Chronic lymphocytic leukaemia (CLL)

CLL treatments aim to put CLL into remission. Remission means your symptoms have gone, you feel well and your scans and blood tests are normal or near to normal.

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.

Treating stage A

You may be advised not to have treatment if you don’t have any symptoms. 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 or active surveillance.

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

Treating stage B or C

If your disease is at a later stage you may be offered treatment. The main treatments are:

The type of side-effects you get will depend on the type of treatment you have, 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.

Some symptoms of CLL may need to be treated straight away. For example:

• Infection: You may be more at risk of infections than someone who doesn’t have CLL, because CLL affects your immune system. Infections include viral ones, like colds, shingles and chickenpox or bacterial infections like pneumonia. Your doctor may prescribe antiviral or antibiotic medications for you, to prevent infection. You may also be given antibodies called immunoglobulins, which boost your immune system.
• Anaemia and bleeding problems: If your red blood cell count is low (anaemia), it can lead to fatigue and shortness of breath. If your platelets are low, you may have bleeding gums and find it hard to stop the bleeding from simple cuts and bruises. In both cases, you may need to receive blood transfusions before and during your treatment. If you have a low red blood cell count because of autoimmune haemolytic anaemia (AIHA) or a low platelet count because of immune thrombocytopenia (ITP), your doctor will prescribe specific treatments for you.
• Enlarged spleen: 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. If you need any further treatment, your doctor will discuss this with you.

You will also be checked closely for any signs or symptoms of the disease getting worse. Tell your doctor if you develop any new symptoms.

You will have blood tests and maybe CT scans to see how well the cancer is responding to treatment. How well your disease responds to treatment depends on factors like the stage of your disease and your overall health.

Partial response

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

Complete response

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. 

Minimal residual disease (MRD)

MRD means looking for very small amounts of CLL remaining in the body after treatment, using sensitive tests on blood or bone marrow samples. MRD positive means that low levels of CLL can be detected. MRD negative means that no traces of CLL can be found. People with CLL who are MRD negative after treatment usually have a longer period of remission after treatment, but this doesn’t mean the CLL has been cured. It may still come back.