Chronic lymphocytic leukemia

Care team

At Fred Hutchinson Cancer Center, we surround you with experts who focus completely on cancer. A handful of people make up the core of your care team. You will have a hematologist-oncologist and a registered nurse who specialize in chronic lymphocytic leukemia (CLL) — or the closely related condition small lymphocytic lymphoma (SLL), if this is your diagnosis. At some visits, you might see an advanced practice provider. Most patients get part of their treatment from infusion nurses. A patient care coordinator will schedule your visits.

Others join your team based on your personal needs. If you need a blood or marrow transplant, we have experts in this form of treatment. If you get a new health issue that might affect your cancer treatment, we call in the right experts. For example, if infections become a problem for you, we might call in an infectious disease doctor. We have specialists based at Fred Hutch who know how to handle the issues that matter for people with cancer.

Supportive care providers are also here to help. You may see Fred Hutch dietitians, physical therapists, psychologists, social workers and others. All of us specialize in caring for people during and after cancer.

Hematologist A physician who specializes in diseases of the blood and blood-forming tissues. Infusion An injection of medications or fluids into a vein over a period of time. 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.

Your care team

Meet the caring, dedicated people who take care of you and your family at Fred Hutch.

What each team member does

Advanced practice provider (APP)

Advanced practiced providers have training that is similar to doctors and can see you without your doctor. At Fred Hutch, these health care professionals work closely with your hematologist-oncologist in the clinic. There are two types: physician assistants (PAs) and advanced registered nurse practitioners (ARNPs). They help provide and plan your treatment and also help manage the effects of your disease and treatment.

Hematologist A physician who specializes in diseases of the blood and blood-forming tissues. Nurse practitioner A registered nurse who has additional education and training in how to diagnose and treat disease. In cancer care, a nurse practitioner may manage the primary care of patients and their families. A registered nurse who has additional education and training in how to diagnose and treat disease. Nurse practitioners are licensed at the state level and certified by national nursing organizations. In cancer care, a nurse practitioner may manage the primary care of patients and their families, based on a practice agreement with a physician. Physician assistant A health professional who is licensed to do certain medical procedures under the guidance of a physician. A health professional who is licensed to do certain medical procedures under the guidance of a physician. A physician assistant may take medical histories, do physical exams, take blood and urine samples, care for wounds and give injections and immunizations.

Hematologist-oncologist

This doctor monitors your condition if you are on watchful waiting. They also manage any medicine-based treatments you have. Most people with CLL who need treatment get immunotherapy, targeted therapy, chemotherapy or a combination of these.

Your hematologist-oncologist will:

See you during your first visit. They will give you an exam and order any tests you need to diagnose or stage your disease and understand how it is affecting your body.
Explain what your diagnosis and stage mean and answer your questions.
Recommend watchful waiting or medicines to match your exact needs. They choose the medicines, doses, schedule and sequence. They also talk with you about the benefits and risks.
See you on a regular schedule to check how you are doing on watchful waiting or how your cancer responds to treatment.
Offer you ways to prevent, relieve and deal with side effects of treatment, like medicine to help with nausea.
Work with the rest of your care team if you need other types of treatment.

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. Hematologist A physician who specializes in diseases of the blood and blood-forming tissues. 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. Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body. 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. 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.

Infusion nurse

If you are getting any therapies by infusion, these treatments happen in a special area of the clinic. Cancer nurses who are experts in infusions give these treatments. They will also check you during each infusion. They respond to any medical issues that come up and help keep you comfortable.

Infusion An injection of medications or fluids into a vein over a period of time. Infusion An injection of medications or fluids into a vein over a period of time.

Patient care coordinator

Your patient care coordinator works closely with you and your doctor. They will schedule your appointments.

Registered nurse (RN)

Your nurse manages your care alongside your doctor. They also help with procedures and treatments. Nurses are resources for you and your caregiver. They can answer questions on a wide range of topics, like how to cope with side effects or get other services you need at Fred Hutch.

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. 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.

Supportive care services

Many types of supportive care team members are here to help you and your family. They include dietitians, physical therapists, pain medicine specialists, psychologists, social workers, spiritual health staff, palliative care specialists, naturopaths and acupuncturists.

Supportive Care Services

Transplant team

If you need a blood or marrow transplant, you will have a specialized team from the Fred Hutchinson Blood and Marrow Transplant Program. Your team includes a transplant oncologist, advanced practice provider, transplant nurse, pharmacist, dietitian, team coordinator and social worker.

This team will:

Give you an exam (and your donor, if you need one).
Decide on a transplant approach to match your case.
Prepare you and your caregiver.
Do your transplant.
Provide care as you recover.

Your Blood and Marrow Transplant Team

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. Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation.

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