title: Update of the Grupo Español de Leucemia Linfocítica Crónica clinical guidelines of the management of chronic lymphocytic leukemia.
abstract: OBJECTIVE
  The broad therapeutic arsenal and the biological heterogeneity of patients with chronic lymphocytic leukemia (CLL) makes it difficult to standardize treatment for CLL patients with specific clinical settings in routine clinical practice. These considerations prompted us to elaborate the present consensus document, which constitutes an update of the previous version published in 2013, mainly focusing on novel treatment strategies that have been developed over last 5 years, namely B-cell receptor inhibitors (ibrutinib and idelalisib), anti-CD20 monoclonal antibodies (ofatumumab and obinutuzumab), and Bcl-2 inhibitors (venetoclax).
  
  
  METHODS
  A group of experts from the Spanish Chronic Lymphocytic Leukemia Group reviewed all published literature from January 2010 to January 2016, in order to provide recommendations based on clinical evidence. For those areas without strong scientific evidence, the panel of experts established consensus criteria based on their clinical experience.
  
  
  RESULTS
  The project has resulted in several practical recommendations that will facilitate the diagnosis, treatment, and follow-up of patients with CLL.
  
  
  CONCLUSIONS
  There are many controversial issues in the management of CLL with no appropriate studies for making consensus recommendations.
authors.affiliation: Servicio de Hematología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, España. Electronic address: jagarciam@aehh.org.
authors.forename: José A
authors.initials: JA
authors.lastname: García-Marco
authors.affiliation: Servicio de Hematología, Hospital Clínic i Provincial, Barcelona, España.
authors.forename: Julio
authors.initials: J
authors.lastname: Delgado
authors.affiliation: Servicio de Hematología, Hospital Universitario Infanta Leonor, Madrid, España.
authors.forename: José A
authors.initials: JA
authors.lastname: Hernández-Rivas
authors.affiliation: Servicio de Hematología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Ramírez Payer
authors.affiliation: Servicio de Hematología, Hospital Universitario de La Princesa, Madrid, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Loscertales Pueyo
authors.affiliation: Servicio de Hematología, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: Isidro
authors.initials: I
authors.lastname: Jarque
authors.affiliation: Servicio de Hematología, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors.forename: Pau
authors.initials: P
authors.lastname: Abrisqueta
authors.affiliation: Servicio de Hematología, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: Pilar
authors.initials: P
authors.lastname: Giraldo
authors.affiliation: Servicio de Hematología, Hospital Clínico Universitario San Carlos, Madrid, España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Martínez
authors.affiliation: Servicio de Hematología, Hospital Universitario Marqués de Valdecilla, Santander, España.
authors.forename: Lucrecia
authors.initials: L
authors.lastname: Yáñez
authors.affiliation: Servicio de Hematología, Hospital Clínico Universitario, Valencia, España.
authors.forename: Mª José
authors.initials: MJ
authors.lastname: Terol
authors.affiliation: Servicio de Hematología, Hospital Clínico Universitario-Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España.
authors.forename: Marcos
authors.initials: M
authors.lastname: González
authors.affiliation: Servicio de Hematología, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors.forename: Francesc
authors.initials: F
authors.lastname: Bosch
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D019086:Bridged Bicyclo Compounds, Heterocyclic / Q000627:therapeutic use; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D010880:Piperidines; D011687:Purines / Q000627:therapeutic use; D011720:Pyrazoles / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D052999:Quinazolinones / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D019086:Bridged Bicyclo Compounds, Heterocyclic; D010880:Piperidines; D011687:Purines; D011720:Pyrazoles; D011743:Pyrimidines; D052999:Quinazolinones; D013449:Sulfonamides; C551803:ibrutinib; D000225:Adenine; C527517:ofatumumab; C579720:venetoclax; C543332:obinutuzumab; C552946:idelalisib
keywords: Actualización; Chronic lymphocytic leukemia; Diagnosis; Diagnóstico; Grupo Español de Leucemia Linfocítica Crónica; Guidelines; Guías; Leucemia linfocítica crónica; Spanish Chronic Lymphocytic Leukemia Group; Tratamiento; Treatment; Update