Figure 1: Evolution of systemic inflammation parameters under successive lines of treatment, under conventional chemotherapies (chlorambucil, fludarabine and cyclosphophamide, RCD: rituximab, cyclophosphamide, dexamethasone), systemic inflammation persisted. Steroids (prednisone) are very effective but stopped because of poor tolerance. Tocilizumab (Toci) introduced since the end of 2013 is still effective with CRP around 20 mg/L, fibrinogen under 4 g/l and ESR around 40 mm/hr.