The Institute has carried out a search for information relevant to this appraisal, and as part of this has liaised with those working on the MRC CLL-4 trial.

As a result, we propose that the review of the original guidance, and an appraisal of the use of fludarabine as 1st line therapy, be deferred until the results of CLL-4 are available to allow this research to be used to inform the process.

In order to be completely confident that this is appropriate, we are asking all original consultees, to inform us of any evidence which would suggest that an earlier review would be beneficial.