨论,和辅助文献综述。
结果:在50个声明中,几乎所有声明都达成了共识。声明涵盖了与CLL相关的主题,包括诊断评估,分期,风险评估,不同的病人资料,预后评估,治疗决定,治疗序列,反应评估,并发症,和CLL在COVID-19大流行期间。
结论:近年来,随着许多诊断测试和几种新的治疗方法的出现,CLL管理取得了显着进展。这一共识汇集了数十年的巩固原则,新颖的研究,以及治疗这种疾病的前景。
Despite recent advances in diagnosis, prognostication, and treatment options, chronic lymphocytic leukemia (CLL) is still a largely incurable disease. New concepts on diagnosis, staging, treatment, and follow-up on CLL have been incorporated throughout recent years. The lack of regional
consensus guidelines has led to varying practices in the management of patients with CLL in the region. This manuscript aims to reach a consensus among expert hematologists regarding the definitions, classifications, and related practices of CLL. The experts developed a set of statements utilizing their personal experience together with the current literature on CLL management. This consensus aims to provide guidance for healthcare professionals involved in the management of CLL and serves as a step in developing regional
guidelines.
Eight experts responded to 50 statements regarding the diagnosis, staging, treatment, and prognosis of CLL with three potential answering alternatives ranging between agree, disagree, and abstain. This
consensus adopted a modified Delphi
consensus methodology. A
consensus was reached when at least 75% of the agreement to the answer was reached. This manuscript presents the scientific insights of the participating attendees, panel discussions, and the supporting literature review.
Of the 50 statements, a
consensus was reached on almost all statements. Statements covered CLL-related topics, including diagnostic evaluation, staging, risk assessment, different patient profiles, prognostic evaluation, treatment decisions, therapy sequences, response evaluation, complications, and CLL during the COVID-19 pandemic.
In recent years, CLL management has progressed significantly, with many diagnostic tests and several novel treatments becoming available. This consensus gathers decades of consolidated principles, novel research, and promising prospects for the management of this disease.