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This study was supported by the Ministerio de Economía y Competitividad, Grant n. SAF2015-67633-R ,and PI16/00420 which are part of Plan Nacional de I+D+I and are co-financed by the European Regional Development Fund (FEDER-“Una manera de hacer Europa”) and the CERCA program from Generalitat Catalunya. European Union’s Seventh Framework Programme for research, technological development and demonstration under grant agreement n. 306240; Generalitat de Catalunya Suport Grups de Recerca AGAUR 2017-SGR1009, and Departament de Salut (SLT002-16-00350), Instituto de Salud Carlos III (ISCIII) International Cancer Genome Consortium for Chronic Lymphocytic Leukemia (ICGC-CLL Genome Project), and project PM15/00007, which is part of Plan Nacional de I+D+I and are co-financed by FEDER. NG is a recipient of a predoctoral fellowship from Agaur and EC is an Academia Researcher of the "Institució Catalana de Recerca i Estudis Avançats" (ICREA) of the Generalitat de Catalunya., Giménez, N., Martínez-Trillos, A., Montraveta, A., Lopez-Guerra, M., Rosich, L., Nadeu, F., Valero, J.G., Aymerich, M., Magnano, L., Rozman, M., Matutes, E., Delgado, J., Baumann, T., Gine, E., González, M., Alcoceba, M., Terol, M.J., Navarro, B., Colado, E., Payer, A.R., Puente, X.S., López-Otín, C., Lopez-Guillermo, A., Campo, E., Colomer, D., Villamor, N.

Background and objective The broad therapeutic arsenal and the biological heterogeneity of patients with chronic lymphocytic leukemia (CLL) makes it difficult to standardize treatment for CLL patients with specific clinical settings in routine clinical practice. These considerations prompted us to elaborate the present consensus document, which constitutes an update of the previous version published in 2013, mainly focusing on novel treatment strategies that have been developed over last 5 years, namely B-cell receptor inhibitors (ibrutinib and idelalisib), anti-CD20 monoclonal antibodies (ofatumumab and obinutuzumab), and Bcl-2 inhibitors (venetoclax). Material and methods A group of experts from the Spanish Chronic Lymphocytic Leukemia Group reviewed all published literature from January 2010 to January 2016, in order to provide recommendations based on clinical evidence. For those areas without strong scientific evidence, the panel of experts established consensus criteria based on their clinical experience. Results The project has resulted in several practical recommendations that will facilitate the diagnosis, treatment, and follow-up of patients with CLL. Conclusions There are many controversial issues in the management of CLL with no appropriate studies for making consensus recommendations.

Resumen La leucemia linfocitica cronica es el sindrome linfoproliferativo cronico mas frecuente en nuestro pais, existiendo una amplia heterogeneidad en su abordaje clinico. En la actualidad, en Espana no se dispone de guias de consenso nacionales similares a las publicadas en otros paises para su diagnostico, clasificacion pronostica y tratamiento. El presente trabajo revisa la evidencia cientifica actual y aborda cuestiones relacionadas con el diagnostico, el estudio de extension, la presencia de comorbilidades y la clasificacion de escalas pronosticas, los esquemas de tratamiento habituales estratificados por grupos de riesgo, el tratamiento de las complicaciones asociadas tanto a la enfermedad como a los procedimientos, asi como diferentes controversias que rodean a la enfermedad y su tratamiento. El documento, realizado con la colaboracion de expertos nacionales, permite establecer unas recomendaciones de caracter practico, con su correspondiente nivel de evidencia y grado de recomendacion, que facilitaran el diagnostico, tratamiento y seguimiento de los pacientes con leucemia linfocitica cronica.