Treatment for Chronic Lymphocytic Leukemia
Your treatment will depend on how advanced your disease is, the type of CLL you have, and whether your cancer has come back. Sometimes several treatments are used together.
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Watchful Waiting
If your CLL is caught early, is growing slowly, or does not have symptoms, your doctor may suggest an observational stage before starting other treatment.
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Doctors call this “watchful waiting.”If your CLL is in early stages, treatment will not prolong survival, according to research. You can, however, expect follow-up exams every three to six months to monitor your condition.
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Targeted Therapy
Targeted therapies include medications that block specific proteins on cancerous cells. They may be your doctor’s first recommendation for treatment because their side effects may be less severe than other treatments.
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Example medications may include:
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- acalabrutinib (Calquence)
- ibrutinib (Imbruvica)
- idelalisib (Zydelig)
- pirtobrutinib (Jaypirca)
- venetoclax (Venclexta)
- zanubrutinib (Brukinsa)
Chemotherapy
With chemotherapy, you receive strong medication as a pill or intravenously that is designed to kill cancerous cells. Your doctor might recommend one chemotherapy drug or a combination of them.
Your doctor may recommend chemotherapy to treat CLL if you are unable to tolerate targeted medications or other types of therapies, or if you have an aggressive form of CLL.
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Immunotherapy
Immunotherapy uses your body’s immune system or clones of your immune system’s proteins to target and fight cancer.
In chimeric antigen receptor (CAR) T-cell therapy, specific immune cells from your blood are removed, enhanced, and infused back into your body to find and destroy leukemia cells. It is typically used if targeted therapy is not successful, and it may have serious side effects.
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In another form of immunotherapy, proteins called monoclonal antibodies are made in a laboratory and infused into your body to react to or attach to certain proteins on cancer cells. They attract your immune cells to cancerous cells, allowing the immune cells to then kill the cancerous cells.
Some monoclonal antibodies used to treat CLL are:
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- rituximab (Rituxan)
- obinutuzumab (Gazyva)
Stem Cell Transplant
In a stem cell transplant, chemotherapy or radiation is used to destroy cancerous cells in your bone marrow. Healthy stem cells, be they yours or from a donor, are inserted to replace them. This treatment is uncommon for CLL.
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Radiation
Radiation may be used to treat pain or before a stem cell transplant. It uses X-rays or other types of energy to destroy cancer cells. This treatment is uncommon for CLL.
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Surgery
Surgery alone will not cure CLL because the condition often spreads to many organs.
If CLL causes your spleen to become enlarged, however, you may need surgery to remove it. This can reduce strain on other organs and improve your red blood cell counts.
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Leukapheresis
In rare cases, having many CLL cells in your blood causes circulation problems. If this happens, your doctor may recommend a procedure called leukapheresis.
In this treatment, your blood is removed and passed through a machine that removes white blood cells and leukemia cells before returning it to your body. It works quickly but is usually used temporarily to allow other treatments a chance to take effect.
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