Sandbox: HCL therapy

Initial patients evaluation

History Physical examination Complete blood count

Asymptomatic patients with no therapeutic indications

Symptomatic patients or evidence of therapeutic indications

Patients managed by observation and close follow-up

Cladribine Pentostatin

Complete response

No evidence of complete response

Follow-up and close observation

Retuximab alone Interferon alpha alone Alternative purine analogue ± rituximab

Relapse after one year: same initial purine analogue ± rituximab Relapse before one year: alternative purine analogue ± rituximab

No evidence of complete response

Vemurafenib