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Treatments and drugs
By Mayo Clinic staffYour treatment options for chronic lymphocytic leukemia depend on several factors, such as the stage of your cancer, whether you're experiencing signs and symptoms, your overall health, and your preferences.
Treatment may not be necessary in early stages
People with early-stage chronic lymphocytic leukemia typically don't receive treatment, though clinical trials are evaluating whether early treatment may be helpful. Studies have shown that early treatment doesn't extend lives for people with early-stage chronic lymphocytic leukemia. Rather than put you through the potential side effects and complications of treatment before you need it, doctors carefully monitor your condition and reserve treatment for when your leukemia progresses. Doctors call this watchful waiting.
Your doctor will plan a checkup schedule for you. You may meet with your doctor and have your blood tested every few months to monitor your condition.
Treatments for intermediate and advanced stages
If your doctor determines your chronic lymphocytic leukemia is progressing or is in the intermediate or advanced stages, your treatment options may include:
- Chemotherapy. Chemotherapy is a drug treatment that kills cancer cells. Chemotherapy treatments can be given through a vein in your arm or taken in pill form. Depending on your situation, your doctor may use a single chemotherapy drug or you may receive a combination of drugs. Side effects depend on what chemotherapy drugs are used. Common side effects include fatigue, low blood cell counts and a risk of frequent infections.
- Targeted drug therapy. Targeted drugs are designed to take advantage of the specific vulnerabilities of your cancer cells. Chronic lymphocytic leukemia cells have a variety of proteins on their surfaces. Targeted therapy drugs are designed to bind to a specific protein as a way to target and kill leukemia cells. Targeted therapy drugs used in treating chronic lymphocytic leukemia include rituximab (Rituxan), alemtuzumab (Campath) and ofatumumab (Arzerra). Side effects of these drugs include fever, chills and infections.
- Bone marrow stem cell transplant. Bone marrow stem cell transplants use strong chemotherapy drugs to kill the stem cells in your bone marrow that are creating diseased lymphocytes. Then healthy adult blood stem cells from a donor are infused into your blood, where they travel to your bone marrow and begin making healthy blood cells. A reduced intensity, or "mini," bone marrow stem cell transplant is similar to a standard stem cell transplant, but it uses lower doses of chemotherapy drugs. Bone marrow stem cells may be a treatment option for people who aren't helped by other treatments or for certain people with very aggressive chronic lymphocytic leukemia.
- Kipps TJ. Chronic lymphocytic leukemia and related diseases. In: Lichtman MA, et al. Williams Hematology. 8th ed. New York, N.Y.: McGraw-Hill Companies; 2010. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=69. Accessed Sept. 16, 2010.
- Grever MR, et al. Chronic lymphoid leukemias. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2007:2293.
- Elphee EE. Caring for patients with chronic lymphocytic leukemia. Clinical Journal of Oncology Nursing. 2008;12:417.
- Chronic lymphocytic leukemia treatment (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/CLL/patient/allpages. Accessed Sept. 15, 2010.
- Arzerra (prescribing information). Research Park Triangle, N.C.: GlaxoSmithKline; 2009. http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/125326lbl.pdf. Accessed Sept. 15, 2010.
- Cancer-related fatigue. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/PDF/fatigue.pdf. Accessed Sept. 15, 2010.
- Shanafelt TD, et al. Phase I trial of daily oral polyphenon E in patients with asymptomatic Rai stage 0 to II chronic lymphocytic leukemia. Journal of Clinical Oncology. 2009;27:3808.
- Green tea. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Sept. 24, 2010.
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