How is CLL treated?

The aim of treatment is to put the CLL into remission. Remission means no traces of CLL can be found. You have no symptoms of the disease such as enlarged glands or a raised number of abnormal lymphocytes. 

Remission is not the same thing as cure, as symptoms may appear again after a time. How well your disease responds to treatment depends on factors like the stage of your disease and your overall health.

CLL can usually be treated successfully and you can often live with it for many years.

Treatment for different stages of CLL

Treating stage A

You may be advised not to have treatment if you don’t have any symptoms. Your disease is not active, your doctor will give you check-ups every few months and take regular blood samples to monitor your CLL. You can start treatment if things change. This is called watch and wait.

You may never need treatment if your disease does not move beyond the early stage.

Treating stage B or C

Targeted therapies: Drugs that target genetic changes. Monoclonal antibodies are the type most commonly used. They can be given along with chemotherapy. Read more about targeted therapies.

Chemotherapy: Using drugs to kill the cancer cells. Chemotherapy drugs may be given on their own, in combination with each other or with other treatments like steroids or targeted therapies. Read more about chemotherapy.

Steroid therapy: Drugs to help control CLL when used with other treatments.  Steroids can also help with the symptoms of CLL, such as anaemia and fatigue. Read more about steroids

Stem cell transplants: All the blood cells in your bone marrow are destroyed and replaced with healthy stem cells. Transplants are not suitable for every patient. Read more about stem cell transplants.

Will I get side-effects?

The type of side-effects you get will depend on the type of treatment, the dose, the duration and your own general health. You can read about the different treatments to find out more about possible side-effects. We also have information on ways to cope with different side-effects and symptoms.

Enlarged spleen (CLL)

Some people with CLL get an enlarged spleen. This can cause pain and bleeding problems. Your doctors may prescribe painkillers to ease any pain or discomfort you have. Radiotherapy may also be used to ease the pain or reduce the swelling. A small dose is normally needed. Usually, you attend the radiotherapy unit for 5 days (Monday to Friday) for 2 weeks for the treatment. In rare cases, your doctor may decide to remove your spleen. This operation is called a splenectomy and you will be referred to a surgeon. The surgery can relieve pressure but it is not a cure for CLL.

Has the treatment worked?

You will have blood tests and maybe CT scans to see how well the cancer is responding to treatment. 

Minor response

This means there has been a small response to treatment. The CLL is still active.

Partial response

Here your enlarged glands have reduced by half and also the number of abnormal lymphocytes has reduced. This means that you have responded to treatment, but not completely.

Minimal residue disease (MRD)

This means there are very few CLL cells remaining. They can only be found using special blood or bone marrow tests.

Complete response

This means that no traces of CLL can be found. You have no symptoms of the disease such as enlarged glands or a raised number of abnormal lymphocytes. Complete response is not the same thing as cure, as symptoms may appear again after a time. How well your disease responds to treatment depends on factors like the stage of your disease and your overall health.