Full Answer
How is chronic lymphocytic leukemia (CLL) treated?
Chronic lymphocytic leukemia (CLL) treatment can include observation, steroids, radiation therapy, chemotherapy, surgery, or targeted therapy. Learn more about the diagnosis, prognosis, and treatment of newly diagnosed or recurrent CLL in this expert-reviewed summary.
When should I see an oncologist for CLL?
If you’ve been diagnosed with early stage CLL, follow up with your doctor regularly to monitor the status of your cancer. If you start having symptoms of CLL progression, such as unexplained weight loss, fever, night sweats, swollen lymph nodes, and significant fatigue, schedule an appointment with your oncologist or hematologist right away.
What are the early symptoms of chronic lymphocytic leukemia (CLL)?
Many patients in the early stages of CLL do not have any symptoms and do not require immediate treatment. The disease is monitored regularly, and treatment is started when CLL progresses to the intermediate and advanced stages.
Are new treatment options outperforming old-fashioned chemotherapy for CLL?
New treatment options are outperforming the “old-fashioned” chemotherapy regimens for patients with CLL and SLL, according to Dr. Locke J. Bryan.
When should treatment for CLL start?
Patients with chronic lymphocytic leukemia (chronic lymphoid leukemia, CLL) do not need drug therapy until they become symptomatic or display evidence of rapid progression of disease, as characterized by the following: Weight loss of more than 10% over 6 months.
How soon after leukemia diagnosis does treatment start?
Remission induction therapy. This is the first round of treatment given during the first 3 to 4 weeks after diagnosis. It is designed to destroy most of the leukemia cells, stop symptoms of the disease, and return the blood counts to normal levels.
What is the first line of treatment for CLL?
Chemoimmunotherapy (CIT) has been the standard first-line therapy for CLL. Age and comorbidities can help decide which patients may benefit from a CIT approach. FCR (fludarabine, cyclophosphamide, and rituximab) is the current standard treatment option for younger patients with CLL.
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.
How many cycles of leukemia do you need for chemo?
Treatment of most patients with acute myeloid leukemia (AML) is typically divided into 2 chemotherapy (chemo) phases: Remission induction (often just called induction) Consolidation (post-remission therapy)
Can leukemia go into remission?
Most often, acute myeloid leukemia (AML) will go into remission after the initial treatment. But sometimes it doesn't go away completely, or it comes back (relapses) after a period of remission. If this happens, other treatments can be tried, as long as a person is healthy enough for them.
What percentage of CLL patients need treatment?
This happens in 2% to 10% of CLL cases, and is known as Richter's transformation. Treatment is often the same as it would be for lymphoma and might include stem cell transplant, because these cases are often hard to treat. Less often, CLL may progress to prolymphocytic leukemia.
How do you know if CLL is getting worse?
Unexplained weight loss of more than 10 percent of your body weight over the course of 6 months or so could mean your CLL is progressing. This means that you're losing weight when you're not trying to diet.
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 fast can CLL progress?
Speed of progression CLL is a slow-progressing form of cancer. It can take several years for symptoms to manifest. Doctors and researchers in the United States typically follow the Rai staging system, which classifies CLL into five stages , ranging from 0 to 4.
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.
How high are lymphocytes with CLL?
A diagnosis of chronic lymphocytic leukemia requires a lymphocyte level of greater than or equal to 5,000 B cells per μl for a minimum of 3 months. Doctors refer to abnormally high lymphocyte levels as lymphocytosis.
Where does CLL spread?
In chronic lymphocytic leukemia ( CLL ), the leukemia cells may spread from the blood and bone marrow to other parts of the body, such as the lymph nodes, liver, and spleen. It is important to know whether the leukemia cells have spread in order to plan the best treatment.
What is stage 0 leukemia?
Stage 0. In stage 0 chronic lymphocytic leukemia, there are too many lymphocytes in the blood, but there are no other signs or symptoms of leukemia . Stage 0 chronic lymphocytic leukemia is indolent (slow-growing).
What is the name of the cancer in which the bone marrow makes too many lymphocytes?
Chronic lymphocytic leukemia is a type of cancer in which the bone marrow makes too many lymphocytes (a type of white blood cell). Chronic lymphocytic leukemia (also called CLL) is a cancer of the blood and bone marrow that usually gets worse slowly. CLL is one of the most common types of leukemia in adults.
What is BCL2 inhibitor therapy?
BCL2 inhibitor therapy: This treatment blocks a protein called BCL2 which is found on some leukemia cells. This may kill leukemia cells and make them more sensitive to other anticancer drugs. Venetoclax is a type of BCL2 therapy used to treat symptomatic or progressive, recurrent, or refractory CLL.
How does chemo work?
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body ( systemic chemotherapy ). Combination chemotherapy is treatment using more than one anticancer drug.
Why do we do clinical trials?
Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Can lymphocytic leukemia cause tiredness?
Signs and symptoms of chronic lymphocytic leukemia include swollen lymph nodes and feeling tired. In the beginning, CLL does not cause any signs or symptoms and may be found during a routine blood test. Later, signs and symptoms may occur.
What Is CLL?
Chronic lymphocytic leukemia (CLL) is a cancer that affects a type of white blood cell called lymphocytes. When you have it, some blood stem cells in your body don't grow properly and the resulting lymphocytes can't fight infection very well.
How CLL Spreads
This type of leukemia starts in bone marrow -- the spongy tissue inside bones where blood cells are made. From there, it moves into your blood. Over time, the cancer cells can spread to other parts of your body like the liver, spleen, and lymph nodes.
How Serious Is It?
The Rai staging system is usually what doctors in the U.S. use. It describes CLL based on the results of blood tests and a physical exam when you're diagnosed. Everyone with CLL will have more lymphocytes in their bone marrow and blood than there should be, for no good reason. And a large number of them will have come from the same cell.
Stage 0
The number of red blood cells and platelets are almost normal. Your lymph nodes, spleen, and liver are fine. You're at low risk and probably don't need treatment now.
Stage I
This stage is intermediate risk. The difference is that your lymph nodes are enlarged. These are part of your immune system. They help fight infections as well as filtering out dead and damaged cells, and they swell when they're working hard.
Stage II
Your spleen or liver is larger than normal. Your lymph nodes might be swollen, too, but not necessarily. This is also an intermediate risk stage, and you'll start treatment if your doctor thinks your symptoms or lymphocyte count are serious.
Stage III
The number of other blood cells are affected. At stage III, you don't have enough red blood cells (a condition called anemia), although your platelet count is near normal. Your lymph nodes, spleen, or liver might be enlarged, but they don't have to be. This is an advanced, high-risk stage, and you'll need treatment.
Symptoms Indicate Need to Start Treatment
Generally, chronic lymphocytic leukemia is not treated until symptoms appear. Symptoms may include:
Ask Questions and Get a Second Opinion
No one ever wants to hear the words, “You have cancer.” But once you’ve received a diagnosis, it’s critical to be your own best advocate.
What is the spread of CLL?
The spread of CLL is staged based on the enlargement of lymph nodes and other organs, as well as the effect on red blood cells and platelets. All stages of CLL have lymphocytosis or a high lymphocyte count.
What is CLL in medical terms?
Chronic lymphocytic leukemia (CLL) is slow-growing leukemia that progresses over many years. Many patients in the early stages of CLL do not have any symptoms and do not require immediate treatment. The disease is monitored regularly, and treatment is started when CLL progresses to the intermediate and advanced stages.
What is the most common type of leukemia in adults?
CLL is the most common type of leukemia in adults. In CLL, the bone marrow produces too many functionally incompetent lymphocytes. These abnormal cells compete with healthy cells for oxygen and nutrition, eventually starving and killing healthy cells.
What is the best diet for chronic lymphocytic leukemia?
According to recent research, the Mediterranean diet is considered the best diet for patients with chronic lymphocytic leukemia (CLL).
Where does myeloid leukemia come from?
Myeloid leukemia (myelogenous leukemia) arises from the uncontrolled production of the blood cells called myeloblasts in the bone marrow. Normally, myeloblasts would turn into neutrophils. Lymphoid leukemia (lymphocytic or lymphoblastic leukemia) arises from cells called lymphoblasts in the bone marrow.
How old is the average person with leukemia?
In adults, leukemia is most common in people older than 55 years, with the average age of diagnosis being 66 years. It is also one of the most common cancers in children and adults younger than 20 years. The survival rate is higher for younger people.
Is leukemia a chronic disease?
Based on how fast it progresses, leukemia is classified as acute or chronic: Acute leukemia: Most of the abnormal blood cells are immature and do not function normally. It progresses very quickly.
What is the symptom of CLL and SLL?
One symptom of CLL and SLL is swollen lymph nodes; the location of the swelling could play a role in whether or not the disease is treated. “It’s about location … a big node may not be causing any problems, but a smaller node pushing on an organ may cause some problems.
When was Venclexta approved?
Since then, there have been three more approvals in the space: Venclexta (venetoclax), which was approved in 2016 ; Copiktra (duvelisib), which was approved in 2018; and Calquence (acalabrutinib), which was approved in 2019.
Does CLL need immediate treatment?
Treatments for chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL) have drastically improved in recent years, although patients may not need immediate treatment directly after being diagnosed.
What is the best treatment for CLL?
One of the most promising future treatment options for CLL is CAR T-cell therapy. CAR T, which stands for chimeric antigen receptor T-cell therapy, uses a person’s own immune system cells to fight cancer.
How many clinical trials are there for CLL?
These new treatments may work better for you than the ones currently available. There are currently hundreds of clinical trials ongoing for CLL.
Why are targeted therapies called targeted therapies?
These drugs are called targeted therapies because they’re directed at specific proteins that help CLL cells grow. Examples of targeted drugs for CLL include:
What is CLL in medical terms?
Chronic lymphocytic leukemia (CLL) is a slow-growing cancer of the immune system. Because it’s slow-growing, many people with CLL won’t need to start treatment for many years after their diagnosis.
What does it mean when you have a high risk CLL?
High-risk CLL describes patients with stage 3 or stage 4 cancer. This means you may have an enlarged spleen, liver, or lymph nodes. Low red blood cell counts are also common. In the highest stage, platelet counts will be low as well.
What is intermediate risk CLL?
Intermediate-risk CLL describes people with stage 1 to stage 2 CLL, according to the Rai system. People with stage 1 or 2 CLL have enlarged lymph nodes and potentially an enlarged spleen and liver, but close to normal red blood cell and platelet counts. High-risk CLL describes patients with stage 3 or stage 4 cancer.
What is low risk CLL?
Treatments for low-risk CLL. Doctors typically stage CLL using a system called the Rai system. Low-risk CLL describes people who fall in “stage 0” under the Rai system. In stage 0, the lymph nodes, spleen, and liver aren’t enlarged. Red blood cell and platelet counts are also near normal. If you have low-risk CLL, ...
What is the best treatment for CLL?
Steroids. Corticosteroids (“steroids”) curb inflammation and are used to treat many conditions. They may also be part of your CLL treatment and to help control side effects from chemo. Your doctor may prescribe one, such as prednisone, as part of your CLL treatment.
How long does it take for tumor lysis to start?
Tumor lysis syndrome needs to be treated right away. Symptoms usually start 2 to 3 days after treatment. Call your doctor right away if you have severe vomiting and diarrhea, trouble peeing, feel dizzy, or have seizures. Kinase inhibitors target certain proteins in and on cancer cells that help them grow and spread.
How does chemo work?
You get chemo in cycles that give the medicine time to work before your next dose. You may get chemo as tablets or by IV.
How long does it take for chemo to go away?
You can also get infections more easily. You can take medicine to help with some of these problems. Most of these side effects peak 3-5 days after you get chemo and go away after your treatment ends, though some last longer.
What are the two types of drugs that stop cancer cells from growing?
Targeted Therapies. These are drugs that stop cancer cells from growing. They include two types of drugs: monoclonal antibodies and kinase inhibitors. Monoclonal antibodies (MABs) mimic or boost the action of your own immune system. They attach to your cancer cells so your immune system can destroy them.
Does curcumin kill CLL?
Since there’s no cure for CLL, so some people look to natural treatments. EGCG from green tea and curcumin from the herb turmeric show promise. In early lab tests, they kill CLL cells but don’t harm healthy ones. But it’s too soon to know if that’s true in people or what the right dose is.
Is ibrutinib better than chemo?
For some people, they may work better than chemo. Examples include acalabrutinib ( Calquence ), duvelisib ( Copiktra ), ibrutinib ( Imbruvica ), idelalisib ( Zydelig ), and venetoclax ( Venclexta ). You take them in pill form, usually once or twice a day.
