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Getting the guidelines right for CLL

By Pat Kelly - 22nd Mar 2026

guidelines
iStock.com/Charday Penn

The Annual Conference of the Chronic Lymphocytic Leukaemia (CLL) Alliance 2026 included presentations by keynote speakers Prof Fréderic B Davi, Hôpitaux Universitaires Pitié Salpêtrière, Paris, France, whose talk was titled an ‘A B-cell receptor (BCR)-centric view of CLL’, and Prof Barbara Eichorst, Consultant Haematologist, Cologne, Germany, who provided an update on CLL guidelines and discussed new treatment approaches in Richter’s transformation.

Prof Davi touched on BCR as a biomarker and mutational status in CLL, and he also spoke about EuroClonality, an independent European scientific foundation dedicated to promoting innovation and standardisation in laboratory diagnostics in haemato-oncology.

EuroClonality, of which Prof Davi is a member of the steering group, places a special emphasis on clonality testing and supporting quality control and education in the field of laboratory diagnostics. It has also produced novel PCR assays for detection of immunoglobulin and T-cell receptor gene rearrangements, which are now used widely in diagnosing lymphoproliferative disorders.

“IGHV mutational status by NGS is now a robust and reproducible methodology on cDNA and gDNA and there is a very high success rate when combining a gDNA and cDNA strategy,” said Prof Davi.

“Of course this raises other questions, as interpretation of results might be difficult. We need to develop guidelines, including establishing new recommendations, and we need to provide dedicated education and training.”

Prof Eichorst discussed the development of CLL treatment, synopsised the evolution of guidelines in recent years, and reviewed data from trials on specific drug therapies that balanced continuous treatment regimens against limited-duration strategies.

She also spoke about the European Haematology Association (EHA) guidelines: “There are two major changes to the EHA guidelines,” Prof Eichorst told the attendees.

“We have included not only specialists in CLL; we have also included patient representatives who read the text and gave their input on the patient perspective, in particular how we should handle the watch-and-wait period, and this is really a major achievement for the guidelines.”

Another important update, Prof Eichorst explained, is the addition of the MCBS:H Score, which is the Magnitude of Clinical Benefit Scale for Haematological Malignancies. Developed by the European Society for Medical Oncology and the EHA, this score is designed specifically for haematology and takes into account overall survival, progression-free survival, and quality-of-life.

“The MCBS differentiates between treatment that is curative or non-curative and there are certain degrees of value of benefit from a new treatment compared to standard treatment,”
she commented.

“The scale doesn’t only measure the improvement or progression-free survival, it also considers side-effects, and I think that’s very important for informing our patients.”

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