Criteria of National Cancer Institute (NCI) for Response to Therapy in B-Cell CLL

Date when therapy completed (enter MM/DD/YYYY)

Date of evaluation (enter MM/DD/YYYY)

Does the patient show constitutional symptoms?

Was there lymphadenopathy before treatment?

Was there splenomegaly before treatment?

Was there hepatomegaly before treatment?

White blood cell count before treatment

Percent lymphocytes before treatment (enter from 0 to 100)

Hemoglobin before treatment

White blood cell count at evaluation

Percent lymphocytes at evaluation (enter from 0 to 100)

Percent neutrophils at evaluation (enter from 0 to 100)

Platelet count at evaluation

Hemoglobin at evaluation

Has the patient been recently transfused?

Hemoglobin prior to transfusion

Percent lymphocytes on bone marrow (enter from 0 to 100)

Are lymphoid nodules present in the bone marrow?

Was the bone marrow hypocellular?

• have any new lymph node groups become enlarged in size?

• has the patient been diagnosed with Richter's syndrome?

• has the patient developed prolymphocytic leukemia with > 55% prolymphocytes?

Previously enlarged lymph node(s)

Spleen size

Liver size