Treatment for chronic lymphocytic leukaemia (CLL)
The aim of treatment for CLL is to put the disease into remission. This means there are no active signs of it – you have no abnormal white cells and your symptoms have disappeared. CLL is rarely cured by current treatments but people can live with it for many years.
There are a number of ways to manage CLL:
- Active monitoring
- Steroid therapy
- Biological therapy
- High-dose therapy with stem cell transplant
- Treatment of symptoms
When you are diagnosed with CLL, you may have few if any signs of active disease. In this case, there is little or no benefit giving you treatment. Instead you can visit your doctor regularly to watch and wait if the disease becomes active. This can take many years.
Chemotherapy uses drugs to cure or control your leukaemia. This is the main treatment for CLL. You may need several courses of chemotherapy before the leukaemia is said to be in remission. These drugs are often used in combination.
Some common drugs used are:
Please see our booklet Understanding Chemotherapy and Other Cancer Drugs, which you can download from our "Publications about cancer treatment side effects" list on the right hand side of this page, for more details.
Steroids are substances made naturally in your body. They can be given with chemotherapy to treat CLL because they work well together. They can also be given to help with some side-effects that you might experience, such as feeling sick. Steroids are usually taken in tablet form but can also be given into a vein.
These drugs use your body´s immune system to treat leukaemia. There are different types of biological therapies. For example, monoclonal antibodies. The most common drugs used in CLL are rituximab (Mabthera) and Mabcampath (Alemtuzumab).
High-dose treatment with stem cell support
For a small number of people with CLL it is possible to have a stem cell transplant. This can happen if you have not responded to chemotherapy or other treatments. The aim is to give high doses of chemotherapy to destroy the blood cells in your bone marrow and replace them with stem cells. These stem cells can then grow into new healthy blood cells.
Before the high dose chemotherapy is given, the stem cells are taken from your bone marrow or your bloodstream (peripheral blood). If the cells are taken from you, it is known as an autologous transplant. If they are taken from someone else, it is known as an allogeneic transplant. For more information, see our booklets and factsheets:
- Understanding Chronic Lymphocyctic Leukaemia booklet
- Understanding Stem Cell Collection
- Understanding Autologous Stem Cell Transplants
- Total Body Irradiation
Treatment of symptoms
Some symptoms of CLL will need to be treated immediately.
- Infections: These are treated with antibiotics or antibodies.
- Anaemia: This is treated with blood transfusions.
- Bleeding problems: These are treated with platelet transfusions.
- Enlarged spleen: This is treated with painkillers, radiotherapy and rarely surgery.
The type of side-effects you get will depend on the kind of treatment, the dose, the duration and your own general health. Some treatments might make you feel sick (nausea), vomit or have diarrhoea. You might also lose your appetite or your hair. Many treatments cause you to feel very tired (fatigue). Infertility may be a problem if you have chemotherapy. Steroids can increase your blood pressure and blood sugars and even cause mood changes.
Most side-effects do not last long and disappear once treatment is over. Your doctor or nurse will discuss any possible side-effects with you before treatment begins.
For more about coping with side-effects, see the booklets Understanding Chemotherapy and Other Cancer Drugs, Understanding Radiotherapy, Coping with Fatigue, Diet and Cancer and Understanding Cancer and Complementary Therapies, all available to download under the "Important cancer information booklets" list on the right hand side of this page.
If a treatment looks like it might be helpful, it is given to patients in research studies called clinical trials. Trials may be taking place at the hospital you are attending. If you are interested in taking part, talk to your doctor. He or she can advise you if the trial would suit you or not.