Mangement guided by-
Rai classification system
# stage 0, lymphocytosis only
# stage I, lymphocytosis plus lymphadenopathy
# stage II, organomegaly
# stage III, anemia
# stage IV, thrombocytopenia
Most cases of early indolent CLL require no specific therapy, and the standard of care for early stage disease has been observation.
Indications for treatment include progressive fatigue, symptomatic lymphadenopathy, or anemia or thrombocytopenia
symptomatic and progressive Rai stage II disease or stage III/IV disease-initial treatment of choice is the combination of the chemotherapeutic agent fludarabine plus the antibody rituximab, with or without the addition of the chemotherapeutic drug cyclophosphamide
In the case given, the patient is asymptomatic and only has lymphosytosis-->stage 0-->no intervention, observation is the answer...
Ref-CMDT 2010