Chronic lymphocytic leukemia

Chronic lymphocytic leukemia overview

Chronic lymphocytic leukemia (CLL) is a cancer of the bone marrow and blood. It is also called chronic lymphoid leukemia. It happens when a type of white blood cell called a lymphocyte changes and grows out of control. Small lymphocytic lymphoma (SLL) is closely related to CLL. But in SLL, cancer cells are found in the lymph nodes and spleen. Most of the information in our web section about CLL also applies to SLL.

Fred Hutchinson Cancer Center provides all standard therapies for CLL. Our experts are national leaders in CLL research and have developed many of these approaches.

Many of our CLL patients join clinical trials — led by world-renowned doctors from Fred Hutch and UW Medicine — to get promising therapies that are not available anywhere else.

We also treat other rare types of leukemia or lymphoma that come from lymphocytes. These include prolymphocytic leukemia, large granular lymphocytic leukemia and hairy cell leukemia.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Lymphocyte A type of immune cell that is made in the bone marrow and is found in the blood and in lymph tissue. The two main types of lymphocytes are B lymphocytes and T lymphocytes. A type of immune cell that is made in the bone marrow and is found in the blood and in lymph tissue. The two main types of lymphocytes (white blood cells) are B lymphocytes and T lymphocytes. B lymphocytes make antibodies, and T lymphocytes help kill tumor cells and help control immune responses. Lymphocyte A type of immune cell that is made in the bone marrow and is found in the blood and in lymph tissue. The two main types of lymphocytes are B lymphocytes and T lymphocytes. A type of immune cell that is made in the bone marrow and is found in the blood and in lymph tissue. The two main types of lymphocytes (white blood cells) are B lymphocytes and T lymphocytes. B lymphocytes make antibodies, and T lymphocytes help kill tumor cells and help control immune responses. Lymphoma Cancer that begins in the cells of the immune system. There are two basic categories of lymphomas: Hodgkin lymphoma and non-Hodgkin lymphomas. Cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer. Spleen An organ that is part of the lymphatic system. The spleen makes lymphocytes, filters the blood, stores blood cells and destroys old blood cells. It is on the left side of the abdomen near the stomach. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies. White blood cell A type of blood cell that is made in the bone marrow and found in the blood and lymph tissue. White blood cells are part of the body’s immune system and help the body fight infection and other diseases. A type of blood cell that is made in the bone marrow and found in the blood and lymph tissue. White blood cells are part of the body’s immune system. They help the body fight infection and other diseases. Types of white blood cells include granulocytes (neutrophils, eosinophils and basophils), monocytes and lymphocytes (T cells and B cells). Checking the number of white blood cells in the blood is usually part of a complete blood cell (CBC) test. It may be used to look for conditions such as infection, inflammation, allergies and leukemia. Also called leukocyte and WBC.

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Fred Hutch: A Leader in CLL Treatment

Many people with CLL do well without treatment for years. But in some cases, getting treatment right away is essential. To protect your health, it’s important to work with CLL experts who know how to get you the right care soon after diagnosis. We understand the complex details that go into planning the right approach for each person, like whether you need treatment at all, and if so, what kinds of treatment you need and when. Our deep experience means the best care for you.

Confirming your CLL diagnosis

Diagnosing CLL involves a series of blood tests, and sometimes a bone marrow biopsy, which shows if you have cancer. The biopsy gives details about the type and subtype of cancer you have.

At Fred Hutch, our experts check and confirm your cancer type and the molecular features of your subtype. We also look for factors that tell us if your CLL is likely to get worse (called high-risk disease). This information matters in planning your personalized care.

Hematopathologists are lab experts who look at samples of your blood under a microscope. They can see important details by carefully studying your blood. At Fred Hutch, our hematopathologists are very experienced in identifying CLL.

Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets.

Confirming your CLL diagnosis

To give you the most precise treatment, we will begin by checking details about your disease.

Your first appointment

From the first time you come to see us, your CLL team will begin getting to know you and your family. What are your questions? What are your concerns?

At your first appointment, your hematologist-oncologist will also explain your specific disease. They will talk with you about if you need to begin active treatment and how your care will be customized to you. Before you leave, your team makes sure you understand the next steps.

Hematologist A physician who specializes in diseases of the blood and blood-forming tissues.

CLL First Appointment

Care at Fred Hutch

How does Fred Hutch approach treatment?

The safest, most effective and most widely accepted therapies for cancer are known as the “standard of care.” For many patients, these therapies will be a large part of their treatment. At Fred Hutch, we provide all standard therapies for CLL. We know how to choose the right ones for you and how to deliver them to give you the best chance at getting to remission.

Our doctors and researchers are always asking how we can make CLL treatments more effective and reduce side effects as much as possible. This is why we do clinical trials (also called clinical studies). Through these studies, we are able to offer you therapies that aren’t available everywhere. A therapy that is going through trials today may become the new standard of care tomorrow.

Along with treating your cancer, a group of world-class professionals is here to support you. This team includes nurses, dietitians, physical therapists, social workers and psychologists. We also include supportive care services for your physical, mental and emotional well-being.

Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease. Remission A decrease in, or disappearance of, signs and symptoms of cancer. A decrease in, or disappearance of, signs and symptoms of cancer. In partial remission, some (but not all) signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although cancer still may be in the body. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies.

Treatment plan and process

Often, CLL grows slowly. It may not cause any symptoms or other health concerns for years. But in some cases, it grows faster, and getting treatment quickly matters. To know the outlook in your case and to plan the right approach for you, it’s important to work with CLL specialists.

Your care team will design a treatment plan specifically for — and with — you. At Fred Hutch, doctors with knowledge and experience in CLL will design and provide your care.

We offer watchful waiting, if that matches your needs, as well as every standard therapy for CLL. These include targeted therapy, immunotherapy and bone marrow transplant. Novel (new) therapies are available here, too. Because of recent advancements in treating CLL, chemotherapy is rarely used now.

As you go through treatment, your needs may change. Your care team at Fred Hutch is with you each step of the way. For example, we will help you deal with any side effects you have from treatment. We may suggest adding a new therapy that was just approved. To protect your health over the long term, we will keep seeing you as long as you need us.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Side effects A problem that occurs when treatment affects healthy tissues or organs. Some side effects of cancer treatment are nausea, vomiting, fatigue, pain, decreased blood cell counts, hair loss and mouth sores. Standard care A treatment or other intervention currently being used and considered to be of proven effectiveness based on past studies. Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain. Targeted therapy A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. A type of treatment that uses drugs or other substances to identify and attack specific types of cancer cells while causing less harm to normal cells. Some targeted therapies block the action of certain enzymes, proteins or other molecules involved in the growth and spread of cancer cells. Other types of targeted therapies help the immune system kill cancer cells, or they deliver toxic substances directly to cancer cells and kill them. Targeted therapy may have fewer side effects than other types of cancer treatment. Most targeted therapies are either small molecule drugs or monoclonal antibodies. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends. Watchful waiting Closely watching a patient’s condition but not giving treatment unless symptoms appear or change. During watchful waiting, patients may be given certain tests and exams. Closely watching a patient’s condition but not giving treatment unless symptoms appear or change. Watchful waiting is sometimes used in conditions that progress slowly. It is also used when the risks of treatment are greater than the possible benefits. During watchful waiting, patients may be given certain tests and exams. Watchful waiting is sometimes used in prostate cancer. It is a type of expectant management.

Treatment for CLL

For Caregivers

When someone close to you needs treatment for CLL, you might step into the role of caregiver. Being a caregiver can mean many things, from lending a hand with daily living tasks to helping with medical decisions. It can also mean dealing with your own emotions and stress.

At Fred Hutch, caregivers are valuable members of a patient’s care team. We see every day that your presence and your support make a difference. We know that what your friend or family member is going through affects you, too.

Part of our mission is to help you take care of yourself. Caring for yourself is good for your own physical, mental and emotional health. It also helps you give your best to your loved one. Our social workers, Spiritual Health team and Patient and Family Resource Center staff are here to help support you.

Caregiver A person who gives care to people who need help, such as children, older people or patients who have chronic illnesses or disabilities. A person who gives care to people who need help taking care of themselves, such as children, older people or patients who have chronic illnesses or disabilities. Caregivers may be health professionals, family members, friends, social workers or members of the clergy. They may give care at home, in a hospital or in another health care setting.

For Caregivers

Resources for Caregivers

Other resources

Care team

At Fred Hutch, a team of dedicated people surrounds you and your family to give you the highest level of care and support. You are the most important person on your care team. Our patients are at the center of everything we do.

CLL Care Team

Care team

Research

Fred Hutch is a national leader in CLL research. Our scientists and doctors are working all the time to improve current treatments for CLL and develop new ones so every person with this disease lives a long, healthy life.

CLL Research

Research

Resources

There are many resources for learning about your disease, as well as organizations that provide support. Health educators at the Fred Hutch Patient and Family Resource Center have put together a list of trusted sources to help you get started.

Learn More

Resources

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