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Peer-reviewedCC BY-NC-NDHemaSphere

EHA Guidelines on management of chronic lymphocytic leukemia and Richter transformation

  • Barbara F. Eichhorst1
  • Paolo Ghia2,3
  • Francesc Bosch4
  • Ruth Clifford5,6
  • Michael Gregor7
  • Romain Guièze8
  • Arnon Philip Kater9
  • Carsten U. Niemann10
  • Sarka Pospisilova11
  • Tadeusz Robak12
  • Anna Schuh13
  • Kostas Stamatopoulos14
2 more authors
  • Tamar Tadmor15
  • Nick York16
16 affiliations
  1. 1Department I for Internal Medicine, Center of Integrated Oncology Aachen, Bonn, Cologne, Duesseldorf University of Cologne Cologne Germany
  2. 2IRCCS Ospedale San Raffaele Comprehensive Cancer Center Milano Italy
  3. 3Medical School Università Vita‐Salute San Raffaele Milano Italy
  4. 4Department of Hematology, University Hospital Vall d'Hebron Vall d'Hebron Institute of Oncology (VHIO) Barcelona Spain
  5. 5Department of Haematology, Cancer Services University Hospital Limerick Limerick Ireland
  6. 6Limerick Digital Cancer Research Center, Health Research Institute, School of Medicine University of Limerick Limerick Ireland
  7. 7Division of Hematology Luzerner Kantonsspital Luzern Switzerland
  8. 8University Hospital of Clermont‐Ferrand and Université Clermont Auvergne Clermont‐Ferrand France
  9. 9Department of Hematology, Cancer Center Amsterdam Amsterdam University Medical Centers, Amstewrdam, Netherlands, also on behalf of HOVON
  10. 10Department of Hematology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
  11. 11CEITEC and Department of Internal Medicine, Hematology and Oncology, Faculty of Medicine Masaryk University and University Hospital Brno Brno Czech Republic
  12. 12Department of Hematology, Medical University of Lodz, and Department of General Hematology and Internal Medicine, Lodz Copernicus Memorial Hospital Lodz Poland
  13. 13Department of Oncology University of Oxford Oxford United Kingdom
  14. 14Institute of Applied Biosciences Centre for Research and Technology Hellas Thessaloniki Greece
  15. 15Hematology unit Bnai‐Zion Medical Center, and the Ruth and Bruce Rappaport Faculty of Medicine Technion Haifa Israel
  16. 16Leukaemia Care, One Birch Court Blackpole East Worcester United Kingdom
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Abstract

Previous editions of the European guidelines for the management of chronic lymphocytic leukemia (CLL) were developed by experts in CLL under the auspices of the European Society for Medical Oncology (ESMO). These previous editions have served as a reference text for many physicians caring for patients with CLL. The current, 2026 edition, represents the new, updated guidelines that, for the first time (and in agreement with ESMO), were written on behalf of the European Hematology Association (EHA), which will be solely responsible for subsequent editions, published annually to keep pace of the fast-moving field of CLL research and clinical applications. The new guidelines support approaching the management of CLL in a more holistic fashion, from the initial diagnosis (including active surveillance) to treatment need, with particular emphasis on the interplay between disease- and patient-specific criteria for decision-making, to the latest stage of possible Richter transformation, which is now specifically mentioned in the title of the guidelines. These new recommendations are the result of a consensus reached among medical experts from several European countries and, for the first time, have involved patient advocacy representatives, which is in line with EHA standard operating procedures for clinical practice guideline development. Updates in terms of treatment options include the recently European Medicines Agency-approved, time-limited combination therapy acalabrutinib and venetoclax ± obinutuzumab as first-line treatment, and continuous pirtobrutinib for patients exposed to covalent Bruton's tyrosine kinase inhibitors in the relapsed/refractory setting.

Related

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  3. IDENTIFYING BARRIERS TO THE IMPLEMENTATION OF RECOMMENDED TESTING GUIDELINES IN CHRONIC LYMPHOCYTIC LEUKEMIA: A DELPHI SURVEY IN LATIN AMERICA
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  4. A Rare Case of Chronic Lymphocytic Leukemia and Chronic Myeloid Leukemia in an Elderly Patient: A Case Report
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  5. Richter Transformation of Chronic Lymphocytic Leukaemia: Biology, Diagnosis, and an Evolving Therapeutic Landscape
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Cite

BibTeXRIS
BibTeX
@article{eichhorst2026guidelines,
  title = {{EHA Guidelines on management of chronic lymphocytic leukemia and Richter transformation}},
  author = {Barbara F. Eichhorst and Paolo Ghia and Francesc Bosch and Ruth Clifford and Michael Gregor and Romain Guièze and Arnon Philip Kater and Carsten U. Niemann and Sarka Pospisilova and Tadeusz Robak and Anna Schuh and Kostas Stamatopoulos and Tamar Tadmor and Nick York},
  journal = {HemaSphere},
  year = {2026},
  month = jun,
  doi = {10.1002/hem3.70403},
  url = {https://doi.org/10.1002/hem3.70403},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - EHA Guidelines on management of chronic lymphocytic leukemia and Richter transformation
AU  - Barbara F. Eichhorst
AU  - Paolo Ghia
AU  - Francesc Bosch
AU  - Ruth Clifford
AU  - Michael Gregor
AU  - Romain Guièze
AU  - Arnon Philip Kater
AU  - Carsten U. Niemann
AU  - Sarka Pospisilova
AU  - Tadeusz Robak
AU  - Anna Schuh
AU  - Kostas Stamatopoulos
AU  - Tamar Tadmor
AU  - Nick York
PY  - 2026
DA  - 2026/06/01
JO  - HemaSphere
DO  - 10.1002/hem3.70403
UR  - https://doi.org/10.1002/hem3.70403
AB  - Previous editions of the European guidelines for the management of chronic lymphocytic leukemia (CLL) were developed by experts in CLL under the auspices of the European Society for Medical Oncology (ESMO). These previous editions have served as a reference text for many physicians caring for patients with CLL. The current, 2026 edition, represents the new, updated guidelines that, for the first time (and in agreement with ESMO), were written on behalf of the European Hematology Association (EHA), which will be solely responsible for subsequent editions, published annually to keep pace of the fast-moving field of CLL research and clinical applications. The new guidelines support approaching the management of CLL in a more holistic fashion, from the initial diagnosis (including active surveillance) to treatment need, with particular emphasis on the interplay between disease- and patient-specific criteria for decision-making, to the latest stage of possible Richter transformation, which is now specifically mentioned in the title of the guidelines. These new recommendations are the result of a consensus reached among medical experts from several European countries and, for the first time, have involved patient advocacy representatives, which is in line with EHA standard operating procedures for clinical practice guideline development. Updates in terms of treatment options include the recently European Medicines Agency-approved, time-limited combination therapy acalabrutinib and venetoclax ± obinutuzumab as first-line treatment, and continuous pirtobrutinib for patients exposed to covalent Bruton's tyrosine kinase inhibitors in the relapsed/refractory setting.
SN  - 2572-9241
ER  -