BCSH (2008) Indications for treatment: Progressive hematopoietic failure: manifested by anemia and/or thrombocytopenia or exacerbation; massive lymph node enlargement (e.g., >10 cm in longest diameter) or progressive or symptomatic lymph node enlargement; giant spleen (e.g., >6 cm below left costal margin) or progressive or symptomatic splenomegaly; progressive lymphocytosis, e.g., >50% increase within 2 months, or lymphocytic multiplication.