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[2] [46] A "watchful waiting" strategy is used for most patients with CLL. [46] The International Workshop on CLL (iwCLL) has issued guidelines with specific markers that should be met to initiate treatment, generally based on evidence for progressive symptomatic disease (summarized as "active disease"). [72]
In many applications, a key component of watchful waiting is the use of an explicit decision tree or other protocol to ensure a timely transition from watchful waiting to another form of management, as needed. [15] This is particularly common in the post-surgical management of cancer survivors, in whom cancer recurrence is a significant concern.
[3] [6] Certain types of leukemia may be managed with watchful waiting. [3] The success of treatment depends on the type of leukemia and the age of the person. Outcomes have improved in the developed world. [10] Five-year survival rate was 67% in the United States in the period from 2014 to 2020. [4]
Treatment can occasionally consist of "watchful waiting" (e.g., in CLL) or symptomatic treatment (e.g., blood transfusions in MDS). The more aggressive forms of disease require treatment with chemotherapy, radiotherapy, immunotherapy and—in some cases—a bone marrow transplant.
Treatment options include watchful waiting, radiation aimed directly at the affected lymph nodes, chemotherapy, and immunotherapy. For patients whose disease becomes more aggressive, autologous stem cell transplantation may be used. [citation needed] There is no consensus on the optimal first-line treatment for follicular lymphoma.
No longer waiting to die. Because Looney had donated a kidney to her mother in 1999, she was at the top of the transplant list when she needed one herself about eight years ago.