The treatment options for chronic lymphocytic leukemia (CLL) vary widely with the extent of the disease and the symptoms you have. If the disease is in an early stage and you don’t have symptoms, your doctor may discuss with you the option of watchful waiting or observation. If tests confirm that your CLL is progressing rapidly and if you are having symptoms, more aggressive treatments may be used. These include chemotherapy, monoclonal antibody therapy, radiation therapy and bone marrow transplant.
Particularly in older adults and those who have no symptoms of leukemia, a period of observation may be chosen. During watchful waiting, you will be closely monitored for changes in your physical health and any increase in symptoms, and regular blood tests will be performed. Further treatment may be needed if your disease worsens.
Systemic chemotherapy treatment uses powerful anticancer drugs, injected into a vein or taken by mouth, that attack the quickly dividing cancer cells growing in your body. Because the chemotherapy drugs search out and destroy any cells that divide quickly, they also affect some of your healthy cells, such as your hair follicles and the lining of your mouth and intestines. When these healthy cells are destroyed, you may experience side effects such as hair loss, loss of appetite, nausea, fatigue and mouth sores.
Monoclonal Antibody Therapy
Sometimes called immunotherapy or biotherapy, monoclonal antibodies are lab-created immune-system proteins that are designed to stick to certain substances. In CLL treatment, these proteins stick to the surface of a substance on the cancer cells, helping your immune system to identify and destroy the cancer cells. The monoclonal antibodies are given by subcutaneous (under the skin) injection or intravenously (injection into a vein). Sometimes side effects occur, including fever, chills, nausea and low blood cell counts.
Radiation therapy uses focused high-energy radiation to destroy cancer cells. This treatment may be used to treat certain symptoms of CLL, such as an enlarged spleen or bone pain.
Bone Marrow Transplant
Chemotherapy with bone marrow transplant (also called stem cell or hematopoietic cell transplant) may be used to treat CLL that hasn’t responded to standard treatment. In this procedure, chemotherapy is used to destroy your leukemia-producing bone marrow. Then disease-free stem cells from a compatible donor (allogeneic transplant) are used to replenish your bone marrow with healthy cells. Only a few patients with CLL are treated with bone marrow transplant because it is a complex procedure with significant side effects, which must be weighed with possible benefits to the patient.