Chronic lymphocytic leukaemia Australasian consensus practice statement

Mary A Anderson; Rory Bennett; Xavier Badoux; Giles Best; Nicole Chia; Tara Cochrane; Gavin Cull; Kyle Crassini; Rosemary Harrup; Sharon Jackson; Bryone Kuss; Masa Lasica; Thomas E Lew; Paula Marlton; Stephen Opat; Emma Palfreyman; Mark N Polizzotto; Sumita Ratnasingam; John F Seymour; Asha Soosapilla; Dipti Talaulikar; Constantine S Tam; Robert Weinkove; Joel Wight; Stephen P Mulligan

doi:10.1111/imj.16207

Chronic lymphocytic leukaemia Australasian consensus practice statement

Intern Med J. 2023 Sep;53(9):1678-1691. doi: 10.1111/imj.16207.

Authors

Mary A Anderson^{1

2

3}, Rory Bennett¹, Xavier Badoux⁴, Giles Best⁵, Nicole Chia⁶, Tara Cochrane⁷, Gavin Cull⁸, Kyle Crassini⁹, Rosemary Harrup^{10

11}, Sharon Jackson¹², Bryone Kuss⁵, Masa Lasica¹³, Thomas E Lew^{1

2

3}, Paula Marlton¹⁴, Stephen Opat¹⁵, Emma Palfreyman¹⁶, Mark N Polizzotto^{17

18}, Sumita Ratnasingam^{19

20

21}, John F Seymour^{1

22}, Asha Soosapilla²³, Dipti Talaulikar^{24

25

26}, Constantine S Tam²⁷, Robert Weinkove^{28

29}, Joel Wight^{30

31}, Stephen P Mulligan^{32

33}

Affiliations

¹ Department of Clinical Haematology, The Royal Melbourne Hospital and The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
² Division of Blood Cells and Blood Cancer, The Walter and Eliza Hall Institute, Melbourne, Victoria, Australia.
³ Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia.
⁴ St George Hospital, Sydney, New South Wales, Australia.
⁵ Flinders University and Medical Centre, Adelaide, South Australia, Australia.
⁶ Genomic Diagnostics, Healius Pathology, Brisbane, Queensland, Australia.
⁷ Gold Coast University Hospital, Griffith University, Gold Coast, Queensland, Australia.
⁸ Sir Charles Gairdner Hospital, PathWest Laboratory Medicine and University of Western Australia, Perth, Western Australia, Australia.
⁹ Mid North Coast Cancer Institute, Coffs Harbour Health Campus, Coffs Harbour, New South Wales, Australia.
¹⁰ Cancer and Blood Services Royal Hobart Hospital, Hobart, Tasmania, Australia.
¹¹ Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia.
¹² Te Whatu Ora health New Zealand Counties Manukau, Auckland, New Zealand.
¹³ St Vincent's Hospital, Melbourne, Victoria, Australia.
¹⁴ Department of Haematology, Princess Alexandra Hospital and University of Queensland, Brisbane, Queensland, Australia.
¹⁵ School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
¹⁶ Royal Darwin Hospital, Darwin, Northern Territory, Australia.
¹⁷ Department of Clinical Haematology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia.
¹⁸ Clinical Hub for Interventional Research, The Australian National University, Canberra, Australian Capital Territory, Australia.
¹⁹ St John of God Hospital Geelong, Geelong, Victoria, Australia.
²⁰ University Hospital Geelong, Geelong, Victoria, Australia.
²¹ School of Medicine, Geelong Clinical School, Deakin University, Geelong, Victoria, Australia.
²² Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
²³ Flow Cytometry, Healius Pathology, Sydney, New South Wales, Australia.
²⁴ Department of Diagnostic Genomics, ACT Pathology, Canberra Health Services, Canberra, Australian Capital Territory, Australia.
²⁵ Department of Haematology, ACT Pathology, Canberra Health Services, Canberra, Australian Capital Territory, Australia.
²⁶ Australian National University, Canberra, Australian Capital Territory, Australia.
²⁷ Alfred Hospital and Monash University, Melbourne, Victoria, Australia.
²⁸ Te Rerenga Ora Blood & Cancer Centre, Te Whatu Ora Health New Zealand Capital Coast & Hutt Valley, Wellington, New Zealand.
²⁹ Cancer Immunotherapy Programme, Malaghan Institute of Medical Research, Wellington, New Zealand.
³⁰ Department of Haematology and Bone Marrow Transplantation, Townsville University Hospital, Townsville, Queensland, Australia.
³¹ James Cook University, School of Medicine, Townsville, Queensland, Australia.
³² Royal North Shore Hospital, Sydney, New South Wales, Australia.
³³ Healius Pathology, Sydney, New South Wales, Australia.

PMID: 37743239
DOI: 10.1111/imj.16207

Abstract

Chronic lymphocytic leukaemia (CLL) is the most common haematological malignancy in Australia and New Zealand (ANZ). Considerable changes to diagnostic and management algorithms have occurred within the last decade. The availability of next-generation sequencing and measurable residual disease assessment by flow cytometry allow for advanced prognostication and response assessments. Novel therapies, including inhibitors of Bruton's tyrosine kinase (BTKi) and B-cell lymphoma 2 (BCL2) inhibitors, have transformed the treatment landscape for both treatment-naïve and relapsed/refractory disease, particularly for patients with high-risk genetic aberrations. Recommendations regarding appropriate supportive management continue to evolve, and special considerations are required for patients with CLL with respect to the global SARS-CoV-2 pandemic. The unique funding and treatment environments in Australasia highlight the need for specific local guidance with respect to the investigation and management of CLL. This consensus practice statement was developed by a broadly representative group of ANZ experts in CLL with endorsement by peak haematology bodies, with a view to providing this standardised guidance.

Keywords: CLL; consensus; diagnosis; management.

MeSH terms

COVID-19*
Consensus
Hematologic Neoplasms*
Humans
Leukemia, Lymphocytic, Chronic, B-Cell* / diagnosis
Leukemia, Lymphocytic, Chronic, B-Cell* / genetics
Leukemia, Lymphocytic, Chronic, B-Cell* / therapy
SARS-CoV-2