Canterbury DHB
The following are recommended:
The following are recommended for fludarabine-based treatment:
Patients with CLL should receive annual influenza vaccinations. In addition pneumoccocal vaccination is also advised. Although antibody formation by CLL patients may be sub-optimal, pneumonia is a common cause of death in this disease.
See Nausea and Vomiting.
Blood and platelet transfusions will be given at the discretion of the treating physician. Patients treated with fludarabine or fludarabine plus cyclophosphamide must receive irradiated blood products to prevent the rare occurrence of transfusion associated graft versus host disease. This should continue for at least 6 months after the end of the fludarabine therapy.
This may be indicated in non-responding patients who remain with a markedly enlarged spleen after an adequate trial of primary therapy. For further information, see Prevention of Infection Pre-splenectomy and in Splenic Atrophy in the Infection including Prophylaxis section.
Topic Code: 5530