Treatment for Chronic Lymphocytic Leukemia

Early stage CLL may take years to evolve. Doctors may recommend watchful waiting for some patients, depending on the disease stage.

Chronic Lymphocytic Leukemia (CLL) may remain stable for several years, but may evolve to become more aggressive, sometimes transforming into non-Hodgkin's lymphoma (Richter's transformation). If such changes occur, more aggressive treatment may be necessary.

The best approach for some patients may be to closely monitor their blood count regularly and to check for possible manifestation of a symptom, rather than undergoing any treatment.

Radiation Therapy is rarely used in the treatment of CLL.

The following are the basic tenets involved in CLL treatment-

Treatment of the newly diagnosed
Treatment of those with a progressive disease
Treatment of those whose disease is resistant to standard treatments
Treatment of complications / side-effects

Some of the popular treatment modes for CLL are -

Chemotherapy

Initial CLL treatments depends on

the exact diagnosis
the progression of the disease
the preference / experience of the health-care practitioner

There are dozens of drugs used for CLL therapy, and considerable research activity is taking place analysing them individually and also in combination with each other.

This treatment aims to destroy the abnormal cells present in the blood and the bone marrow, in order to facilitate the normal cells to multiply. Chemotherapy drugs are administered orally or intravenously. Patients undergoing chemotherapy are prone to infections because their immune system is impaired. To counter this, antibiotics are administered intravenously.

Corticosteroids, purine analogs, anti-tumor antibiotics, monoclonal antibodies, growth factors and cytokines are employed in the treatment of CLL.

Monoclonal antibody therapy

Monoclonal antibodies are artificial proteins that attack specific proteins on the malignant blood cells, causing them to die. Besides this function they also alert the body's immune system to eliminate other leukemic cells.

Surgery

Surgery may be required, sometimes, to biopsy the lymph node tissue or to remove the spleen, if it is enlarged.

Bone Marrow Transplant

Patients who do not respond to or benefit from other treatment options are ideal candidates for bone marrow transplants.

The first step towards a transplant is by treating the leukemia with chemo- and/or radio- therapy to suppress the immune system. Then healthy marrow cells, from a matching donor, are injected into the patient intravenously. These normal cells multiply and re-populate within the patient's bone marrow. The patient also benefits from the immune system components, found in the donor's marrow cells, which attack the leukemic cells by treating them like infection.