How do you know when it’s time to start treatment for CLL?
Your blood work can show a decrease in your red blood cells and platelets. Your white blood cells may start to increase at a rapid rate, doubling in a period of six months. Signs such as these will prompt your doctor that it’s time to begin treating your CLL.
Do we have a cure for CLL?
So, they also have a lot of comorbidities and even though right now we have great treatments for CLL that are generally well tolerated, all drugs do have side effects. So, if a person feels fine and the disease is not causing any problem in their life, why give them a treatment for it?
What is the watch and wait approach for CLL?
Many CLL patients start in a period called watch and wait. Would you give us a brief overview of this approach? Sure. The reason that we do watch and wait, or as some patients like to call it, watch and worry, is because many people present asymptomatically.
How do you feel about telemedicine for CLL patients?
It’s really important for patients with CLL to follow those same guidelines that we’re giving to everybody. But very important for them because they are in a higher risk group. How do you feel telemedicine is working for CLL patients? Telemedicine works I’d say better for CLL patients than some other patients, particularly watch and wait patients.
When should you start treatment for CLL?
Doctors usually wait until there are signs the CLL is progressing before suggesting you have treatment. There is no evidence that starting treatment before this helps, and it can cause side effects. CLL usually develops very slowly, so you may not need treatment for months or years.
What percentage of CLL patients need treatment?
Around 30-50% of people diagnosed with CLL never require any treatment for their disease and can survive for many years despite their diagnosis.
Does early stage CLL always progress?
Every case of CLL is different, and it can be difficult to predict if and when your CLL will progress. Some people experience fast progression, while others go on for years without experiencing any new symptoms. People who are diagnosed at a higher stage of CLL are likely to progress at a faster rate.
How do you know what stage of CLL you are in?
Stage I: The patient has lymphocytosis and enlarged lymph nodes. The patient does not have an enlarged liver or spleen, anemia, or low levels of platelets. Stage II: The patient has lymphocytosis and an enlarged spleen and/or liver and may or may not have swollen lymph nodes.
Can CLL go into remission without treatment?
While there is not yet a cure for the condition, a wide range of effective treatments are available. And some people don't need any treatment if the CLL is slow-growing or in a period of remission.
How do you slow down CLL?
Choose healthy fats. Get most of your fat from healthy unsaturated fats, such as those in vegetable oils and seafood. Research suggests that the omega-3 fats found in fish may curb CLL activity.
What is the newest treatment for CLL?
In May 2019, the FDA approved venetoclax (Venclexta) in combination with obinutuzumab (Gazyva) to treat people with previously untreated CLL as a chemotherapy-free option. In April 2020, the FDA approved a combination therapy of rituximab (Rituxan) and ibrutinib (Imbruvica) for adult patients with chronic CLL.
Can you live 20 years with CLL?
CLL has a very high incidence rate in people older than 60 years. CLL affects men more than women. If the disease has affected the B cells, the person's life expectancy can range from 10 to 20 years.
What happens if you don't treat CLL?
If left untreated, you can develop serious complications from the disease such as anemia and symptoms such as fatigue and shortness of breath, bleeding and difficulty fighting off infections or frequent infections. In extreme circumstances you may need transfusions of blood or platelets prior to the diagnosis of CLL.
What is a high lymphocyte count in CLL?
The diagnosis of CLL is usually confirmed by tests for specific characteristics of B-cells in individuals with an absolute lymphocyte count above 5,000.
What is low grade CLL?
CLL and SLL are slow-growing (low-grade or 'indolent') cancers. Many doctors group them together as a type of non-Hodgkin lymphoma. They usually behave like a long-term (chronic) condition that needs treatment from time-to-time to keep it under control.
How high are lymphocytes with CLL?
To be diagnosed with CLL, there must be at least 5,000 monoclonal lymphocytes (per mm3) in the blood. For it to be called SLL, the patient must have enlarged lymph nodes or an enlarged spleen with fewer than 5 ,000 lymphocytes (per mm3) in the blood.
What happens when you have chronic lymphocytic leukemia?
Chronic lymphocytic leukemia occurs when your body produces abnormal lymphocytes, a type of white blood cell. These abnormal lymphocytes don’t function as white blood cells should to help your immune system. They also multiply faster and live longer. Over time, they can “crowd out” other healthy blood cells in your bone marrow, such as your red blood cells and platelets. The cancerous cells may travel through your blood to other organs, affect ing them as well.
What is the treatment for high white blood cells?
Another type of treatment, such as targeted therapy or chemotherapy, will still be needed afterwards.
Is CLL better tolerated?
The new stem cells then create new and healthy blood cells. Getting any kind of cancer diagnosis can be scary, but new treatments for CLL are often more effective and better tolerated than those of the past. With the addition of these novel therapies to the CLL treatment arsenal, the outlook looks brighter than ever.
Does leukemia improve life expectancy?
Several studies have shown treating chronic lymphocytic leukemia early in the disease process doesn’t improve your overall outcome or increase your life expectancy. And since most people don’t experience any symptoms in these early stages, there’s less of a benefit and more of a risk of side effects or complications from cancer treatment.
What is the BCL-2 inhibitor?
And then we have a different category of oral treatment where we only have one drug, which is a BCL-2 Inhibitor, which is Venetoclax. So, what these drugs do, they’re not chemotherapy, but they interfere with certain proteins in the CLL cell. And by doing that, cause the cell to die off.
Why is it important to repeat a 17p deletion?
And why that’s so important is there is a particular chromosome abnormality called a 17p deletion where we know that those patients respond very poorly to chemotherapy.
Can a sequence of therapies get a patient to a normal lifespan?
Well, yes , a sequence of therapies might not get that patient to a normal lifespan, because they’re so young to start. So, really the consideration is pretty much reserved for younger patients where we might need a curative strategy that we might not have otherwise.
Is allergenic stem cell transplant curative?
So, stem cell treatment – if we’re talking about stem cell transplant, allergenic stem cell transplant is a transplant where you need a donor and you receive stem cells from the donor. And that can be a curative therapy, but it can also be associated with significant risks including risk of dying from the transplant.
Can you keep people alive with CLL?
So, what we want to do is keep people alive as long as we can with CLL until they likely die of other causes that people die of as they age . Heart disease, et cetera. So, if they don’t need any treatment, we don’t want to expose them to the side effects.
What is the mantra for CLL?
The " watch and wait " mantra in CLL can be a test of wills unlike most other cancer experiences. Let's face it, sitting there and doing, "nothing" is hard enough when we are conditioned to believe "early detection saves lives" or "catching it early is your best chance to beat it.". Those things are true in common cancers like breast, prostate, ...
How long does it take for a white blood count to go from 20 to 50?
It is one thing for a white blood count to go from 20 -30 - 50 - 80 over a two year period. It is another thing all together if that happens over four months. All too often, I hear people get anxious when the wbc goes from 30 to 50 without other changes.
Is 100 CLL different from 100 AML cells?
In some of the "acute leukemias" which are very different conditions - such numbers would be terrifying. The biology is very different though - 100 CLL cells is very different than 100 AML cells. So if we don't look at a single number - then what should we look at.
Is rituxan good for follicular lymphoma?
In follicular lymphoma, things are changing for the better. Rituxan is "biologic therapy" that is a pretty effective treatment that does not necessarily need to involve chemotherapy. 70% of patients will respond to rituxan and disease control can be quite durable for some patients.
What is the best treatment for CLL leukemia?
Chemotherapy: Until recently, this was the primary method of treating CLL leukemia, but treatment advances including targeted therapies and immunotherapies have given us more options with fewer side effects. Chemotherapy attacks rapidly growing cells in your body, like cancer cells.
What are the symptoms of CLL?
It may be time to start CLL treatment if you develop the following: Swollen lymph nodes. Enlarged spleen or liver. Decreased red blood cells or platelets on blood work. Rapidly increasing lymphocytes on blood work. Symptoms like fever, infection, fatigue, chills, night sweats, or weight loss.
What are the side effects of CLL?
Potential side effects include fever, chills, anemia, infection, stomach upset, fatigue, and others. Stem cell transplant: If your CLL is considered high-risk, you may be a candidate for this procedure.
How does chemotherapy kill cancer cells?
Chemotherapy is first used to kill your cancer cells, as well as the stem cells in your bone marrow that are producing the abnormal lymphocytes. Then, new stem marrow cells from a donor are transplanted into your system. These cells take over the process of creating new healthy blood cells for your body.
How does CLL affect the body?
As the abnormal cancer cells increase in number, they can build up in your blood, lymph nodes, liver, and spleen. CLL may eventually impact your body’s ability to make healthy blood cells, including white blood cells, red blood cells, and platelets. Your doctor will look at several things to decide if you’re ready for treatment.
Does chemotherapy damage hair follicles?
Chemotherapy attacks rapidly growing cells in your body, like cancer cells. But it can also damage fast-growing healthy cells, like those in your hair follicles and intestines, and lead to unpleasant side effects. Fludarabine (Fludara) and cyclophosphamide (Cytoxan) are two examples.
Does CLL progress slowly?
This can help determine the “aggressiveness” of your leukemia and the likelihood of the cancer progressing. CLL often advances slowly. If you are in the early stages of the disease and not experiencing any symptoms, the benefits of treatment usually don’t outweigh the risks. This is called “watchful waiting.”.