Types of treatment for chronic lymphocytic leukaemia (CLL) | Cancer Research UK
Cancer Research UK on Google+ Cancer Research UK on Facebook Cancer Research UK on Twitter

Types of treatment for chronic lymphocytic leukaemia (CLL)

Men and women discussing chronic lymphocytic leukaemia

This page gives you an overview of the treatments for chronic lymphocytic leukaemia. There is information about

 

A quick guide to what's on this page

Treatment in early CLL

You may have no symptoms when you are first diagnosed with CLL. So your specialist will probably suggest you do not have treatment at this time. If your CLL starts to get worse, your doctor will suggest treatment. Doctors generally treat for the following reasons

  • Fast developing disease
  • Bulky lymph nodes
  • Bone marrow failure
  • Fatigue, severe weight loss, drenching night sweats

The usual treatment is chemotherapy. Your doctor may also recommend radiotherapy if you have very swollen lymph glands, or surgery to remove a swollen spleen. The treatment can put CLL into remission – where you have no sign of CLL and no symptoms. With CLL a remission can last for years. After some time the leukaemia may become active again and cause symptoms. This is called a relapse.

Treatment for relapse

When the chronic lymphocytic leukaemia comes back, you have more treatment with chemotherapy or biological therapy or a combination. Many people with CLL can have further remissions. The remissions tend to get shorter, the more treatment you have.

Intensive treatment

After initial chemotherapy or treatment for relapse, some people have more intensive treatment to try to stop the CLL coming back. This means having a bone marrow or stem cell transplant.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating CLL section.

 

 

The main treatments

When your doctors are deciding on the best treatment for you they will look at

  • How far your leukaemia has developed (the stage)
  • Your general health
  • Your age and level of fitness

If you have very early stage CLL you may not need treatment straight away if you don't have symptoms. If you do need treatment, you will have chemotherapy. You may also have radiotherapy. 

If your CLL is more advanced or has come back after earlier treatment, you may have chemotherapy with biological therapy.

A small number of people may have intensive treatment, which means chemotherapy with a bone marrow or stem cell transplant. 

 

Treating early CLL

Many people have no symptoms when they are first diagnosed with CLL. Your CLL may have been picked up on a routine blood test for something else. If you have no symptoms, your specialist will probably suggest that you do not have any treatment at all for the moment. CLL can develop very slowly. Many people are already quite elderly when they are diagnosed. Some of them may never need any treatment if the leukaemia is not causing them any problems. Starting treatment when you have no symptoms is unlikely to help your CLL. Your GP or haematologist will monitor you regularly and check your blood cell count. Doctors call this watchful waiting. 

Doctors generally treat CLL for the following reasons

  • Fast developing disease
  • Bulky lymph nodes or spleen
  • Bone marrow failure
  • Fatigue, severe weight loss, drenching night sweats

When you need treatment for CLL, your doctor will usually suggest that you have chemotherapy. They may also recommend radiotherapy to shrink swollen lymph nodes, or surgery to remove a swollen spleen. 

Although the treatment will not get rid of the CLL completely for good, it can put CLL into remission. Remission means there is no sign of the leukaemia on scans or tests and you have no symptoms. With early stage CLL a remission can last for years. After some time the leukaemia may become active again and cause symptoms. This is called a relapse.

 

Treating later stage or relapsed CLL

Later stage CLL includes stage B CLL with symptoms, or stage C CLL. If you have later stage CLL, your doctor may suggest chemotherapy, perhaps combined with a biological therapy called rituximab. The treatment may get your leukaemia under control (in remission). You may then have a period where you do not need any treatment. 

If the CLL comes back after treatment, your doctor may suggest more chemotherapy or they may suggest a biological therapy. Many people with CLL can have further remissions with more treatment each time the leukaemia comes back. But generally, the remissions tend to get shorter, the more treatment you have. If you have swollen lymph nodes your doctor may recommend radiotherapy to shrink them. If your spleen is swollen they may recommend surgery to remove the spleen. 

 

Intensive treatment for CLL

A small number of people have intensive treatment with a bone marrow or stem cell transplant for CLL but this is still experimental. The intensive treatment aims to try to get rid of the CLL completely for good, or to control it for longer than standard treatments. Before you can have this type of treatment, you will have tests to make sure that you are well enough to get through it. Intensive treatments are too risky if you are not fit enough.

If you are going to have intensive treatment, you will have chemotherapy first, to try to get your CLL into remission. You then have a stem cell or bone marrow transplant. This means more chemotherapy and sometimes radiotherapy, followed by a drip (infusion) of donor bone marrow or blood stem cells.

 

Clinical trials for CLL

Researchers and doctors continue to look for better treatments or different treatment combinations for CLL. They test them in clinical trials. Your doctor may suggest that you join a trial. In our research section, there is information about clinical trials, including what it is like to take part. You can find details of individual trials for chronic leukaemia in our clinical trials database. You can find detailed information about current research into CLL on our CLL research page.

Rate this page:
Submit rating

 

Rated 5 out of 5 based on 62 votes
Rate this page
Rate this page for no comments box
Please enter feedback to continue submitting
Send feedback
Question about cancer? Contact our information nurse team

No Error

Updated: 5 March 2015