A 72-year-old male presents with a history of feeling
tired, weak and breathless. He also complains of bleeding gums.
On examination he is found have lymphadenopathy and his
spleen is just palpable.
Hb 9.0 g/dL normocytic normochromic picture
WBC 86,000 predominantly lymphocytes
Platelets 85 x 109/L
Coomb’s test negative
In this patient which of the following treatment options
would you choose?
Observe with serial blood counts
Vincristine, prednisolone, doxorubicin, cyclophosphamide