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A 7 LJ-year-old male with no sign i ficant medical history is referred by h is primary care physician For Further evaluation of generalized lymphadenopathy. Patient reports no preceding weigh t loss. n igh t sweats. or Fever. On physical examination. lymphade-nopathy and splenomegaly are Found. with the spleen edge pal pable 7 em below the left costal margi n. Laboratory workup reveals a total leu kocyte count of 36.500/pl. with the majority of cells of the type shown below. hemoglobin 1 LJ.S g/dl and a plate-let count of 3LJ2 .000/ pl.
What would be an appropriate therapeutic regimen at this time given the new clinical development?
- Single-agent rituximab
- Chlorambucil
- Allogeneic hematopoietic stem cell transplantation (HSCT)
- Alemtuzumab
- Retreatment with FCR
Medicine
D. Alemtuzumab has modest activity in cases of prolymphocytic transformation. Retreat-ment with FCR can be considered if no other options are available. Allogeneic HSCT is unlikely to be an option, given patient's advanced age (Leuk Lymphoma. 2002;43(5):1007).
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