when to start chronic leukemia treatment

It may be time to start CLL

treatment if you develop the following: Swollen lymph nodes Enlarged spleen or liver

Full Answer

What is the best treatment for chronic lymphocytic leukemia?

When treatment is needed, the main treatments used are: Chemotherapy for Chronic Lymphocytic Leukemia. Monoclonal Antibodies for Chronic Lymphocytic Leukemia. Targeted Therapy Drugs for Chronic Lymphocytic Leukemia. Supportive Care for Chronic Lymphocytic Leukemia. Stem Cell Transplant for Chronic Lymphocytic Leukemia.

What is chemotherapy for leukemia?

Chemotherapy is the major form of treatment for leukemia. This drug treatment uses chemicals to kill leukemia cells. Depending on the type of leukemia you have, you may receive a single drug or a combination of drugs. These drugs may come in a pill form, or they may be injected directly into a vein.

Does everyone with CLL need to be treated immediately?

Because CLL often grows slowly, not everyone needs to be treated right away. When treatment is needed, the main treatments used are: It's important to take time and think about your choices. Because CLL often grows slowly, not everyone needs to be treated right away.

How do doctors determine the stage of chronic lymphocytic leukemia?

Once a diagnosis is confirmed, your doctor uses the information about your cancer to determine the stage of your chronic lymphocytic leukemia. The stage tells your doctor how aggressive your cancer is and how likely it is to get worse quickly. Chronic lymphocytic leukemia stages can use letters or numbers.

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.

Does chronic leukemia need chemotherapy?

Chemotherapy uses anticancer, or cytotoxic, drugs to destroy cancer cells. It may be used to treat chronic lymphocytic leukemia (CLL). Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments.

Do you need treatment for CLL?

Many different drugs and drug combinations can be used as the first treatment for CLL. The options include monoclonal antibodies, other targeted drugs, chemotherapy, and different combinations of these. Some of the more commonly used drug treatments include: Ibrutinib (Imbruvica), alone or with rituximab (Rituxan)

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 Stage 0 CLL always progress?

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.

What happens if I don't treat CLL?

Both treated and untreated people with CLL can develop acute myeloid leukemia or myelodysplastic syndromes. These complications are more common after treatment with fludarabine and cyclophosphamide (FC) or fludarabine, cyclophosphamide and rituximab (FCR).

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.

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 long can a person live with chronic lymphocytic leukemia?

The prognosis of patients with CLL varies widely at diagnosis. Some patients die rapidly, within 2-3 years of diagnosis, because of complications from CLL. Most patients live 5-10 years, with an initial course that is relatively benign but followed by a terminal, progressive, and resistant phase lasting 1-2 years.

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.

What is first line 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 serious is chronic lymphocytic leukemia?

Chronic lymphocytic leukemia (CLL) can rarely be cured. Still, most people live with the disease for many years. Some people with CLL can live for years without treatment, but over time, most will need to be treated.

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).

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 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 the WBC of a CLL patient?

Nine months after diagnosis, a fellow patient with CLL tells you that his WBC (white blood cell count) is 49,000 with an ALC (absolute lymphocyte count) of 42,000. He has clusters of 2 x 1 cm nodes in both axillae (armpits). Labs are otherwise OK. He feels well, just a bit tired and stressed. He asks what symptoms or lab results might indicate it is time to treat. You tell him:

What is CLL in hematology?

Hematology in general and CLL specifically are full of jargon and acronyms that can be both overwhelming and daunting . With time and experience, you’ll become familiar with the terminology and acronyms. We will try to explain each medical term the first time it appears in an article, but we will use the true terminology so that you gain comfort and familiarity with the medical terms that you will see in your lab reports and in medical articles. We have also provided a glossary and a list of abbreviations and acronyms for your reference.

Is Watch and Wait better than Chlorambucil?

In fact this famous study published in 1998 compared “Watch And Wait” to early intervention with chlorambucil, an oral chemotherapy and at that time the standard of care, and found that the group on chlorambucil fared slightly worse. Admittedly, we have much better treatments today.

How to cope with chronic lymphocytic leukemia?

Explore ways to cope with the nagging, chronic nature of the disease. If you have chronic lymphocytic leukemia, you'll likely face ongoing tests and ongoing worries about your white blood cell count. Try to find some activities that help you relax, whether it's yoga, exercise or gardening.

What kind of doctor would you see for lymphocytic leukemia?

If your doctor determines you may have chronic lymphocytic leukemia, you may be referred to a doctor who specializes in diseases of the blood and bone marrow (hematologist). Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared.

What test is used to diagnose chronic lymphocytic leukemia?

Blood tests . Tests and procedures used to diagnose chronic lymphocytic leukemia include blood tests designed to: Count the number of cells in a blood sample. A complete blood count may be used to count the number of lymphocytes in a blood sample. A high number of B cells, one type of lymphocyte, may indicate chronic lymphocytic leukemia.

What test is used to determine if a person has an increased number of lymphocytes?

Determine the type of lymphocytes involved. A test called flow cytometry or immunophenotyping helps determine whether an increased number of lymphocytes is due to chronic lymphocytic leukemia, a different blood disorder or your body's reaction to another process, such as infection.

Does green tea help with leukemia?

A green tea extract has shown some promise in initial clinical trials for treating chronic lymphocytic leukemia. Laboratory research determined that a compound in green tea extract, called EGCG, can kill chronic lymphocytic leukemia cells. A study of people with early-stage chronic lymphocytic leukemia found that EGCG in pill form reduced some signs of the disease. But green tea trials haven't been conclusive, and this subject requires more study before doctors can agree on the merits of this treatment.

Can bone marrow transplants help with leukemia?

As new and more-effective drug combinations have been developed, bone marrow transplant has become less common in treating chronic lymphocytic leukemia.

Is leukemia a slow growing cancer?

Coping and support. Mayo Clinic Connect: Blood cancers & disorders. Chronic lymphocytic leukemia is typically a slow-growing cancer that may not require treatment. While some people may refer to this as a "good" type of cancer, it doesn't really make receiving a cancer diagnosis any easier.

What tests can you do for leukemia?

If this happens, or if you have signs or symptoms that suggest leukemia, you may undergo the following diagnostic exams: Physical exam. Your doctor will look for physical signs of leukemia, such as pale skin from anemia, swelling of your lymph nodes, and enlargement of your liver and spleen. Blood tests. By looking at a sample of your blood, your ...

Why is leukemia confusing?

The term "leukemia" can be confusing because it refers to a group of cancers that aren't all that similar except for the fact that they affect the bone marrow and blood.

What is the treatment for bone marrow transplant?

Radiation therapy may be used to prepare for a bone marrow transplant. Bone marrow transplant. A bone marrow transplant, also called a stem cell transplant, helps reestablish healthy stem cells by replacing unhealthy bone marrow with leukemia-free stem cells that will regenerate healthy bone marrow.

What is clinical trial?

Clinical trials are experiments to test new cancer treatments and new ways of using existing treatments. While clinical trials give you or your child a chance to try the latest cancer treatment, treatment benefits and risks may be uncertain. Discuss the benefits and risks of clinical trials with your doctor.

Can targeted therapy cause cancer?

Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Your leukemia cells will be tested to see if targeted therapy may be helpful for you. Radiation therapy.

Can leukemia be devastating?

A diagnosis of leukemia may be devastating — especially for the family of a newly diagnosed child. With time you'll find ways to cope with the distress and uncertainty of cancer. Until then, you may find it helps to: Learn enough about leukemia to make decisions about your care.

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 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.

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.

Is CLL a slow growing cancer?

Chronic lymphocytic leukemia, or CLL, is a slow-growing form of cancer. In contrast to more aggressive cancers, many cases of CLL do not require immediate treatment, and some people won’t need treatment for many years after diagnosis.

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.

Can you take turmeric supplements for cancer?

Feel free to enjoy green tea and turmeric-flavored foods -- that can’t hurt. But remember, supplements can’t treat cancer and don’t take the place of medical treatments. If you’re thinking about taking something, talk to your oncologist first so you can find out what’s safe and what the research shows. Pagination. 1.

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.

Diagnosis

• Blood tests
  Tests and procedures used to diagnose chronic lymphocytic leukemia include blood tests designed to: 1. Count the number of cells in a blood sample.A complete blood count may be used to count the number of lymphocytes in a blood sample. A high number of B cells, one type of ly…
• Other tests
  In some cases, your doctor may order additional tests and procedures to aid in diagnosis, such as: 1. Tests of your leukemia cells that look for characteristics that could affect your prognosis 2. Bone marrow biopsy and aspiration 3. Imaging tests, such as computerized tomography (CT) an…

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Treatment

Clinical Trials

Coping and Support

Preparing For Your Appointment

Diagnosis

Treatment

• Treatment for your leukemia depends on many factors. Your doctor determines your leukemia treatment options based on your age and overall health, the type of leukemia you have, and whether it has spread to other parts of your body, including the central nervous system. Common treatments used to fight leukemia include: 1. Chemotherapy. Chemotherapy ...

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Clinical Trials

Coping and Support

Preparing For Your Appointment