Chronic Lymphocytic Leukemia (CLL) Treatment
Treatment for chronic lymphocytic leukemia (CLL) is based on several factors, including the stage of CLL, whether the patient is experiencing symptoms, the age of the individual, and their general health. CLL is generally a slow-growing cancer, and some people may not need to begin treatment when they are first diagnosed.1
Types of treatment for CLL
There are several different types of treatment that may be used for CLL, including:
- Watchful waiting
- Chemotherapy
- Radiation therapy
- Surgery
- Targeted therapy2
Watchful waiting
Watchful waiting may be recommended if a person with CLL is not experiencing symptoms from their disease. During watchful waiting, the person does not receive treatment for blood cancer, although problems like infections are treated. A person's health is monitored closely during watchful waiting, and doctors will watch for any changes in their condition and the potential appearance of symptoms, including fatigue, weight loss, or an enlarged spleen.2
Chemotherapy
Chemotherapy is the use of drugs to stop cancer cells. Chemotherapy medications may be used in combination, and chemotherapy drugs may be taken by mouth or injected into a vein or muscle. Chemotherapy works by targeting fast-growing cells, such as cancer cells. However, there are other fast-growing cells in the body that can also be affected, such as those in the gastrointestinal tract and hair.2,3
Radiation therapy
Radiation therapy uses high-energy radiation, and it may be used in cases of CLL that has caused an enlarged spleen or to treat bone pain from the growth of leukemia cells in the bone marrow. Additionally, radiation therapy may be given to a patient’s entire body in preparation for stem cell transplant.2,4
Surgery
In some cases, a person with CLL may have surgery to remove an enlarged spleen. This surgery is called a splenectomy. While this surgery does not cure CLL, it can relieve some of the symptoms, such as when an enlarged spleen presses on other organs like the stomach.2,5
Targeted therapy
Targeted therapies are cancer treatments that block or slow the spread of cancer by interfering with specific areas of cancerous cells that are involved in the cancer cell's growth, or by focusing on particular characteristics that are unique to cancer cells. While chemotherapy drugs are often cytotoxic, meaning they kill cancer cells, targeted therapy is typically cytostatic, meaning it blocks the growth of cancer cells. Types of targeted therapy that may be used to treat CLL include monoclonal antibody therapy, kinase inhibitors and BCL2 inhibitor therapy.2
Other possible treatments for CLL
While they aren't used as often, some people with CLL receive treatment with leukapheresis or with a stem cell transplant. Leukapheresis is a technique in which the blood is filtered through a special machine that removes a portion of white blood cells, both the normal and leukemia cells, and then returns the blood to the patient. Leukapheresis can be helpful in cases where high numbers of leukemia cells in the blood are overwhelming the normal blood cells.6
Stem cell transplants are used in combination with high doses of chemotherapy. The high dose of chemotherapy destroys the cancer cells and also damages healthy blood cells. The transplant of stem cells, immature cells that can become new blood cells, is given to restore the bone marrow. Stem cell transplants are not commonly used for people with CLL, although some clinical trials are testing their effectiveness for this type of blood cancer. Not everyone is a candidate for stem cell transplants, however, as the high doses of chemotherapy can be very taxing on a person's body and may not be tolerated by older patients or those with other health problems.7
Clinical trials
Clinical trials are a type of research where new treatments are studied. Clinical trials are an important part of the scientific process to find and prove the safety and effectiveness of new treatments, and they offer patients a chance to receive the latest treatments and be closely monitored by healthcare professionals. Clinical trials can be found by talking to a doctor or through the website ClinicalTrials.gov. Patients can discuss treatment options with their doctor to determine if they might be eligible to participate in a clinical trial. 2,8
