Objective To apply the evidence-based treatment method to direct the clinical therapy of refractory chronic lymphocytic leukemia (CLL). Methods Such evidence-based medicine databases as The Cochrane Library (Issue 10, 2010), OVID database, PubMed (January 1992 to October 2010) and http://www.nccn.org/ were searched to find the clinical evidence with high quality and the optimum treatment was designed based on the patient’s preferences. Results Two RCTs and five CCTs were included. The available clinical evidence displayed that rituximab could improve the therapeutic effect of combined chemotherapy on the refractory CLL, the COP/CHOP regimens were effective for the fludarabine-resistant CLL, and hematopoietic stem cell transplantation could be an effective salvage therapy for the relapsed/refractory CLL, but not the first-line recommendation drug. This patient was treated by CHOP regimen combined with rituximab, the condition of disease was improved two months after stopping chemotherapy, and the follow-up was conducted. Conclusion Current evidence reveals that rituximab combined with CHOP regimen produces good tolerance with a better clinical outcome than that of CHOP regimen. Clinical practice results display that the combination of rituximab and CHOP regimen can bring good prognosis to the patient, but still needs high-quality evidence to prove．
目的 增加对慢性淋巴细胞白血病合并非霍奇金淋巴瘤临床病例的认识。 方法 通过报道2011年11月和2012年7月入住的2例确诊为慢性淋巴细胞白血病合并非霍奇金淋巴瘤患者的诊治过程，复习文献，讨论其发病机制、治疗及预后。 结果 该2例患者均予以化疗，其中1例浅表淋巴结明显缩小，骨髓涂片基本恢复正常，病情控制较好；另1例合并症多、病情恶化快、肿瘤化疗效果欠佳，最后因呼吸衰竭死亡。 结论 慢性淋巴细胞白血病合并非霍奇金淋巴瘤，治疗上应综合考虑患者年龄、ECOG评分、临床分期、预后指数等因素，原则上以治疗恶性程度更高的非霍奇金淋巴瘤为主，可根据慢性淋巴细胞白血病分期进行观察、随访或积极治疗。
Chronic lymphocytic leukemia (CLL) / small lymphocytic lymphoma (SLL) is a malignancy of mature B cells characterized by progressive lymphocytosis, lymphadenopathy, and splenomegaly. On February 21st 2019, with the accumulating of new data, the National Comprehensive Cancer Network updated the guideline for CLL/SLL. This article aims at providing a reasonable interpretation of the most important messages conveyed in the guideline.