Chronic leukaemia: CLL and CML
CLL diagnosis and staging, the iwCLL indications to treat, time-limited venetoclax combinations versus continuous BTK inhibitors, infection and autoimmune complications, Richter transformation; CML diagnosis, TKI choice and toxicity, the ELN 2025 molecular milestones and treatment-free remission.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- CLL: clonal mature B cells in an older adult, usually found on a routine FBC. Many never need treatment. Treat only for active disease by iwCLL criteria. Chemoimmunotherapy has been replaced by BTK inhibitors and venetoclax.
- CML: a myeloproliferative neoplasm driven by BCR::ABL1 from t(9;22). Daily oral tyrosine kinase inhibitors give near-normal life expectancy, and about half of deep responders can stop.
- Both are monitored with blood tests in clinic for decades; the exam tests indications to treat, drug toxicity and molecular targets.
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Sources
- EHA Guidelines on management of chronic lymphocytic leukemia and Richter transformationEichhorst B, Ghia P et al., European Hematology Association, HemaSphere 2026, 2026
- iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLLHallek M et al., Blood 2018;131:2745-60, 2018
- 2025 European LeukemiaNet recommendations for the management of chronic myeloid leukemiaApperley JF et al., Leukemia 2025;39:1797-1813, 2025
- Optimal care pathway for people with chronic lymphocytic leukaemia, 1st editionAU/NZCancer Council Australia
- Optimal care pathway for people with chronic myeloid leukaemia, 1st editionAU/NZCancer Council Australia
- Schedule of Pharmaceutical Benefits, November 2026 (acalabrutinib, zanubrutinib, ibrutinib, venetoclax, asciminib)AU/NZAustralian Government Department of Health, Disability and Ageing, 1 November 2026
- Asciminib in newly diagnosed chronic myeloid leukemia (ASC4FIRST)Hochhaus A et al., N Engl J Med 2024;391:885-98, 2024
- Quinquenel A, Al Nawakil C, Baran-Marszak F et al. Old DAT and new data: positive direct antiglobulin test identifies a subgroup with poor outcome among chronic lymphocytic leukemia stage A patients. Am J Hematol 2015;90:E5-8American Journal of Hematology, 2015
- Criteria for immunoglobulin use in Australia: acquired hypogammaglobulinaemia, haematological malignancy or post HSCT (version 3.5)AU/NZNational Blood Authority, 2025
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy