Chronic Lymphocytic Leukemia (CLL) Treatment

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Treatment for chronic lymphocytic leukemia (CLL) is based on several factors, including:1

  • The stage of CLL
  • Whether the person is experiencing symptoms
  • The age of and general health of the person

CLL is generally a slow-growing cancer, and some people may not need to begin treatment when they are first diagnosed.1

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Types of treatment for CLL

Several different types of treatment may be used for CLL, including:2

  • Watchful waiting
  • Chemotherapy
  • Radiation therapy
  • Surgery
  • Targeted therapy

Watchful waiting

Watchful waiting may be recommended if you are not experiencing symptoms from CLL. During watchful waiting, you do not receive treatment for blood cancer. However, problems like infections are treated. Your health is closely monitored during watchful waiting. Your doctor will watch for any changes in your condition and the potential appearance of symptoms like fatigue, weight loss, fever, drenching night sweats, or an enlarged spleen.2

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Chemotherapy is the use of drugs to stop cancer cells. 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

Chemotherapy drugs may be used along with other drugs or alone. Chemotherapy drugs may be taken by mouth or injected into a vein or muscle.2,3

Radiation therapy

Radiation therapy uses high-energy radiation. It may be used in cases of CLL that have caused an enlarged spleen or to treat bone pain from the growth of leukemia cells in the bone marrow. Radiation therapy may also be given to the entire body in preparation for a stem cell transplant.2,4


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 kill cancer cells to slow the growth and spread of cancer. They do this by interfering with specific areas of cancer cells that are involved in cell growth or by focusing on specific features that are unique to cancer cells.2

Types of targeted therapy used to treat CLL include:2

  • Monoclonal antibody therapy
  • Kinase inhibitors
  • BCL2 inhibitor therapy

Other possible treatments for CLL

While they are not used as often, some people with CLL receive treatment with leukapheresis or a stem cell transplant.

Leukapheresis is a method in which the blood is filtered through a special machine. The machine removes a portion of white blood cells, both normal and leukemia cells, and then returns the blood to the person with CLL. 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 along with high doses of chemotherapy. The high doses destroy cancer cells. However, they also damage healthy blood cells. The transplant of stem cells (immature cells that can become new blood cells) is given to restore the bone marrow.7

Stem cell transplants are not commonly used for people with CLL. However, some clinical trials are testing their effectiveness for this type of blood cancer. Not everyone is a candidate for stem cell transplants. Since the high doses of chemotherapy can be very taxing on a person's body, the treatment may not be tolerated by older adults 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. They offer people a chance to receive the latest treatments and be closely monitored by doctors. You can learn more about clinical trials by talking to your doctor or visiting the website. Your doctor can help you decide if a clinical trial may be right for you.2,8