Thus, treatment is withheld until patients have one of the following: Symptoms attributed to CLL Progressive lymphocytosis with an increase of ≥ 50% over a 2-month period Lymphocyte doubling time (increase of ≥ 100%) < 6 months Symptoms that prompt treatment in patients with CLL include Constitutional symptoms (fever, night sweats, extreme fatigue, weight loss) Significant hepatomegaly, splenomegaly, or lymphadenopathy Recurrent infections Symptomatic anemia and / or thrombocytopenia Disease-directed treatment options include Chemoimmunotherapy Targeted therapy Radiation therapy Supportive care includes Transfusion of packed red blood cells for anemia Platelet transfusions for bleeding associated with thrombocytopenia Antimicrobials for bacterial, fungal, or viral infections Because neutropenia and hypogammaglobulinemia limit bacterial killing, antibiotic therapy should be bactericidal.