Chronic Lymphocytic Leukemia Treatment (PDQ�)
General Information About Chronic Lymphocytic Leukemia
Chronic lymphocytic leukemia is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell).
Normally, the body makes blood
The myeloid stem cell develops into one of three types of mature blood cells:
Red blood cellsthat carry oxygenand other materials to all tissuesof the body. White blood cellsthat fight infectionand disease. Plateletsthat help prevent bleeding by causing blood clotsto form.
The lymphoid stem cell develops into a
B lymphocytesthat make antibodiesto help fight infection. T lymphocytesthat help B lymphocytes make antibodies to fight infection. Natural killer cellsthat attack cancer cells and viruses.
In CLL, too many blood stem cells develop into
This summary is about chronic lymphocytic leukemia. See the following
Adult Acute Lymphoblastic Leukemia Treatment. Childhood Acute Lymphoblastic Leukemia Treatment. Adult Acute Myeloid Leukemia Treatment. Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment. Chronic Myelogenous Leukemia Treatment.
Hairy Cell Leukemia Treatment
Adult Non-Hodgkin Lymphoma Treatment
Older age can affect the risk of developing chronic lymphocytic leukemia.
Anything that increases your risk of getting a disease is called a
Being middle-aged or older, male, or white.
family historyof CLL or cancer of the lymph system.
Having relatives who are Russian Jews or Eastern European Jews.
Possible signs of chronic lymphocytic leukemia include swollen lymph nodes and tiredness.
Usually CLL does not cause any
Painless swelling of the
lymph nodesin the neck, underarm, stomach, or groin.
Feeling very tired.
Pain or fullness below the ribs.
Weight loss for no known reason.
Tests that examine the blood, bone marrow, and lymph nodes are used to detect (find) and diagnose chronic lymphocytic leukemia.
The following tests and procedures may be used:
Physical examand history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient?s health habits and past illnesses and treatments will also be taken. Complete blood count(CBC): A procedure in which a sample of blood is drawn and checked for the following:
The number of red blood cells, white blood cells, and platelets.
The amount of
hemoglobin(the proteinthat carries oxygen) in the red blood cells.
The portion of the blood sample made up of red blood cells.
Cytogeneticanalysis: A test in which cells in a sample of blood or bone marrow are viewed under a microscope to look for changes in the structure or number of chromosomesin the lymphocytes. Immunophenotyping: A test in which the cells in a sample of blood or bone marrow are looked at under a microscope to find out if malignantlymphocytes (cancer) began from the B lymphocytes or the T lymphocytes. Bone marrow aspirationand biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologistviews the bone marrow, blood, and bone under a microscope to look for abnormal cells.
Certain factors affect treatment options and prognosis (chance of recovery).
Treatment options depend on:
stageof the disease.
Red blood cell, white blood cell, and platelet blood counts.
Whether there are symptoms, such as fever, chills, or weight loss.
liver, spleen, or lymph nodes are larger than normal.
The response to initial treatment.
Whether the CLL has
Whether there is a change in the
DNAand the type of change, if there is one.
Whether lymphocytes are spread throughout the bone marrow.
The stage of the disease.
Whether the CLL gets better with treatment or has recurred (come back).
Whether the CLL
progressesto lymphomaor prolymphocytic leukemia.
The patient's general health.
Stages of Chronic Lymphocytic Leukemia
After chronic lymphocytic leukemia has been diagnosed, tests are done to find out how far the cancer has spread in the blood and bone marrow.
Bone marrow aspirationand biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologistviews the bone marrow, blood, and bone under a microscope to look for abnormalcells. Chest x-ray: An x-rayof the organsand bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body, such as the lymph nodes. MRI(magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the brain and spinal cord. This procedure is also called nuclear magnetic resonance imaging (NMRI). CT scan(CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dyemay be injectedinto a veinor swallowed to help the organs or tissuesshow up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it. Antiglobulin test: A test in which a sample of blood is looked at under a microscope to find out if there are any antibodieson the surface of red blood cellsor platelets. These antibodies may react with and destroy the red blood cells and platelets. This test is also called a Coomb's test.
There are three ways that cancer spreads in the body.
Through the blood. Cancer cells travel through the blood, invade solid
tissuesin the body, such as the brain or heart, and form a solid tumor.
lymph system. Cancer cells invade the lymph system, travel through the lymph vessels, and form a solid tumor in other parts of the body.
Through solid tissue. Cancer cells that have formed a solid tumor spread to tissues in the surrounding area.
The new (
The following stages are used for chronic lymphocytic leukemia:
Refractory Chronic Lymphocytic Leukemia
Treatment Option Overview
There are different types of treatment for patients with chronic lymphocytic leukemia.
Different types of treatment are available for patients with
Five types of standard treatment are used:
See Drugs Approved for Chronic Lymphocytic Leukemia for more information.
Monoclonal antibody therapy is a cancer treatment that uses
See Drugs Approved for Chronic Lymphocytic Leukemia for more information.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site.
Chemotherapy with stem cell transplant
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from
Follow-up tests may be needed.
Some of the tests that were done to
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has
Treatment Options by Stage
A link to a list of current
Stage 0 Chronic Lymphocytic Leukemia
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage 0 chronic lymphocytic leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Stage I, Stage II, Stage III, and Stage IV Chronic Lymphocytic Leukemia
Watchful waitingwhen there are few or no symptoms. Monoclonal antibodytherapy. Chemotherapywith 1 or more drugs, with or without steroidsor monoclonal antibody therapy.
dose external radiation therapyto areas of the body where canceris found, such as the spleenor lymph nodes.
A clinical trial of chemotherapy and
biologic therapywith stem cell transplant.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I chronic lymphocytic leukemia, stage II chronic lymphocytic leukemia, stage III chronic lymphocytic leukemia and stage IV chronic lymphocytic leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Treatment Options for Refractory Chronic Lymphocytic Leukemia
clinical trialof chemotherapywith stem cell transplant.
A clinical trial of a new treatment.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with refractory chronic lymphocytic leukemia. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
To Learn More About Chronic Lymphocytic Leukemia
For more information from the
Leukemia Home Page
What You Need to Know About? Leukemia
Drugs Approved for Chronic Lymphocytic Leukemia
Targeted Cancer Therapies
Understanding Cancer Series: Targeted Therapies
Biological Therapies for Cancer: Questions and Answers
What You Need to Know About? Cancer
Understanding Cancer Series: Cancer
Chemotherapy and You: Support for People With Cancer
Radiation Therapy and You: Support for People With Cancer
Coping with Cancer: Supportive and Palliative Care
Information For Survivors/Caregivers/Advocates
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Changes to This Summary (11/04/2011)
Changes were made to this summary to match those made to the health professional version.
PDQ is a comprehensive cancer database available on NCI's Web site.
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