Treating Chronic Lymphocytic Leukemia (CLL)

Chronic leukemia, CLL for example, sometimes doesn’t require any treatment. One of the judgment calls for leukemia, while we have the technical expertise to make the diagnosis to evaluate those lymphocytes in the bloodstream to determine what kind they are, is to determine whether they all come from one original parent cell.

Mark H. Holguin, MD, Hematology/Oncology; Chief – Section of Hematology

Chronic lymphocytic leukemia in some cases may be slow growing, and in some cases it may progress rapidly. Your physician team will carefully assess your CLL to determine whether you need immediate treatment or whether your treatment can be delayed.

Often, people with CLL have successful outcomes with treatment, living many good years with the disease well controlled.

Treatment options generally depend on whether you have:

  • Fever
  • Night sweats
  • Weight loss
  • Painful lumps
  • Abnormal blood counts
  • Anemia
  • Low platelet count

Your physician team may recommend a special examination of your CLL cells, called a chromosomal analysis, to determine whether you have a more aggressive form of CLL. With information from the chromosomal analysis, your physician team can better plan your treatment protocol.

CLL is generally not considered curable. But your physician team will work to shrink and control it, with the goal of putting it into remission.

It’s wonderful for us to have the cytogenetics laboratory with Dr. Dobin and her group available to us to be able to analyze CLL cells and better prognosticate for patients — what are you likely to see with this one and what are if anything do we need to do about it?

Mark H. Holguin, MD, Hematology/Oncology; Chief – Section of Hematology

At Scott & White, we explore every treatment option. In many cases, your leukemia treatment will include a combination of approaches.

Treatment options for CLL include:

  • Active Surveillance
  • Chemotherapy
  • Allogeneic Blood Stem-Cell Transplantation
  • Surgery
  • Targeted Therapy
  • Radiation Therapy

Your physician will discuss which treatment options are best for you.

At Scott & White, treatment goals for leukemia generally are centered on inducing remission.

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Active Surveillance

Active surveillance means careful watching and waiting. Active surveillance delays treatment and its harsh side effects. Your physician will monitor the course of your disease, intervening with treatment if your CLL advances.

Active surveillance is a good choice if your CLL is:

  • Slow growing
  • Has no symptoms
  • Has minimal changes in blood counts

Your physician will watch for these signs:

  • Increased fatigue
  • Enlarged lymph nodes
  • Decreased red blood cell or platelet counts

If you show signs that your condition is worsening, your physician will begin active treatment.

Chemotherapy

Chemotherapy is often used to treat fast-growing CLL. Chemotherapy is a form of cancer treatment where high-powered drugs are given to stop the leukemic cells from multiplying.

Chemotherapy for CLL can be given orally, intravenously or through a small tube (catheter). It’s often used in combination with drug therapy, particularly monoclonal antibodies (lab-created proteins that carry drugs directly to tumors), to help control disease.

In many cases, your chemotherapy treatments for CLL can be done in an outpatient setting.

Find out more about chemotherapy for your leukemia

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Allogeneic Blood Stem-Cell Transplant

In some cases, your physician may suggest you consider receiving blood stem-cell transplant.

Blood stem-cell transplant is a procedure replacing your leukemic bone marrow with healthy bone marrow stem cells. An allogeneic transplant (ALLO) involves removing bone marrow from a matched donor. (Allo means “other.”)

Scott & White does not offer allogeneic blood stem-cell transplants. All allogeneic blood stem-cell transplants are referred to one of our accredited partners in the state.

Find out more about allogeneic blood stem-cell transplant

Surgery

Splenectomy

A splenectomy is the surgical removal of your spleen. In some cases, your physician team may recommend a splenectomy if your spleen becomes enlarged due to your CLL. Because your spleen contains large groups of lymph nodes, it may become painful and lower your blood cell counts.

A splenectomy may help improve your blood cell counts, but it may also increase your risk of infection.

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Targeted Therapy

In some cases, depending on the subtype of CLL you have, your physician team may recommend one or more several federally approved targeted therapies for your CLL.

Find out more about targeted therapies

Radiation Therapy

Radiation therapy uses high-powered X-rays, seeds or radioactive material to shrink or destroy your tumor.

Radiation therapy is infrequently used to treat leukemia. However, in some cases, your physician team may recommend concurrent radiation therapy in addition to other treatments for your leukemia.

Find out more about radiation therapy for your leukemia

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